I had an interesting encounter last week with an individual at a local coffee shop. Usually, and like most people, I walk with a certain level of indifference to the world around me and simply get to where I’m going. That being said, what differentiates me from most members of the general public, is an increased state of situational awareness. This is born out of decades of martial arts training mixed with law enforcement experience, which has cursed me with an unshakeable case of hyper-vigilance.
On this particular day, I was running a couple of errands and asked my wife if she’d like a coffee. As I walked into this particular location, I saw a guy waiting for his coffee that, at first glance, appeared to have a CGM on his tricep. This, in and of itself is not unusual. After all, I’ve used devices such as the Freestyle Libre, which is essentially best used on one’s tricep. However, as I got closer I realized this was an actual Medtronic Guardian sensor, which pairs with a Medtronic insulin pump.
When I started with my second insulin pump, I was introduced to the wonder that is CGM, which ultimately changed my life and the way I control my blood sugars. However, during the training sessions for CGM, I was warned that the Guardian sensor was to be placed on the abdomen or lower back around the love handles. I was trained that the Guardian sensor would not function properly on the back of the upper arm by virtue of the reduced amount of interstitial tissue at these sites. I’ve never tried it and always took it as a given, since the people who made the damn thing said so.
This is why seeing the sensor on a tricep caught my attention. Never one to be shy, I had to ask. I approached the individual and asked how the sensor had been functioning for him at this sight. And to be clear, for my Diabetic brethren who may inquire, this individual appeared to be slim and muscular, made references to farming and did not appear to have an abundance of, shall we call them, “bingo wings.” This made it all the more fascinating that he was using the sensor at this site.
The individual explained that he couldn’t use the sensor on his abdomen as he tended to sweat excessively during his farming duties, which would result in the adhesives giving out and the sensors to fall out. While experimentation and sensor failures are a part of pump training, it becomes an issue where you have to pay for these bad boys out of pocket. At best, you’re looking at $250 to $400 per month, if your sensors all function properly. So, if you have failures, the financial cost can start to build up. This was one of the issues this individual was dealing with.
It took him a bit of experimentation on the placement and calibration, but he was successful in getting it to work and had been doing so for some time. The only issue he faced now was the occasional ripping off of the sensor if he hooked his arm on something wile working. We had a good conversational exchange on sensors, where I also passed on my use of Patchabetes adhesives, which would likely provide him with better protection for his sensors. He was grateful for the conversation and said it was nice to have a conversation with another Type-1 Diabetic who could relate.
The interaction, although unintentional, was refreshing and acted as a stark reminder that Diabetes treatment is never a black-or-white thing. Rather, it’s subjective to the one receiving the treatment and what works for them. While the standard in this case is to use a CGM on the abdomen and never on the tricep, this individual tried it and made it work; something that would have otherwise meant that he wouldn’t have been able to indulge in pump therapy otherwise. Speaking from experience, that would have been a huge loss for him.
But it was interesting and gave me hope, considering that eventually, I’ll likely develop enough scar tissue on my abdomen that I’ll have to move on to different areas of the body. It also reminded me how important it is to keep your eyes up and observe the world around you. After all, I would have totally missed this if I had been a phone zombie walking with his head down. That’s why it’s so important to pay attention. You never know what you might miss. Food for thought… ☯️
The Blogging Buddhist 