Sunday, April 24, 2011

On Thursday morning, sensor 19 having been in for a full three weeks and starting to act up (???s and false lows), I pulled it, took a bath, and put in sensor 20. One thing I hate about changing sensors- I change sensors in no small part because the old sensor is not working really well and I want fewer ??? episodes and better accuracy. So I put on a new sensor, and for the next two days I might get better numbers, but more often than not, I get less accurate numbers and sometimes ???s. At first I tend to wonder if the sensor is a bust or if I misremembered how accurate the previous sensor was.
This sensor took a few days to shape up in terms of accuracy and is now doing pretty well, although overacting a bit to lows and highs (it claimed I was LOW when I woke up this morning, whereas my meter said 46).

As you know, my insurance policy changed to cover CGMS usage in people in my demographic (under 25s with type 1 diabetes, intense blood sugar control efforts, and labile blood sugars) on Jan 1, 2011. I called Dexcom to ask them to get me coverage in light of this new policy and they confirmed that I ought to be covered on Jan 18th. Dexcom then sat on its ass. On March 23, my doctor and I filled out all of the forms that Dexcom could want and the doctor faxed them over while I waited in his office. No word from Dexcom.
Last week I called to bug the rep who said she would get me coverage. I left her an irate message, and an hour or so later got a call from the person who apparently replace her. The new person didn't know anything other than that she'd just been forwarded some of the paperwork from my doctor, on which a diagnosis code was missing, so she called to talk about what we could do if I had a miscellaneous form of diabetes (I don't). I filled her in, she said she thought she could get me coverage within a week but would update me within a week in any case.
It's been a week, and I did get an update. Apparently my insurance might cover without pre-authorization, she wanted to know if I wanted to place an order now or get pre-authorization first. Of course I want pre-authorization, I already HAVE sensors!!! So hopefully next week I'll have authorization aka coverage.

I'm thinking about placing the next sensor on my butt. I was trying to figure out where on my butt a sensor would go. I'm thinking maybe to the side? Where do people place sensors and infusion sets when they wear them on their butts?

Oh! And I drank about three cups of low alcohol (about 3%) Rashi wine on the first night of passover. I then took a little less insulin for the meal as well as for the overnight. I went high after the meal, came down really smoothly and had a great blood sugar night.
The second night I didn't drink any wine (different household, different wines available) and had a similar meal time blood sugar experience. That night I forgot the Lantus (!!!) so I really can't compare it to the previous night. On the plus side, I didn't get ketotic.

I've been thinking a lot lately about life expectancies in various contexts and what people expect from life when childhood mortality is low. About how most Americans assume that their kids will grow up, that it is an outrage that one kid might die... but in many countries, kids die as a matter of course. Malnutrition is among the leading causes of childhood death in South Africa, a country in which life expectancy is in the 50s, and a quarter of deaths in 2000 were related to HIV. More than a dozen countries have a mortality rate for children under of five years of 1 in 6 or higher.

1 comment:

Reyna said...

First off let's hit the "butt question"...We place Joe's sites on the upper portion of his buttocks cheeks. You don't want to sit on the device (the sensor would most likely give you ??? readings while you displaced the interstitial fluid with your weight). The discomfort of sitting on it would also be a reason to place it higher. Be careful to not place it where your waistbands would rub or hit it too...from a comfort standpoint...again.

On the childhood mortality. I agree. I am also acutely aware of Joe's fortunate state of being "teched-out" and having the best of care...access to insulin...CGM... pump... etc...However, I get the "outrage", from a "parental standpoint". He is my son. I love him like no other Jonah. I cannot even go there...unfortunately, with "D" in the mix, my reality is different than other American parents. Perhaps I would view it differently if I was in contact with parents from third world countries. I don't focus on the negatives of "D". I try to be the best possible mother and supporter of Joe while I teach him to manage "D", while I help him manage "D", while I let him be a child. I don't know if that makes sense or not.