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Category: CGM

Hershey World Day Trip

Hershey World Day Trip

Chris Stocker

Last April, I had to drive to Harrisburg, PA to go to the PA Real Estate Commission office in order to pick up my real estate license. If you want to start practicing real estate immediately after passing your exam, then I recommend driving to Harrisburg to get your license information in person rather than waiting for them to mail it to you.

Hershey, PA is very close to Harrisburg and how could I just drive out to Harrisburg and not bring the family along to stop at the sweetest place on earth.

So, that’s what we decided.

Stopped for Gas and BG Check 

Harrisburg is about 2 hours away, depending on traffic, but we were planning on about 2 hours. As I mentioned in my post about going to the aquarium, anytime we go on a drive, our daughter’s blood glucose levels just start an upward trend.

We had breakfast at home before heading on the road. We were making good time and we were only about 30 minutes outside of Harrisburg when our daughter….and myself… had to go potty. We stopped off at a Sheetz.

We utilized this time to check her blood sugar. And of course, she was high. Well into the 300s. Once again, a long ride = elevated blood sugars.

Pre Dexcom and Omnipod

We could have suspected this was going to happen, which we did, but this was pre-Dexcom and also pre-Omnipod, so everything was being done manually.

We had to give a correction shot while she sat in her car seat, which is never fun having to give an additional shot. This is exactly why we wanted to go on an Omnipod as soon as possible. We did what we had to do, gave a shot, got back in the car and headed off to Harrisburg.

One Last Pit Stop before Hershey

We arrived at where I needed to go in order to get my real estate license, but we had no clue how long it was going to take and I knew she was going to have to use the potty again soon due to the elevated blood sugar levels.

My wife stayed in the car with her to check her BG again. Luckily, it was coming down.

I ran into where I needed to go and found out I would be in and out in about 5-10 minutes so they just stayed in the car waiting for me. About 15 minutes later, I was back in the car and we were going to make it to Hershey, PA in about 30 minutes, so we buckled up and got back on the road.

Hershey World

We were not going to Hershey Park, in fact, I don’t even think it was open. It was freezing cold and it didn’t seem like the park itself was open. Just outside of the actual park is Hershey World, which is an indoor attraction that includes a ride to tour how the Hershey Kiss is made and a few other rides and activities.

Test Before Getting on Ride

I had gone through Hershey World a few times before in my life, but I couldn’t remember how long the factory tour ride took, but we wanted to check her blood sugar before we went on the road, because if she was going low, there was nowhere for us to simply get off and give juice or snack.

Her blood sugar level was in a decent range, so we got in line for the ride. If you have never experienced Hershey World and you are anyway near PA, I highly recommend it. The ride is pretty cool too.

Injection for Chocolate Sample of Course

At the end when you exit the ride, you are given a Hershey Kiss sample. This is one of the best parts of the ride to me! Kidding aside, you can never go wrong with a free Hershey Kiss.

At the end when you exit the ride, you are given a Hershey Kiss sample. This is one of the best parts of the ride to me! Kidding aside, you can never go wrong with a free Hershey Kiss. Click To Tweet

We knew that our daughter was going to want her Hershey Kiss right away and not wait, but we weren’t going to give a bolus injection for just that, so we decided to give a snack / lunch as well so that we were getting our money’s worth with the injection.

Injections were always easier when you can bribe with a Hershey Kiss (which we did for a while after that as well, because we obviously bought a ton of Hershey Kisses!)

We spent the rest of the time at Hershey World shopping through the store. They have more flavors of Twizzlers than I even thought was possible. I loaded up on Twizzlers and flavor mixes of Hershey Kiss that you can’t buy in a regular store.

Primanti Bros. = Bolus-worthy!

After we left Hershey World, it was time to go to Primanti Bros. I have never been there before, but I have heard amazing things about it from people that I know who live in Pittsburgh. We wanted to eat somewhere that is unique to the Hershey area, and when I saw they had a Primanti Bros. it was a no-brainer from there.

