Monday, February 7, 2011

Letter to Larry

You may recall that in early January I began a trial run with the Minimed 523 Paradigm Revel, a loaner from my local pump rep who offered to help out in making a decision about whether I truly wanted to purchase a Continuous Glucose Monitor (CGM). Affectionately, I named this loaner pump and CGM combo Larry The Loaner.

A month in, this is a letter to the device that has given me a chance to look beyond fingersticks for a short time.

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Dear Larry The Loaner:

This is tough to write.

Frankly, because it's not going to be what you were hoping for when we set out on this adventure a little more than a month ago.

Unlike my two-week ride with Lex The Dex and my short Flight of the Navigator more than a year ago, our time together has enabled me to trial-test a handful of sensors rather than just a one-time test. This has been a beneficial look at how you'd really be if we were to partner up in the long-run.

Instead of a one-night stand, we've had a chance to date before deciding whether marriage is the best way to spend our diabetes-focused futures. But I've decided it's not, and there's no engagement ring in our future.

The newness has worn off, and I've been able to see what it's like to connect multiple sensors on different body sites. Five, to be exact. Each has offered less than a week before the sensor bites the dust: 6 days, 3 days, 5 days, 5 days, and 7 days.

Comparitively, this is far less time than the 15 days obtained from that single Lex The Dex sensor. Since Navigator isn't really an option anymore thanks to the Abbott unreliability, it's not useful to compare them.

You generally take a day or so off at the start of a cycle to get used to my body fluids. Then, on the final day, you've demonstrated no coherent train of thought before ultimately proclaiming "CAL Error" and "Lost Sensor" in defeat. From there, attempts to revive you with that same sensor are futile.

Even on those "real-time" days, I'm sad to say you haven't offered me much consistency. If we're dancing between that good range of 80-200 mg/dL, things have generally been OK. But you aren't consistent or reliable, and so results have ranged anywhere from perfectly on par with my meter to more than a 100 points off.

Net effect?

Five days average out each sensor.
MINUS one day on each end.
=  Three days of accurate results.
DIVIDE that in half, since I'm in range about 50% of the time.
-->
1.5 days of real, true, accurate results
(Not factoring in that 20+/- margin of error issue...)

When looking at Lex The Dex, you figured on 15 days, with one day cut off on each end equaling 13 days. Cut that in half, you're looking at about 6 days.

Six compared to 1.5... That's the comparison. And Larry, you just can't compete.

The benefit of having your CGM capability merged into the pump and allowing for one device to haul around is nice. But in the big picture, it doesn't weigh heavily on my decision-making.

I've had one major Low in the past month and you missed it. didn't catch it. At the time I was dropping in the middle of the night, and that's when you decided to get all confused and scream CAL ERROR at me. Therefore, missing the very point of alerting me to the impending low you're supposed to serve.

That's not to say you haven't been helpful. I'd be remiss if I didn't admit that.

You have helped me spot some trends, impacts of certain foods and how boluses play out over time. And mentally, you get me to pay more attention to what I'm eating and how I am dosing and trying to stay "in range" more often in order to keep the graph lines straight and within the boundaries.

But in weighing the Pros and Cons, you are on the losing end, Larry. You just aren't worth the cost and insurance hassles of purchasing a Minimed CGM for the long haul. We just aren't meant to be. I trust you'll find someone else down the road who'll be more of a match for what you offer. That's just not me.

Sorry, Larry. I'm glad you are a loaner and gave me some valuable insight, but it's just not worth more than that - at least in this early CGM generation that we're in. Maybe, when technology gets a little better and leads to more increased accuracy, we can sing a different tune together. Just not now.

4 comments:

Alexis of Justices Misbehaving Pancreas said...

We had the same experience with The Guardian and once we switched to Dex it was like a different breed. We love it.

Do you see any cgm in your future?

Donna ((Sweet Momma)) said...

Wow! I am thinking we must be the luckiest Medtronic CGM users ever... because we dont have all the issues that everyone else does with them. I am not questioning it... I am just going to consider us VERY lucky and go on my way. LOL
The one thing that DID run true for us is we usually only get 6 days out of a sensor... but since I change his site every 3 days I just do a site and sensor every other time, so it doesnt bother me... its just sort of our routine. But our numbers are usually much more accurate than what you experienced. :(
I am so glad you got to trial each of them before deciding who to "marry". :)

Reyna said...

We tried the Guardian when Joe was four years old and HATED it. It turned me off to CGMs for a couple of years and then I meet (batting eyelashes here) "DEXTER" (Dexcom 7+). We have been quite happy with him. The sensors last for 10 days or so...and I love it for the trending. Dex can run amuck on accurracy too, but not too often.

Great post...and I am curious on Lexi's question...are you thinking of a CGM in the future? Like "Dexie"?

Michael Hoskins said...

Thanks for the comments!

Alexis: I'm not sure about a CGM in my future... Like the Dex the most of the three, but am not necessarily convinced that it's worth it at this point in time. May assess a little more to decide. But in the end, maybe it's a matter of just waiting for a future CGM generation when they're a little more accurate. We'll see.