Learning.

It’s been two months since I started on the #Medtronic 530G pump and #Enlite CGM. I have to say, it was something I fully expected to just be able to just jump into and use with no issue at all. Go ahead.. laugh… I understand.  While the pump’s operations are relatively the same (as far as bolus, basal, etc), the CGM is actually a very different thing than I remember the CGM being like with the old SofSensors.

Coming from the Dexcom and reading how the literature in the manual for the 530G’s Enlite was supposed to work, I thought it would be a simple transition, but there are some things that still hold true I’ve learned with the Enlite system. You do still need to have a schedule that you can stick to throughout the day to calibrate 4 times. For me, I find the best results come when I calibrate first thing in the morning, about an hour after that (so, when I wake up and then before I drive for work), at lunch, and then supper or bedtime. That, and making sure I don’t see ANY arrows ( I know the book allows for one, but I still don’t calibrate then) when I calibrate have helped tremendously.

One thing that Medtronic won’t… well… can’t (due to FDA) tell you is to explore other site locations. For me, my Dexcom was always a happy camper in my thigh. I never had issue there and it was out of the way. While my thigh would still be a good place for the Enlite, I have a very active (almost) 3 year old (GAH!) that I play with and he will inevitably knock the sensor in a way that would jar it and I would lose that sensor. For me, I’ve learned that my arms are my sweet spot for those. The problem is that it’s not always easy to insert there, and my hubby has to help me with it sometimes. Which, that’s okay because I’m finally getting full use out of the sensor and not having it zonk out after only a few days. For the past week and a half, I’ve had almost spot-on readings. Most of the sensor glucose values on my pump will be within 10mg/dL of my meter. And honestly, the amount even within 2 or 3 mg/dL have been uncanny. I’m hoping the trend continues and it’s not just because I’ve found a “sweet” spot for now.

Another hurdle I had to overcome was the taping issue. I’m allergic to the tape that they send so I had to find an alternative way to tape it. I know how to use Opsite pretty well and I don’t react to it, so I wanted to find a way to make it work. After trying various ways by myself and with the clinical nurse for Medtronic in my area, I think I have a solution… which is honestly nothing more than just buying the smaller 2″ width of Opsite (I had 4″ for my Dexcom sensors.. which was too wide) and cutting a piece the size of the Medtronic overtape, and cutting a hole in it similar to how the MedT overtape looks. By using that the same way you would use the supplied overtape and a thin long strip of the 4″ over the shell to hold it in place (since your arm isn’t flat, you sort of need something to keep the sides from catching on door ways, etc), It’s a pretty good system that has worked so far.

Most of all, I’ve learned to have patience with this system. If you take the time to learn it and don’t rush it, it can be used to your advantage. I’ve also learned that you can’t always follow everything exactly by the book. The instructions are meant to be there for the greater good of all of the customers as most are universal, but some things – like sensor placement and tape options – may have to be individualized…

and that’s okay.

🙂

Maybe It’s In The Design

I’ve been trying to wear the new Enlite sensors from Medtronic for a month now and have only had success with two of them. I’ve also been trying to find out what is going wrong with them when I wear them to throw them off so much. The only thing I can come up with is the same as everyone is telling me (trainers, helpline people, etc) – the head of the sensor is just moving too much or it’s getting jostled.

While I thoroughly tape my sensors down and I don’t see how they could have any room whatsoever to move, I guess there is a remote possibility. But what puzzles me is why they went with the design that they did. If the key to success with the sensors is to not have it move, then why not create a head to the sensor to be more secure by making a more stable plastic base for the head of it and a wider tape area?

This is my thought process: Take for instance the Dexcom sensors. If you’ve ever seen one, they are made in a plastic base that is attached to a larger tape that goes all the way around the sensor. Also, the sensor is inserted at about a 1/3 or 2/3 position of the sensor base (imagine two lines equally spaced on top of the sensor base… it would fall on one of those lines.. like, almost where the G is on the Dexcom transmitter shown in the picture), and so it is surrounded by lots of tape as well as a wide plastic base on top that prevents it from moving or being jostled. That sensor is so protected, it’s hard to say that anything could knock it and cause the filament to break or bend. (Not to mention, it’s inserted at an angle, so you don’t have to worry about pressure directly on it causing the sensor to go deeper and possibly hit muscle or something and bend from that.)

I think Medtronic (FINALLY) has a good *comfortable* sensor, but that it’s design and base design doesn’t help it be the best it could possibly be. There’s not much tape there on the bottom. And considering the transmitter connects on the side of it and not on top, one would think that the head of it would need more security anyway due to the possibility of the transmitter being knocked, causing pressure on the head of the sensor to move. So, maybe if they created a more solid base for the sensor head. If it were sitting on a flat, thin “sheet” of plastic with a bed and possibly a 1/4 – 1/2 inch rim of tape going all the way around it, it would help to anchor it a bit better and keep that fragile sensor from moving.

I don’t think we should have to worry about taping the darn thing so much just to keep the head of it steady. I think the design needs to be centered around the optimum stability of the sensor head.

But what do I know, I’m not a rocket scientist or anything. Just a (successful) Dexcom user for 4 years who is trying to make these Enlite sensors work and not fail.

It’s HOW old??!?

So, the last few site changes I’ve been doing have resulted in a horrible rash wherever my tape touched my skin. I tried everything I knew to do. I cleaned the area with alcohol before use, and I didn’t clean it with alcohol before use. I used IV Prep wipes before use, I used my Diabete-ezy wipes. Still, there was a rash. I text my sister a picture to see what she thought.

Rash after removing tape and sensor

The picture doesn’t show it very well, but it was definitely there. And ITCHY.

Could I be developing an allergy? OH lordy I hoped not!

 

“But I’ve been using this stuff for years! WTFructose??”

(Her) “Well, how old is your tape?”

“I dunno… I’ve had it for years too… lemmie check”.

The manufacture date was 1/2003 ! Holy crap! This tape was almost 10 freakin years old !!!!

(Her) “Yeeah… try some new one”

 

So I’m on the hunt. After some research and re-reading Kerri’s post about it, I’m pretty sure I’m going with Smith And Nephew Flexifix Opsite Transparent Adhesive. I have to find something good and cost effective since my insurance will not cover tape dressing at all.

If you have any other suggestions for other tapes, please let me know!!

Oh I’m so going to cringe throwing out those 3 {OVERLY expired} boxes I have left!