Image courtesy: https://www.goldbelly.com/primanti-bros

I’m talking about a pastrami on rye with french fries on it, gravy, cheese, and kraut. It was everything that I thought it would be. It was bolus-worthy as they call it.

Luckily, Primanti Bros. has carb counts on their website, so we were able to get an estimated carb count for our daughter’s meal. This required taking her to the restroom to take her insulin shot. We sometimes gave a shot at the table, but at other times we would do it in the bathroom.

This was a fun and exciting day trip. It started out as just me needing to do something for work and turned into a memory-filled family day.

How do you handle amusement parks? I’d love to hear. Please comment on this post or head on over to Facebook or Instagram to continue the conversation.

We Chose to Use Dexcom Immediately!

Chris Stocker 1 Comment

One of the first discussions that we had with our Pediatric Endo was the plan to start using a Dexcom almost immediately. Unfortuantely, the insurance requires 90 day of blood sugar logs, so we couldn’t get started for at least 90 days.

I know that for people who may be new to diabetes, learning the basics for 90 days and having logs for 90 days is beneficial before jumping right into using a CGM, however, with my 10 years of CGM experience, I was adamant that I wanted a Dexcom as soon as possible.

Our endo was OK with that, as long as I promised not to make rash decisions and quickly give a correction just because I started to see a CGM arrow somewhere.

I agreed with her because we were still figuring out how insulin worked in our daughter’s body. We didn’t know exactly what her ratios and correction factors should be set at, so I didn’t want to make quick decisions to stop an arrow (like I do for myself) and then cause a quick drop in her glucose level.

Why Did We Choose Dexcom

I knew that I wanted her to use a Dexcom for a few reasons.

Ease of Insertion

I had previously used a Medtronic CGM and I hated it. It was primarily because I didn’t like the insertion process. I actually hated the old Dexcom insertion process even more, which is why I used Medtronic for some time. But, with the new Dexcom insertion device, it’s a breeze and much easier and doesn’t look as scary, so I knew that was going to be part of the decision of being able to get her to let us do this every 10 days.

Not as Painful

As compared to the Medtronic CGM, the Dexcom is not as painful of an insertion. For myself, I don’t even feel it going in and sometimes wonder if it’s even in properly. Of course not every insertion is painless, but majority of them are. Pain was obvious a huge decision factor because what kid is going to want something super painful every 10 days being inserted into them?

My Comfort Level

I use Dexcom and I trust Dexcom. There is a comfort level like no other with Dexcom

I literally trust my own life with it. I check my blood sugar with test strips maybe once a month, I’d say in the last 12 months of using Dexcom G6, I have tested manually less than 10 times. I don’t feel the need to test, that’s how much I trust it.

Now, when it comes to our daughter, we still check her blood sugar on her finger about 3 times a day. We have become a lot more comfortable bolusing off of her Dexcom, but we still do check several times a day.

Future Compatability with Omnipod

I also knew that we would be putting her on an Omnipod as soon as we could also. So, I wanted to use Dexcom so that when the Omnipod and Dexcom are fully compatible and working together for a semi-closed loop system, we would already be ready with the Dexcom.

Why CGM So Quickly

The reason why we wanted a CGM as soon as possible was pretty obvious. We wanted to know as close to real-time glucose levels as possible. The thought of not knowing what our daughter’s glucose levels were drove us insane.

We went to Target one day and she said that she felt wobbly and dizzy, so we checked her. She was 42. This was only about an hour after eating lunch. I ran to the front of the store with her and grabbed an apple juice and just had her start drinking.

With a Dexcom, we could have spotted that low coming before it was freak out time. That was when my wife knew she did not ever want her to not have a Dexcom on at some point. Those 2 hour warm up times are still the most stressful 2 hours for my wife.

I know, we could do it without a CGM

I know that there are plenty of people without CGMs and do perfectly fine and when I was first diagnosed, we didn’t have CGMs and I made it through. They also didn’t have showers 100 years ago but I’d prefer running water and showers over using a bucket to wash myself.

But, I digress, back to the story.

My endo worked with us to ensure that on day 90 we were able to submit all of our logs and get started on the Dexcom. We used her diagnosis day as day 1 of starting her logs so we could get approved a few days earlier.

