DexcomG4 - what do I need to know? And lots of other questions....

I have been waiting since August 26, 2011 for our endo and ins co Kaiser to prescribe/approve the Dexcom for DD. Of course that meant waiting on the FDA's approval for pediatric use, logging a bunch of BG#s and waiting and waiting and waiting some more. I just got a call today from our Dexcom rep that our order was placed and should be here in the next 3 days! Last night DD was a 66 at her 2 am check...that bad boy Dex can't come soon enough! Puberty is HERE and this pancreas mama needs HELP!

I'd love some feedback on what to have on hand for our initial start.

What should I expect the first few days? Is starting a CGM a big learning curve like the pump?

Did you/CWD get trained on the Dex by your rep or endo? Or did you read the manual / watch videos and do it on your own?

Does your CWD use their stomach and bum area exclusively?

How do you get your sensor to last past the 7 days? Would I just stop/ restart the sensor while she is still wearing it? How do you know a sensor will last past the 7 days?

When do you typically insert a new sensor? I know it will take 2 hours for the CGM to start up before you can calibrate so I am just trying to figure out when in the day it would be OK to be without the CGM working.

How often do you have to recharge your transmitter? Once a week? Every few days?

What BG range do you have for your Dexcom G4?

How does your CWD address their Dex alarms at school?

Where does your CWD keep their Dex receiver when they're at school/PE? Do you have it set to vibrate?

Do you have any tips you've learned that are not in the manual?

BIG THANKS to all those who reply!! :cwds:

 

Hope that helps!

 

You will LOVE it.

 

Good Luck!

 

The only slightly challenging aspect is the first insertion. I highly recommend doing the first one on either yourself or your husband. Once you have that down, you'll be golden :wink: And if you waste one, call Dexcom and tell them that your first insertion didn't go right and I'm sure they will replace it.

Good luck - it really is a brilliant piece of technology.

 

It doesn't even have to be your first one that you mess up that they will replace. They have truly awesome customer service. My DH called one night because he wasn't paying attention and he messed something up (prior to inserting it). I told him to call and see if there was a way to fix it, prevent it from happening again, or were we just out of luck and they replaced it without issue (which is not what we were looking for).

 

Definitely suggest this. There are some good youtube videos out there on insertion, and the first one you'll do is weird, figuring out how to hold your hands, so I ditto Sarah's suggestion to try one on yourself but after that you'll be all, "oh, this is so quick and easy!" It's also a great way to see that it really doesn't hurt. You'll be amazed.

And I ditto this too. Any time we've had a sensor crap out before 7 days, or simply have adhesive issues before 7 days, I just call and they'll replace it. They're great about it.

I'm not really going to add much to what the others have already posted. We find that inserting a new sensor close to bedtime usually results in a bad night. Something about a new sensor and sleeping, doesn't work. So we shoot for middle of the afternoon, if possible. We try not to over calibrate. And we most always get a good 12-14 days out of our sensors. Usually on that last night of day 13 we'll see a lot of ???. I should just learn to pull them on day 13, but I always try for more. LOL.

Good luck! You're going to really love it. It's such great technology. I usually tell people that I have slept better in the past year than I had for the previous 7. Last night, for instance, my son had some big, non-responding lows at 10pm, and once he was coming up, I knew that I could safely go to bed and know that the dex was going to alert me to anything wrong. I still set my alarm for mid way through the night, just to be safe, but I was able to quickly check the G4 and then roll back over and go to sleep. In the past, I never would have felt comfortable sleeping most of the night after dealing with a 36 that only responded after multiple juices and mini-glucagon. I would have been up every hour or so, checking. Most nights I don't even set an alarm now.

 

This thread is very helpful, answered lots of questions I had about the Dexcom too. We are hoping to get a Dexcom.

Is the sensor waterproof? Can you swim with it? Someone mentioned using a numbing cream for the insertion, is the insertion painful? Do most of you use a numbing cream?

Thanks!

 

The sensor and transmitter are waterproof and you can definitely swim (and sail, waterski, jet ski, tube etc.) with it! The receiver is not waterproof at all though.

The insertion is not necessarily painful but it is a brief pinch sometimes. I was the one who mentioned the numbing cream. Personally, I think if you are introducing a new medical device to a child with an insertion device that may be a little scary looking, it can be helpful to use numbing cream to make the process as stress free as possible. You use just a pea sized amount under a bandaid for 30-40 minutes and the child will not even notice the insertion. It is a personal choice whether or not to use it at first but I really don't see a reason not to if the parent and/or child is at all concerned about the first few insertions.

ETA: I don't personally use numbing cream but when I was younger we sometimes used it for the old medtronic sensors. I personally found it really removed any anxiety for both me and my parents from the whole sensor change process.

