It’s not directly about the pageviews. It’s about the connections that can come from those pageviews. One single pageview could put a person down a path to a happier, healthier life. It’s a bit hyperbolic but that’s the power of this community. That’s the power of support. Sure, it can be about the numbers, just make sure you’re focusing on the *right* numbers.

-Me

Have a nice weekend.

Across the Internet you will find countless success stories about the Dexcom CGM. Scary lows avoided, A1c’s lowered, pregnancies a little bit easier to manage (because giving birth is easy, right ladies?), and ultimately quality of life has been raised. For those of us with insurance living in the now, this thing is great. I know Dexcom is working on, among other improvements, a 10-day sensor but that isn’t what I want out of the next-gen Dexcom. Although, the thought of getting a single sensor to last a full month does sound like a nice achievement.

Since Dayle and I started hanging out way back when, diabetes has always been something of a shared experience with us. We’ve dealt with failing OmniPods, forgotten test strips, I’m-out-of-lantus-pen situations, and plenty of low blood glucose readings. We both work pretty damn hard to get things right diabetically speaking. It’s her “fault” I’m eating healthier and ultimately using the Dexcom CGM. I’d like to think I’m part of the reason she switched to insulin pens after a number of consecutive bad experiences with her OmniPod. If one of us forgets our CGM charger on our way to work, there’s a good chance the other has one in their bag (She saved me on that one today). Included with this shared experience are the Dexcom alarms.

Despite what the pictures I post on Twitter may suggest about my diabetes management, I’m not perfect. Highs and lows are a frustratingly persistent recurring theme of my life with diabetes. I do what I can to minimize the bumps in the road, but it’s never a smooth or easy process. Most of the time it’s “Oh, you’re low, would you like some juice?”, “Can I have a (pepper)mint (patty)?” or the dreaded “that’s your high alarm. Again.” That last one is the kicker.

During the day I can do a pretty solid job of staying on top of my blood glucose. I think being at work helps focus on the important things of the moment, namely 1. whatever report I have to complete at the moment and b. what my blood glucose reading is. By the time I get home, make and eat dinner and watch last night’s Jimmy Fallon my brain is fried and I need sleep. It’s those hours between 11pm and 5am that lack my full attention diabetically speaking – naturally, I’M TRYING TO SLEEP. The last thing I want to do is (half) wake up, find an insulin pen needle and deal with another injection at 2:30 in the morning. Sometimes I treat high or rising blood glucose levels immediately and with swift justice. Other times I just acknowledge the alarm and try to make the most of sleepy time before the morning routine begins.

If I don’t treat the high or at the very least acknowledge the alarm then the Dexcom receiver gets angry and starts yelling. BEEEEP BEEEEP. Sometimes I hear it. Sometimes I don’t. Sometimes Dayle hears it. Sometimes she doesn’t. No matter what happens, there’s a chance I may wake Dayle up and that’s not fair. We may share some of our diabetes experiences, but this is one I wish I could bear on my own. Yes, my blood glucose is high. I’ll deal with it at some point but please leave her out of this.

What I want, back to the point of this post, is a way to set alarm thresholds and alerts throughout the day based on the time – much like basal rates for an insulin pump.

During the day I could probably do well to lower my high threshold from 180 mg/dL to 160 mg/dL, assuming I have the motivation to stay on top of things. But at night I want a little more flexibility. Not that high blood glucose readings should ever be tolerated but let me move the threshold up to 200. Or, let me keep the high threshold at 180 and have a secondary “okay, you really need to do something about this” threshold set above that – like the 55 mg/dL on the low side. Give me an initial high threshold of 180 with a 2 hour snooze and a Super High threshold of 200 from the hours of 11 to 5, or something like that and we’ll be set.

Yes, I can manually change these settings each time I wake up and before I go to sleep but you pump users aren’t manually changing your basal rates every hour, are you? It’s not unreasonable to think the same is possible with a CGM, is it?

If I can manage the different thresholds depending on the time then maybe nights would be a little more restful and more importantly I can respect the fact that I’m not the only one having my sheep counting disturbed at night.

So what do you think? Time-based Dexcom alerts that you set and manage similar to a pump’s basal settings?

