Wednesday, July 14, 2010

I called Minimed and a replacement receiver is 550, a replacement transmitter is 649. If you are a previous Guardian user, getting a new receiver and transmitter is 1199 dollars. If you then bought a box of four sensors, you'd be at the 1344 cited as the price of start up. But you could buy only 10 pack boxes.
I think I'm going with Dexcom anyways. I want less pain.

I talked it over with my mother. She thinks I should have my thyroid function retested, as I have a history of thyroiditis and thyroid dysfunction can mess up blood sugar. She agreed that, at least if this continues, she's willing to help pay for a CGMS for me.

So I'm thinking about whether I should go in soon to see the endo for a TSH. Maybe. I'm overdue to see my other doctor anyways, so maybe I'll ask her to run a TSH even though it's always been my endo who's done that.

Tuesday, July 13, 2010

Guardian v Dexcom

I have had nutsy blood sugar in the past month, details below. I'm therefore thinking about buying a CGMS out of pocket again. My last experience, in 2008, was with the Guardian. I found it accurate for at least a week per sensor, all sensors I wore in the arm, but continuously painful and itchy. I lost the transmitter and decided not to get another. I still have some sensors, now expired. Anyways.

I'm looking at the Dexcom Seven Plus. I spent a couple hours reading about it today, plus I called customer service. Sales there says I can buy a starter pack and a box of four sensors now for the price of 999 dollars if I pay out of pocket. A box of 4 sensors is 319 dollars unless I agree to buy six or more boxes in a 12 month period, in which case it's 289 dollars per box. The transmitter and receiver each have 12 month warrantees.
So for one year, if I used 28 Dexcom sensors, the total cost would be 2733 dollars.
But if I had to use 36 Dexcom sensors, the cost would be 3311 dollars.

If I went with the Guardian again, then as I remember it startup cost is 1344 dollars and that includes 4 sensors (despite what the internet says). A box of 10 sensors is 350 dollars. The receiver is warranteed for twelve months, but the transmitter only for six months. I forget the replacement cost for the transmitter; either it's 450 or 650 dollars. So if it's 450 and I had to replace it, and I used 34 Minimed sensors, the total cost over one year would be 2844 dollars.
If I needed 44 sensors, the total cost would only grow to 3194 dollars.

Now, I've used the Guardian before so I'm pretty sure I really could stretch 34 sensors over a whole year. I've never used the Dexcom so I don't know how long I could get out of one of their sensors, which is one of the things making me hesitate. Some other thoughts:

The Dexcom only needs to be recharged, and doesn't need batteries. This would probably be a savings of over 100 dollars over the course of a year of full time use.

The Dexcom people charge shipping and handling, which I hear can add up to 15 dollars per shipment. That could add up quick.

I hated dealing with Minimed customer service. Although they replaced the receiver twice, they were horrible with my financial transactions and with talking to insurance.

I hated the feeling of wearing the Minimed sensors and I hope the Dexcom ones would feel less painful.

I loved the data analysis, graphing, and predictive alarm features on the Guardian. I also loved that the screen stayed on. The Dexcom has none of these features. Even worse, the Dexcom has a low alarm that can't be turned off. This would make continuing to use the sensor as it fails probably worse because it reads a little low as it goes bad, and I could accommodate for that if I could turn off the alarms.

Dexcom users can't use tylenol. Probably not a big deal as I don't use tylenol.

The dexcom transmitter doesn't store data and you're not supposed to go swimming with it for more than 30 minutes. I don't go swimming often... but sometimes.

The shape of the dexcom makes buying additional tape to keep it down less likely to be necessary.

I went on a road trip in early June for a week and my Lantus needs went down.
I came home and my Lantus needs rose back to 8 units per day or so.
I left again after two weeks, and on the road I achieved steadyish overnight blood sugar with Lantus doses of 4-6 units.
I got home and my wake up numbers climbed. I took 8 units, 9 units, 10 units.
I woke up in the 200s, 300s, 300s, and more 300s.
I opened a new vial of Lantus.
I still woke up in the 300s. Not only that, but my daytime numbers kept rising out of nowhere, no food on board, 300s and 300s and I took 20 units of Novolog last night when my suppertime number was 316. I ate about 30 cabs (my usual ratio is 1:8, so that means I ate for about four units). I kept checking to see if I'd come down, but all I got down to was 180.

Well, finally I just rage basaled and took 15 units of Lantus last night. I woke up with a blood sugar of 75. But after breakfast I was up at 302. Hoping it would come down, I didn't correct; at 11 AM it was 324. I took 6 units of Novolog. At 12:30 it was down to 296. I left it alone. At 2:30 it was 90. At 2:50 it was 54. I ate 24 carbs of granola bar. At 3:25 it was 52. I ate a muffin and put lots of honey on top, then walked home, a distance of about a mile and a half. At 3:50 I was 132. At 4:50 I was 192 and I took 2 units. At 7:00, I was 232.