 

We don't use numbing cream. I would try a dexcom on yourself and see how it feels. Personally, I tried it, it didn't hurt. I think a finger stick hurts more. Your tolerance may vary. (I've tried the minimed one. It hurt. A LOT. We did use numbing cream for that). Half the time the g4 is inserted my son says he feels nothing.

The whole process of inserting and attaching the transmitter is completely done within about 1 minute or less. To me, the introduction of numbing cream just prolongs the whole process. We really noticed this with Minimed (which DID hurt) but it just dragged out the whole process.

Again, your child's tolerance may vary. I'm usually one to say to mine, try it first, see how it feels.

 

Thank you everyone for the replies! All great info and ideas! I think DD will love the idea of me putting a sensor on the first time. ;-) We do have EMLA cream, but if DD doesn't ask I think I won't offer. I could just see myself not remembering to put it on in time for a new sensor change. DD has not felt her lows lately. This CGM will be a real blessing. I have said it before....ALL T1s should be given a pump, CGM and an accurate meter after diagnosis. It is daunting duty being a pancreas mama....I can't wait to see how this new tool helps me manage the uninvited diabetes beast! :cwds:

 

I'm so glad you posted this! I was going to post the same thing tonight, our Dex was shipped today. One question, should we plan on having to tape them right away or should we wait and see how they stick to her? Infusion sites stick really well except sometimes in the summer when its hot and she's very active.

 

I would just wait and keep an eye on it for the edges starting to peel up. It really depends on their skin and if you don't have problems with infusion sets you likely won't need tape until the second week.

 

We tape over it immediately at insertion with four little strips of hypafix around the tape and then a 4" square of hypafix that goes over everything, including the transmitter. Before we started doing it this way, the sensor tape would pull out from underneath the tape strips. We've increased both the number of days the sensor lasts and accuracy by overtaping. If the edges of the hypafix start to curl up, we trim them.

 

How are you liking the Dexcom? We're on day 3 and already can't imagine being without it. Not a single low that we haven't caught long before it was an issue. And only 1 bad high that was a site that went bad. My wife who was a bit tentative about it is completely sold on it now. A really great product!

 

You're welcome!

 

We LOVE the DEX!!! We inserted DD's first sensor on Monday. Tuesday I got a call from DD at school. Some how she managed to snag the sensor and it ripped off and the adhesive was still on her skin. We inserted the second sensor that day and it has been clear sailing since. I do have to remind DD to respond to the alarms and take action if she is low. This morning she had breakfast and got ready for school and her dex alarmed she was a 55. She silenced that alarm and by the time we were getting in the car Dex said she was a 49! I told DD that this is a tool to keep you safe please don't ignore. Knowing my daughter....fixing her hair and finding the right outfit for school was too great of a priority than stopping for a low! Oui Vey! Oh the battles with a preteen girl are just too much fun! :wink:

 

I don't mean to hijack the post but I have a question. Charles is interested in the Dex since he saw it at the summit and I am thrilled. How many times do you still need to check bg daily? Charles and my husband thought it meant no more checks. :cwds:

 

It depends on the day. We still test in blood before meals and bed. Sometimes for lows. We don't dose off the CGM (at least not usually). We see enough variance at times that I'm not comfortable doing so. We're in the puberty ups and downs of basal needs, and the lag is BGs coming back up is enough that I switch to blood on those nights. One morning after a particularly bad night, I counted up 13 test strips from the wee-hours.:blue: We test very little on sick days when she's not consuming food. Once I have her basal adjusted, we watch the CGM flat-line and don't bother with pricks.

When I first heard about CGM, I wanted something that would eliminate the pokes. A year later, I was desperate for help with the nights as I'd been feeding lows every two hours for two weeks while dropping her Lantus doses at the same time.

The CGM exceeded anything we'd realized it could do for improving her quality of life. We rarely see bad lows and we catch highs before they get terrible. We're more comfortable going aggressive when we need to. My kiddo is sick right now, and yesterday, I switched her basal rates from 90% of her profile to 175% of her profile and felt safe doing so, knowing we'd see the change when her body no longer needs the extra.

It lets her be a kid without focusing on diabetes all the time. It alarms when she needs to focus. This winter she went out tubing with a friend and came in when it alarmed telling me, "I completely forgot I had diabetes!" To me, that makes it worth its weight in gold, that she could go have fun with her friend, not have to test every couple times down the tubing hill, and yet not have to deal with the consequences of a serious low because of forgetting about her chronic condition.

 

We have been testing for meals, lows under 80 and calibrations and that seems to work well for us so far. We have gone from testing 12-14 a day to 4-6. We love the Dex!