Oh yeah, also, he wasn't my primary care doctor when the crisis started. He became my primary doctor because the ER called downstairs to the practice where the doctor who was my primary doctor works, asking if he could send me down to follow up on this rather urgent business, and they said "uh yeah, the doctor can see him in July? Maybe? or he could see the PA next month."

(note: this was all happening at my small local hospital, not the huge hospital in Bangor that 86ed the weight management practice.)

So they sent me across the street--literally across the street--to the other PC practice the hospital runs, whose doctor could see me the next day. He was Dr. Decisive about a bunch of stuff, including getting hold of a (as we thought at the time) temporary supply of insulin to knock down the steroid-induced sugar spike. He and I both thought this would be a problem, since we couldn't envision MaineCare just dispensing that stuff without a prior authorization and it was a Friday, so he handed me a card with his cell number on the back saying, "If the pharmacy says MaineCare is giving them a hard time about this, have them call this number and I'll pay for it myself."

(In the end, he didn't need to. Amazingly, they were able to just dispense it, like it was an ordinary prescription for a statin or something. In a far greater quantity than anyone thought I needed, at the time, which is how I came to have a bunch of it lying around handy when we realized, a week and a half later, that my levels weren't coming back down despite the steroids being long since over.)

As I was leaving I asked the receptionist, "Uh, is he accepting new patients? I mean nothing against the other folks, but it seems like they're having some serious availability problems over there and DAMN," or words to that effect. She said not really but she'd ask, and then called back an hour later like "yeah, he's your doctor now."

So that was nice, albeit the weirdest possible time to change horses.

Anyway, where was I? Oh yeah. Due to a bizarre accident of timing, Trulicity is possibly-unfairly suspected of having somehow caused the entire thing at this point, although I'm willing to revisit it later. I mean, I've still got three of them in the fridge. Dr. Decisive and I will probably talk about it, among other matters, when I see him next Thursday.

As an aside, did you know the test strips for a OneTouch glucose meter don't work with a TrueMetrix meter? I didn't! And neither did the pharmacy. They look like they would, I mean, they're exactly the same size, shape, and layout. The meter even acts like they will. If you plug one in, it does its little self-test, tells you the lot number of the strip, and then shows the "OK gimme blood" screen. Not until you actually give it blood does it think for a second and then put up a code that, when you look it up in the book, means "wrong brand of strip, shit for brains." You'd think it could maybe tell you that BEFORE you puncture yourself, but no... no. Of course not.

I get all the best conditions.

--G.
* she actually prescribed Ozempic, but MaineCare said "yeah no, you can ride bandwagons on your own money, when you're spending ours you'll take this other drug and like it," because that's how MaineCare rolls
-><-
Benjamin D. Hutchins, Co-Founder, Editor-in-Chief, & Forum Mod
Eyrie Productions, Unlimited http://www.eyrie-productions.com/
zgryphon at that email service Google has
Ceterum censeo Carthaginem esse delendam.

... but man, it was great training for lesser self-injected medications. Those little tiny needles you give yourself insulin with? After nine years on Avonex, I feel like the Heavy Weapons Guy from Team Fortress 2 confronting those things. "What sick man sends babies to fight me?!"

--G.
-><-
Benjamin D. Hutchins, Co-Founder, Editor-in-Chief, & Forum Mod
Eyrie Productions, Unlimited http://www.eyrie-productions.com/
zgryphon at that email service Google has
Ceterum censeo Carthaginem esse delendam.

And lo and behold, after the next week's dose the trend was in the other direction and except for a bit around the start of this year when approximately ALL THE CELEBRITIES discovered Ozempic (and by extension, Trulicity) and gobbled up the EN-TIRE fucking supply and thus I was off the regimen for a couple months, not that I'm bitter or anything... where was I? Except for that thankfully brief period, I've been pretty stable since getting on it.

Mind you, I'm not suggesting you get right back on that thar horse, I'm just saying I had something similar happen. :D

Re: the needle thing: Trulicity *used* to come in non-auto-injector pens and while the needle was still short, it was approximately the diameter of a ballpoint pen tip. No lie, I had one of them clog on me when I was trying to administer and when I pulled it out and looked, it was because the hole in the needle had swallowed a chunk of, well, *me*, on its way in -- carved it out neat as you please like an apple corer.

I am *extremely* thankful for the autoinjectors, 'cause they're about a million times less painful than those damn things were. I can only imagine -- and don't want to! -- how bad intramuscular would be. Ugh.

