Freestyle Libre - Placing Sensor - Advice Pls

[Energize]

Hi

I have recently bought the Freestyle Libre and have found it brilliant. My BG has improved somewhat due to being able to see, so easily, how different foods affect it and how my BG rises once I get up in the mornings, so I have been working on how to minimise this am rise etc.

However, my question is regarding placing the sensor. So far, I've put the sensor on my left arm but have realised that means I can't have my blood pressure checked, nor have bloods taken, on that arm as the sensor will be in the way. So, I'm wondering whether I would be safe putting the sensor on my right arm, in respect of risk of infection etc mainly. I can't think any other reason there could be a problem. Then I could continue with blood pressure checks and blood taken on my left arm, which I would assume is likely to be more problematic if my right arm was used.

I appreicate I may need to check with the relevant staff at the hospital but I thought I'd try asking here first as the Nurse Specialists may not appreciate what the Libre sensor involves.

Thanks very much for any advice or suggestions.
Julie

 

[donnellysdogs]

Is there a reason why you are concerned about infections etc on your right arm and not your left?

I had lymphnode removal and my left arm cannot be used for BP, blood tests by me or blood tests by hospitals/ambulances etc.

I had ambulance out last Monday. They still used my other arm with the libre on it. They used a childs arm band for the BP. However that was the ambulance men. The first paramedic didn't have a childs cuff so put on pads and did an ECG instead.

If you have a soecific reason for using only one arm then it can be probs but my problem was and is being able to tell medics when not fully conscious they can't use my left arm!

 

[Energize]

Hi donnellysdogs

I was hoping you'd be on line before too long Thanks for your response

No, I suppose I don't have reason to worry about infection on right vs left arm but assumed an infection on right arm could cause more problems re the lymphatic system. I've not had any signs of infection with the sensors either, and they do seem well set up to prevent any contamination etc. I'm very careful if using my right hand fingers to finger prick but I seem to think I shouldn't be using my right hand at all, as you don't use your affected hand for testing.

Like you, I have been advised not to have blood pressure or bloods taken from my right arm but I wasn't told how long this is to continue. I'm 4 1/2 yrs since the surgery now.

I was wondering if there was any reason not to use my right arm for the sensor, therefore leaving my left arm free for BP and bloods? Alternatively, I could try other sites, such as abdomen or upper legs perhaps?

 

[AndBreathe]

Hi donnellysdogs

I was hoping you'd be on line before too long Thanks for your response

No, I suppose I don't have reason to worry about infection on right vs left arm but assumed an infection on right arm could cause more problems re the lymphatic system. I've not had any signs of infection with the sensors either, and they do seem well set up to prevent any contamination etc. I'm very careful if using my right hand fingers to finger prick but I seem to think I shouldn't be using my right hand at all, as you don't use your affected hand for testing.

Like you, I have been advised not to have blood pressure or bloods taken from my right arm but I wasn't told how long this is to continue. I'm 4 1/2 yrs since the surgery now.

I was wondering if there was any reason not to use my right arm for the sensor, therefore leaving my left arm free for BP and bloods? Alternatively, I could try other sites, such as abdomen or upper legs perhaps?

I don't have any lymph node challenges thankfully, so can't comment in that respect. What I would say is though is that the Libre is only "authorised" for use on the arms, as per the instruction pack. I don't know how Abbott would react if you had an errant sensor and called for support. Any time I have called, a check on the sensor location is always on the list to be answered.

Many others have tried other locations (as I have myself - at my own risk). On my tummy, it was certainly comfortable enough, but if I wore tight jeans I had to be very careful not to dislodge the sensor as I raised or lowered my jeans. Makes a dash for the loo a bit of a pain, but that's probably just me.

I also tried one on my chest wall, sort of to the side-ish, above any breast tissue. That was fine and comfy enough. Others have used upper legs, back and so on. One the various Libre threads they have made various comments.

Please bear in mind the support issue if you do try it though.

 

[donnellysdogs]

Mmm, I'm not 100% sure. I know for me if I had not had lymph nodes removed I would still be using my left arm....

I have cut my left arm and accidentally had paramedics prick it and some thorns in it and have been so worried but all been ok (so far, touch wood).

For me Drs and hospital appts are generally known in advance and I'm just putting a bit lower or higher up on arm. Its the paramedics and emergency people that scare me.

They do have childrens cuffs etc..

Laughable in A&E other night. It took 3 staff and 3 attempts to get blood out. Cannula was in elbow vein. Never had any persons let alone 3 of them struggle to get bloods before but guess it waa cos in the same arm. Think they were meant to stop the drip a while before taking bloods, not sure they did this.

 

[Energize]

Hi AndBreathe and donnellysdogs

Thank you both for your responses. I appreciate this very much

AndBreathe, I really do thank you for pointing out the support aspect. I hadn't thought of this so, if I do choose to use an 'alternative' site, it will be at my own risk regarding support etc. Also, thanks for sharing the sites you have used and, in particular, the issue regarding needing the loo, especially if in a hurry That's definitely me!!! I assume that, in time, Abbott may extend their authorisation and support to cover alternative sites, once they are assured there is no extra issue.

donnellysdogs, I'm so sorry you are having to deal with Paramedics and/or in A/E too often. How unfortunate you had to be stabbed so many times for the staff to get some blood from you I hope you are feeling better again since that episode in A/E.

Regarding BP cuffs, I don't think a childrens' cuff would be suitable as I have large arms and need a large cuff. Even if a smaller cuff is holding while being inflated, the readings aren't reliable because of the wrong sized cuff. Thanks for the idea, though.

