# CGM is in!



## bigpurpleduck (Feb 18, 2011)

Well, I've just had the Medtronic CGM fitted. Aesthetically, I wasn't at all bothered until DSN stuck a great big Tegaderm-film on it (i.e. sticky clingfilm!)  Now I look like I belong in the fridge! Does anyone know if this stuff is necessary or not? I guess I'll worry about knocking the CGM less, but it's not at all attractive...

Anyhow. I've just done my first calibration and am looking forward to seeing the graph on my pump in a few hours' time.

DSN didn't really say very much about it. She went through the basic settings on my pump, but most of them she just skipped past and didn't explain, so I will likely be using this thread for all sorts of CGM-related questions.

Also got a box of Sils from her to tide me over until Medtronic deliver on Wednesday (I've just placed an order). I swear I will never use a stinking Quickset ever again! Many thanks to Shiv for offering to post me some Sils, you're awesome 

DSN also told me, yet again, to stop being such a perfectionist. She did also warn that, because of my perfectionist tendencies, the CGM may just give me even more information to stress about! 

I have an extra 2 sensors, so enough to do me for a couple of weeks if I like it. Will let you all know how it goes


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## novorapidboi26 (Feb 18, 2011)

Good luck with it all, I am sure you will get the answers you need.........


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## shiv (Feb 18, 2011)

I think the Tegaderm will just keep the CGM in place for longer. Imagine if you knocked it out after a day or 2  I know it's unlikely, but I think it's better to be safe than sorry if you want to get some really good info out of it!


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## bigpurpleduck (Feb 18, 2011)

shiv said:


> I think the Tegaderm will just keep the CGM in place for longer. Imagine if you knocked it out after a day or 2  I know it's unlikely, but I think it's better to be safe than sorry if you want to get some really good info out of it!



Do you know how long one Tegaderm will last? Should I be changing it regularly, or just when I change the sensor, i.e. after 6 days?

OH is not going to be Tegaderm's biggest fan!


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## bigpurpleduck (Feb 18, 2011)

First question is in already!

CGM was just displaying 17.9 with one up arrow. Meter said 12.9, and I know this is coming down, not going up.

Does it take a while for the CGM to "settle"? Or could it be because I calibrated with a fairly high BG (14.5) an hour ago?

Thanks all, and apologies in advance for the bombardment of questions!


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## Copepod (Feb 18, 2011)

I can't find any references for how long to leave Tegaderm film dressings in place. However, when I was nursing, we left Tegaderm on IV canulae for days, and more recently, I've left Tegaderm in place for 6 days or longer when using it to prevent blisters / rubbing. The big advantage is that, being clear, you can see if skin is getting sore / infected. Often, peeling it off makes skin redden in colour, and it's so sticky that it's difficult to remove without moving the canula at the same time. If corners / edges start to peel off, then it's worth trimming off the loose bits with scissors.


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## bev (Feb 18, 2011)

bigpurpleduck said:


> First question is in already!
> 
> CGM was just displaying 17.9 with one up arrow. Meter said 12.9, and I know this is coming down, not going up.
> 
> ...



Hi Emma,
How long did you leave it before you callibrated and are you using the 'veo' or the 522 as I think they callibrate at different times. I always leave first callibration for a few hours to let it get wet.

Because you callibrated at 14.5 this means it might confuse the sensor to begin with - so its better to callibrate when you are on a good level - perhaps four or five hours after eating or on waking. Dont be tempted to over-callibrate either as this confuses it - just leave it until it asks you for callibration.

The tegaderm can stay in place for six days - and it is there to make sure the transmitter doesnt get wet and also to keep the sensor in place.Bev

p.s. Sensors get better as the days go on - so dont expect perfection yet - give it time.


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## bigpurpleduck (Feb 18, 2011)

bev said:


> Hi Emma,
> How long did you leave it before you callibrated and are you using the 'veo' or the 522 as I think they callibrate at different times. I always leave first callibration for a few hours to let it get wet.
> 
> Because you callibrated at 14.5 this means it might confuse the sensor to begin with - so its better to callibrate when you are on a good level - perhaps four or five hours after eating or on waking. Dont be tempted to over-callibrate either as this confuses it - just leave it until it asks you for callibration.
> ...



