Starting last Wednesday Naomi has become a bionic woman. That is when she started using her Continuous Glucose Meter or CGM. This little machine (that looks like an old Ipod Nano) takes glucose measurements using a sensor that is attached to her belly every 5 minutes. So instead to getting blood sugar measurements 4 times a day using her regular old glucose blood meter, she now has her blood sugar tested every 5 minutes all day and night.
The Pros
The advantages of the CGM is that it allows a person to see what is happening to their blood sugar throughout the day. It allows you to see in real time how your blood sugar changes when you eat or take insulin. And it warns you (including in the middle of the night) if your blood sugar is dangerously high or low. So what what this tool allows you to do is really see patterns in your blood sugar and attempt to control your blood sugar closely, with the reassurance that you will get a loud beeping noise if it is dangerously low or high. As the husband of someone with Type I diabetes I can't tell you what a relief it is that she has this thing. Before, every time I would head out for a run in the evening (most of the times without my phone) I would get these moments and think "Oh crap what if she goes low and there is no one there to help her." Sometimes this anxiety would overwhelm me and I would take off almost sprinting home and say "Are you OK?" She would just look me like I was crazy.
My worries are not unfounded. I just finished reading a great book by James Hirsch called Cheating Destiny: A Life with Diabetes. James (a former New York Times and Wall Street Journal Writer) is the brother of Irl Hirsch who is a world famous diabetes doctor here in Seattle who Naomi works with. James, Irl, and James' son (who was 3 or 4 when he was diagnosed) all have Type I. The book is an amazing description of the history of diabetes, the constant controversy regarding the pros and cons of tight glucose control, what it is like to live with and have a child with diabetes, and how research to find a cure is kind of stuck. There are terrifying stories inside, including one about how James (who has had diabetes since he was a kid) is driving his SUV on the freeway with his son and he starts to feel strange, but keeps driving. Before he knows it he loses consciousness, rolls the SUV, and is barely able to get himself and his son out safely. Luckily a woman driving by sees this happen and calls 911. He is interrogated by the police, they assume he is drunk. He gets a CGM right after the accident to make sure this doesn't happen again and even takes it to court to show the judge (he was given a ticket for the crash) to prove that it won't happen again. This is of course is the thing I fear most, Naomi's blood sugar going dangerously low and her being alone and unable to do anything about it. The CGM is an insurance policy, at least for my anxiety. It's also a way to get tight blood sugar control and hopefully prevent long term complications-my other equally important goal!
And now to the Cons
The CGM is small, but it has to be within 20 feet of you all the time! That isn't fun. And then there is the sensor and transmitter. The sensor is injected under your skin and then attached to a sensor and receiver. Its not so big, but it is not something any of us would want to have attached to us all the time. You can't wear tight shirts without people seeing it and it is just weird to have something constantly attached to your body. AND you also have to still do those annoying finger pricks because you have to use your regular blood sugar meter to calibrate your CGM. NOT cool! Also I have to say getting information about your blood sugar every 5 minutes 24/7 is overwhelming and stressful. Seeing your blood sugar swing way up for no apparent reason can be exasperating. So the price of this close monitoring and the potential of tighter blood glucose control is the stress of getting continuous data whether you want it or not. The last con is the cost. This little thing is expensive and the insurance company doesn't want to pay for it. If not for Naomi's persistence there is no way she would have been approved for one until she had a car accident or had to go to the ER for low blood sugar. The little sensors that have to be replaced every week cost $10 each (after insurance). Who knows how much they actually cost our insurance company.
What it Means for the Family
Well we have all quickly grown accustom to the CGM. Oliver wakes up every morning and walks into our room and says "Mom, how is your diabetes? What does it [the CGM] say?" She shows him the numbers and the little graph. It's between the yellow (too high) and red (too low) lines. He looks at it and enthusiastically and says "Good job Mom! Dad did you see her numbers? Her diabetes is really good. Good job Mom!" Then he runs downstairs and plays. I now take my phone on my runs but I do feel so relieved that she has the CGM to make sure she knows when her blood sugar is low. Naomi, who of course is the one who really has to adjust, has handled it well. It has been stressful. She now sees the the big spikes in her blood sugar and the times her blood sugar changes and she can't figure out why. Also the stupid sensor has started falling off, so now her stomach is covered in tape to hold it on. But after one week, it seems that this little thing is going to be a helpful, though inconvenient, thing and it will be a part of our lives for many years to come.
Training.
I will keep it short. I ran 63 miles last week, including a 22 miler on Sunday. I felt great on my 22 mile run and could have run a full marathon. I was even able to get down to race pace for a few miles. I have 7 more weeks till the marathon and for the first time I am thinking my goal of a sub 3 hour marathon is realistic.
Donate
Race day is getting close and we need to raise some money so we can either cure Type I diabetes (my preference) or at least get these CGMs to be smaller, cheaper, and more convenient.
We have some work to do to get me to my goal of raising $5,000 so please donate if you have thought about it but just haven't had a chance. Also please pass this on to others if you think they would be interested! Thanks everyone for reading and your support. Have a great last few days of summer.
