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Sensor Anxiety Disorder due to ???

Discussion in 'Continuous Glucose Sensing' started by suej, Nov 11, 2015.

  1. suej

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    I think I have developed a brand new psychiatric disorder: Sensor Anxiety Disorder (SAD). It feels as if whenever I look at the receiver there are ??? and we have to change sensors/transmitter. And I am so used to relying on CGM especially at night I feel very anxious if I can't fix it. Please can some of the Dexcom veterans advise?

    Started Dexcom April 2015. First 3 1/2 months bliss, each sensor 12-16 days, good accuracy. Use back of upper arms. Became complacent.

    Then had 3 sensors fail in a row day2 - day4 with persistent ???. First theory sensors overheated in shipping as box warm when I received it and so Dexcom replaced it. However problem persisted with the next 2 sensors so Dexcom replaced the transmitter. Then OK but not brilliant (2x 14 day sensors, 1 x 8 day, 1 x6 day and 1 x2 day followed by most recently a 8 day sensor. Then last night replaced it as ??? for 3 hours.

    But then the new sensor went ??? from 1 hour into warm up and stayed that way. I decided to replace transmitter with a new transmitter that I had and then warm up happened normally and readings provided overnight - not sure how today has gone as Ben at school.

    We insert through granuflex extra thin which is a hydrocolloid dressing like tough pads, but thinner, as Ben developed fierce allergy to sensor tape. Can't get tough pads here, but hoped that as a similar dressing to that used successfully by some posters on this forum it would work and 2 sensors have gone 2 weeks with it.

    There is no helpline or troubleshooting mechanism, just the distributors

    1. How do you decide if it is the sensor or the transmitter?
    2. Could the receiver be the problem?
    3. Could the hydrocolloid dressing be the problem?
    4. Are my expectations too high? What use do your kids get from sensors usually?
    5. What are users experiences with ??? in general, how often do they occur and also in the warm up period
    6. Lastly, does playing sport eg tennis affect sensors placed in the upper arms

    Sorry, so many questions but feeling anxious as really want to get this technology to work for my son. And sensors seem to be fine and accurate and then boom, out of the blue, ???

    Many thanks

    Kind regards
    Sue
     
  2. rgcainmd

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    If I were someone who bets, I'd put my money on the fact that you are inserting the sensor wire through something other than skin. I'd try punching a tiny hole through the dressing through which to insert the sensor wire. You can figure out the placement of the tiny hole (I'm talking small single hole punch) by looking at where the sensor wire exits from a used sensor?
     
  3. Megnyc

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    Could be the issue but I would be extremely surprised. I have inserted well over 50 sensors directly through a tough pad and rarely get ??? until the third week. There are plenty of other people who do it this way and I have never heard of this problem.

    Personally, I would try a different location (maybe bottom or upper legs) and see how that works before messing with exposing his skin to the tape. Also isn't warm where you are right now? Possibly dehydration could be an issue. Maybe encourage him to drink a lot of water before and after sports.
     
  4. Cheetah-cub

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    We also insert our sensors directly through the tough pad, and we are not experiencing this ??? problem.

    We buy our Tough Pad on Amazon, for some reason I have not seen many pharmacies carrying the tough pad on their shelf.
     
  5. rgcainmd

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    Over on tudiabetes (my second favorite diabetes site) I've read about other PWDs (granted the majority of them are adults) who have had intermittent problems when inserting their sensors through dressings. Quite a few people noted that sometimes this worked just fine and other times they had problems similar to the OP's. My theory is that sometimes the sensor wire picks up a little something from the dressing that interferes with transmission accuracy and sometimes it doesn't. Luck of the draw. When they eliminated all other possible causes for error, they tried leaving a tiny "clear" (i.e. dressing-free) area through which to insert the sensor, and it solved their problems. I'd consider it at least worth a try...

    Changing location is also a good strategy. Some people swear by tummy sites, others back of the arms. My impression is that more people have had more success with the back of the arm. But who knows, you son may be one of those people in the minority that have problems with arm sites.

    Please keep us posted and I hope you are able to get to the bottom of this issue ASAP.
     
  6. caspi

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    I'm assuming your son is staying hydrated? Usually a bottle or 2 of water will eliminate my son's ???. But, I'm betting it's the transmitter. We started getting a lot of ??? when ours started going. Since you just changed it, hopefully things will start improving.

    Edit: I just noticed you said they replaced it at around the 3 month mark, making this transmitter only 4 months old. So there goes that theory, lol.
     
  7. suej

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    Thanks everyone

    Sadly problem persisted with brand new transmitter - went ??? yesterday after about 16 hours of being fine. Goes from being fine to boom ???. Then it did a spontaneous system check with green tick saying system passed, then back to ???. (has done that about twice before)

    But weirdly enough all the days readings had vanished.

    I then tried to restart sensor at about 7pm but after 90 mins ??? again. Tried the reboot trick with paper clip in little hole at the back but just goes back to ???. At some point days readings reappeared. At 2am requested cal, threw out intermittent readings but mostly ???. Hoping now it is the receiver and trying to get a temporary replacement.
    aaaagh

    PS. I think he is well hydrated, exam time now so no sport
    His arms worked perfectly for the first 3 1/2 months, and we use upper buttocks for sets, will run out of space, tummy too lean even for sets
    I did try cutting a small hole in the hydrocolloid dressing but did not seem to make a difference, and skin reacted around hole
    Any experience with tegaderm?
     