It took a few days for the supplies to come in and then we did a training in the diabetes educator’s office and that was a nightmare. Our daughter freaked out and cried a lot, however, it was a good sensor and it made it all 10 days. It took her a little while to get used to it, but the second one we inserted, we did from the comfort of our own home and she was perfectly fine.

Now, a year later, she gets a little nervous right before we put a new Dexcom on, but we let her watch a video or watch a cartoon on TV and she is good to go.

Distraction is the best method of diabetes device insertion for us.

What kind of distractions do you use for inserting Dexcom or Omnipod on your children? Comment below or join the conversation on Facebook.

omnipod or tslim

Is It Time to Give Up MDI? My Omnipod or t:slim Possibilities

Chris Stocker 1 Comment

Back in January of 2018, I went off my Medtronic insulin pump that I wore for over 12 years and went back to MDI mixed with Dexcom. During this past year, I’ve had ups and downs with loving and hating MDI. I’ve been asked so many time, “how could you give up a pump to go on MDI?” and the answer has always been simple:

I love the freedom of not being attached to something and my A1C is pretty much the same as it is when I was on a pump.

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patient privacy from using wearables

Despite Patient Privacy Risks, More People Use Wearables for Health

Chris Stocker 1 Comment

A recent Deloitte Survey of US Health Care Consumers found overwhelming numbers of people who utilize wearables in their health management despite the patient privacy risks.

I am one of those people. I wasn’t surveyed, but I wear a CGM and an Apple Watch at all times. There is a lot of things that I give up some privacy for in order to have the convenience of what that product gives me.

The interesting part of this study is that:

Sixty percent of the 4,530 respondents said they are willing to share PHI generated from wearable devices with their doctor to improve their health.

I’d think that number would be higher. If you’re going to use wearables, why wouldn’t you want to share the data with your doctor?

I’d assume the main reason is because you don’t want the doctor to judge you from an unhealthy or for being a “bad” patient.

I use wearables because I want the real-time data to make short term decisions and then when I visit my doctor, that’s usually when I discuss long-term decisions and strategies.

diabetes heart rateWearing an Apple Watch and seeing that my heart rate is way too high tells me right away that I need to calm down and get my heart rate back to an ideal level.

Then, I will share this data with my doctor because if there is a pattern of high heart rates, we can figure out what that pattern is and how I can try and avoid whatever is causing that.

The main issue of the study and article that I am writing about is that once the data from a wearable is uploaded to your healthcare professionals system (EHR), HIPPA regulations now apply and this is where their could be privacy issues.

There are a lot of numbers and stats in this report that I found interesting, so I recommend checking it out.

Another one is that 31% are interested in connecting with a live health coach.

That’s one feature that I love about mySugr. Live health coaching.

What are your thoughts on all of this?

Do you use wearables?

Would you share your data with your doctor or keep it for yourself?

Share this article on Facebook or Twitter now and keep the conversation going.

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How Entrepreneurship Saved my Diabetes Management - new size

How Entrepreneurship Saved my Diabetes Management

Chris Stocker 1 Comment

As many of you may, or may not, know, I own my own business(es). I first started my own business back in 2009, but still worked full-time and just ran the business at night. During this time, I was not sleeping a lot. I worked until about 2 am and then woke up at 7 am to go back to my day time job.

During this time, I was hustling my ass off to grow my business on the side, while keeping my day time job. The day time job was important for two reasons.

First, I needed the money.

Second, I needed the health insurance.

There was a third reason, life insurance, but then I found a place that specialized in life insurance for type 1 diabetics.

This was back in 2009, so this was back in the day when pre-existing conditions were an automatic denial.

I wasn’t sleeping well at that time. I wasn’t eating healthy at that time. But I was hustling and growing a business and at that time, that’s all that mattered to me.

Fast-forward almost 10 years, I am still running that same business. It’s changed a bit, but not much. I own and operate an SEO and Social Media Management agency.

I also help my wife in running her Etsy business (soon to not call it an Etsy business, because we are launching our own site and adding more categories).

