I received my pump (the MM Paradigm REAL-Time Revel 523) and was trained on Jan. 27, 2011, so I’ve been pumping for just over a week now and I love it already. I had some basal issues for the first several days (too high a rate during the night leading to morning lows), but now I think we’ve got that part figured out. After I really get the hang of using my pump, I’ll be going for training on the CGM part of it.
So, any advice (hints, tips, etc.) on using the Medtronic CGM? I’ve read lots of horror stories, but now that I’m (kind of) over that shock, I’m looking for realistic, helpful information from anyone who is using or has used it. The biggest concern for me is the actual insertion and anything that will help with the pain and discomfort I’ve read about. Any advice is appreciated!
Also, I already have it in a box at home waiting for the day I’m ready, so I’m not interested in hearing how much better the Dex or other CGMs are. Thank you! =)
I think that it’s a good idea to plan to eat conservatively and eat stuff that you are extremely confident in the carb counts on and know how your body responds. My BG will require more thoughtful management when I eat eggs, corned beef hash and biscuits and gravy for breakfast than if I just have a piece of toast with the eggs? I didn’t do this and went running a few hours after I stuck it in and got the 3 hour “Meter BG NOW” alert while I was out running w/ no meter and was like “what the hell does that mean” having forgotten everything I learned in class. I remembered and just calibrated to what it said and was off to the races. I still do that occasionally but it’s not nearly as good of an idea as having relatively safe, stable blood sugars rather than eating giant heaps of greasy food or carb heavy stuff that requires big doses of insulin, particularly while you are playing with your new toy?
The rule of thumb mentioned in Dr. Bernstein is 7U is the number above which, because of the fluid dynamics of the insulin itself, the shots or, I presume, boluses, get absorbed less directly which causes problems on both ends, in that the dose matched to the food will be “short” because the “slow hand” that is having absorption problems won’t “materialize” in your BG reading until later. So you will either run higher or, perhaps, hit the high with a CB and then run low on the back end as the slow stuff hits. Smoother curves will give you a better idea how the CGM lags behind your BG a bit while you are gettin the hang of it. Then, by the weekend, you should be ready to let 'er rip? Or at least I would be?
I like loud music while I am using the nasty inserter gizmo. There’s no way around it. It is also useful to make sure that 1) you are not wearing white pants and 2) have paper towels handy, in case you get a gusher. I think that you sort of get an idea where they are after a while but I had some “woah there” moments early on? Good luck! I like my MM CGM just fine. I have no experience with the other flavor though.
That completely makes sense. I was diagnosed as Type 2 in August, started insulin on January 14th (after a slow onset Type 1 “re-diagnosis”), and received my pump just two weeks later…Needless to say, this has been a huge learning curve for me! I would like to think I’ve stood up to the challenge (after reading a dozen books you would think so at least), but there are still some things (like the CGM) that are just beyond my brain capacity right now!
Thanks for the advice, and I’ll definitely keep that in mind!
To insert, chose the location. Grab a ice cube (some people use it with a stiff drink, I on the other hand—) ice the area you are going to insert the CGM. After you have iced, clean the area (alcohol), wait to dry, and insert. I found it helped with the pain and the bleeders. And ice is quick and easy, everyone has it on hand!
Tape the whole thing down - only way you can be sure it’s going to stay on. It’s heavy! Hint - cut a piece of cloth tape to fit over the top of the transmitter before you hook it up. When you tape over the entire thing, if you want to remove the tape for a recharge/restart/the ‘itchies’/whatever, it makes it so easy to get the big tape off without pulling it all out.
A gauze pad is good to have on hand for the bleeders, gentle pressure to stop if they happen. Don’t hesitate, when you get the area ready and the inserter lined up, just do it! Good luck!
