My name is Clemma and I am writing about my experience with the Dexcom Seven continuous glucose monitoring system. I live in Minneapolis with my young son and my not so young husband. I was diagnosed with Type 1 diabetes 11 years ago, when I was almost 21 years old. I started pumping 7 years ago, first with a Minimed 508, then an Animas IR1200, and now with the OmniPod. Friday, June 29 I hooked up to my newest constant companion, the one and only Comrade Dex...
Tuesday, September 18, 2007
Last Sunday morning I wake up and try to do a finger stick test so I can calibrate the Dexcom. "ER 4". Ooops, maybe that's one of those not-enough-blood, or one of those you-idiot-wait-for-the-blood-drop-prompt messages. Try again. "ER 4". And again "ER 4". Screw it. Wait a couple more hours. Try again. "ER 4". Where the heck is my OneTouch Ultra manual? Can't find it. Oh, there's the OneTouch Ultra2 manual, the meter I really prefer but can't use because for some messed up reason they only synced the technology with the plain old Ultra. Still, the error messages are probably the same, right? Look up "ER 4". To summarize: 1) High glucose and a cold tester; 2) Test strip problem; 3) Sample was improperly applied; or 4) Meter problem. OK, I have been using OneTouch meters for 6 years, and I know how to properly insert the test strip and apply the sample. I suppose there is a slim chance it got cold, lying there under my pillow during the night, so I stick it in my pocket to warm it up. Try again "ER 4". Screw it and wait a few more hours. Realize I have to call Lifescan customer service because the thing is going to quit on me if I don't calibrate soon.
Now the fun really begins. I happen to know I initiated the call to Lifescan at approximately noon. They have an annoying voicemail maze before you are awarded the honor of being on hold for a customer service representative. I sat there on hold for quite a while, gosh, maybe 10 minutes. I got bored and started painting my living room while holding the phone to my ear (I really have to get a headset for times like this). About 30 minutes later I remarked to my sister that I thought this might be the longest on-hold experience of my life, but I was making good progress on the baseboard trim. Twenty minutes later, after one full hour on hold, I estimated that I had listened to their canned message telling me how much they appreciate my patience at least 20 times. Oh - and did I know they are on call for my needs 24 hours a day, 7 days a week? I know smart people have done research showing we customers prefer occasional recorded reminders that we haven't been cut off, but by this point the recorded voice only reminded me how completely my patience had gone away.
After 75 minutes my sister speculated that they don't actually have any customer service agents working on a Sunday, and they just use that recording hoping we'll get annoyed, hang up, and call back on a week day. I am nearly done with the living room trim by now, and I have a crick in my neck from holding the phone, and I am really, really, mad. BUT I stay on the phone because what else can I do? I have no other way to calibrate the meter, and the clock is ticking on my very expensive sensor!
As mad as I was, I tried to temper my rage when the hapless customer service representative finally did pick up the call after NINETY MINUTES on hold. I like to assume that this is not her preferred career, and have compassion that her idiot bosses didn't hire enough staff to, well, SERVE their CUSTOMERS. Actually, she had to wait for me for a couple minutes, because I had finally let my sister hold the phone while I used the facilities. Now, this was a nice woman. She went through the protocol and fairly quickly told me a replacement meter would arrive on Tuesday. Part of her protocol is she has to ask questions about whether the glitch in the product caused any actual medical calamity. Did I have to alter my medication because of the problem? Did I have any adverse reactions to too much or not enough medication because of the problem? Well, no, I guess not, I mean I still took my insulin and I didn't pass out or go into ketoacidosis, but where is the question about how much money it will cost me to go three days on this sensor with no way to calibrate the system? Since she didn't even know what the Dexcom CGMS was, I wasn't surprised she didn't ask about the financial ramifications of the meter failure.
Before I end this rant, let me just make sure you noted that last point. This CGMS system, which requires us to use a Lifescan OneTouch Ultra meter, is totally unknown to at least one of the customer service representatives who answer the phone if you have meter problems. Does that seem weird to anyone else? It seems weird to me, but maybe I'm still reeling from the paint fumes I inhaled while hyperventilating from on-hold rage.
The key takeaway here is: try to convince your Dexcom rep to send you two new OneTouch Ultra meters when you buy the system. This is the first time I had a OneTouch meter fail, but it cost me at least 3 days of my sensor, which was extremely vexing. Also, don't have the poor planning to EVER need Lifescan customer service on a weekend.
Wednesday, September 12, 2007
I have also been on the fence about whether to continue using the Dexcom system. On the whole I like it, but honestly I'm not sure it's worth $240 each month. I know for some people it is working great and totally worth it, but for me I'm still undecided. I don't know what my standard deviations were before starting the Dexcom, so it's hard for me to tell if I'm reducing my overall variation.
Back to the endo visit: At the office I was expecting a high A1c. My last reading, about a month and a half before I started the CGM, was 6.4%. Imagine my shock when the A1c came back at 6.1%! I was so surprised I asked if their machine might have been wrong. The tech assured me it was accurate, so something is going right, the last three weeks notwithstanding.
Conclusion: I'll stick with it for now and see if I can go under 6.0 next time.
Thursday, September 6, 2007
The Dexcom insurance submission goes as follows:
1) Contact the woman who is in charge of obtaining insurance coverage for Dexcom customers.
2) Fax this woman a copy of my insurance card; subscriber's name, employer, and date of birth; my relationship to the subscriber, and my name/employer/date of birth
3) That is as far as I have gotten. Presumably this nice woman at Dexcom will submit the request to my insurance, at which point they will cover it in full. Hey a girl can dream...
I'll update this post as soon as I have something to report.
If you are a CGMS user who has obtained insurance coverage, please comment to this post and share your story. Heck, even comment if you tried and were denied.