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mcsnail,
I guess I am fortunate that I don't seem to have much scar tissue. I've heard that scar tissue isn't much of a result from using the Dexcom because you are not putting anything foreign through that sensor whereas an infusion set is used for administering the insulin. Nonetheless I have experienced, as you so aptly called it, "Sending my blood sugars into the stratosphere". Usually due to an infusion set that has pulled out, has gotten kinked somehow, or suddenly the insulin stops absorbing for I don't know why.
I place my Dexcom on the central part of my abdomen, in an arc around the navel due to it being always "in line of sight" with the Tandem pump and my phone. I do rotate infusion sites to different areas and have been using sites more on the far sides of my stomach to give the other areas a breather. I tried an infusion set on the outside of my thighs but seemed the absorption wasn't very consistent due to the action of walking causing more blood flow in the area or so I assume.
In dealing with the bad infusion set site and going crazy high I first check that the Dexcom sensor is accurate with a finger stick and write that down. Next I check if the pump is working by disconnecting from the infusion set and pumping out 1/10 of a unit and look for the drop at the end of the tubing. Pump has never failed me in that test. I then put in a higher infusion of insulin via the pump to see if the Dexcom readings level off or start coming down after a half hour. I will again do a finger stick to verify if is coming down or if rising. Keeping in mind the sensor lags the finger stick reading by 15 minutes or so. If still rising, swap out the infusion set. At that point either make some corrections input through the pump or I may use a needle and make a correction. One can't count on the pump to make an accurate correction because it thinks there is insulin on board when there either isn't any on board or what's there isn't working. Worst when it happens at night. One finds out what shows are on early morning tv. The few times it has happened I can't say that the "phantom" insulin has come back to haunt me. Again trusting my Dexcom will alarm if I start going low.
Hopefully others will chime in on how to handle your specific problem. Hang in there.
Replies to "mcsnail, I guess I am fortunate that I don't seem to have much scar tissue. I've..."
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Thank you so much for responding! I don't think that the Dexcom caused any scarring--but I had a lot of problems with it when i wore it on my abdomen because of the scarring caused by all those injections through the decades (I probably made this much worse by injecting through my clothes when I wanted to stay where I was and be discrete). I was interested that you also have absorption issues with your pump. Have those issues gotten any worse with age--or do they seem like something that just goes along with pump use? I also use the methods you mention (finger sticks, checking for drops, sometimes using a needle for a correction). The phantom insulin (great phrase!) does sometimes come back to haunt me--or as I tend to put it -bite me in the butt-lowering my normal insulin needs by absorbing very slowly over the next half day or so. I also have had my sleep interrupted by an occlusion alarm or mysterious highs--and have spent too much time with late night or early morning tv while waiting to see how things are going. Still--I am much more stable on the pump and it usually works very well. I recall that I used to have mysterious highs that might have been caused by absorption issues when I just used injections--and had fewer ways to zero in on the problem. All those injections were shots in the dark (so to speak).