Need tips and advice, just starting my new Dexcom

I will be starting my new Dexcom today. I have read through some of this forum, especially Michelle starting up, and I have also read through the Dexcom group. But I do have a few questions. For those who insert the sensor at night, do you wait until morning to put the transmitter on? Then do the initial calibration 2 hours later? And how do you make the sensor go beyond 7 days? Thanks in advance for your help!

I insert, clip the transmitter up as instructed, make sure the Dex has the little icon present that it is communicating with the transmitter, but do not start sensor on the dex until the morning. I keep the receiver with me during the night so they “commuicate” just no actual readings. Once you are up in the morning (and I have learned to even wait until my sugars are pretty stable) hit start, the dex will always go through it’s programmed start upand prompt you to enter two blood sugars when it’s ready.
To restart the sensor, I have allowed mine to completely quit on it’s own at the end of 7 days. Most of the time, I go ahead and just tell the Dex to start new sensor right away - unless I am unstable - then I wait until things have settled down again to begin again. Again, the Dex will do it’s programmed start up and prompt you to enter the two blood sugars when it’ ready.
The “start new sensor” icon is not on the screen unless the 7 day period has fully ended, or you went in and told the Dex to stop sensor yourself. Once you begin a new sensor, that option dissappears from the screen on your Dex.
Good luck! I love mine!

A bit late Melitta, sorry! I know a lot of people start their sensors before going to bed, but I’ve gone low too many times during the night to want to risk it. I’ve only been using it for a few weeks (I’m in love!), but haven’t had any issues starting a new sensor during the day and making sure I’m stable before entering the initial 2 BG readings.

When it asks you to recalibrate twice a day, wait until you’re stable if you’re not already. The dex won’t show the number you enter right away - remember it’s behind fingersticks. Don’t know exactly how it works but there’s some algorithm that determines what new number will show.

How’s it going so far?

Hi Jrtpup: I just started on Saturday, so in my first week, and like you I started during the day. I am absolutely blown away by the Dexcom’s accuracy! Plus it is easy to insert and easy to calibrate (as you suggest, I only calibrate when I have that horizontal arrow). I had tried the Medtronic Guardian two years ago, and it was so wildly inaccurate and difficult to calibrate that I just gave up. So I am REALLY happy to be having such success with this Dexcom, albeit only a few days in yet.

Thanks for the support!

That’s great! I think I was dependent on it within a couple of days :wink:

I have used mine 4 months now and I regularly calibrate at each meal (4x/day). I never pay attention to the arrows when I calibrate and have not had an issue with it. Dex claims it doewsnot matter and I have not had an issue using it this way. I figure if i need a fingerstick, I might as well input it to the Dex. I will start a new sensor most anytime of day - I dont like doing it before bed because it needs the 2 hour calibration. I restart up to 2 times and usually get 12 to 21 days on a sensor.

Thanks, Dick. Tips like yours are so helpful to me, since I am just starting out and finding my way. So far so good!

Welcome to the Dex.

I never have inserted my sensor at night but I just might try it. I usually insert in the morning.

I calibrate when I’m told to and every once in awhile when I feel like it. Be careful not to fall into the trap of constantly calibrating because you think the numbers need to match exactly. It will drive you nuts.

To wear past seven days I either let the sensor run its course then restart it or stop it myself when I get the warning that it will expire soon. The major issue I’ve had with +seven day use is keeping the sensor secure to my abdomen.

Terry two items that help on the sensor to the abdomen:

Tegaderm or" ReliMed" Transparent Thin Film dressing. I use 4" X 4 3/4 these usually last a week. When the edges are peeling I use scisors to remove all the dressing from the skin but careful not to pull off the cloth dressing area on the dex. Then I put on a coating of IV prep and secure a new dressing. I cut a rectangular hole in the dressing for the size of the transmitter. I have also tried tape called FleciFix - you can order either online - I think the flexifix is better but I have 1 1/2 boxes of the ReliaMed. The tape is more economical. You can either use the 4 inch and cut the rectangular hole or they also sell the 2 Inch and then use 4 strips around the perimeter. I prefer the 4"

Did you name it yet? You really have to name it.

really have to?? Maybe that will help the wife and I keep them seperate - I do wish we could give them unique ring tones so when they buzz we dont wonder was that you or me?

