Can I just tell you: I LOVE THIS THING!
I finally received the sensors for my Paradigm 522 on Friday night. The small box came encased in an even larger styrofoam carton, packed with paper and a gel pack. It was like Christmas in June. I was too excited to wait and impatiently ripped into the box as soon as I got to my car. Each little sensor lay enticingly in its' clear blister package, just waiting for insertion, and I couldn't make the poor things wait. So I popped one in as soon as I hit the door.
The sensors are inserted with the Sen-Serter, and my pump trainer recommended that manual insertion be avoided (for depth accuracy reasons). The first sensor that I inserted caused me a bit of trouble; it didn't insert all the way, and I had to push it in myself as best I could. Unfortunately, the design of the sensors doesn't make this easy. But it is doable.
It bled. And bled. And bled. The manual states (in bold, no less) that one should never hook the transmitter up to a sensor site that is bleeding. Press gauze or tissue on the area for three minutes blah blah blah and if bleeding stops hook up blah blah blah if it doesn't stop after five minutes remove the sensor and insert a new one. Blah blah blah. Yeah, well, Minimed's not the one purchasing these suckers for almost $50 a piece (that's CDN $, people). OK, neither am I, but it's the principal of the thing. I managed to stop the bleeding initially and hooked the sucker up. But it bled (and sometimes badly) periodically as I was wearing it.
Now, here's a big tip that I learned by trial and error: Tape this sucker down, and tape it good. 
Pretend it's a hockey stick and tape the living hell out of it. Why? Because the first sensor I inserted slipped right out after only 20 hours of wear. Here I am, getting a million alarms (Self test failed, Calibration Error, etc etc) and I can't figure out why...until I get frustrated and yank the tape off. Lo and behold, the inserted part of the sensor was laying right on top of my skin in a pool of blood. Whoops. Lesson learned. The picture to the right is the current sensor (inserted today) that *fingers crossed* will not slip the joint. One layer of IV300, two layers of Op-site. I will prevail!
After insertion and connection to the Transmitter, the pump has to recognize the new sensor. This requires only a few button pushes, but there's a two hour and twenty minute wait while the system initializes, during which no BG values are recorded. Once the system has finalized, the pump displays a 'BG NOW' alarm for calibration. A quick finger poke and the system is all go.
The calibration part is a biggie. Especially that first calibration. I've learned that if I do the initial calibration while my BG's are swinging high or low, I will have up to a 2.0 mmol difference between the pump and my meter. I was expecting this from the research that I did prior to purchasing the 522, but it's a lot different when you're actually trying to get the system to jive with glucometer values. The unfortunate part is that you have to calibrate the system or the pump will just keep on bugging you to do it, and you'll get a whole wack of errors. So here's what I did. Calibrate it on the low or high number. Then wait until your BG's have stabilized and calibrate it again. At this point I was 2.0 mmol higher on my glucometer than the results of the transmitter, and I got a calibration error. So I waited fifteen minutes (this forces the transmitter to restart itself), took another manual BG, and calibrated with that. Voila, every reading I've had since then is within 0.2 mmol of the glucometer (yes, people, it is accurate!). And I write off the half an hour of wacked out sensor readings that occurred in the interim. Not bad. Not damned bad.
So far, those are the only problems I've encountered with this system. Everything else is roses. It is unbelievably exciting to be able to see exactly what your BG's are at any given time without having to unzip the pack, pull out a test strip, poke a finger, entice some blood from that finger, and wait five seconds. One button push and I can see what my BG is while I'm driving, or gardening, or walking Mollie...you get the picture. Sure, the transmitter is not tiny by any stretch of the imagination, but the trade-off is worth it. I can go into my daily totals menu and see an average of ALL BG's for the day - all 258 (or so) of them.
And then there's the status screen. When I first hooked up to this bad boy, I was literally looking at the 3-hour screen every five minutes. After almost two days of wear, I'm appreciating this feature more and more. Have a look at the picture to the right; it's a snapshot of the 3-hour status screen 
on my pump (click on the picture for a full-sized version). Pressing the ESC key once will access this screen. When the screen is first accessed, the most recent BG value will display; pressing the up and down arrow buttons will scroll through every BG value that was recorded (in five minute increments) for the last three hours. As in the picture, the value will be highlighted and titled "History". The line graph to the left represents dots for each and every BG occurrence; horizontal dotted lines are low and high BG thresholds, and the small bar below the low threshold line represents a bolus (a correction in my case). When you access the menu without going into the history, the current BG value will sometimes display arrows representing trends. One arrow up or down, and BG values are changing by 1.2-2.2 mmol per 20 minutes; two arrows and BG levels are rising or lowering at a rate of more than 2.2 mmol per 20 minutes. Big BIG value in this one. I can tell whether I need to correct or temp up a basal by these arrows. If one arrow is pointing up, I temp a basal. If two arrows are pointing up, I correct. One down, I temp. Two down, I pop some glucose tabs. (These depend on where the BG value is within my target range, of course) So much easier to triage this way!