I also run an eBay / Amazon re-sellers business that takes up most of my weekend time.

Why am I talking about all of this?

Well, I made the decision a long time ago that I wanted to own my own business. I wanted this so that I am in control of my own income, my own future, and most importantly in control of my own time.

Time is the most valuable thing in this world and it’s something that we can’t buy more of or return and get back.

Entrepreneurship has allowed me to use my time how I see fit.

This is not only important for my family, but also for my diabetes.

In the last decade, I could schedule doctor appointments whenever I wanted. I could change an infusion set or a CGM sensor whenever I wanted. I could go exercise at any time that I wanted. I could eat lunch whenever I wanted.

I could do whatever I wanted, whenever I wanted.

This is important to me. This has helped me manage my diabetes because I can take breaks when needed, I can be flexible on my appointment times, and I can also take the time to make a lunch during the middle of the day and prepare a healthy snack.

Now, listen, I know you can do that all when you work for someone else and work in an office or a typical 9-5.

However, when I was working a 9-5, I didn’t do those things. I ate out all the time. I didn’t exercise. I didn’t drink water.

Entrepreneurship has done wonders for my diabetes management.

I was always scared that I could never be an entrepreneur because of having diabetes. I thought that needing insurance would hold me back.

Well, it hasn’t and I’ve been able to do this for nearly a decade and I don’t plan on stopping here!

If you want to hear more about diabetes, entrepreneurship and the combo of both which I call my life, then subscribe to the Type One Entrepreneur Podcast. I tested the waters with this podcast earlier in the year, but I’m going all in on it. The scheduled re-launch date is August 13.

Diabetes in a Cave

Chris Stocker 1 Comment

Even though the title may sound like I was trapped in a cave with type 1 diabetes, that’s not the case. Although, that would be one hell of a movie, if Hollywood could get it right of course.

Anyway, we decided to take a family trip to Crystal Cave out near Kutztown, PA with myself, wife, daughter and my brother’s family, including my niece who also lives with Type 1 Diabetes.

I have never gone into a cave before, so I was not 100% sure what to expect.

I was told that the tour would take about 45 minutes in total, so I assumed a lot of walking. Because of that, I wanted to keep my BG at about 200 before entering the cave that way I would hopefully not have to correct while I was on the tour.

Start of the Tour

We were starting the tour around 12:45 and I did not eat lunch yet, jut breakfast and decided to have a few of my daughters chips before heading into the cave for the tour.

The tour started with a 10-15 minute video explaining the history of the cave and how the cave was formed and what some of the things we will be looking at inside the cave are. Once the video was over, it was time to head into the cave.

I knew going into this that the cave was going to be cold, and it was. It was a constant 54 degrees, which that’s actually not cold to me, that’s perfect temperature.

For me, the heat drives my BG straight down, so I knew the cool, damp climate inside the cave would not be effecting my blood sugar.

The tour was slow, meaning that we walked about 20-30 feet and would then stop at the next station for them to explain what we were seeing. During this time my blood sugar was staying around 200-220 and pretty flat and steady.

The walking part of the tour lasted about 20-25 minutes and when I walked out of the cave my BG actually went from 200 to about 245, so there was no drop at all from the activity of walking through the cave. Grant it, there really wasn’t any steps or much walking uphill. There was only one section that we could opt-in to walk up to the highest point of the cave, which was maybe 30-35 feet high.

As soon as we got out of the cave, I asked my sister-in-law what my niece’s blood sugar did while in the cave. Her answer, “stayed flat”. Exactly the same that my blood sugar did.

Lunchtime

It was then time for lunch and I was hungry and started eating before I took my insulin. Actually, I finished my entire meal before I took any insulin.

What happened next… I’m sure you can guess that.

A straight shot up like the mountain we were standing on. And that BG of over 350 lasted for several hours and made me feel like crap.

Luckily, after the cave, we went to pick strawberries and it was getting hot, so that helped bring the BG down a bit too.

I’ve been doing much better at pre-bolusing and this was an example of exactly why the pre-bolus is so important.