Also, after like ten years now of insulin, I admit I kind of enjoy surprising nurses with how blase I am about needles in general.

--sofaspud
--the effin fingersticks hurt more than them drawing blood does, dangit

My doc put me on a CGM, which means that instead of stabbing my fingertips four times a day, I get to wave a sensor over a little gubbin on my arm!

I mean this is not the cyberpunk future I was promised but it's a start :D

--sofaspud
--they ARE eye-wateringly expensive, though, so Arasaka might be involved anyway

I'm curious about those, but also highly doubtful that MaineCare would ever cover one.

--G.
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Benjamin D. Hutchins, Co-Founder, Editor-in-Chief, & Forum Mod
Eyrie Productions, Unlimited http://www.eyrie-productions.com/
zgryphon at that email service Google has
Ceterum censeo Carthaginem esse delendam.

So, funny story. On Wednesday this week, I found out from someone over at my local hospital that Mainecare does cover CGMs for patients with a Type 2 diagnosis who have to do at least three injections a day. Which wasn't me!

Until Thursday, when I saw my doctor and mentioned that the long-acting insulin titration we were doing didn't seem to be working, and his reaction to that was "OK, so we'll throw in short-acting before each meal on top of it. Damn the torpedoes!" (He didn't actually say "damn the torpedoes" but he's that kind of guy.)

Soooo now I have a compartment in my refrigerator that I think is meant to have butter in it, but which actually contains two different kinds of pen things with two different kinds of insulin in them, and I'm thinking about the people I know who have been diabetic for literally years before they needed to start thinking about injectable anything and wondering how the fuck I went from diagnosis to "responding well to first-line treatment" to "let's try this new maintenance med that people are having really good results with" to "dependent on two different kinds of injections adding up to four shots a day" in three and a half fucking months and boy would I like to have a word or two with Eris right about now.

They're not saying it out loud, but I'm pretty sure the folks at my doctor's office think these glucose numbers are coming from a lot of self-pity M&Ms and I promise you they're not. I haven't eaten anything I really wanted to eat since New Year's.

Oh yeah, got kind of lost in my rant there. Anyway, now that all those shots are on the board, I think I qualify for a CGM device once all the paperwork gets done (and I've made the executive decision that I'm not going to start doing the ones that need instant titration until I've got one, because fuck all that finger stabbing), so before I go in on Tuesday to be formally introduced to one I may or may not get to keep, I have a curious about them.

Mostly, I'm wondering: How invasive are they? I mean, I assume they must have some kind of probe on the back of the thingus that goes on your arm, but my doctor was talking about changing said thingus something like every three days, which... I mean, one of my MS injectables was a sub-Q with a biggish needle (nothing like the roofing nails I used for Avonex, but way bigger than those starched rat hairs one uses for insulin) every three days and I handled it, but it's not an experience I'm thrilled at the idea of repeating. At that point the "this or constant finger stabs" calculus turns into that classic Too Much Coffee Man comic about working retail.

--G.
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Benjamin D. Hutchins, Co-Founder, Editor-in-Chief, & Forum Mod
Eyrie Productions, Unlimited http://www.eyrie-productions.com/
zgryphon at that email service Google has
Ceterum censeo Carthaginem esse delendam.

That's been my grandmother's fridge for as long as I can remember, the butter tray always having at least one box containing a vial of insulin and the box of needles up in the cabinet above the sink. At some point in my young life, I got it in my head that that was the intended use for that spot. Either that or storage for all the packets of fast food restaurant condiments you saved "just in case."

>Mostly, I'm wondering: How invasive are they? I mean, I assume they
>must have some kind of probe on the back of the thingus that goes on
>your arm, but my doctor was talking about changing said thingus
>something like every three days, which... I mean, one of my MS
>injectables was a sub-Q with a biggish needle (nothing like the
>roofing nails I used for Avonex, but way bigger than those starched
>rat hairs one uses for insulin) every three days and I handled it, but
>it's not an experience I'm thrilled at the idea of repeating. At that
>point the "this or constant finger stabs" calculus turns into that
>classic Too Much Coffee Man comic about working retail.

One of the transformations in my life that happened with my hospital stay was pretty much losing any lingering fear of needles I had*. Had at least 3 blood draws before they put a cath in my right arm, from which they were drawing blood and injecting meds until they put the second line in the back of my left hand for the catheterization procedure on the second day. Now the only thing I dread is doctors who try to jab me themselves instead of leaving it to the nurses.

* Except finger pokes, which is something I will never stop cringing at.

