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Successful use of Dexcom w/ adhesive allergy

Discussion in 'Parents of Children with Type 1' started by Megnyc, Apr 15, 2013.

  1. Megnyc

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    Hi all,

    A lot of people have asked me to update once I figured out how to manage my pretty severe allergy to the dexcom adhesive. So I figured I would post an update to my ongoing saga.

    Feel free to scroll past this info if you want.

    Background info: Around 3 weeks into dexcom use I suddenly developed an allergy to the adhesive. In the outline of the adhesive I had a burn mark that blistered (and left a scar I still have). It was on my upper arm and I also had hives up and down my arm as well as my neck as well as a generalized red itchy rash (but very minor compared to the hives).

    Now: I was gchating with my cde on thursday and she suggested trying to get the dex to work sooner rather then later to deal with some pretty scary lows the medtronic is just not catching in time. It just so happened that, that night I was working with 2 guys who went to my college and came back to visit who happen to be er docs. We were all hanging out at my house and figured it might be a nice project to remove the adhesive and see what we could do. I was fine with it since I was in pretty great hands if I were to have any sort of reaction.

    DISCLAIMER: I 100% don't recommend doing this without speaking to your doctors. This is probably not the most responsible thing I have ever done. And I am pretty sure dexcom would not approve of this in any way.

    A side note here: I get hives on my hands from touching the adhesive. I wore latex gloves for this whole thing and changed them between steps. The guys made sure not to touch my skin without changing gloves.

    To remove the adhesive, we first just tore it off. We then used a uni-solve wipe to get the rest off. We then used some wax remover I found in an old home eyebrow waxing kit to remove the rest. It was then cleaned with alcohol prep and sterile water several times and the bottom and sides of the sensor were covered with 3 layers of opsite tape.

    For my skin we put down 2 criss crossing layers of opsite tape. We then put down a piece of opsite tape sticky side up and taped 2 edges.

    [​IMG]

    We then removed the green back of the tape and taped the other sides.

    [​IMG]

    We then placed the sensor on top of the sticky part and inserted. We attached the transmitter and taped over with opsite tape. 1 piece in each direction.

    [​IMG]

    My boyfriend did all of the touching of the sensor for the process of inserting it.
    The entire process took around 20 minutes. But we were fooling around a lot so it could probably take under 10 if you were actually concentrating.

    Results: I have had close to perfect accuracy. It is putting the medtronic sensor to shame with regards to catching lows. I have not had such great blood sugars in forever. I am on day 4 now with no reaction of any kind. My skin looks great under the tape.

    Reason we used the 7+ instead of G4: Well first the G4 is at home not at school and we gave away the sensors once we realized I was allergic. And, I have a bunch of expired 7+ sensors a friend gave me so I figured we wouldn't be wasting a sensor if it didn't work. I am not really sure how this could be any more accurate any way. I am finding little to no delay- maybe 5-6 minutes at the most for highs. Other then some wacky extreme numbers the first 12 hours it has been +/- 10 points for every single bg check. Since I got hives from touching the adhesive for this sensor I am assuming whatever I am allergic to is in both adhesives.
     
  2. BittysMom

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    Thank you. I'm making a list of things to try.
     
  3. ecs1516

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    Please post pictures when you remove the sensor. We tried this with my younger son a couple of years ago for the Dexcom 7+. I pulled off all the tape and removed the residue with a drummel tool and sanded it off. Put a layer underneath with a hold cut out for the sensor.Put Opsite on top. It was better, but when we removed it there were water blisters under the plastic part even though there was opsite there. I hope it works for you. We may try again.
     
  4. BittysMom

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    My daughters bad reaction right now is because we put Opsite on her leg first... It's is an interesting idea, but I'd have to try it with something other than Opsite. Maybe Hypafix. She never used to react to any of these things.
     
  5. denise3099

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    has anyone used duct tape? I read someone tried it with good results, but I'd be careful of course with such severe reactions.
     