All in all, the cave adventure was fun. Check out some of the photos below.

Dexcom: One Week Later

Chris Stocker

I have been using Dexcom for longer than a week, but I’m just now getting a chance to write this post. I shared my thoughts on my first 24 hours with Dexcom, so now it’s time for my first week with Dexcom.

Comfort

From the time I inserted the sensor until it ended and I removed it, there was no discomfort. I inserted the first sensor just under my left breast. I was very happy with the comfort of the insertion and the fact that I barely even knew it was there for an entire week.

Adhesive

The adhesive stuck for an entire week. Now, I did have to use some reinforcements during the week. I started going back to the gym, so the sweat was really making the sensor adhesive come off of my skin. I actually used the Medtronic sensor tape to help reinforce the Dexcom adhesive. I’ve included an image to show you the Medtronic sensor tape in case you have never seen it. I cut it in half and then put half on the top of the Dexcom sensor and half on the bottom.

Accuracy

I cannot complain about the accuracy at all. There were a few finger stick checks that were a bit off, but nothing that was more than a few percentage points off. The accuracy came back quickly after a calibration. Two thumbs up for accuracy.

Overall Thoughts

So, my overall thoughts are that I am super excited and happy with the Dexcom. I’m going to do a full post on the Dexcom Clarity reports, but my time in range has increased tremendously in just one week being on Dexcom. Wearing it has allowed me to become an it more aggressive with my insulin as well. No fear of lows. No more not knowing my blood sugar is high until I test and going 2 hours with a high blood sugar and then another hour until it came back down.

More to come in later posts, but those are my initial feelings after a week.

First 24 Hours with Dexcom

Chris Stocker 2 Comments

This post was originally written last week, but just now posting it….

I’ve been using my Dexcom for a little over 24 hours now, close to the 36 hour range. My initial thoughts are pretty simple….AWESOME!

If you haven’t checked out my Dexcom G5 Unboxing video yet, go check it out.

I have had a CGM in my life in the past, but I didn’t wear it consistently. It was always a hassle and a pain and I was just always too lazy to insert a new sensor.

My first sensor insertion was super easy and was done in seconds.

The first sensor site that I chose was where I used to wear my Medtronic sensor which is just under the breast. I like this spot because I don’t feel it and it does not move a lot.

I have problems using my stomach because of how overweight I am and the “rolls” that I have on my stomach. This causes the sensor to fall off pretty quickly.

Setting up the receiver and the app on my phone was pretty easy as well. I also wear an Apple Watch, so I installed the app on my phone as well. Being able to use my phone to see my current glucose levels is one of the primary reasons I was so excited to start wearing a Dexcom. And, I must say, it didn’t fail. It is pretty exciting to see those numbers right on my watch.

The 2 hour waiting period was not a big deal for me. I’ve been without a CGM for such a long time that 2 more hours isn’t that much. We will see how the 2-hour warm up period is when I am so used to having the CGM data.

 

Everything has been pretty accurate so far. Meter and CGM have not been more than 10 “points” off, so that’s a huge plus.

I have set my low and high limits at 70 and 200. I will slowly move the 200 “high” down to 150. I am still getting used to MDI and now that I have the CGM, I can get a lot more aggressive with my insulin. Previously, I had to rely on feeling low or testing more often. At this point, with the CGM, I am ready to get aggressive to hit my overall time in range goals and ultimately my A1C  (although I don’t put too much weight on that number, it’s still a goal of mine)

I haven’t had two consecutive A1C’s below 7.0 in almost 10 years, so that is my goal.

That’s pretty much everything from my first 24 hours with Dexcom.

I will continue to share my journey with Dexcom and how it has helped me manage my diabetes.

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Back to MDI After 13 Years

Why I Decided to Go Back to MDI After 13 Years

Chris Stocker 2 Comments

When I was first diagnosed with diabetes back in 2004, I was on MDI for the first year and a half. In December of 2005 I began using a Medtronic insulin pump. I have been on one ever since. During those 13 years, I have taken plenty of pump breaks and used MDI for a few days, even weeks at a time. I would eventually just back to my trusty insulin pump.

