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CGM insertion

Discussion in 'Parents of Children with Type 1' started by minniem, Mar 2, 2012.

  1. minniem

    minniem Approved members

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    We have made the decision to get a CGM for DS and have ordered the CGM and the Guardian. When I asked about numbing the site before insertion the CDE told me we can't use anything on the site besides alcohol. She said if you used emla or anything like that it could affect the readings. So my question for all of you is: do you use anything to numb the site?

    My DS is 9 and while he is open to the CGM he is a bit apprehensive about the needle. We currently use Mios which he tolerates just fine but when we tried the silhouette he said it hurt and he didn't like it. I am sure I have read on here that some of you numb the site, do you find that it alters the readings? For those that don't numb it, does your child tolerate the insertion ok?

    We are using the Medtronic CGM since he is already using the revel pump.

    Thanks!
     
  2. momof2here

    momof2here Approved members

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    numbing cream on cgm

    Yep, we have always used numbing cream on each and every cgm insertion.

    I don't think he would do it without. Readings getting messed up usually has more to do with site selection, laying on it, or old sensor.
     
  3. PixieStix

    PixieStix Approved members

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    We have never used Emla & DS has always tolerated the insertions w/o much fuss. Started using 24/7 in 2006 at age 7 so have done lots of sensors over the years. I know many others do use it and will disagree, but for us I am all about getting all D tasks done w/ as minimal time & distraction from life as possible, and did not want to have to be tied to the extra hour waiting for the numbing cream to take effect every time a new sensor was needed.

    When he was smaller I used to do the inserts as he was engrossed in TV or even in his sleep, but now he really doesn't care, insists it is pretty much pain free. Every once in a while he will flinch on insert and say it hurts for a moment but nothing monumental. If you do chose to use Emla, just have to be sure to thoroughly wipe off skin so it doesn't interact w/ the sensor. Another alternative is to try holding an ice cube on the area before insertion.
     
  4. zoomom456

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    We just started using a CGM and we use numbing cream. We just make sure to clean the area really well with lots of alcohol swabs. We have not had any problems with our readings so far. Generally they are +/- 10 points of the meter. For my son, the 1 hour wait is worth the time.
     
  5. Darryl

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    We've used EMLA for 1-hr every time for the past 5 years. No problem at all for accuracy, the site, or anything else. Clean the site well with alcohol of course before inserting.

    I recommend tilting the senserter up around 10 degrees (in other words, more straight up) from the built in 45-degree angle. This virtually eliminates bleeding.

    To tape the sensor, purchase Tegaderm 1624W. Cut two pieces in half (make the cut through the shorter dimension). After the insertion, put one half-piece over the clear part of the sensor, the other half-piece over the adhesive (slide it as close to the clear part as you can). When you're done, the tegaderm should look from above like you've "put it back together" just with a slight gap where the two pieces meet.

    Then wait 2+ hours to install the transmitter (I wait 6 hours), and after it blinks, use another half-piece to tape down the edge of the transmitter (this piece will partly overlay the existing tegaderm).
     
  6. Flutterby

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    We always numb the site. As long as you clean it off well there is no problem.
     
  7. minniem

    minniem Approved members

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    Thanks, Darryl, for the taping instructions...I'll have to try that when we start. We are supposed to have our training next Friday so I am excited (as excited as I can be about D;)). Our trainer is pretty adamant about not using anything on the site. Does anyone know if you can get EMLA over the counter or is it just by prescription? We will be using nothing next week so we will see how it goes. I really hope this works out for my son, as I think the information it can provide for us is invaluable. He is willing to try it for me, but not too thrilled that it might hurt going in.

    Thanks to everyone else too. It is helpful to hear how others are managing it!:cwds:
     
  8. AJMom

    AJMom New Member

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    We get our Guardian CGM training on Wednesday:) Our rep had Endo office call in numbing creme so we would have it for training! She asked that we put it on (and cover with plastic wrap) at least 1/2 hourt before she arrives.
    Daryl, thanks for the taping hints!
     
  9. hawkeyegirl

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    Your trainer is wrong. We've used numbing creme for four years with no issues.

    EMLA is RX only, but LMX4 is similar and over the counter. You'll have to ask for it at the pharmacy counter, but you won't need a prescription. :)
     
  10. minniem

    minniem Approved members

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    Thank you for this. I will look into getting it at the pharmacy if need be.
     
  11. mysweetwill

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    We are only in week 3 of CGM and have not used numbing cream at all. Will has been totally fine with the insertions. Darryl, Im curious why you dont put the transmitter on for 6 hours? We put it on within a half hour and then the initial warm up is 3 hours. Am I misunderstanding?
     
  12. minniem

    minniem Approved members

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    Rosemarie,

    This is good to hear too. I really hope DS will be ok too...I think his fear is definitely more anxiety that it is going to hurt more than it actually does. In fact, today when we changed his pump site he was moving away from me saying he thought it would hurt and when we actually put it in, he was fine saying it didn't.

    Can I ask, where does Will wear the CGM? And where does he wear his pump sites? My DS uses upper tush mostly for the pump but will rotate to arms/legs every few weeks for a break. He is super skinny so we are not using his stomach at all.

    Thanks!
     
  13. mysweetwill

    mysweetwill Approved members

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    We started CHM before the pump, in fact I think it may have worked in our favor because if the pump insertion is easier than CGM. We've only used upper bum so far.
     
  14. Mish

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    we also don't use numbing but only because he is too impatient to sit around and wait for an hour. There are days where he would probably wish he did it (and we have some on hand, it's entirely his choice) but nearly all of the time he just can't be bothered.

    Probably half the time he says it really hurts and the other half of the time he says he doesn't feel anything.
     
  15. lisanc

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    We use ice to numb the spot and it works great for Maddie! She has no problem with the insertion.

    We also started the CGM prior to pump and it really helped us establish basal rates.
     
  16. Kimby

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    We numb for cgm sites too. The extra hour is a hassle sometimes, but it's worth it for Andrew.
     
  17. Darryl

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    The sensor's sensitivity to glucose can change a lot in the first 6 hours. You can install the transmitter and cal 2 hours after insertion, but then you may see significant changes in sensitivity in the first 6 hours until the sensor has stablilized.

    Our usual routine is sensor insertion Sunday 9 PM, transmitter installed at 1 AM, first cal Monday morning at 7 AM. This allows plenty of time for the sensor to stablize so that it's accurate on the first day. The old transmitter provides data overnight until the new one is cal'd.

    Also note that at the end of day 6 you need to disconnect and reconnect the transmitter from the sensor or it will turn off completely at the end of day 7.
     
  18. mysweetwill

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    Thanks Darryl, I read some of your posts in your signature over the weekend and they are very helpful. Thank you!!
     
  19. Meredithsmom

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    We go four our CGM training on Wed. Thanks for all of the hints. I am a little apprehensive.:cwds:
     

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