No names yet here and same w pump oh well just an old fuddy duddy I guess

Just got a roll of Opsite Flexifix that dick mentioned. It comes in a roll. I cut 4 strips for the edges -so far it’s lasted a week. It’s also a totally clear film like tegaderm, easy to handle because there is paper on both sides. I have really sensitive skin but so far so good. Expensive, but the roll is big and I think will last at least a year.

My insulin pump’s name is Mr. Pumpy (I know, original). I haven’t named my Dexcom yet, I’ll need to get on that.

Our ‘search’ tool is hard to use, but I’ll offer a few hints:

1. With regard to “plugging in early”:
When you insert a Sensor and Transmitter, there is a plastic “plate” assembly underneath which will lie underneath the Transmitter. On the top, it has two metal contacts for the Transmitter to measure the “raw” reading from the Sensor. (It measures current through a fixed resistance internal to the Transmitter). Inside the Plate, it terminates the wire – with one contact into the Reagent, and the second contact serving as “ground”.

Unfortunately, this plate floats up in the air, at an angle, until you press it down in place with the Transmitter assembly. Old timers (like me) can plug in an old, dead Transmitter to protect the plate and keep the water-tight box sealed-- while still running the “active” Sensor and Transmitter on the other side of our bodies (left versus right).

People with only one Transmitter can’t do this; they must either come up with some kind of cover for the area, one which DOES NOT! damage the “plate assembly” in any way, and one which DOES fully cover the area.

I would look for a plastic container lid. The round lid on a 50-count pakcage of glucose tabs is wide enough to cover the whole area, but it will press down on the “plate assembly.” When you move, any motion by that assembly (versus your underlying skin) is DEADLY for Sensor accuracy and lifespan. So, IMO, you’re looking for something slightly taller. But I don’t have any experience in choosing one, because I’ve got several “old” Transmitters which I can use instead.

I usually do an overnight “pre-warmup”, but keep I my current Sensor running through the night. For me, it’s to risky to be without for that much time. (YMMV, of course.) If you end up like me, unwilling/unable to “fly blind” through the night, then you should finding a nice, tall, “cover” which can assure that both the Transmitter-holding assembly AND the “contact plate” won’t be disturbed by motion, or open to infection agents, during your “warmup” period.

2. After waiting, do you still have the whole “Initial Calibration” thing 2 hours later?
Yes. Even if the Sensor has already been running for a week, and is ready for continued use IMMEDIATELY, you can’t avoid the two-hour wait.

3. How to use past 7 days?
At a convenient time (at least two hours away from driving; at least two hours away from going to sleep) execute “Stop Sensor”. Do NOT remove the Transmitter! Immediately execute “Start Sensor”, and verify that display shows the two-hour countdown graph at the spot which normally shows the estimated bG value.

I disagree with the “twice per day” schdule which the current device spits out. During the first two days of my use, a Sensor’s output current versus true bG characteristics are changing too rapidly to “get by” with only two re-calibrations. (The Sensor wire surface, your body tissue reaction, and the reagent break-in are ALL changing quickly.)

I have four recommendations WRT calibration. This post lists them, and my reasoning behind them:

Dick, I could be wrong, and YMMV, but it’s possible that you’re working WAY too hard at this – and getting worse results than you could be getting.

I’ll SWAG that you could have better lifespan by using “Skin-Prep” as your bottom layer, right on your skin. “Skin-Prep” and “I.V. Prep” are both made by Smith+Nephew, and the packaging is nearly identical, and the ingredients are nearly identical… but the purpose, and the balance of ingredients in the formula, are a lot different. (That’s why they make two DIFFERENT things.)

I.V. Prep is for short term appliances, things which are “punched in” for only a few minutes or hours. In contrast, the on-label usage indication of Skin-Prep is for “long-term adhesion of medical appliances”. (Direct quote). Which happens to be exactly what we’re doing!

With Skin-Prep, the secret to good results is TOTAL dryness. Go with the single-use, foil-wrapped wipes. You will want to apply it the entire “target area”. (Your insert site, the Dexcom pad, and the surrounding area which you will cover with Flexifix strips.) Yes – you shoot the needle in right through the Skin-Prep barrier layer, it seems to have no effect on Sensor readings or lifespan.

** BUT **

The key to using Skin-Prep is assuring TOTAL dryness before putting the Sensor pad down. You need to have the hair dryer ready to grab, already running, when you wipe your target area.

So the order is: clean your skin really well.