After a lot of thought and consideration, I have decided to give up the insulin pump and go back to MDI full-time. There are several reasons for this, but before I get to that I just want to mention this. I think that MDI is looked at as a barbaric, old school method of management these days, especially with all of the amazing technology that we have, but since we all know that your diabetes may vary, it works for some people.

Overweight

One of my biggest issues is that I am overweight. Big time overweight. Because of this, I use a lot of insulin. Primarily because of the unhealthy food choices that I make, which has caused me to be overweight. In any given day, I may range from 180-220 units of insulin in just one day!

That’s 180 units of insulin going into one infusion site. There is absolutely no way that the infusion site can handle that much insulin in such a short period of time. This then leads to my sites leaking, not absorbing the insulin, and hard build ups in areas which then do not allow me to use them again as an infusion site for a long-time.

The primary solution here is to stop eating like an idiot and lose weight, but in the meantime, I have decided to go MDI.

One Bolus, Multiple Injections

With MDI, I can divide all of my shots to different areas throughout the day. For example, my Tresiba is taken in two shots, both at the same time, but I split the amount in two, one shot in the left arm, one shot in the right arm. That way, my body absorbs the insulin much better. Same goes with bolus shots. I am able to split them and inject insulin into different locations for the same meal. This helps my body absorb the insulin much better, not cause scar tissue to soak up the insulin, which all leads to better blood sugars.

With all that being said, my new game plan to manage my diabetes is going to be Tresiba, Novolog, and Dexcom (more on this tomorrow). I am also going to take a trial run of Fiasp, which is a much faster acting insulin. I sometimes don’t take my insulin until after I ate (lazy) or right before the meal, so this Fiasp reacts much quicker. I’ll have a full review of Fiasp after I can sample for a week.

Switching back to MDI is the number one reason why I stepped down as a MiniMed Ambassador. I could not continue to do that while not being on the pump. I feel like this is the best management for me and the best way for me to lower my A1C and spend more time in range!

Here’s to a new journey in life and I’m looking forward to sharing everything that I discover in this new journey with you.

Aaron Kowalski and Cynthia Rice on Medicare and CGM’s

Chris Stocker

Yesterday, The Diabetes Patient Advocacy Coalition (DPAC) held its March Ask an Expert webinar series. The webinar included Dr. Aaron Kowalski and Cynthia Rice, both from JDRF.

The webinar brought attention to CGM data that shows it helps, data that shows Artificial Pancreas systems work, and how Medicare is not covering CGM’s and why they are not.

Throughout the hour, hearing them both talk, it was constant note taking. A lot of the information that they spoke about I had either heard or seen elsewhere before, but it didn’t all make total sense or fully sink into my brain until yesterday.

The reasoning behind why Medicare does not cover CGM’s is based on 100% BS. We, as a community, have done a great job reaching out to politicians to explain why it’s BS and why the Medicare CGM Access Act needs to be sponsored and cosponsored, but we need to continue the fight.

After every webinar from DPAC, I like to create some sort of actionable plan that I can easily do in order to continue to do something. Yesterday, I set up a calendar reminder once every 2 weeks to send letters, tweets, emails, etc. to my elected officials. Why didn’t I do it every week? Because, I have to be practical for myself and advocate the way that works best for me. I already knew that if I did it every week, it wouldn’t get done and then I would start hitting the snooze or remind button on it and then eventually it would be months later and never taken action on the events.

I also set up a few tweets and posts that I would like to send out over a period of time. One thing that Aaron Kowalski said was, “One thing that I do everyday is just try and get people involved.” That definitely resonated with me. If I can only do 10 things in a day, but I can also somehow get 10 others every day to do something, that is a lot more getting accomplished.

Another thing that I plan on doing in the next few days is to create “My Story” so that I can have saved and ready to just copy and paste when reaching out to my elected officials. As Cynthia Rice mentioned, officials like data, but they love to hear the stories of their constituents.

If you did not get a chance to attend the webinar, then you can watch the replay.