Tech Struggles

I planned on writing weekly reflections. But things don’t always work the way they’re supposed to – especially technology.

The CGM sensors from Levels arrive in a package of three. The sight of the needle, meant to be jabbed into the back of the arm, is initially scary.

But, putting on the CGM didn’t hurt at all, not even a little poke (which is good because you need to replace it a few times). Once on, I barely noticed it.

On the flip side, I had connection issues. The CGM I used (Dexcom G7) was super easy to connect to the Dexcom app. But the Levels app? That was a challenge. The process looked easy, but would not work. My CGM was working (at the time) and showed up in the Dexcom app, but would not connect to Levels.

Even during the holidays, the Levels team was very responsive. Over email, they sent me troubleshooting tips that “work 99% of the time”. Lucky for me, I’m a one-percenter. I was frustrated. This stuff is expensive (almost $10/day) and I didn’t want to lose out on any days. I scheduled a 1:1 video troubleshooting with Levels, but that was a week out. Persistence paid off, though, and on the third day, I managed a breakthrough. I was in.

I had 3 days of CGM data that was working correctly with Levels, then the CGM stopped working. On New Year’s Eve I was out, not messing with my sensor at all, and it just stopped getting readings. The Dexcom app sent me critical alerts in the middle of the night to wake me up (more on that later) after it went a few hours without working.

I called Dexcom in the morning to troubleshoot, but there was nothing that could be done. It was over with after 5 days (less with an actual Levels connection), despite supposedly lasting 10 days.

Fortunately, Dexcom said they would send me a replacement. But, at the time I was visiting friends at the time and didn’t have a backup with me. I had to go another few days burning through my Levels membership without a CGM connection.

I got back home and subbed in a new CGM, but my troubles weren’t over. No setup issues this time, but the second device also failed after just three days.

Again, it dropped out while I was sleeping and the critical phone alerts woke me up in the middle of the night (please, turn these off).

Two CGMs combining for 8 days of function when they’re supposed to get 10 each is tough. Levels has the option to connect with an Abbott device, and that may be the move. At least the customer service was good, but my Levels experience was off to a rocky start.

It wasn’t all tech issues though. I did learn a few things while the CGM was working. Here are a few things I’ve learned…

What I’ve learned

So what have I learned?

• Movement matters. At the start of this, I was either on crutches or wheeling around on a knee scooter. My physical activity was limited and I was stuck on the couch. I did some light machine workouts where I’d crutch from machine to machine with the old ladies, but nothing intense, or cardio. By the end of the second week (and start of my second CGM period) I started ramping up the exercise. I jumped in the pool and hopped on my indoor bike trainer for easy bike workouts. Not as intense as my normal workload, but something. The differences have been huge. In the prior period, my glucose would consistently spike over 150 (Levels says the optimal is to never spike over 110). Since exercising, my average glucose has come down, and my spikes aren’t as spikey (though still higher than I’d like).
• Sickness can kill your glucose response. In that first testing batch, I was sick. There were confounding variables with exercise, but my glucose would spike easily. I don’t know how much of this was poor sleep (it’s hard to sleep when you can’t breathe through your nose) or my body fighting the virus. All I know is my average glucose and glucose spikes were higher when I was sick.
• Don’t eat processed snacks. Duh. I already knew this. You already knew this. But my CGM really drove home the lesson. I got off a flight and had to wait at the airport an hour for my friends to pick me up and got hungry. Digging around in my backpack I found an old fig bar. I knew it was sugary and bad to eat, especially when I when I’m just sitting there. It comes in a pack of two and I had 3/4 of one of the bars. Uh oh. Instant madness. My CGM spiked higher than I thought possible. Straight to 190! (Remember the Levels 110 guidance). The spike was immediate too. So yeah, don’t eat processed high-carb snacks unless you are mid-workout or something. (I should have tested the crappy airplane snacks – for science)
• Turn critical alerts off when you sleep. You have to connect your CGM with the Dexcom app. The app sends our critical alerts when glucose levels drop, which are essential for diabetics. But not for non-diabetics. When my CGM had issues in the middle of the night, the readings dropped low and I got woken up. I like my beauty sleep. I can’t handle my delicate sleep getting disrupted. The solution: turn off your critical alerts, at least for sleep. You can’t use the Dexcom app without critical alerts turned on, but it will still collect readings and send data to the Levels app. Your partner already thinks you’re crazy for doing this. They don’t want to be woken up by it. You’re an optimizer, you want your sleep. So do yourself a favor and turn off critical alerts before you get in bed.

Going forward

As I get back to my typical routine I want to spend a couple weeks gathering data, and then try to optimize my glucose ranges.

I was home for the holidays, traveling to visit friends, and inured; so not at all my normal routine. As my schedule returns to normal, I’m eating at home, and moving again, I want to see how my normal foods/routines affect me. Can I still make my baked oats? Can I still eat 3+ bananas/day (yes it’s a lot)? How does this change after I do a 3-hour ride? I’m looking forward to gaining real insights into my typical routine.

The next phase I want to optimize. My glucose levels are consistently spiking up to 140+. My average glucose is in the 100s. I’m not hitting the Levels targets (shown below). After my learning period, I want to dial this in, learn what to carry with me post-CGM, and live a long, healthy life.

Now heck out my first post in this series.