Sunday, March 05, 2006

Changes needed after seeing graphs
Jenny says:

O.K. It has been an interesting couple of weeks. Our Medtronic Rep came out to do our first home sensor change. Tommy inserted the sensor into the fatty spot on his back above his hip. That was a huge accomplishment for him. He does not like to move away from his stomach. We decided to put a piece of IV 3000 UNDER the transmitter because Tommy's skin really reacted to the tape from the transmitter. It got really red and bumpy. I tried hard not to ask Tommy to see his numbers when I was simply curious. I behaved. We both made more of an attempt to enter the insulin events and the food events into the Guardian, but there is still room for improvement. And we figured out how to keep it on for longer, so we elimated some of the breaks in the lines of the graphs.

I have been careful not to jump to any conclusions about whether I like the Guardian or not because I have been warned that it takes time to adjust, just like with the pump. We also don't know how often he is going to wear it. However, I just analyzed Tommy's second three day period and I learned a ton about how Tommy's body really works, (for now.) I love this thing. (Tommy has not fallen in love with it yet. I'll keep you posted.)

After carefully studying his graphs, I now know that he is not getting enough insulin around 10:00 pm because he starts to go high at 12:00 am every day. My husband and I typically test Tommy at 1:30 a.m. and 4:45 a.m. Our pokes were missing the highest part of the peak at around 2:30 am. So, when Tommy does not have the Guardian on, we might change the time of our nighttime checks. I bumped up Tommy's basals from 10:00 pm - 2:30 a.m.

We also have to do a better job of giving the insulin a few minutes BEFORE meals with Tommy. The graphs showed a few peaks past 300 after breakfast and supper which I never caught because he finger sticks usually 2 1/2 hours after eating.

After seeing the data, I have set up a weekend pattern with his basal insulins. It is pretty apparent that his needs change when he sleeps in and moves around more during the day.

One of our future strategies with the Guardian might be to wear it one weekend a month and one weekday shift per month. That way I can make some monthly adjustments. I'm not sure yet how often Tommy will wear it. (If it were up to me, it would be 24/7.)


Anonymous said...

Tommy is a real trooper! That is such a bulky package for a little kid to wear. I am most curious about the site changes and how his skin holds up while using the Guardian. E. has extremely sensitive skin. You already mentioned his skin gets red and bumpy, while it does not with pump site changes. I would love the Minimed pump/sensor combination like they have in Canada but I also thought it might be useful to use the Guardian for about a week a month to accurately keep up with her constantly changing blood glucose patterns. And do we really know what those patterns are, since we are only getting BG levels at the time we test (12 static points in a day)? I don't think we have a clue what her patterns are based on current BG testing technology. As an example, we used to test at 9:30 pm bedtime, then 12:30 midnight and 2:30am. Or we would do 1 and 3am. We never did an 11pm check. When we were told to check 11pm, turns out she often dropped low at 11pm, so the midnight high BS was a reaction to the low. She does go higher at midnight, but because we had not seen the lows at 11pm, we were giving her more insulin than she should have had. Consequently, she would then go low later in the night. People keep saying the Guardian is "not accurate." I keep hearing this, that the Guardian's blood sugar data is not reliable, can only warn you of lows and highs. I, for one, feel they just don't know how to use it. Can you comment in future blogs as to how you feel the Guardian's accuracy level is? And thank Tommy for being a guineau pig for the other children who need this technology.

Tommy said...

Jenny says:
The red and bumpy part of wearing the Guardian RT has, for now, gone away because we now put a IV300 bandage under the transmitter.

We too are evaluating skin issues. We are relatively new to this disease, and Tommy really likes using his stomach. We are trying to come up with ways to get him to try other spots for all these contraptions. The dot that the sensor leaves is not as big as the dot that the pump leaves.

It is my understanding that the Minimed Pump (522), that is out in Canada, is almost exactly what Tommy has. It is the same transmitter, the same sensors and instead of the monitor, it is just a software inhanced pump a step up from Tommy's Paradigm Pump. So instead of looking at the monitor for his numbers, we will look at his new pump. People wearing the pump in Canada still wear the sensor and the infusion site separate. 2 sites, 1 computer. When the new pump comes out we will only be buying the pump, not the transmitter or the sensors because we already own them. We will have the Guardian Monitor as back up if the pump ever needs service.

I can already tell you that I was missing a lot by just having the 10-15 or so finger pokes.

I will comment in future posts about the accuracy, but Wil describes it best in his blog. It is really hard so far not to compare each number. But when you see the graphs from the software it is truly amazing. The numbers from the 5 minute sensor readings and the blood glucose finger pricks are all on one graph. They seem to all be in the ball park and when they alarm because of a low that is 20 points off it really doesn't matter to me in the grand scheme. It is a warning for me to take notice.

Thank you so much for the comments. I have told Tommy many times how proud I am of him! I wouldn't of purchased this if he hadn't been so excited to try this. He gets excited everytime I tell him that someone has left a comment or sent an e-mail.

Anonymous said...

Thank you for the updates....