--------------------------
CdrMike, Overwatch Reject

Oh yeah, I forgot to follow up on this. Turns out: not very! The thingus makes me anxious because I'm constantly fretting about snagging it on something and pulling it off, but actually getting it installed didn't feel like anything.

The one I have on me right now isn't the one the nurse wanted to use, but it turns out my faithful phone is so old that none of the current-generation CGMs will work with it. That makes me sad, because phones are expensive, but as reasons to finally bite the bullet after a full five years and get a new(er) one go, "this CGM is new-old stock and they don't actually make this model any more, so even if your insurance approves you for them, we won't be able to get you more of these ones going forward" is a pretty good one.

And I must say, even a generation or two back as this monitor's technology is, it's pretty impressive. I can't speak for its longevity, since I've only had it for three days (of the 14 this model is supposedly good for, assuming the glue lasts that long), but it does the thing without making me bleed my own blood. I'm a little uncomfortable with the fact that it rats me out to the hospital (half an hour after I got home, the nurse called me to say "I see your sensor is online now, your numbers look pretty good!" which kind of freaked me out even though I knew it was going to happen), but I suppose that's life in our modern dystopia.

Also, I'm not crazy about the way the level-over-time graph in the app looks like a stock ticker in a time of insane national instability. Don't do steroids, kids! It's just not worth it.*

So, yeah. The paperwork is in, and I'm hopeful that I'll be approved for a permanent supply of these things--preferably one of the fancier new models that can go somewhere other than the really quite inconvenient spot where this one's stuck. The new phone I broke down and ordered should be here tomorrow, and I made sure it was on the compatibility list for all the latest widgets.

--G.
* well, OK, with a platelet count below 3 it's probably worth it, but fuck
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Benjamin D. Hutchins, Co-Founder, Editor-in-Chief, & Forum Mod
Eyrie Productions, Unlimited http://www.eyrie-productions.com/
zgryphon at that email service Google has
Ceterum censeo Carthaginem esse delendam.

Sounds like you landed on more or less the same type of CGM that I have. There are two big players in the field right now doing 14-day units, that I'm aware of: Abbott and Dexcom (making the Freestyle Libre and the G-whatever units, respectively). I'm on the Freestyle unit; I'm guessing you're on Dexcom (or another I haven't heard of) because mine doesn't rat me out automatically; I have to upload my data every once in a while.

I've found over the past few years using them that the glue is remarkably good. I sweat. Like, a lot. And mine has stuck to me no problems. I've gone swimming, obviously (I should hope 'obviously') I take showers with it on, and I even lounged around in a hot spring wearing mine. No real issues. When I went to Hawaii and planned to spend all my time in the water, I did pick up a pack of covers for the sensor, but other than extreme situations like that I don't bother.

That said, I *have* snagged it on things and yanked it off a couple of times, and the aforementioned covers would protect against that. Basically they create a slope that whatever surface you're bumping against can ride over rather than snagging on the cliff face that is the edge of the sensor.

--sofaspud
--

The approval I have is for the Dexcom G7, but the order only went in last Friday so the supply hasn't started arriving yet. In the meantime, the sample unit the DE nurse over at the hospital put on me last week is a Libre 2 she had left in her stash, because the phone I had at the time wouldn't run the app for any Dexcom or the Libre 3. We had to set up the data sharing, which involved looking up a Secret Code in a large book, before I left the office.

(Of all the things to finally push me to replace my five-year-old Galaxy S8+, CGM app compatibility. What is this life? Although Slack and my insurance company have been nagging me about it for a while too.)

As an aside, it annoys me that all these newfangled Bluetooth things need location to be turned on nowadays. Why the fuck do my headphones need to know where they are? They're headphones. Sorry, I digress.

>I've found over the past few years using them that the glue is
>remarkably good. I sweat. Like, a lot. And mine has stuck to me no
>problems. I've gone swimming, obviously (I should hope 'obviously') I
>take showers with it on, and I even lounged around in a hot spring
>wearing mine. No real issues.

I've been wondering (for values of "wondering" that include "super-anxiously paranoid") about that, since pool time is a valuable source of activity for me in the 11 hours per year it's possible here in Maine. Since the sample/demo sensor I'm wearing now didn't come with purpose-built covers or shields of any kind, I've been trying various forms of water-resistant bandage over it (Tegaderm, those big square waterproof Band-Aid-type things), but I can't get any of them to stay sealed reliably to save my life, and it's stressing me out more than if I just didn't bother. The sensor's been on for a week now and I can see it's starting to get a little loose around the edges. It vexes me.

