Of mySentry, The Great Race, the Bat Signal and Teens

We are in the early stages of using mySentry, Medtronic’s remote CGM screen. Right up front I need to say that the good folks at Medtronic have made the device available to me to try for a a few months at no charge. They did not ask me to write about it or make any request other than I give it back when I’m done and if I write that I disclose they are lending us the device and supplies.

Delaney is the guinea pig.

Initial I thoughts that mySentry is a great device for folks with younger kids, not teens. Little kids are more sensitive to insulin. Their crazy growth and activity patterns make overnights hard to manage. A remote CGM scree that alerts, loudly (and this thing is loud) I thought would be brilliant to help parents sleep better when the numbers are okay and be altered when they are not.

I didn’t think it was as advantageous for older kids. We are not using it for overnight alerts. In fact it doesn’t live in our bedroom but I do see real value in it.

Don’t get me wrong, I do look at the overnight trend lines. CGM is brilliant for managing overnight trend lines. I made a few minor tweaks to her night time basal. Little adjustments that would not have been possible with finger-sticks unless I got up every 20 minutes or so. This is great but not the surprise that makes me see value in the remote CGM screen with a teen.

The value is mySentry helped me not nag my kid about diabetes. No small feat.

There are time all d-parents worry about their kid’s diabetes. Most of these times our kids are not actively worrying about there diabetes. They are going about their lives as if they have actual lives. Smart.

A quick glance at mySentry could show me that everything was okay and not go nagging her about her blood sugar. Not bugging the kids based on my fears is a good thing. Now that didn’t mean I didn’t talk to my kid. It meant that I knew to shut the heck up about diabetes or If I did say something to positively reenforce good behaviors. So we would talk about her latest sewing or other creative adventure and I could say nothing about diabetes or I could say “Max” says you are doing a great.

“Max” is the Delaney gave the CGM’s. Loosely after Perter Falk’s character in the Great Race. The guy Jack Lemmon’s Professor Fate would tell, “Push the button Max.” Classic film. Go rent it now... No wait... buy it, its a keeper.

Max also is a great way to see how fast insulin from a bolus takes to start being effective and how long it lasts. I found out that her bolus doesn’t really kick in for 45 minutes to an hour. Then it seems to trend down for about three hours. Good to know. I do most of the dinner cooking and so I know when dinner will hit the table. I can give her a pre-bolus heads up sooner than I was to better match dinner. I also a clearer idea of the time there is IOB. This is good information that your typical teen could care less about but dad can adjust in the pump settings.

Not nagging you teens is good.
Giving teens positive feed back is good too.
So are better pre-bolusing and IOB understanding.

What about when things are less than good? Well sensing shows trends and sometimes those are heading the wrong way. (This is gong to get confusing because while “Max” is the CGM sensor the other mySentry parts have other names. The relay station in her bedroom that listens to the pump and retransmits that signal to the screen down stairs Medtronic calls the mySentry Outpost,  we call it the “Bat Signal” because it is a night light with stuff on the light part. That makes the mySentry screen either the “Bat Computer” or “Commissioner Gordon.”)

Sorry I digresses.

Anyway if Max tells Bat Signal something is amiss then Commissioner Gordon gives me the opportunity to intervene before it becomes a real big issue. The key here is not to be  seen as an idiot. Not easy for a parent of a teen.

That is not to go running over and say “Max lit up the Bat Signal and Commissioner Gordon sent me over on an emergancy call.” First that sound ridiculous. Second the key with teens is to build a relationship of trust and they aren’t gonna trust Max if he is a stool pigeon. So when it is clear she missed a bolus, I can stop by her room and chat about about her latest sewing or other creative adventure and as I am leaving casually mention checking and correcting. The message here being the stuff she is interested in is more important than diabetes and oh yeah don’t forget the diabetes.

Still, she is not a huge fan of Max. It is another thing to wear and carry (I didn’t ask her to try to learn to use a new pump too.) inserting a sensor is a little less than user friendly and at times so is taking it off. As a result I find I like Commissioner Gordon more than she likes Max.