  6. denise3099

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    Wouldn't it be great if they made sensors without tape? Then you could just use whatever you wanted. Like if they just made a sensor with no adhesive and you bought the double sided sticky tape of your choice.

    Dex, are you listening??? Make a line of different double sided sticky tapes and a adhesive free sensor.
     
  7. denise3099

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  8. BittysMom

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    Are there any tapes/ adhesives that are known to interfere with transmission if put over the sensor?
     
  9. Lizzy731

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    Meg...so it sounds like basically you did an opsite barrier...I am curious why you didn't try to do an opsite barrier without removing the adhesive from the dex? The opsite would protect your skin from it I would think? Also...it sounds like you didn't cut a hole for the sensor to go through the skin? Am I right in saying this? Isn't that a big no no with insertions devices? Lol

    Also you taped over the dex which I read is also not recommended...I am certainly not scolding you because if this works I would definitely try it for Bethany's sensitive skin if we do try the dex in June when the Medtronic monitor is out of warranty!

    Just wanted to clarify a few things...thanks for the explicit directions! We actually did an opsite barrier way back when for Bethany's pod but I found the cavilon wipes did a great job on its own
     
  10. Lizzy731

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    Opsite is safer and just as strong...believe me. Been using it for years and I tried EVERYTHING!!
     
  11. Megnyc

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    I will! I am hoping to get 2 weeks out of the sensor since it was somewhat of a procedure to put on. So far it feels great though and I have no visible irritation.
     
  12. Megnyc

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    The initial dex sensors I used were placed on top of opsite (and several layers after the first reaction). I still had a severe reaction. I am guessing some of the adhesive or more precisely whatever chemical in the adhesive I am allergic to managed to seep through.

    We did insert through the tape without cutting a hole. I know it is not recommended. I guess my view on it is that it really isn't any different then having a slightly different skin thickness. I don't really see how the sensor knows that it is going through tape instead of skin ;) I am pretty sure the sensor wire is inside of the needle so it would not be directly contaminated by the tape. I guess when the needle is pulled out it leaves some tape residue inside the skin but it hasn't caused any problems yet....

    I did tape over the transmitter as well. Without the adhesive there is no way to secure it without taping over it, at least that we could figure out. From what I understand the transmitter sends the same signal as the medtronic transmitter. Since I tape over the the medtronic transmitter with no problems I didn't worry about that.
     
  13. Lizzy731

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    Ok thanks for that clarification! Now if I could just ask you something off topic from your OP...the alarms...how are you dealing with no low/high predictor alarms? From what I read on the online manual there is only alarms for low, highs and the rate of dropping and rising?
     
  14. moco89

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    ***News Flash-Waterproof does not mean VAPOR impermeable!!!!!***

    OPSITE ◊ is a transparent, adhesive film. The film is moisture VAPOR permeable, conformable and extensible. It is widely used to provide a moist wound environment for superficial wounds; it is also ideal for use as a secondary dressing.

    http://www.smith-nephew.com/professional/products/all-products/opsite/

    ...

    Obviously the adhesive on the Dexcom has solute (and a minimal amount of moisture-to make it stick), and therefore can be permeable via the vapors.

    Thus, this is probably a very likely problem causing the issue.

    ________________

    You need a virtually vapor/moisture impermeable dressing. You will probably have to search and read various manuals on dressings. (More info on impermeable dressings-here)

    It looks like a hydrocolloid dressing is what you should be considering.

    ____________

    If I were you, I would probably rip off the tape from the Dexcom sensor, initially, and go from there with your idea regarding taping modifications.
     
    Last edited: Apr 17, 2013
  15. Megnyc

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    Yes, there are only alarms for high, low, fall rate, and rise rate. I never use the high predict alarm. I only recently started using the low predict (my old 522 didn't have it). Right now I have my low alarm at 80 and my high at 140 and it is working great. It is about 6 minutes ahead of the MM (I am wearing both right now) so it would be catching the high when MM is predicting it.