The 24-hour screen looks similar to the 3-hour screen, but it displays BG values for the last 24 hours, in 20 minute increments. Picture to the left this time. It also displays the most recent BG value and has a charting of all BG values over the last 24 hours. The shaded area represents the 12 hours from 6 pm to 6 am; the light area is the hours from 6 am to 6 pm.
The pump allows you to set high and low thresholds, and if your BG goes over or under that number the pump will alarm. I experienced this feature several times on Friday night while I was sleeping. Turns out I dumped during the night; though I woke myself the first time (shakes and all) I would've slept through the second hypo episode at about 4 am had the siren not woken me (and my dog). Yikes! Instinct tells me that the first episode was an aberration, but I'm not sure about the second. A few more nights and I should know. The pump has unique alarms for high and low BG levels. You all know the standard Paradigm beep BEEP beep? Well, they got crafty with these ones (haha). The low alarm is a most amazing beepbeepBeepBeep, with each beep ascending in tone. The high alarm is the polar opposite: BeepBeepbeepbeep, each beep a lower tone than the last. If you don't answer the alarm within fifteen minutes, off goes the siren. And in that case, it's a great thing to be woken up.
Now, we've all been told that these sensors are only good for three days. Well, that's not true. My pump trainer wears hers for six. She also told me of a guy out East who wears his for nine. I'm shooting for ten ;) The sensor will automatically expire after 72 hours; however, this doesn't mean you have to insert another one. Although I haven't yet tried this myself, my trainer has told me that all you have to do is pretend you inserted a new one and tell the pump that. It doesn't know any better. Bing bang boom, you're good for another 72. Suddenly that $475 box of sensors lasts you two months, not one. Barring any Bad Sensor errors, of course. The trick, I've been told, is to tape tape tape. The sensor needs to be anchored against any sort of movement, and it is possible - and feasible - to wear it for another three days. She also assured me that she hasn't seen any decline in accuracy after extended wear. I'll let you know how that goes.
Other than all that, I am in love. I've attached a few extra pictures for fun. Enjoy!
Sensor/Transmitter:
Old 'Purple' 515:
New 'Smoke' 522 (complete with Thinset Reservoir):
Can I just tell you: I LOVE THIS THING!
I finally received the sensors for my Paradigm 522 on Friday night. The small box came encased in an even larger styrofoam carton, packed with paper and a gel pack. It was like Christmas in June. I was too excited to wait and impatiently ripped into the box as soon as I got to my car. Each little sensor lay enticingly in its' clear blister package, just waiting for insertion, and I couldn't make the poor things wait. So I popped one in as soon as I hit the door.
The sensors are inserted with the Sen-Serter, and my pump trainer recommended that manual insertion be avoided (for depth accuracy reasons). The first sensor that I inserted caused me a bit of trouble; it didn't insert all the way, and I had to push it in myself as best I could. Unfortunately, the design of the sensors doesn't make this easy. But it is doable.
It bled. And bled. And bled. The manual states (in bold, no less) that one should never hook the transmitter up to a sensor site that is bleeding. Press gauze or tissue on the area for three minutes blah blah blah and if bleeding stops hook up blah blah blah if it doesn't stop after five minutes remove the sensor and insert a new one. Blah blah blah. Yeah, well, Minimed's not the one purchasing these suckers for almost $50 a piece (that's CDN $, people). OK, neither am I, but it's the principal of the thing. I managed to stop the bleeding initially and hooked the sucker up. But it bled (and sometimes badly) periodically as I was wearing it.
Now, here's a big tip that I learned by trial and error: Tape this sucker down, and tape it good.
Pretend it's a hockey stick and tape the living hell out of it. Why? Because the first sensor I inserted slipped right out after only 20 hours of wear. Here I am, getting a million alarms (Self test failed, Calibration Error, etc etc) and I can't figure out why...until I get frustrated and yank the tape off. Lo and behold, the inserted part of the sensor was laying right on top of my skin in a pool of blood. Whoops. Lesson learned. The picture to the right is the current sensor (inserted today) that *fingers crossed* will not slip the joint. One layer of IV300, two layers of Op-site. I will prevail!
After insertion and connection to the Transmitter, the pump has to recognize the new sensor. This requires only a few button pushes, but there's a two hour and twenty minute wait while the system initializes, during which no BG values are recorded. Once the system has finalized, the pump displays a 'BG NOW' alarm for calibration. A quick finger poke and the system is all go.
