Important Santa Information Revisited

Santa Knows. We Proved It. (A post from the past, but it bears repeating!)

One Christmas when my daughter was about 4, she asked me what would happen if Santa came down the chimney while she was awake with a middle-of-the-night low blood sugar.

After I'd blinked the tears out of my eyes, I reminded her of a favorite Christmas song.  It's probably the one from which she got the idea Santa would skip over her if she was awake, but I managed to turn it around. "Santa will know if we're awake.  But he also knows everything about you, including that you have diabetes. He'll just visit other houses in our neighborhood first, and come back when you're asleep."

The same conversation has taken place regarding the Tooth Fairy and the Easter Bunny, with significant anxiety around the issue.

Should your household have similar concerns, I hope the following tale will provide some reassurance:

On Christmas eve, around 9 p.m., my child was dozing off with a blood sugar of 110.  A check at 10 had her up for juice to treat a 77.  By 10:45, she'd balanced out to a nice 118, and around 11 we were all dreaming of sugar plums.  Yet at 2 a.m., I was rummaging around Grandma's refrigerator for more juice to treat a 79.

We must have been asleep by 3 when my nephew claims to have been awakened by reindeer hooves on the roof.  But at 4:30, I was awakened by my daughter fumbling with her meter in the little guest room we were sharing.  She was 73.  More juice.

We all (magically) fell back to sleep, and when we emerged to the living room around 7 a.m., the stockings were filled!  Santa had come.  Not close to 10, or 2, or 4:30.   Despite so much wakefulness, he knew when we were sleeping, and that's when he came.

Maybe next year, if I'm really good, he'll put on a pot of coffee for me before he gets back in his sleigh.

First Impressions

While it's just a few days 'til Christmas and I have mile long to-do list, I wanted to share just a few first thoughts about our new Dexcom.  Better formulated thoughts, perhaps even in complete and proper sentences, will follow after the first of the year.

What I like:  

• Finding trends and trying to fix them
• Knowing what happened during the school day
• High and low alarms
• Not worrying about her sleeping in
• Not checking a million times the day she had a stomach bug

What I don't like:

• The adhesive needs to be supplemented early and often.
• The receiver has spotty service in our bedroom. 
• The inserter is still scary.

What my daughter likes:

• The trend arrows help for better decision-making before gym, sledding, etc.
• A quick glance shows if a correction or low treatment is working
• Knowing it will alarm if she's low or high

What my daughter doesn't like:

• The sensor is awkward under a leotard
• Inserting a new sensor is scary (though the second time was better than the first)
• Worrying about the adhesive and whether she needs to add tape so it doesn't fall off

After the first one fell off (it had outlived its intended lifespan so it was fine) I wasn't sure what we'd do.  Our original agreement was that she didn't have to wear it all the time, that breaks were o.k.  All the pros and cons above are hopefully interesting and helpful, but the bottom line is this:

My daughter couldn't wait to start up a new sensor.  She was concerned she didn't have it while sledding at a friend's house.  "I wish I'd known which way that 102 was going, Mom."  If she likes it and finds it useful, then it's a keeper.

The First Time

Binge viewing videos about Dexcom sensor insertion eased my anxiety, but the person for whom it was being inserted was still pretty nervous about the whole thing.  Understandably.

Once I felt prepared, I gave her the choice of whether to start right away or wait a day.  I expected her to wait, but she decided she was so nervous about it that she'd rather get it over with.  So before we knew it, she was reclined on a pillow, belly exposed.  With one hand she had a vice grip on her stuffed rabbit.  With the other she was scrolling through pictures on the ipod.

The first obstacle was that she's very ticklish.  So every attempt to come near her, even with an alcohol wipe to clean the area, was a met with flailing hands (rabbit included) and giggly yelling.

Once we'd chosen and cleaned the area, we unwrapped the inserter.  We peeled back the adhesive and stuck the contraption to her skin.

This is when she balked.  "No!  I'm not doing it.  I can't."

Negotiations ensued.  See above for her arguments.  Mine included: 'We've gotten this far...we can't turn back now.'  'Let's just get it over with.'  Less helpfully, 'This thing cost us a lot of money...we're not wasting it.'  More helpfully, since it made her laugh, 'If you don't let me insert it, I'm going to leave the whole thing stuck to your stomach and you'll wear it that way for a week.'