So, in view of all this, I've just phoned the hospital and spoken to one of the Nurse Specialists and she has advised -

1 - To avoid having blood pressure and bloods taken from the arm on the side of the breast surgery/nodes removed but not to panic if accidentally used. This situation should be the case forever, or until other circumstances (ie similar surgery to other side) in which case the priority would be to protect the 'newest' affected side. (I hope that makes sense?)

2 - The Nurse Specialist is very wary re any sort of needle/puncture to the affected side and suggests it would be less risk re lymphoedema, for blood pressure and bloods to be taken infrequently, rather that the sensor in place.

So, it would appear that the answer is to avoid blood pressure, bloods, finger-pricking and sensors on the affected side, 'full stop', unless there is no other option. I'll work towards placing the sensor in such a place that checking my blood pressure and taking of bloods would be OK. Trial and error, I suppose. I'm not due for BP check and bloods to be taken for a couple of months as yet so a few opportunities to work on this before then.

Many thanks to you both. I really appreciate your advice
Julie

 

[AndBreathe]

Hi AndBreathe and donnellysdogs

Thank you both for your responses. I appreciate this very much

AndBreathe, I really do thank you for pointing out the support aspect. I hadn't thought of this so, if I do choose to use an 'alternative' site, it will be at my own risk regarding support etc. Also, thanks for sharing the sites you have used and, in particular, the issue regarding needing the loo, especially if in a hurry That's definitely me!!! I assume that, in time, Abbott may extend their authorisation and support to cover alternative sites, once they are assured there is no extra issue.

donnellysdogs, I'm so sorry you are having to deal with Paramedics and/or in A/E too often. How unfortunate you had to be stabbed so many times for the staff to get some blood from you I hope you are feeling better again since that episode in A/E.

Regarding BP cuffs, I don't think a childrens' cuff would be suitable as I have large arms and need a large cuff. Even if a smaller cuff is holding while being inflated, the readings aren't reliable because of the wrong sized cuff. Thanks for the idea, though.

So, in view of all this, I've just phoned the hospital and spoken to one of the Nurse Specialists and she has advised -

1 - To avoid having blood pressure and bloods taken from the arm on the side of the breast surgery/nodes removed but not to panic if accidentally used. This situation should be the case forever, or until other circumstances (ie similar surgery to other side) in which case the priority would be to protect the 'newest' affected side. (I hope that makes sense?)

2 - The Nurse Specialist is very wary re any sort of needle/puncture to the affected side and suggests it would be less risk re lymphoedema, for blood pressure and bloods to be taken infrequently, rather that the sensor in place.

So, it would appear that the answer is to avoid blood pressure, bloods, finger-pricking and sensors on the affected side, 'full stop', unless there is no other option. I'll work towards placing the sensor in such a place that checking my blood pressure and taking of bloods would be OK. Trial and error, I suppose. I'm not due for BP check and bloods to be taken for a couple of months as yet so a few opportunities to work on this before then.

Many thanks to you both. I really appreciate your advice
Julie

Perhaps it could be worth contacting Abbott and asking what, if any arrangements they have in place for those in similar circumstances. I'm not necessarily suggesting you have to disclose your BC journey, but there must be more reasons an individual could only have one viable arm available to them. Sadly, some people can end up in that situation, literally, after an accident, say?

I feel fairly sure, over time, the range of "approved sites" will expand, but with such a revolutionary product, at launch, they had to add some usage parameters where they could.

Obviously, it's a bit of a long shot, but it they are running any discreet testing of additional sites for sensors, you may be able to either be included in that or be given some sort of dispensation. I have no idea if such exploration/testing is currently on the radar, but the worst they can say is "nothing doing".

If you decide to contact Abbott, please send me a PM, and I can help you with some details. It's usually pretty simple to find out who the relevant big cheeses are by asking Dr Google, but the information you would return is not up to date.

 

[Brunneria]

I have had my bp checked at the surgery, and repeatedly taken my own blood pressure with the cuff over the sensor. Never had any pain or discomfort, and it hasnt affected the bp reading or the sensor performance.

I can't envisage it being a problem when having blood taken, either. They would just position the strap above the sensor, and take blood from inside the arm, as normal.

 

[AndBreathe]

I have had my bp checked at the surgery, and repeatedly taken my own blood pressure with the cuff over the sensor. Never had any pain or discomfort, and it hasnt affected the bp reading or the sensor performance.

I can't envisage it being a problem when having blood taken, either. They would just position the strap above the sensor, and take blood from inside the arm, as normal.

The tourniquet above the sensor? On me, that would be above my armpit!

Sorry for going somewhat off-piste there.

 

[Brunneria]

The tourniquet above the sensor? On me, that would be above my armpit!

Sorry for going somewhat off-piste there.

Where do you put the sensor? I place it at least 2/3 of the way down the back of my upper arm.

Having said that, I used to place it higher but found i was sleeping on it (when lying on my side), so now place it lower. Works much better for me, but it really does have to be on the back of my arm, or i knock it on doorframes.

 

[AndBreathe]

Where do you put the sensor? I place it at least 2/3 of the way down the back of my upper arm.

Having said that, I used to place it higher but found i was sleeping on it (when lying on my side), so now place it lower. Works much better for me, but it really does have to be on the back of my arm, or i knock it on doorframes.

Using your thirds metric, I'd say around the borderline between the upper and middle thirds. That way if I'm wearing something with short sleeves it's invisible. Of course, with a cap sleeve or sleeveless, it's on show, which is fine. Nobody seems to bother about it.

Maybe I should try the next one a bit lower. I doubt we have too many sleeveless days to look forward to in UK, this year. I'm sensor-free at the moment, so will try that next time.