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Entries in ConsultYourDoctor (2)

Monday
Dec032012

DexCom G4 Platinum: Second Look

Arden modeling her G4 tucked into her pocket.

 

Arden has been wearing the new DexCom G4 Platinum CGM for every second of the last month. I initially wrote a 'First Impressions' piece about three weeks ago - let's see how things have gone since then.

 

Sensor Life:

The worst kept secret in the DOC is that the DexCom sensors can be restarted at the end of their seven day life and often gain accuracy as the days go on. The package insert indicates that you have to change your sensor site at the end of those seven days, I am in no way suggesting that you should ignore that direction. I'm merely sharing how we do things... Many times in the past the DexCom 7+ would happily restart twice and would still be going strong as the last bit of adhesive was holding on for dear life. So far we haven't gotten a G4 to a second restart, but I'm not giving up on getting one into the three week range. Having said that, two weeks is really very good.

 

Adhesive:

Not as long lasting as the 7+. The G4 is not weathering showers like that 7+ did even when covered. I wonder if DexCom changed the adhesive, maybe I'll ask.

 

Form and style:

The reciever is a huge inprovement in both size and shape. I've heard a few call it 'unsturdy' or 'light' but we don't have that feeling. 

The sensor is slightly taller then the last generation. I've asked Arden multiple times if the size change is annoying and she has always answered, "no". Mindful that I don't wear the product I read about what some others have said and I did find a few adults that aren't happy about the increase. Again, Arden is unfazed by the change.

 

Signal Range:

I have for years been unable to let Arden sleep on the sofa during her sleepovers becasue I wouldn't be able to hear her CGM. Once I even slept on the floor so that she and her friend could 'camp out' in our family room, but that was so uncomfortable that since that day sleepovers are confined to the bedroom. Until last weekend that is. On Saturday night Arden had a friend over to spend the night, she asked just as she always does if they could crash on the sofa, I said yes without hesitation becasue of the G4. Our family room is underneath of our master bedroom and the G4 cruises through walls, floors and ceiling like they aren't there. 

As the parent of a PWD this new feature trumps any other and makes the Platinum a winner in my book. Here is my Instagram picture of Arden's G4 sending a signal through the floor of her bedroom and into our kitchen. Kelly and I were watching 'The Walking Dead' on AMC while Arden slept soundly in her bed. In the past, we would have to pause the show while I ran up and down the stairs like a loon. Now we just listen for the beeps.

@ArdensDay on Instagram

The Sensor Wire:

The insertion of the sensor wire seems less painful but the real win of the wire being smaller is that Arden doesn't seem to notice it under her skin anymore while she is wearing it. It the past with the 7+, Arden would sometimes be bothered by the wire if she moved the wrong way. 

 

Pound the Alarm:

The alarms on the G4 are louder then the 7+. Additionally, you can vary them if the one you are using ceases to get your attention. So far the default sounds are waking me from my slumber, though Arden never hears them when she is sleeping. DexCom has samples of the alarms on this page of their site (scroll to the bottom), if you'd like to give them a listen. 

 

Freedom:

With the new signal range comes freedom. In a movie theater I can hold the CGM to give Arden a break. When she gets home she can take it off and roam the house without fear of dropping the signal. Arden sleeps upstairs, we live our life downstairs. I wish you could have heard the lilt in Arden's voice when she gleefully told me, "I just peed without my CGM", she was seriously thrilled that she left her receiver in the kitchen while she used the powder room, thrilled! Connected but frequently untethered is a major advancement in my opinion, it gives back some of Arden's humanity and releases burdens. 

 

Wrap:

I know of a couple people who have experienced build quality issues, for example Stacey's thumb pad fell off. So far we haven't had any such isues, but be sure that I will tell you if we do. 

I've always been an early adopter of technology that I believe in. I expect a few bumps along the way and take the chance on something new when I think the chance is a good bet. So far, the G4 has been a terrific bet. Wait until you see the signal range and how it changes your life.

 

Be Well!

Monday
Nov282011

OmniPod Rash?

If you've ever experienced a rash under your OmniPod, CGM or infusion set adhesive, read on.

Before I begin I need to say that I'm not a doctor and you should never confuse me sharing my experiences with health care advice. Never make adjustments to a care plan without first checking with your physician.

In the summer of 2010 Arden began to develop a rather severe rash under her OmniPod. I was confused because she had been wearing her OmniPod for a rather long time with no issues and it seemed random that she would suddenly have such a reaction. I turned to the internet, called Insulet and was presented with a number of "solutions". My problem with the answer that I was given was that it included buying more stuff and it complicated the pod application process. I really believe that the simple answer is often the best, so I held off on putting the conventional fix into practice and took another shot at diagnosing the issue myself.

Before I could put my thinking cap on I noticed that I was rubbing my finger tips against my thumb and that my finger tips were sore. I looked at them and saw that they were dry and begining to crack. I drifted away from Arden's issue momentarily to wonder about my own and then it hit me - I'm always touching alcohol swabs, that's probably why my fingers are so dry.

That realization led to an epiphany and suddenly I (thought) knew why Arden was developing rashes. At Arden's next pod change and every DexCom and OmniPod application since, I have cleaned Arden's sites with warm water and a clean towel - nothing else. Not only has she never had another rash but her pods don't stick to her like they've been cemented on when it's time for them to be changed (don't worry, they don't come off prematurely).

Turns out for Arden, chemically wiping away the oil that her skin makes naturally and then covering the area with an adhesive strip, wasn't a good idea.

I've shared our process with Arden's endo NP. She wasn't thrilled that I stopped disinfecting Arden's sites before poking a hole into her but she does acknowledge that we may have had to discontinue using Arden's pump without this adjustment. For us it's a calculated risk, you and your doctor can decide if it's the right thing for you to do. I wish you much luck!