The calibration part is a biggie. Especially that first calibration. I've learned that if I do the initial calibration while my BG's are swinging high or low, I will have up to a 2.0 mmol difference between the pump and my meter. I was expecting this from the research that I did prior to purchasing the 522, but it's a lot different when you're actually trying to get the system to jive with glucometer values. The unfortunate part is that you have to calibrate the system or the pump will just keep on bugging you to do it, and you'll get a whole wack of errors. So here's what I did. Calibrate it on the low or high number. Then wait until your BG's have stabilized and calibrate it again. At this point I was 2.0 mmol higher on my glucometer than the results of the transmitter, and I got a calibration error. So I waited fifteen minutes (this forces the transmitter to restart itself), took another manual BG, and calibrated with that. Voila, every reading I've had since then is within 0.2 mmol of the glucometer (yes, people, it is accurate!). And I write off the half an hour of wacked out sensor readings that occurred in the interim. Not bad. Not damned bad.
So far, those are the only problems I've encountered with this system. Everything else is roses. It is unbelievably exciting to be able to see exactly what your BG's are at any given time without having to unzip the pack, pull out a test strip, poke a finger, entice some blood from that finger, and wait five seconds. One button push and I can see what my BG is while I'm driving, or gardening, or walking Mollie...you get the picture. Sure, the transmitter is not tiny by any stretch of the imagination, but the trade-off is worth it. I can go into my daily totals menu and see an average of ALL BG's for the day - all 258 (or so) of them.
And then there's the status screen. When I first hooked up to this bad boy, I was literally looking at the 3-hour screen every five minutes. After almost two days of wear, I'm appreciating this feature more and more. Have a look at the picture to the right; it's a snapshot of the 3-hour status screen
on my pump (click on the picture for a full-sized version). Pressing the ESC key once will access this screen. When the screen is first accessed, the most recent BG value will display; pressing the up and down arrow buttons will scroll through every BG value that was recorded (in five minute increments) for the last three hours. As in the picture, the value will be highlighted and titled "History". The line graph to the left represents dots for each and every BG occurrence; horizontal dotted lines are low and high BG thresholds, and the small bar below the low threshold line represents a bolus (a correction in my case). When you access the menu without going into the history, the current BG value will sometimes display arrows representing trends. One arrow up or down, and BG values are changing by 1.2-2.2 mmol per 20 minutes; two arrows and BG levels are rising or lowering at a rate of more than 2.2 mmol per 20 minutes. Big BIG value in this one. I can tell whether I need to correct or temp up a basal by these arrows. If one arrow is pointing up, I temp a basal. If two arrows are pointing up, I correct. One down, I temp. Two down, I pop some glucose tabs. (These depend on where the BG value is within my target range, of course) So much easier to triage this way!
The pump allows you to set high and low thresholds, and if your BG goes over or under that number the pump will alarm. I experienced this feature several times on Friday night while I was sleeping. Turns out I dumped during the night; though I woke myself the first time (shakes and all) I would've slept through the second hypo episode at about 4 am had the siren not woken me (and my dog). Yikes! Instinct tells me that the first episode was an aberration, but I'm not sure about the second. A few more nights and I should know. The pump has unique alarms for high and low BG levels. You all know the standard Paradigm beep BEEP beep? Well, they got crafty with these ones (haha). The low alarm is a most amazing beepbeepBeepBeep, with each beep ascending in tone. The high alarm is the polar opposite: BeepBeepbeepbeep, each beep a lower tone than the last. If you don't answer the alarm within fifteen minutes, off goes the siren. And in that case, it's a great thing to be woken up.
Now, we've all been told that these sensors are only good for three days. Well, that's not true. My pump trainer wears hers for six. She also told me of a guy out East who wears his for nine. I'm shooting for ten ;) The sensor will automatically expire after 72 hours; however, this doesn't mean you have to insert another one. Although I haven't yet tried this myself, my trainer has told me that all you have to do is pretend you inserted a new one and tell the pump that. It doesn't know any better. Bing bang boom, you're good for another 72. Suddenly that $475 box of sensors lasts you two months, not one. Barring any Bad Sensor errors, of course. The trick, I've been told, is to tape tape tape. The sensor needs to be anchored against any sort of movement, and it is possible - and feasible - to wear it for another three days. She also assured me that she hasn't seen any decline in accuracy after extended wear. I'll let you know how that goes.
Other than all that, I am in love. I've attached a few extra pictures for fun. Enjoy!
Sensor/Transmitter:
Old 'Purple' 515:
New 'Smoke' 522 (complete with Thinset Reservoir):