[Girlfriend's Note]

Hi. Dayle here. Three things I’d like to add:

1. Let’s not forget that my CGM goes off in the middle of the night, too, and no doubt wakes you up from time to time, so it goes both ways. Although I don’t think that diabetes is what keeps us going (despite my grandma’s comment last month as we pulled out our insulin pens at the dinner table that “those who stick together, stick together”), I do think it’s nice that if my CGM is going to wake up someone else in the middle of the night, at least it’s someone who understands a gazillion %. I know that you won’t judge me for rolling over and snoozing another five minutes. Not sure if that’s because you wear a CGM, too, or if that’s because you’re you – and the best man I know.

2. While I like the idea of time-sensitive threshold shifts, I also like the idea of controllable volume settings. Combine the two, and you could have the volume change for the hours at work, at home, in class, and while you’re asleep. Maybe rather than worrying about waking up our significant others, the “while you’re sleeping” alarm could be more assertive and really say, “Wake up Chris, you need to do something.”

3. To take the idea a little further… if Dexcom doesn’t want to take their technology in that direction, maybe they could create a buddy system with mobile health tools. They are probably looking into bringing readings up on a cell phone already (as the FDA continues to define what a mobile medical app is), but what about alarms? Maybe I like my job too much, but there really could be an mHealth opportunity here: program the CGM to trigger the phone, with its advanced ability to buzz and make all sorts of sounds with volume control, so it’s your mobile phone that wakes you up. Might not be as direct as we’d like, but it’s a thought. You could even combine it with our boy Jimmy Fallon’s mobile app so that when you’re blood glucose gets too high, it’s Jimmy Fallon calling you and telling you that it’s time to get up[and take a correction bolus].

And, for the record, both you and keeping your blood glucose in range are worth waking up for – any time of day or night.

Keep up with the latest in Quinn’s world on her website at quinnnystrom.com and on Twitter @QuinnNystrom.

Run Time – 57:38

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In case you wondered what it’s like to have a small rotisserie oven in your home.

This was from this past weekend.

Hungry?

PS. Happy Birthday Mom!

That book is pretty funny. You should check it out.

I know the only thing you really need to keep is the senor packaging for identification purposes but it just seemed like the natural thing to do to keep everything together.

In less-weird news, Dayle and I booked our flight, stay and car rental in Orlando for Friends for Life. I had a rather green hue about me during last year’s conference following everyone’s tweets, status updates, blog posts and photos. I’ve made so many connections over the past few years that it feels like a genuine disservice to the community to not participate in something as entertaining as Friends for Life. Sure, there are financial considerations to factor that prohibit some people from going – I’m not taking away from the real world. But what good is all of this social media stuff if we’re not Social?

I may not get to every meetup in the world, but I try to make the most out of the opportunities I have. Even if it’s only for a few minutes.

Look who we found – @Diabetic_Iz_Me! (@hellocupcakedc) twitpic.com/8aww9r—
Christopher (@iam_spartacus) January 23, 2012

Anyone else miss the bit about spam monkeys on @sixuntilme's comment form? I always pictured the Wizard of Oz monkeys carrying cans of Spam.—
Christopher (@iam_spartacus) January 20, 2012

Is there a spam theme song? Can it be sung in the tune of 'Yellow Brick Road'?

Have a great weekend.

Cutting the cord works for us logistically because we spend most of our time watching shows off the DVR. We watch Jimmy Fallon the day after it airs. We tape Modern Family and the Thursday night lineup on NBC and watch it later because our jobs and commute leave us with enough energy to make dinner and not much else. Watching live television basically boiled down to Football and Hockey – more on that in a few sentences. Outside of the DVR our media came from a handful of familiar streaming services: Netflix, Amazon and HBO Go. If you add in Hulu Plus, Roku offers the ability to consume all of those streaming services through one handy device.

Simply put: Google Reader : RSS :: Roku : Streaming Television Services. Rather than go to each service individually through an iPad or Xbox or through your laptop’s HDMI output, Roku functions as a central hub for all your streaming needs. After a few minutes of configuration and account verification, you are ready to watch all your favorite programs online. Legally.

Jimmy Fallon, Parks and Recreation, Modern Family, Saturday Night Live? Hulu.

Top Gear (the BBC version, not that American nonsense)? Netflix.

The Wire? HBO Go.*

Downton Abbey (Season 2)? Amazon.