Then, if you’re OCD about infection (as I am), you’ll wash a small area, about the size of U.S. Quarter, with antiseptic-soaked Q-tips. This biological cleaning is right at your is your at your wire-insert target. PVI, the “orange stuff” widely used in USA emergency rooms and Doctor’s offices, is pretty good for this. It’s cheap and over-the-counter at any drugstore. But it’s more likely to cause allergic reactions than CHG. CHG is more widely used in EU facilities for exactly this reason – but in the USA, you’ll need Scrip to get it. You need to keep this small area wet for at least 30 seconds, so plan on using more than one Q-tip. If you do this, note the exact location of the Center of your sterile “Target”, because the Skin-Prep solution is going to wash away the color.

Now turn on your hairdryer (low). Wash your hands again, because the hairdryer handle was filthy. Now tear open the Skin-Prep foil, and wipe firmly over the ENTIRE area which you will using. More than once, but don’t let the pad go dry. With your other hand, grab the hairdryer IMMEDIATELY and tilt it into the wet area from underneath.

Skin-Prep starts out as an extremely “runny” liquid. Gravity will try to make it flow downwards (from the top of your “wet area”, towards the bottom). This is a BAD THING, because the place where your adhesive tapes need the most help is along the top edge. (In addition to being an edge, the TOP edge is the one which gets hit by shower spray- at an angle which tries to separate the tape from your skin.)

Keep the hair dryer going until the appearance changes from “liquid” to “dry”, and then to “shiny, crackled”. TRUE dryness is the stage with nearly microscopic cracks on the surface, and in most climates, YOU CAN’T GET THERE without using a hair dryer.

Unlike the Skin-Prep to hair-dryer stage, you can take a few moments of time here. Personally, this is when I put the hair dryer back in it’s place, and re-wash my hands, clean the Transmitter really well, and open the Sensor package. Then I set the Sensor pad in place and shoot the wire in. Remove the “Shooter”, insert the Transmitter, making sure to hear TWO clicks upon pressing down and latching it in place. (Both sides! Not just one!)

If you’re starting the Sensor immediately, do it now. Personally, I always use an old “battery-worn-out” Transmitter to protect the sterile area and wire insertion for a period of “pre-warmup” time.

Now, I just cut two full length strips (4") and two shorter strips (2.5") of FlexiFix. (The shorter strips need to be centered on the roll, so that you have the seam to pull away the paper tape in the middle. Don’t cut from just one end!) Cut them about one inch wide. There’s no need to “round the corners” of the bottom piece, but the sides and top should have their upper corners rounded off. This helps to prevent them from starting a “loose flap” at one of the top corners. The inner edge, of course, is next to the Transmitter assembly. IMO, you only need to cover the Transmitter assembly in higher-pressure water situations (water skiing, hard swimming with racing turns, or Snorkel/Scuba).

Long ago, I would carefully cut a donut-hole (for the Transmitter) into the middle of a single, bigger piece of FlexiFix. But, with Skin-Prep assisting the tape, this is just as good. With this battle plan, I haven’t had even the slightest bit of “upturned corner” in my 14-15 day Sensor schedules. (I.e., 14 days “running”, plus 6-24 hours of extra warmup time.)

Seems llike such a waste to bother with inseting early. I find acceptable results with starting immediately after inserting

Im workin too hard?

Your process seems way too complicated - I guess we each do what works fr us. I have mty sensor in and started in less than 2 minutes and once a week I take t minutes to replace the transparent dressing. Also dexcom recommends against using a skin prep over the area that the sensor is inserted.

I usually put my new sensor on at night and what I do is I put it on two hours before I go to bed. So, If I go to bed at 11, I put the dex on at 9 or so. Also, I like to put it on at night because during the day, I find it more difficult to enter the two bgs. And, it stinks to have no readings during the day.
I know people who wear the sensor beyond 7 days by simply letting the sensor fail and then hitting, start sensor, as though is has been changed. I, however, do not do this. I am aware of how costly each sensor is but, when I originally tried to keep my sensor on longer than the 7 day period, my skin became irritated and the sensor did not adhere to my skin as well. Also, the sensor was painful and a bit irritating. I feel that it is better to change the sensor.
good luck, I am sure you will love the dex. It has changed my life for the better!

Rickst29…Whaaaaaaaat? LOL! This sounds so complicated!!! LOL, I’ll take my time and read again.