It is her body and her diabetes so ultimately it is her call how much she wares it. I think that is very important, maybe the most important thing for me to take away from the mySentry experiment. Using it is her choice.

Talking with Teens

I had a conversation about teens and type 1 diabetes the other day. It was kind of an interview. I answer a lot of questions. I strayed off topic too.  (I know me digress! Who would think it possible?) 

Some how I think I forgot my favorite teen digression: if you expect your teens to talk with you, you need to have invested time talking with them before they were teens. If you were too busy watching the game, playing golf or skipping the occasional midnight movie premiere when they were tweens, you may have taught them you are not interested in them. 

Learn to be interested in what they like. This may come as a shock but all their music doesn’t suck and a lot of your’s does. Some where there is a balance in there. Netflix can help you both find stuff you didn’t now about and can enjoy a conversation on; Man on Wire, Exit Through The Gift Shop. 

It also helps to be genuinely willing to hear what they have to say if they do talk with you. If they like something you don’t, be open to why. Five will get you ten your behaviors taught them the why and you didn’t even know it. 

I like teens, so far they are the most fun age the kids have been. They start showing flashes of real interesting stuff as teens. Some is a reflection that is an interesting perspective of yourself and some is a fascinating tangent from who know where. Either way teens are as good as the time you have invested in them. 

That guess that isn’t any kind of a surprise.




Also on YDMV about teens at T1D: Dr Freud - Endocrinologist and Teen Motivator


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People with Diabetes are Awesome

People with Diabetes are Awesome by Ginger Vieira:

Ya Oughta Know This

 If you live with diabetes you are the primary care giver. If you are a parent your job is to pass that  on and that is harder than taking the responsibility on the the first place.

Here is my good friend Mark, who was the hero of one of my earliest YDMV posts, with 24/7 on the matter:



The plan for d-blog day is six things I want people to know. Six is a lot. I find most folks don't have that much of an attention span. So if y'all get this Primary Care idea - I'm good with that.

Crash Test Dummy

Raise you hand if you put a car into a ditch or other immovable object off the side of the road as a teenager.

I did.

I was cut off on a highway and ran a perfectly good VW Bug into an Exxon sign pillar. The sign was fine. I popped the windshield off the car with my head and it flew 20 feet in the air, bounced and landed unbroken. The windshield did best. I went to the hospital and the Bug went to the scrap heap.

I loved that car.

It was the American dream in a old German car. It was slow. It was noisy.  The heater didn’t work very well, when it worked at all.  But it was freedom. It would go anywhere and, bonus, it fit on sidewalks. However the statute of limitations on some those sidewalk missions may still not have expired so enough said.

It would’ve been nice to miss the sign.

My T1 son is learning to drive. It would be nice for him to miss the sign too and to stay off sidewalks.

Some of all of y’all (a phrase that here means "In select cities"), can get free hands on training to miss the sign and stay off sidewalks.

Medtronic is sponsoring a free driving program for diabetic teens. It is called Test B4U Drive.

If you are skeptical, I understand. I thought “Test B4U” sounds like diabetes preachiness dressed in text messaging slang trying to be cool. I too was a tad skeptical. I mean I am an American Male and therefor endowed by the creator with certain unalienable rights like life, liberty and the pursuit of happiness.

Hello! I am sure that by that Thomas Jefferson meant driving.

Also it means that my American Maleness grants me presumed naturally superior driving abilities that I can passed on to my son both genetically and spiritually. (Your Honor. I move the testimony of the Exxon sign be excluded on the grounds that it is a sign and so has no business commenting on my natural American Maleness driving superiority.)

I mentioned the class to my son and he responded with the comment that the driving session at Friends for Life a few years back was an extremely boring lecture, where they just sat there and listened to some dude drone on. This is what I call this the Charlie Brown’s Teacher Syndrome   “Wa WAA wa Waa WaWa.” (C.B.T.S. - you know I love the four letter acronyms.)