We spent 20 minutes sitting on her bed, her with the giant applicator taped to her stomach.  At one point, she thought it might be easier if she pushed the plunger herself.  Ultimately she decided she'd rather close her eyes and strangle her rabbit.

Finally she did just that.

I pushed the plunger, heard the two clicks, and pulled the collar up for two more.  Except in super slow-mo. I'm guessing my hesitancy and wanting to be sure I did it all right caused it to be more painful than it will be once we get the hang of it.

"Did it hurt?"  I asked.

"YEAH, it hurt."

"Did it hurt as much as you were afraid it would?"

A half smile.  "No.  I guess it didn't."

The Decision

Regular readers will recall our 'mystery story' of a few weeks ago.  In a nutshell, my daughter was checking her blood sugar on a variety of meters at school and came up with numbers ranging from 140-348.  What I left out of that post was the tail end of the episode.  As we left the nurse's office, for her to return to class and me to try to remember what I had been doing before the phone rang, my daughter made a statement.

"This is why I need a CGM {continuous glucose monitor}."

We'd been talking about it on and off for a year.  The endocrinologist had given us his two cents and was ready to write a prescription if and when we decided to get one.  A friend of my daughter's got one a little less than a year ago and we'd both been watching her experience and asking lots of questions.  We'd been online, looking at the company's website and at personal experiences of bloggers.

We'd been going through a series of mysterious and challenging numbers. I was increasingly ready for Dexcom's graphs, predictions and trends, but we still had some reservations.

These doubts had mostly to do with having another 'site.'  How much would it hurt going in? Where would it go on her slim little body? Would it show under shirts?  Ballet leotards?  Bathing suits?  Would she care?  How much?  Would it be uncomfortable?  Would it get in the way?

There was also the matter of another device to carry.  She's already carrying a meter kit, juice box and cell phone. All of this fits into a cute little purse not too bulky to carry around at school or to a friend's house. The Dexcom receiver is small, but add a protective case of some sort and it gets bigger.  Would she need to ask Santa for a purse as big as she is?

Because these concerns were important to my daughter, they were important to me.  I needed her to tell me that she was willing to accept the discomfort and responsibility which would come with wearing another device.  I needed her to want it not just because it would help me and her medical team manage her blood sugars better.  It was important that she realize how it would help her in everyday situations, and indeed she did.

"This is why I need a CGM," she said.  That was all I needed.  I went straight home and picked up the phone.  We now own a CGM.  In fact (spoiler alert for future posts) she's wearing it right now.

And so far she likes it.

Research

It was tempting to rip the packaging open last Wednesday and click-click a Dexcom sensor into my daughter.  My cautious nature stopped me.

In fact Dex is still nestled in its packaging, though not as tightly as it was last week.  

I've taken it out and set the time, set up the alert parameters, and played with the different sound choices.

I've read through the start-up info and viewed the online tutorial.  

This is where I keep getting stuck:

This terrifying looking contraption will insert the sensor onto and underneath my daughter's skin.

Every time she looks at it, my daughter says, 'that thing's just scary looking.'  It's not really said with terror, just as a matter of fact. And she's right.  

I spent some time yesterday trying to alleviate my apprehension about this process by typing 'dexcom sensor insertion' into my trusty search engine.

Guess what?  It worked.

This video from Diabetic Danica and this one by One Happy Diabetic were the best for what I needed, which was to see how to use this thing on a real person.  I needed it explained step by step in a peer-to-peer sort of way. Watching multiple videos taken from multiple angles was helpful too.  One person, for example, made it very clear how to tell if the transmitter is clicked into place perfectly by checking the two little tabs in the back. Others showed helpful adhesive advice. This one from Arden's Day was uniquely great since it shows a dad putting it on his child.  It's the one I'll show my daughter before we begin.

Blogs were helpful too.  Bigfoot Child Have Diabetes' kid is in my kid's age range, and she's funny, so her recent dex experience was helpful to review again.  Diabetic Advocate's  tips and tricks were clear and practical.  As always,I consulted  D-Mom Blog and SixUntilMe too.  

I read and watched and skimmed countless other resources, and every one had something helpful or reinforced the key things to remember as we start up this week.  

So in a nutshell, 'Yay Diabetes Online Community!'  Advice from the manufacturer and our medical team is, of course, paramount.  But seeing and reading about real people using this gizmo in real life was the extra piece I needed.  My confidence has been built.  Thank you!