Surgery and the Dexcom

I don’t actually use that widget, so I’m shooting blind on the recommendation. On my Android, I can see basic info with the XDrip widget like bg and trend, but need to tap into the app to get finer granular details which requires going past the lock screen

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Before the widget became available, I had an iPhone that did not allow you to disable the lock screen. This was super inconvenient trying to use the app when driving, because I always had to unlock the phone to be able to see the number! And unlocking the phone when driving was a bad thing.

So I came up with a workaround. Whenever driving, I would open the navigation app and just pick a random location. As long as the navigation app was giving me directions, the phone would not lock.

I don’t recall the phone version, it was a version 4 or 5, many years ago.

The widget was definitely a nice addition.

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Thanks to all for comments and recommendations! I decided to offer both the Lock Screen widgets and just unlocking and setting screen to not dim. We’ll see how it goes… Can’t be too worried, I’m already entrusting them with my life, eh?!

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@TomH I wouldn’t stress too much, most gasser’s are interested but won’t avail themselves of the tech instead relying on their own equipment to determine insuline\glucose needs because of lawsuits.

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The short story: Be your own advocate, particularly in the medical community, demand (nicely but firmly), to know who’s watching out for your T1D needs when you and your loved ones can’t; don’t be intimidated by doctors, nurses, or technicians. And be prepared to tell them how to do it, because they might (probably?) not know the what and how.

The long story: I’m done with my procedure, four biopsies taken and all seems ok. Despite telling everyone I was T1D, concerned about my BG during the event, and trying to get answers on the who/how of monitoring my BG from literally everyone I talked with, no one knew a thing. Every time it was “I don’t know, I won’t be there, I’m just taking/making calls.” The closest I got was “talk with the anesthetist when you get here.” That’s a little late for my comfort factor. It didn’t help that the night before, no food, special drinks, etc., led to a 70 BG and dropping; cutting basal 20% did nothing, tried several temp basals, ended cutting 65% just to get it to 120, then wandered to 135; fine with me.

Still didn’t know who/how BG would be monitored! At the surgery center, the first lady had no clue, sent a nurse over. The nurse understood the pump/G6, but wasn’t involved in my case, mentioned doing a finger stick at beginning and end…I don’t think so! She assured the anesthetist would talk with me. Another nurse took me to change, wanted to start an IV; I asked what’s in it (glucose?), she got flustered, said it was a standard IV. I MIGHT have been a bit abrupt, but told her I wasn’t doing another damn thing until I got answers from someone that understood T1D, who/how my BG would be monitored…she mentioned finger sticks before and after. Wrong answer! No longer amused, I told her to find someone that knew something about T1D, that would be involved in my procedure, could speak with authority, or I was leaving. I overheard the conversation outside; a guy said, “He’s got some concerns, he should have, I’ll talk with him.” The center’s lead anesthetist came in; I laid out my concerns, he exhibited a decent T1D understanding of BG levels, though not current tech. I showed him my pump, G6, how I’d set up my phone for use if they wanted, and we agreed the actual anesthetist would discuss before they gave me anything, they’d use my phone to monitor my BG. Sure enough, as soon as I entered the surgery room the anesthetist came over, asked to see my pump and G6, asked for my phone (I’d set it not to shut down), showed him how to access the Lock Screen widgets, gave him the lock code, the G6 icon on the home screen. The comment: “We’ve got to get up-to-date on this stuff!” One more thing: in the prep room, the nurse drew blood for a BG check using some device (red plastic, 3"x2"x8" at least) and told me my BG was 106; I’d just checked my G6, it was 152; I asked to a finger stick with my Contour Next…148…the anesthetist said, “We’re using his readings, get that thing checked!” It could be they were placating me, but I felt better anyway! A I was leaving, the discharge nurse said, “By the way, I’m T2, I use a Libre. It’s good to have someone that knows something!” Thanks to the folks her on FUD for helping educate me!