When the "production" ones get here, my orders are written to wear them for 10 days each, not the full 14 they're rated for, so that's may help.

>That said, I *have* snagged it on things and yanked it off a couple of
>times, and the aforementioned covers would protect against that.
>Basically they create a slope that whatever surface you're bumping
>against can ride over rather than snagging on the cliff face that is
>the edge of the sensor.

Mm-hmm, paranoid about this, too. The Dexcom ones come with an overpatch thing that's featured in the instructions as more or less mandatory, probably for that very reason. (Hilariously, in all the photos on their website, the models aren't wearing that part so you can see the sensor, so they have to add fine print to each and every photo reminding you that everyone you see is Doing It Wrong and you're supposed to have the cover part on. :) Hopefully it's better staying on than any of the improvised coverings I've tried on the demo Libre 2.

--G.
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Benjamin D. Hutchins, Co-Founder, Editor-in-Chief, & Forum Mod
Eyrie Productions, Unlimited http://www.eyrie-productions.com/
zgryphon at that email service Google has
Ceterum censeo Carthaginem esse delendam.

My doc is trying to get me to 'upgrade' to the Freestyle 3 or the Dexcom but so far at least there have been no problems getting refills and I'm crotchety and don't wanna buy a new phone when my existing one works just fine (and gets 4 days per charge still!)

That said, the sensors themselves run me a fair bit o' change out-of-pocket, so if the Dexcom turn out to be cheaper to refill then I may be making the switch anyway. The doc, my insurance, and the pharmacy are playing a three-way game of telephone at the moment because none of them can tell me just how much it's actually going to cost.

(I'm not going to start ranting about how in the modern era I *refuse* to believe you can't tell me how much something is going to cost until you've actually ordered it and charged my insurance company. I'm not. I've ranted about that too much already.)

Re: the water issue -- I ordered these (Amazon: https://www.amazon.com/gp/product/B08CYD77W6 ) and they worked pretty darn well. Obviously they won't fit Dexcom units but the principle is the same. I went with these because they have no glue in the center so I can remove/replace them as needed without affecting the CGM itself. The covers didn't last long individually but replacing them every few days was a lot less expensive or annoying than replacing the sensor would have been.

--sofaspud
--

Oh, sure, Dexcom makes one of those for the G7 as well (maybe also the G6? not sure). The problem was that this first sensor was just a sample that the diabetes education nurse up at my local hospital had on hand, which she wanted to put on as a trial to see how well I took to using the things while we waited to see if the paperwork would go through for an official supply. She only had samples of the sensors on hand, not the reader devices, so for that initial trial, we had to go with one that my old phone could talk to.

(And yes, this does mean I could have gone with the external reader when I ended up approved for the G7 and kept my old phone, but a man only has so many pockets, you know? Besides, it was time.)

One annoying side effect of the way the timing worked out for this whole process is that we'll lose the trend tracking data for this trial period and have to start completely over, since the Abbott and Dexcom apps don't talk to each other. It's not the end of the world, but two weeks is two weeks.

>I went with these because they have no glue in the center
>so I can remove/replace them as needed without affecting the CGM
>itself.

Yeah, that only occurred to me after I stuck a Tegaderm over my trial widget the first time. Fortunately, it wasn't a problem (and they seem to do the best job overall, but they're the hardest to put on and they're expensive), but it did give me a little angst when I realized it.

Also, I wish I could actually wear mine where the model is shown wearing it in the photos on that Amazon page. Not only would it make applying and removing covers and whatnot much easier, I hate not being able to see the damn thing.

--G.
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Benjamin D. Hutchins, Co-Founder, Editor-in-Chief, & Forum Mod
Eyrie Productions, Unlimited http://www.eyrie-productions.com/
zgryphon at that email service Google has
Ceterum censeo Carthaginem esse delendam.

My first thought is to see if you can export the data as a CSV or the like. Then import it to the new app.

Now that I've been fitted with my first G7, I can report that the stock Dexcom "overpatch" is basically the same concept, but a little smaller and in white. I don't have any data on how well they hold up yet, but each unit only comes with one of them, so evidently Dexcom is pretty confident in them.

One significant difference in the end user experience I can report between the two systems is that you don't have to do the actual "scan yourself like groceries" thing with the G7. You just look at the app (or the reader gadget, I assume) and it tells you what your glucose reading is right now. It took me a while to realize that's what was going on, and I wasn't just holding my phone wrong and failing to get a scan.