Many thanks Bev 

It's a Veo, and I callibrated after 2 hours as instructed by DSN. I just callibrated again with the 12.9 because it was so far out - I guess I shouldn't have. When should I callibrate again? With FBG before dinner (if a single number)? Or wait 'til the morning to avoid confusing it?

Thanks again


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## bev (Feb 18, 2011)

bigpurpleduck said:


> Many thanks Bev
> 
> It's a Veo, and I callibrated after 2 hours as instructed by DSN. I just callibrated again with the 12.9 because it was so far out - I guess I shouldn't have. When should I callibrate again? With FBG before dinner (if a single number)? Or wait 'til the morning to avoid confusing it?
> 
> Thanks again



Hi Emma,

I would do it again just before eating tonight. Its not that you *cant* callibrate when levels are high - its just that you have probably given a correction and are on the way down - so because levels are moving quickly it is harder for the sensor to pick it up if you see what I mean. If the 12.9 was a 'stable' level i.e. you havent just eaten then that will be fine - you will get used to it - just dont expect to see perfection between the sensor and the finger prick - because its early days and it takes some getting used to. You will be amazed when you see the first download - if you can - post it on here and we can all have a look to see if there are any patterns before you put your next one in. The 'meal overly' is the best to find out exactly where things are going and do tell a lot - make sure you keep a diary for the foods eaten in this time as it will help to work out all the dual waves for the future.Bev


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## Adrienne (Feb 18, 2011)

Hiya Emma

We have been using sensors for 4 years so will help with all I can.   We had the 522 though until this morning and my daughter is now the proud owner of a VEO (724 - the bigger one).

We also have a sensor in and there are so many more alarms and settings than on the 522.    

It will take about 12 hours for the sensor to settle in.

You did right with the calibration after the two hours BUT what is a good way to do it as you do need to 'wet' it is put the sensor in and leave it without connecting for an hour or so.   Then put the transmitter in.   Before putting the clingfilm on it, you should put a bit of transmitter sized tissue or cotton wool under the transmitter.  People find it rubs and makes the skin sore without any tissue.    We use the V300 clear film things which you get from Medtronic or on script from the GP and we use three, two going across and one down overlapping the other two at one end.  

We keep them on for 6 days, the duration of the sensor.   Some people keep the sensor in for longer and some find it doesn't last that long.

Best to calibrate when levels are ok, whenever that may be and when the finger test is not too far out from the sensor reading ie within about 2 mmol of each other.

At the high levels and at the very low levels the sensor needs to catch up so the gap could be bigger than you would like it to be.  

However the new sensors coming out will hopefully be in a totally different class, beginning of April, we can't wait.

Have you tried Mios by the way.   We hate quick sets and loved sils but hard angle to put them in if Jessica ever wanted to try but Mios are a different playing field altogether.  They are wonderful and so easy to put in and they don't hurt etc etc


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## bigpurpleduck (Feb 18, 2011)

Bev & Adrienne - many thanks. I knew you guys would come to my rescue!

I callibrated with a steady 8.3 just before dinner, and the sensor has been much closer to the meter since then. Shamefully BG hasn't been very good, but it's fascinating watching the graph, and it has already warned me of an unexpected rise in BG so I checked with meter & corrected sooner than I normally would.

Bev - on your point about finding out what's going on at mealtimes. I tend to avoid pizza now because it wreaks such havoc, but am thinking of trying it again with the help of CGM to figure out what to do with my bolus. I will likely ask for your help when I do this!

Adrienne - I have 3 Mios, but haven't tried them yet. I got the impression from DSN that they're quite similar to Quicksets - is this not the case? The Medtronic rep at my clinic said there's a tutorial online for inserting the Mios so will have a look and maybe try one soon.