*There is a huge caveat with services like HBO Go or EPIX (also available on Roku). You must have a current subscription to HBO for HBO Go to work. Thankfully my dad was kind enough to not change his account password. (Kidding, I asked for permission to use his account.) In theory this same set up could work for you, assuming you know and trust someone who currently subscribes to HBO one way or another. It’s not cheating the system. HBO gets their cut and that paid account accesses a service it is entitled to. I’ve rationalized this plenty in my head, so please don’t try to convince me otherwise.

Again, live sports is the biggest drawback to cutting the cord. If you don’t have a friend that you enjoy watching the game with or a bar-type place you can loiter at from 1-8pm every Sunday, this may not be for you. Of all the major sports, Football does not offer any kind of paid streaming service for displaced fans. NHL, MLB and NBA have stepped into the modern age but not the NFL. And if you think about it, their revenue stream is so profitable that they don’t need to consider it. It’s a shame, but it’s reality. For the regular season I can stream NFL RedZone off my phone through mini-HDMI to my TV, so we aren’t completely cut off. As far as NHL, I had a master plan that we’ve yet to implement. But I’ll let you in on the secret anyway.

NHL GameCenter primarily serves displaced fans in out of market areas. Bruins fans living in southern California. LA Kings fans in Maine. That kind of thing. But Capitals fans living in Sterling are out of luck. Technically. But I had set up a deal with Dayle’s sister, who lives in Tennessee, to take my money and set up an NHL GameCenter account in her name, with her address tied to it so the Capitals would be out of market for her. The only games she (“this account”) wouldn’t be able to watch from the DC area would be when the Caps play the Nashville Predators. 2 games out of the entire regular season? I’m okay with that. Ultimately we decided not to go forward with the NHL set up, but I felt confident in my master plan.

At the end of the day Roku was the right choice for us. Our viewing habits match well with how content is made available on the services Roku can access and we have enough external options for live TV if we absolutely need to watch something as it occurs. Ironically we’ve gotten a lot more reading done in the past two weeks since setting this thing up. With less time spent channel surfing, I’m finally making progress through the Stieg Larsson books. Dayle read the Hunger Games trilogy in a week. And my Comcast bill was halved (after returning all the gear and getting my own modem instead of the rented one they supply. Forget that noise).

If you still have questions about Roku, Boxee or any other streaming hub let me know. I’m here to help.

Check out Consetta’s work at Parker Publicity and be sure to see what Rancho Obi-Wan is all about too. If you’re a fan of Star Wars, this place needs to be on your bucket list.

Run Time – 1:12:50

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This is one of those moments that I wish I self-hosted my blog so I could make a more meaningful statement with the lot against censorship. Imagine what the Internet would be like if sites like Wikipedia and YouTube were but a shred of what they are today. Where the Internet is reduced from the utility and necessity that it currently functions as to a place where creativity dies instead of flourishes.

Piracy is real. It’s a problem. I’m not denying that or endorsing illegal activity. But until there is a) a way to accurately quantify what piracy is really doing to the industries that claim to be hurt the most and 2. a smart way to combat illegal activity, the broad strokes proposed are not a sufficient response.

Tomorrow’s post will be up at 7:59am. After that I’ll be off the grid for twelve hours. I’m sure I won’t be missed, but it’s my small contribution.

http://sopastrike.com/

Con: That means twenty-one straight days of insulin injections on the same side of my body.

Somewhere on the way to twenty-one the mentality of getting the sensor reaches a boiling point. Normally the mentality focuses on getting the sensor to last because these things aren’t cheap and it’s economical to stretch the life of a sensor if the data remains reliable. For me, any length past twelve days signifies a well-used Dexcom sensor. Fourteen means I applied additional tape or adhesive at the right time and in the right places to ensure maximum stick-to-me-ness. After that I’m just getting greedy.

Then the reality sets in that I’m approaching the mythical beast that is twenty-one. Do I publicly comment on it and risk jinxing myself? Do I apply more external adhesive and brute force my way to the legal drinking age? Do I do nothing outside of the norm and hope that the status quo is enough to get me to the promised land?

Odd that these are the thoughts that occupy my mind. Not, did I properly bolus for that brownie? Should I have a second piece of bread with my spaghetti? Is a piece of bacon chocolate really required tonight (YES, yes it is). I suppose this means that things are going well for me diabetically speaking. I suppose.

What it does mean is that I’m able to brush the frustrating moments aside with relative ease. They happen. Often. But I’m doing a better job of not letting them get to me for extended periods – even if the highs stick around for way too long.

So take that diabetes. And thank you Dexcom.