    My only issue is the ???. I had it go into that last night and I woke up to the MM alarming and was 480 (MM said 300). It also went into ??? for a fast drop last time I was using it. I am not sure how I can rely on it at night if it won't alarm if it is not getting readings.

    So anyway, I don't miss the predict alarms but the lack of an alarm for ??? is somewhat concerning.
     
  16. Megnyc

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    2 questions...

    1. Do you think if I have all the adhesive removed and the bottom scrubbed and cleaned (w/ sterile water and alcohol prep) there are remaining vapors?

    2. Am I causing any problems by taping over the transmitter? Do you know if it uses the same signal as the medtronic?

    Thanks :cwds:

    I hope you are feeling better!
     
  17. moco89

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    Thanks. I am getting better.

    1. I wouldn't know for sure. I do not know the manufacturing process and how they bond the sensor tape to the transmitter "holster". All I know for sure is that you are eliminating most of the adhesive involved. For removing all adhesive off of the transmitter "holster", I would imagine it would be time consuming.

    2. Dexcom and Medtronic both use RF (encrypted). The electric signal cannot be transmitted under typically rare circumstances, such as through water (when the transmitter is completely submerged), or if the transmitter is covered entirely by metal (theoretically, on all sides-such as by aluminum).

    Anyways, the second condition is called the Faraday cage effect, and is the same reason why mobile/cellular signals are lost in elevators.

    The challenge would be keeping the transmitter from moving, since you have lost the footing/tape supporting the sensor holster. Since the sensor is measuring interstitial fluid, ideally, you do not want the sensor probe/needle moving around at all, since it is a variable. Also, you could just dislodge the probe with little notice, very easily, but at least the insertion is angled.

    You are going to have to be creative. Some other ideas include ostomy adhesive (I've never tried it) to bond the transmitter to a decent surface, such as a dressing. Another idea is using kinesiology tape, that often comes in pre-cut strips, which can often be bought at sporting goods stores.

    In the summer, because I live in Texas, I secure my pods using K-Tape (kinesiology tape) pre-cut strips.

    Another problem is avoiding damaging the (expensive!) sensor in the process.

    No matter what, you are going to have to be very patient and deal with the issues involved. If your method works without complications, you will need to refine a technique to do it efficiently.

    It has to be very frustrating. I wish I could give better advice. If I was in your situation, I would have probably quit.
     
    Last edited: Apr 17, 2013
  18. Jordansmom

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    We recently met an Endo who happens to also have type 1 and has worn the Dexcom since the first iteration. She said the first Dexcom was not waterproof, so they sold "shower covers" for their transmitter/sensors. Dexcom doesn't advertise the fact, but you can still call Dexcom and order them. She continues to use the shower covers with the G4. She said it helps her use the sensor much much longer than recommended. She removes the sensor when she sees water has gotten through and is sitting inside the barrier.

    She showed me her sensor and the "shower cover" looked like a piece of Opsite or tegaderm, cut to an oval so that it covers everything with a small overlap.

    She has never had a problem covering the entire transmitter, and Dexcom doesnt seem to have an issue selling a product that covers it.
     
  19. Lizzy731

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    This is good to know because I don't think I would feel comfortable not taping over the whole thing like with the Medtronic.
     
  20. Lizzy731

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    So if there is no low prediction then overnight how can you prevent a low from happening before it actually does? I would think that relying on fall rates would makes the sensor alarm more because you could be 200 from 215 with a fall rate alarm? And then if you set snooze for let's say 20 min it could alarm again at let's say 130 from 135....I guess what I'm trying to figure out if this is going to be a major issue for us. I rely on low prediction alarms to determine if juice is needed. I then use the look back to see if she is slowing down. I don't want it to keep alarming unnecessarily with fall rates when it's good that she is dropping from a high number...maybe I don't fully understand how the alarms work?

    And I can't believe it won't alarm for what seems to be a weak signal with the ???. That's REALLY bad!!
     

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