A bit annoyingly, while there is a G7 app for Apple Watch, there isn't one for Android smart watches (and if/when there is, it probably won't work on my antique Gear S3 Frontier). But I suppose you can't have everything. At least the notifications should go over there. After all, they're just notifications.

--G.
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Benjamin D. Hutchins, Co-Founder, Editor-in-Chief, & Forum Mod
Eyrie Productions, Unlimited http://www.eyrie-productions.com/
zgryphon at that email service Google has
Ceterum censeo Carthaginem esse delendam.

Following up to your aside, even though it's mostly off-topic for this thread -- the way Bluetooth was designed, any app that can pair to a Bluetooth device can also scan every Bluetooth device in your house, pair with beacons installed in stores, etc., so Google thought this needed to be under a specific app permission so as not to be a privacy nightmare.

But this was basically impossible to explain to ordinary users, so they just folded the permission in as part of "Location". Your headphones app (probably) isn't accessing your GPS, it just needs to be able to scan to find the headphones.

That wasn't a thing Bluetooth did until fairly recently, though; I used BT earpieces, speakers, and so forth for years before they started demanding that I turn on Location on my phone before they would deign to work. That's the part that I find infuriating, because they themselves may not be using GPS, but now I arbitrarily have to have that function switched on in the phone's config itself in order to satisfy them, precisely because they aren't differentiated at the phone's level.

I recognize that this probably annoys me disproportionately, but it still annoys me, in much the same way that it still bugs me how touch screens became the norm after I spent 20 years trying to get people to stop touching the goddamn screens. :)

--G.
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Benjamin D. Hutchins, Co-Founder, Editor-in-Chief, & Forum Mod
Eyrie Productions, Unlimited http://www.eyrie-productions.com/
zgryphon at that email service Google has
Ceterum censeo Carthaginem esse delendam.

*With access to a big honking database mapping groupings of bluetooth addresses to physical locations, but that's at least theoretically possible. Of course, the current permission arrangement would make building that database easier, wouldn't it?

-IA.

(i'm not a phone expert but i get paid to pretend to be one for about half of every working day)

I've thought about suggesting that my mom (also a type 2 diabetic) should check into one of those since her entire reason for avoiding checking her glucose levels as regularly as the docs insist is she hates the finger sticks.

Well, that and her docs up til now seemed happy with her levels after she got them under control by losing weight.

--------------------------
CdrMike, Overwatch Reject

Man. Whatever's going on with mine seems to be more elusive than that, which is both bad and good. The stress test is still a few weeks away, but that two-day Holter I had last week showed nothing abnormal apart from rate. So we'll see how that goes. Hoping it turns out to be something electrical, and that your docs are right about those meds. :/

--G.
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Benjamin D. Hutchins, Co-Founder, Editor-in-Chief, & Forum Mod
Eyrie Productions, Unlimited http://www.eyrie-productions.com/
zgryphon at that email service Google has
Ceterum censeo Carthaginem esse delendam.

Thanks. Yeah, they've got me scheduled for another echocardiogram in a couple weeks, probably to verify that the MRI estimates are good and my heart's ejection fraction has improved (from roughly 20% to 30%) due to the meds. Supposedly they also want to do another cardio catheterization but this time running the line from my neck down into the right ventricle to get an overall picture of my heart health (such as it is), but the cardiologist whose wheelhouse that falls in has not contacted me yet. Speaking as a layman, my guess is if they do both and are satisfied with what they see, then I'll just stay on meds until I eventually get bad enough that I become a candidate for a heart transplant.

On a (morbidly) lighter note, the cardiac surgeon handling my case decided the arterial blockage that led to all this being so complete that I'll never have to worry about future blockages in it counted as "good news." I do so love medical "humor."

--------------------------
CdrMike, Overwatch Reject

---
"She's old, she's lame, she's barren too, // "She's not worth feed or hay, // "But I'll give her this," - he blew smoke at me - // "She was something in her day." -- Garnet Rogers, Small Victory

FiMFiction.net: we might accept blatant porn involving the cast of My Little Pony but as God is my witness we have standards.

--------------------------
CdrMike, Overwatch Reject

See?

While it was off, I got a picture of the back, too. You can see the little wire it does its business with. (That discoloration is lint from the shirt I was wearing, I think...)

--G.
-><-
Benjamin D. Hutchins, Co-Founder, Editor-in-Chief, & Forum Mod
Eyrie Productions, Unlimited http://www.eyrie-productions.com/
zgryphon at that email service Google has
Ceterum censeo Carthaginem esse delendam.