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questions about DD's new dexcom

Discussion in 'Parents of Children with Type 1' started by steph, Jan 3, 2014.

  1. steph

    steph Approved members

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    We just got the dexcom yesterday and haven't put on the first sensor yet. DD is 3 yo and I wanted some advice from the pros bf starting.
    1. Do we need EMLA cream or not really?
    2. I've heard upper tush is a good spot but wondering if that being strapped in tightly to a car seat or frequent up and down of pants while going potty poses any issues. Where do others put CGMs on their little ones?
    3. To tape or not to tape. Is it necessary? Do I just tape over just the adhesive or over the entire transmitter? I was thinking the entire transmitter to keep it from getting caught on her clothes. I got tegaderm for this, but plan on getting oppsite and hypafix to compare them all. Any recommendations?
    4. Best start time? Evening or morning?

    Any other suggestions or tips greatly appreciated.
     
  2. Beach bum

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    My daughter finds that the CGM insertion is practically painless compared to the set. I would say, use Emla if you use one to put on a set, just to keep things consistent. The sound of the insertion might be a bit daunting to the child, so I would encourage you to have some sort of distraction. My daughter wears hers on her hip, right above her pants. Putting it right above the pant line avoids it potentially getting caught on something. If your child has a preferred side to sleep on, avoid putting it on that one. It is uncomfortable and also sends a lot of out of range messages. We don't tape, but we add lots of skin tac and put some on to the sticky side also. But, if your child swims at all, I would say tape. My daughter hates the tape, it bothers her skin, so we avoid it when possible. You don't tape the transmitter, just on the white sticky part. No problems with it getting caught on clothes, it's all smooth. As for start time, do what works best for you. Think about the time of day and what kind of mood your child is in! I always make sure we do it at night so that her skin is dry. I always try to avoid doing it anywhere around shower time, as we've had them start peeling off (even with tape), it must be the soap or shampoo she uses, makes her skin too soft. Keep in mind, if you do it at night you will need to calibrate, so say if you do it at 6, and bedtime is 8, you'll have two BG's to do when the child is possibly falling asleep. I usually do it at 9, then when it's time to calibrate it's also time for the late night BG check.
     
  3. Thornbird

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    Hope that helps! Soon you'll be wondering what you ever did without a cgm!
     
  4. cm4kelly

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    I am so happy for you to get a Dex system. It will make things so much easier for you.

    My son started his Dexcom this year (age 5) and we have almost had it for a year now. From the beginning we always used EMLA cream - the one time I didn't he cried - so to me it is worth it. We put it on about an hour before insertion and I just cover the spot with a bandaid during the hour. This has really worked for us. I even use ELMA cream on my type 1 husband for his Dex. It probably isn't necessary, but it does make things easier for us. (We do not use the cream for regular pump site changes)

    I think early evening is the best time for changes, I can do the cream around 7:00. Do CGM insertion around 8:00 and then put my son to bed. Then that makes calibration around 10:00 PM when he is sleeping -and before we go to bed. That works for us. If my child was at home with me, I would say morning would be fine too, but my son goes to school very early.

    We don't tape or cover with anything and we place the sensor on the upper arm. We use the rear for pump sites so that really isn't an option for us for the Dexcom sites.

    By the way - we have never purchased one, but there is a web site that sells arm bands that go over and cover CGMs and Pods - they are in different patterns and colors. That might be something to look at for the little one instead of using tape.

    You will love it!
     
  5. hawkeyegirl

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    We use EMLA for all pump and sensor changes. It just totally takes the stress out of it for both of us. Just be sure that if you do that you really wipe the EMLA off well before you insert the sensor.

    We used the MM CGM for 5 years and Jack wore that on his upper bottom with no issues. The Dex sticks out a bit more, though, and I wanted to give that area a rest, so he wear the Dex on his arms. It works brilliantly there.

    We do put tape on over the Dex tape to anchor it down. We get 14 days out of sensors doing this. Our favorite tape is Opsite Flexfix. You can order it on Amazon, and $25 will get you a roll that will last months and months.

    I guess I'm in the minority, but I prefer to start a new sensor during the day. We have really bad luck with accuracy that first night if I put a new one on him at night. If I start it during the day, our first day accuracy is much better.

    I did watch a good You Tube video on insertion before I put one on Jack. I think it was Diabetic Danica. We didn't do any training - the video was more than enough to get it going.

    Hope you love it!
     
  6. StacyMM

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    I use numbing cream for site changes but not Dexcom changes.

    Mine prefer arm and belly. Mine are older but I think both would forget it was there and pull it off. DS can't wear pods on his hip because of that - and he's almost 12.

    I tape, but only around the tape and not over the sensor. I was told not to and I haven't had issues so I've never bothered to try it. I use Hypafix and it works really well - but does need retaped when it gets grungy after 7-10 days. I don't think we'd get as long as we do without taping, but again, I haven't tried it. I just tape since the OmniPods always need taped on my kids to keep them from falling off and I'd heard they had the same adhesive.

    I have no set time. I change it whenever we realize it needs changed - either it gets pulled off when they are rough-housing or we see accuracy issues. I have no preference, other then I hate to change close to my bedtime because it means I have to set the alarm for 2 hours later.
     
  7. Shopgirl2091

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    Don't over calibrate - although you may be tempted to - two calibrations a day should be plenty, unless it is way way off - sometimes it just takes a little while to catch up. Usually the first day is not as accurate as the rest of the time, but it gets much better. Don't calibrate unless the arrow is straight across, if the blood sugar is going up or down too fast when you calibrate it can mess it up and give you the hourglass symbol, which is just frustrating because you have to sit there and wait for it to fix itself. Also if you calibrate when BGs are not steady your readings will be more off. If it is ever off by a lot you can also try taking it out of range and bringing it back in, that sometimes helps it to catch up to what the BG really is. We use the tallygear carrier for ours, it works great, has a clear window you can see readings through and you can clip it to a belt or onto their pants if you need to. Most of the time I carry ours because my son is smaller, but it is nice to have the option of being able to hook it onto him if I need to. Good luck - you will love it!
     