The folks at Medtronic were kind enough to talk with me about the program today. They rolled out their big guns, Dr. Francine R. Kaufman, Chief Medical Officer and Vice President and Amanda Sheldon, Director of Public Relations. You put three people on the phone that are passionate about diabetes care and we tent to all talk at the same time. We did somehow sort out taking turns. 

I asked them straight up how they were going to avoid CBTS with an all day deal for teens? I can’t pay attention for 7 minutes how are they gonna get teens to pay attention for 7 hours?

(I can hear regular YDMV readers saying, “Hey Bennet the T1 teens are probably more mature than you are!” Probably that Kerri chick and her pal Christel. Those two are trouble with a capital T of course that's why I love'm.)

I digress. Back to Test B4U Drive. First of all driving is a topic near and dear to the teenage heart so that should help get attention. (How else can you explain the American Dream in a German car above.) Next while there is some diabetes stuff and there will be an actual endo at each session the organizers get that the day is about cars. So they will also have professional diving instructors at each session. Instructors - plural. One instructor to three teens. 1:3.

The day will be mostly driving and only some classroom. They said it is like six hours playing and one hour of classroom time and it sounds like there is fun stuff to do in the cars. Hard breaking, avoidance maneuvering and my personal favorite skidding! (but not into an Exxon sign - avoiding now there is a concept... )

Medtronic is in the program with the Juvenile Diabetes No Limits Foundation, who I had never heard of. The good folks at Medtronic explained it a group based in Minnesota lat is supports T1 kids living full lives. Cool. I think they said something about the founder being a car racer. Even more coolness.

Test B4U Drive is being offered to teens with diabetes at these select locations, none near me, in 2010, 15 kids to a class:

• July 19-21, The Forum, Los Angeles
• July 26-28, Dick’s Sporting Goods Park, Commerce City, Colo. (Denver area)
• August 2-4, KCI Expo Center, Kansas City, Mo.
• August 9-11, Standard Bank Stadium, Crestwood, Ill. (Chicago area)

Yeah they may mention diabetes care and some of Medtronic’s products and/or services but they are also gonna let you go beat up err.. play no wrong word again... learn in a rental car. That’s a fair deal.

For more information see: http://www.medtronicdiabetes.com/testb4udrive/

Dr Freud - Endocrinologist and Teen Motivator

Getting type 1 teens to take care of their diabetes is a challenge. That teens see themselves as immortal isn't much of a new flash. They rebel against their parents. That they rebel against their diabetes care can be a side effect of that natural process of separation.

My friend Barry over at the Children With Diabetes forums wrote humorously about a technique he used. He brilliantly create something useful from all the "little blue pill" commercials on TV. There are long term consequences of diabetes that strike immediate fear into the hearts of even the immortal teen gods of Olympus, like needing ED pills. So Barry brought that up. Everyone has seen the commercials, teens included. He theroy was teen may not be afraid of death but needing ED pills! That is a consequence to avoid.

This is the kind of conversation about diabetes that makes forums like Children With Diabetes' so valuable and at the same time entertaining. Why not surf over and join in?

Jim Vail of the pump maker Animas Corporation gave a talk with a similarly inspiration to the teen boys at the Children With Diabetes - Friends For Live convention last July. It took a day or two to get out of my son why he had a sudden appreciation of blood swings as being as important as A1C.

It was Jim's genius and it was hysterical.

Even kids who are proud of good averages (a1c) often miss the point that wide variations in blood sugar, even with a good A1C, can have negative long term effects. Hell just saying something as dull as "negative long term effect" is enough to make their eyes glaze over. So Jim doesn't say that. He asks what is an average human being? Well since half of the human race is male and half female Jim suggests "that average is an even mix 50/50 mix of gender specific parts, one of these, one of those.... say one breast one testicle."

Simply "average" suddenly seemed significantly less important to my teen who now was preaching the idea that minimizing variance was key. Jim got through where we had failed.
Jim and his compatriots from Animas are a big part of why this convention is so successful. I recommend the convention to all T1 parents.

So here's to Barry and Jim - guys who can still think like teens, brilliantly harnessing the the raging hormones in the quest form better blood sugar control.