Lastly, I participated in a JDRF event on seniors and T1D last Friday (Hey, I’m 67, almost there!). It mostly discussed T1D seniors in carehomes, undergoing surgery, and how little the medical community was prepared for us. It heightened my awareness (possibly a bit much). A lady on there, Joanne Milo, runs “The Savvy Diabetic” blog. I don’t know her, but she has a format she recommends for T1D seniors/others that may be worth a look, its at: Savvy and Prepared T1D, 7/30/21: How to Set up Your Personal Medical Resume & Go Bag | The Savvy Diabetic

Sorry this is so long…

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@TomH, I am so glad the procedure went well and everything is fine. I wish I was surprised by your account, but having worked in the medical system for years, I am not. I do think you handled it well, and advocated for yourself, which is great. I also think you achieved a small victory by their admitting you had a point in your concerns. Crazy that the discharge nurse understands, yet no one else seems to. Compartmentalization at its best /s

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When I went for a colonoscopy, I watched a nurse wheel an IV stand over to me, with a bag labeled “Dextrose” hanging from the hook. As the nurse approached my arm with the needle, I asked her if she had calculated the amount of insulin she was going to give me every 15 minutes so I didn’t go into DKA. She recoiled in shock and another nurse said “Look at his chart. He’s Type 1.” Then they offered me saline instead, which I accepted.

Makes me wonder what happens if they ever wheel me in unconscious.

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You know what will happen. And yes, it will happen, and they will figure it out at your second routine blood work. The worst part is that you will have sky-high glucose but it won’t be discovered until the second routine blood work because they will have drawn the first sample before the dextrose hit your system.

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I think with G6, the transmitter holds the key start date for sensor, not receiver/app. So once trans ID entered and paired, it may just start getting reading from transmitter.

Receiver date may be updated, or just ignored.

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@bkh and @Chris The situation you describe is exactly the problem the JDRF event on seniors discussed! I must say, with some retrospect, that I appreciate the situation healthcare people (Dr’s, RNs, LPNs, etc.) are in. Just as society expects cops to be teachers, social workers, mental health experts, telepaths, etc., we also expect a lot of healthcare workers. They get in a routine (start an IV, ensure fluids), the standard saline or dextrose solution, without checking the chart or for necklaces or bracelets. I get it, we’re the exceptions; but I also don’t want to go around with “T1D” stamped on my forehead! So the solution has to involve both “us” and “them” all of us. I recall when in training to be police officer (I was a reserve officer in Chula Vista CA), they taught: “Don’t be in such a rush that you get yourself killed, walk up to the door, be alert for ‘XYZ’, stand to the side when knocking, etc.” Likewise, healthcare folks need to be alert to the signs the situation may not be “the norm” and particularly when the guy/gal jumps up and down, waves hands, and says, “Hey, I’m different!” perhaps they should listen. Until then, when I go in for any procedure, I’m asking them to sign a piece of paper too, something along the lines of: “I have been advised the person I’m treating is a T1D, and among other factors monitoring his blood glucose is paramount and applying glucose or similar agents will have potentially drastic consequences. I understand the impacts of this T1D condition in the context of all tasks I may complete. I will consider this T1D status in all efforts I undertake and suffer the consequences causing significant, possibly catastrophic, harm to this person!”….I’m betting no one will sign it!

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And you would be right. No employer would want their employees to sign it either without legal review. But interestingly, you might be able to to get your paper initialed. People have a much lower threshold for initialing. With that being said, I think you will be fine going forward because you are advocating for yourself.

edit - I bet you have better luck telling the medical team that you are allergic to dextrose. just a guess though. People appear pretty sensitized to food allergies for some reason.

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In the past 30 years all of my surgeries, in patient and outpatient, have been at the same university health system as my diabetologist. He has a PA that visits all T1s undergoing surgery, and she speaks with the surgery team, and Medicine/Internal Med. In my electronic record is a notice that I am to regulate my own BG, and administer insulin with a pump. I make it clear to my care team I am in control of my diabetes
One time, when I had an extended stay in the hospital, Medicine came in and insisted they control my BG, and were very insistent. I acquiesced, under the condition that if their algorithm did worse than me, I would take over again. Well, they came in 8 hrs later and apologized for my BG being above 300, wanting to know I do it. My answer: Practice.

And be aware of the nurses that insist they are in control, and if they don’t like it, well then read my chart, call the Endocrinologist on call, and bring in the head/charge nurse.

Always let your PCP or diabetologist know you are going into the hospital, and ask that a PA speak to the surgeon.

Mike

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It’s always the last place you look…or not look as the case may be…

My wife took a trip to Boston with her sister, Aunt, niece, daughter, etc. I stayed home, too much estrogen for me! Part way thru the trip, I get this text with a pic of the Dexcom receiver…”Is THIS what you were looking for?” Apparently I packed it as a back-up to my phone when we went to Disneyworld with our daughter, her husband, and grandson last October and it got stuck in one of the suitcases we used! Moral of the story: when you’ve searched “everywhere” in the house, check your luggage!

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