  8. steph

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    So far so good. She did fine with the actual insertion but fussed when we tried to attach the transmitter. The tape started peeling up the next morning so we used hypafix. We did belly bc she wanted it there, but i think we'll give the arm a try next. It has been quite accurate, usually within 15 pts of bg. We've prevented 2 lows in the past 36 hours and had the point reinforced that we really need to work on the post breakfast spike. Thanks for the tips :)
    I find myself feeling very nervous about her active play that it will rip off. I saw one other mother mention this happens. Is this a valid concern of mine? Should I try to teach her to try to pay attention to her sensor and not roll around on it, or just let her completely ignore it? Will it hurt badly if it gets knocked off?
     
  9. Sarah Maddie's Mom

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    Attaching the transmitter does take a bit of force, more than you would expect. Best to commit to doing it and not fuss around. Maybe she'd like a count down or chant or song to distract her - remember that the actual sensor that is left behind after insertion is thin and flexible - you are not pressing an insertion needle when you attach the transmitter. It may feel odd, but it shouldn't hurt.

    I personally think opsite tape is the best for sensors - but I know everyone is different. As for them falling off, we haven't had that happen though we have had then get loose around day 14 or so. If it did come off on it's own (and it likely won't without plenty of warning - being loose, signal interrupted,??? and hourglass) again, there's no needle, so it would not hurt.
     
  10. hawkeyegirl

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    I think my daughter ripped one sensor off of my son's arm when they were wrestling around, but generally speaking, they are hard to pull off. I wouldn't tell her she has to be particularly careful with it. Lord knows my son isn't, and I think that one is the only one we've lost.

    As for whether it would hurt if it got ripped off, I think the only part that might sting is the tape being pulled off of the skin. The sensor filament itself is so small that it wouldn't hurt being pulled out of the skin, even forcefully.
     
  11. StacyMM

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    Can't say that we'll always be this lucky, but DS played baseball with his sensor last summer. He slid into bases, dove over fences and did just about everything else that could make me gasp in worry from the sidelines. I kept seeing that transmitter in the dust, trampled. All my worry was for nothing - he never dislodged a single sensor.

    We have had sites come off but it's usually because of water - long, hot shower...playing dunk football in a pool, etc.
     
  12. MEVsmom

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    Here's my opinion.


     
  13. ksartain

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    For the opsite tape, you might be able to order it through your DME provider. I ordered a box of the same stuff that was on Amazon for $22 from my DME provider and it was only $1.78 with my coinsurance, plus free shipping. I know all insurances are created unequally, but it might be worth looking into.

    We're anxiously awaiting our Dexcom. It was ordered Monday and is scheduled to ship today.
     
  14. Junosmom

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    We are also new Dexcom users as of last Friday. I appreciate the hints for taping down. The sensor on him right now is the third one (in less than a week) and is already coming up at the edges. The first one lasted 24 hours. He was doing pull-ups with a rubber band assist device. I wasn’t home, but heard that it rubbed across the abdominal site. He didn't report that it hurt to be ripped off but he's 11 yo.

    New sensor put on that evening, again following instructions, on the abdomen. It lasted almost 48 hours. He went to a 2 hour tae kwon do class, was doing fine, and toward the end of class, they put on sparring gear which includes a chest protector. The chest protector was laced tight enough, caused friction, and I believe caused canula to come out, because though still attached, he said it poked and hurt him with each breath. Took that one off.

    Third sensor put on following night, after calling Dexcom and we instead chose his arm. Dexcom said they could not recommend an arm as it wasn’t FDA approved (although neither is it for those under 18), but our CDE said it could. The sensor will always have to be on the arm or leg, as it stays on so long that we can’t avoid a class with sparring gear. The pump pod, however, changed every two days, can be coordinated with days where they likely won’t spar and can use the abdomen on those days.

    So, rocky start as far as adhesion. BUT…the first night it alerted at 2 a.m. that he was low at 78 going down and it was confirmed with finger stick. I would not have checked him until 3 a.m. prior to Dexcom. I can sit in the balcony at TKD and see how he is doing, reassuring me. Several times alerted when he didn’t know he was low. And, Dexcom says they’ll replace sets that don’t make it 7 days even though they were aware we knocked one off and removed one that was damaged.

    Now, I am making notes on all of your recommendations for adhesion. Nurse practitioner today told us to use baby or kitchen oils to remove the pods or sensors. Anyone tried that?
    Again, thanks for advice.
     
  15. ksartain

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    We use baby oil to remove pods. I pour it on a cotton ball and rub it into the tape. We give it a few minutes and it comes off easier. Taking it off in the shower accomplishes the same thing for us.
     
  16. Megnyc

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    Like you said Dexcom will replace all sensors that don't last 7 days (they have amazing customer service!). However, I would really suggest taping from day 1. The above suggestions are great. My favorite tape is the 2 inch roll of Opsite which you can buy on amazon. In terms of removal, Unisolve wipes are my favorite. I find they leave the least residue and don't leave the skin feeling greasy. We order them from American Diabetes Wholesale.
     
  17. Junosmom

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    I'm looking on Amazon. I see it comes in 2" and 4". I assume it can be cut down to go along edges, so it would make sense to buy 4" (they're the same length about) and get more for just a little more money?
     

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