    Last edited: Nov 12, 2015
  8. suej

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    New receiver hopefully arriving today, am holding thumbs and toes that it works. Thinking of starting both receivers and so if they both go ??? then it is not the receiver
     
  9. suej

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    Aaaghhhh
    Two receivers going ??? is not a pretty sight. Decided to run new and old receiver at the same time to help troubleshoot (seemed innovative at the time) so restarted sensor session on old sensor with brand new transmitter only to have both receivers go ??? at about an hour into warm up. Resited new sensor with tegaderm with hole cut for sensor, very fiddly and not sure how well it will protect Ben's skin. Did normal start up and behaved so far at 48hrs+, although Ben at school all day so I will see when I pick him up at 5pm.

    Also new receiver has been strange. When I turned it on went through systems passed check with green arrow, our old one does not do that? And at one point I took it out of range (old receiver usually reads him from kitchen to bedroom) and when I took it back to him it did not make contact until about 90 mins later? And the next day when the old receiver alarmed for a low, the new receiver did a long vibrate followed by a loud high pitched beep and the screen tho' live was black. It did this each time I pressed button until used the paper clip trick and then it seemed to remember it had a brain and behave ok. I wonder if the receivers can interfere with each other, I thought they would just passively "catch" a dedicated radio signal.

    Are we the only people on this planet that Dexcom not working? After a brilliant 3-4 month start am really struggling. Any help/advice really appreciated.
     
  10. Theo's dad Joe

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    I am feeling some sensor anxiety disorder just reading about your ??? issues.

    With my son, I get periods of ??? at night. Some times he will start into a compression drop when he is lying on it, the numbers will drop from say 100 to 80 to 60 and since I have the low set at 80 I will catch it and move him before it goes any lower. With some sensors, if it started to do the drop it would go to ??? even if I caught it, so I get 100, 80, 60, ??? for an hour then it comes back at 100. Since we have not had any true lows at night, and his basal is constant, and it comes back within an hour I will just set a no data alert for 1 hour and usually it never goes off-he comes back with an in range reading within an hour. It does worry me though about what I will do when his doses go up.

    We have gotten ??? on the last two startups at 1 hour. Actually one time it read "out of range" first for quite a while even though it was clipped on his shorts. The Dex com rep told me to start a new one and they sent me extras, but the first time it did end up starting up at the two hour mark. The second time I changed it at one hour because we were changing some dosing and I didn't want an extra hour of no data. It never goes ??? in the day. It only gives me ??? on startup if it is the first startup. The second week startup works better in almost every way.

    I have considered placing the new sensor two days ahead of time to allow it to set up and then moving the transmitter over and starting it up. That way the wire will be in a more stable environment. We always get less jagged curves after the second day and I think it is because of the wire getting held in place by a little scar tissue after a couple of days.

    If I was changing doses and got ??? at night, or for more than an hour or so I would probably do a fingerstick. My son wakes up no matter what though, but he forgets about it. I figure that if I am at least getting good data every two hours, and am not changing anything major it is good enough. It is a good thing that I can sleep in the daytime if I have to. By son wears it on his behind, and the problems at night are from lying on it, but I found that if he wears shorts and sweat pants it is a lot less likely even if he is lying on it.

    I tried calling Convatech about DioDerm but the lines are not in service right now for some reason. I agree that it is could be some polymer on the tape that is sticking to the wire.

    Anyway, I mentioned that we got ??? on the last two startups. That was at about 3 months into dexcom use and I am a bit worried that it is the transmitter or receiver. I have had the receiver occasionally read out of range but not more than 10-15 feet away for a time.

    I tried to use my sons arm, but he would inadvertently pull at it at night. He doesn't want to use his tummy.
     
  11. rgcainmd

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    Joe, you may want to consider a Band for Life to see if one of these could stop your son from accidentally pulling off an arm sensor in his sleep. So many people have so much more success with back of the arm sites.

    bands4life.net
     
  12. suej

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    Sorry Joe, don't want to spread SAD. Just find ??? so frustrating, and not usually a good sign for the longevity of the sensor, including in start up. We get ??? usually in the day.

    Current sensor is day 5 and so far ok but hope I have not jinxed it.

    I see on rgcainmd's post on the weird startup some other posters have also had ??? recently. Any chance that in Dexcom's roll out to other market's that quality control could be slipping due to pressure on production? Have other forum members noticed more problems with ???
     
  13. suej

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    Aghhh, just jinxed sensor - has gone ???. school phoned!!!!
     
  14. rgcainmd

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    Sounds like you may very well have a wonky sensor. I'd call Dexcom and ask for a replacement. (Remember not to tell them if you use an "alternative" site, e.g. arms.)
     
  15. suej

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    Thanks, at least I know what went wrong this time - we used tagaderm with a small hole for sensor (like opsite flexifix) and it came loose during swimmimg at school, and his skin looks horrid. so Tegaderm a fail. Did not stick. Did not protect skin.
    Meg just pointed out ebay delivers to SA so am ordering tough pads stat. Am blonde(greying) and did not think to look on ebay, meantime this sensor on the extrathin granuflex with a small hole for sensor. Was not terribly successful before, the dressing is about 0.5mm thick so the sensor wire will not be perfectly flush with the skin.
    Thanks for all your insights, I will keep you posted.

    PS. Just ordered a band for life armband
     
    Last edited: Nov 19, 2015

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