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## Adrienne (Feb 18, 2011)

Hiya

The Mios are 90 degree insertion like the quicksets but each one has its own insertion device as you can see from the ones you have.   Insertion is easier with a Mio than a quick set.   Once inserter the actual set is more like a sil than a quick set.  It is small than a sil and not as flat but not as raised as the quick set.   You also disconnect like a sil not the stupid twisting thing like the quick set.   Much better set, they are getting there with them.

Don't over calibrate.   The sensor won't work to its potential.  Don't do more than four calibrations in a 24 hour period.


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## bigpurpleduck (Feb 19, 2011)

Just wanted to say that I've had the sensor in for 32 hours now, and I *LOVE* it!

After callibrating with  steady, single-figure BGs it is much more accurate. It warned me of a low earlier & told me I was 4.4 - meter said 4.1.

Looking at the graph is great. It's quite clear where my problems lie! And this is just with looking at the pump screen, I haven't downloaded anything to Carelink yet.

Don't want to give it back after my 3 sensors are done.


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## Northerner (Feb 19, 2011)

Excellent Emma! Really pleased it is proving useful!


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## Pumper_Sue (Feb 20, 2011)

bigpurpleduck said:


> Just wanted to say that I've had the sensor in for 32 hours now, and I *LOVE* it!
> 
> After callibrating with  steady, single-figure BGs it is much more accurate. It warned me of a low earlier & told me I was 4.4 - meter said 4.1.
> 
> ...



That's fantastic Emma,
I'm so pleased for you. Once you download the results and have a good look you will be able to make an even more informed decision as to what and where needs changing. Then you can sit back and admire all your handywork


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## bev (Feb 20, 2011)

bigpurpleduck said:


> Just wanted to say that I've had the sensor in for 32 hours now, and I *LOVE* it!
> 
> After callibrating with  steady, single-figure BGs it is much more accurate. It warned me of a low earlier & told me I was 4.4 - meter said 4.1.
> 
> ...



Hi Emma,

Thats great news - lets hope your PCT agree and let you have funding.You will be amazed when you download your data - if you can - put it on here, so we can all see and maybe even advise what we would do (if anything).Bev


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## bigpurpleduck (Feb 22, 2011)

I have another question!

Today is day 4 with this sensor. Up until yesterday it was great - very accurate and helpful. But today it's been way out. Told me I was hypo all day when I didn't have one hypo, and tonight says I'm over 10 when on my meter I'm 6. I've been callibrating 3 or 4 times a day, always with single figures and before meals so not rising or falling.

D'you think it's just not lasting the 6 days it should?

If this is the case, I'm pretty peeved. DSN only gave me an extra 2 sensors


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## Robster65 (Feb 22, 2011)

Hi Emma.

I remember reading on here that you need to drink loads or you can get spurious results. 

I hope that's right and I didn't just dream it. 

Rob


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## bigpurpleduck (Feb 22, 2011)

Yep, you're right Rob. I'm normally good at keeping hydrated anyway, but since I got the sensor I've been even more careful to drink lots of water, so I don't think it's that.

It's also getting really quite itchy. And I just got a callibration error after entering a meter BG, although the second meter BG seems to have worked. I think the sensor is dying 

So I have another question! Since I only have 2 sensors left and am going back to work on Monday I'd like to save the sensors for next week and the week after. Can I take the sensor out without replacing it straight away? What should I do with the transmitter? DSN kept the charger!


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## Adrienne (Feb 22, 2011)

Hiya

Can't believe the DSN took the charger. You will need that. You won't be able to use the transmitter again until it is fully charged.  I suggest you give her a ring.  Yes you can wait until you put the next sensor in but you will need to charge up the transmitter.

It could be that it has come to the end of its life.

Do you know about the ISIG number?  I am presuming you have a VEO.  If you press the escape button three times you will get to the pump info screen.  Use the down arrow button to scoll down and you will see ISIG no. and then a number.  If that number is 8.78 you can't enter a calibration over that so if your BG is 9.0 you can't put that in.   If the ISIG is say 23.15 you can't put in anything higher than that.

Also if the sensor says you are 6 but you are 10, you can't put in 10.   It will just come up cal error.  You can only put in about 2 mmol difference.

You can do a few things.  You can turn the sensor off, wait 10 minutes or so or until your level is ok and not dropping or rising a lot then turn it back on and start New Sensor.  You will have to enter a BG within 10 minutes so keep an eye on that ISIG number and don't enter over it.

Or you can lie to the sensor.  So if you are 10 and the sensor says 6, then you can enter 8 and coax it up to nearer where you are, but keep an eye on that ISIG as it may be lower than 8.

Generally the ISIG is about double the BG but not always and it will always be higher though.

Hope that helps.


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## bigpurpleduck (Feb 22, 2011)

Many thanks for the tips, Adrienne. I didn't know about the 2mmol or the ISIG number so that's a great help 

I've texted DSN to ask her about the transmitter & charger.


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## Adrienne (Feb 22, 2011)

bigpurpleduck said:


> Many thanks for the tips, Adrienne. I didn't know about the 2mmol or the ISIG number so that's a great help
> 
> I've texted DSN to ask her about the transmitter & charger.



Excellent.   I hope she lets you have a charger, it is useless without it unfortunately.


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## bigpurpleduck (Feb 23, 2011)

[rant]Lo and behold, I can't get in touch with DSN.

I phoned Medtronic and they said if I take this sensor out and wait a few days before inserting another, the battery in the transmitter should be okay to begin with, but they couldn't guarantee it. They said the average life of the battery is 14 days. So 6 days with this sensor, 2 days without, and 6 days with another at the most. So the 3rd sensor I have will probably be useless because the transmitter will likely die before I can insert it.

I think the reason my DSN kept the charger was so that I couldn't just run off with the transmitter, seeing as it's so expensive. I got the impression she did that with everyone who borrowed a transmitter. And this is an area of Scotland with *good* funding for diabetes care.

I don't want to waste a sensor on this weekend. I really wanted the CGM for when I go back to work for peace of mind (I did tell DSN that, but she slapped it on me there and then anyway). I think I'll take my chances and wait until Sunday for the next sensor. The combination of the sensor and the tegaderm are making the skin on my stomach really itchy, so it would be nice to have a break from wearing it.

In all honesty, I can't wait to pull this thing out! It's getting really quite uncomfortable, and the results it's giving me are way off. I seemed to get 2, maybe 3, days of accurate results out of the sensor. Now it's starting to annoy me because a) when I download to Carelink it will be a lot of rubbish and b) it keeps buzzing at me - this morning in the shower I got "lost sensor", and I got another callibration error earlier. [/rant]

Again, I am coming to the conclusion that I need to win the lottery


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## shiv (Feb 23, 2011)

bigpurpleduck said:


> Again, I am coming to the conclusion that I need to win the lottery



Amen to that!

I really hope you get the charger sorted and you can use the sensors as you'd planned.


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## bev (Feb 23, 2011)

bigpurpleduck said:


> [rant]Lo and behold, I can't get in touch with DSN.
> 
> I phoned Medtronic and they said if I take this sensor out and wait a few days before inserting another, the battery in the transmitter should be okay to begin with, but they couldn't guarantee it. They said the average life of the battery is 14 days. So 6 days with this sensor, 2 days without, and 6 days with another at the most. So the 3rd sensor I have will probably be useless because the transmitter will likely die before I can insert it.
> 
> ...



Hi Emma,
Although you feel that the sensor's readings are out - you will still be able to see patterns emerging when you download the data. Some people do find that they can only tolerate the sensor for three or four days and some sensors seem to work very well for this time and then suddenly start giving data that is not correct - sometimes if you do 'start new sensor' this can rectify the problem and because it has has had time to get 'wet' then it could be more accurate. You should be allright with the power in the transmitter for this sensor and possibly even starting another one - but you will need to take that off half way through to re-charge if its getting near to the two weeks. It does seem strange that you havent been given the charger though.Bev


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## bigpurpleduck (Feb 23, 2011)

Many thanks, Bev. This sensor is now 5 days old so I'm just going to take it out now, but I'll definitely try "start new sensor" with the next one if I have the same problem.

I'll keep chasing DSN for that charger.

I'm very grateful to Bev and Adrienne for all your help this week


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