On the pump!
Hi all,
My 14-year-old daughter, Lucy, just went on the pump 2 days ago. She
started with saline on Monday, then switched to insulin on
Wednesday. The first 2 days it went ok, though her numbers were a
little up and down. Then this morning she changed her site, and was
running high all day. Somehow, I hadn’t understood from the trainer
that if she was high after 2 boluses, that we should change out the
set. Anyway, I called the doctor this evening, who of course told me
that she needed to change out, and when she removed the set from
this morning, we saw the tiny catheter (Animas pump inset) was bent
and not inserted properly. She tried it again tonight, and 2 hours
later her meter said “HI” which it has never done before! She
removed the set and saw it was bent again. I gave her an injection
of Humalog and called Animas. They asked if Lucy had “pinched” her
skin to make it tight upon inserting the set (it has sort of a snap
mechanism). Lucy remembered that the trainer had something about
pinching an inch, but she didn’t actually do that the first two
times and it still inserted fine.
Anyway…she pinched her belly to make it tight for the new
infusion, and when it snapped, she said it hurt immensely and began
crying. I think it was because of her stress and high blood sugar
(she didn’t even want me to tell the group that she was crying
because she didn’t want to seem like a wimp), but she never cries
when she does her BG testing or injections so it worried me.
a) Is it supposed to hurt? Or is there a better way to insert the
pump?
b) The Animas 24/7 nurse said to just change the inset and leave the
tubing and cartridge. If anyone uses this pump, do you know if we
need to “fill canula” again? I know we don’t need to prime, but
we’re a little confused. Maybe I should just call Animas back…
In any case, I do think it was inserted properly this time, but we
definitely had a scare. She is so excited to be on the pump, but
tonight was the first time she’s cried over her diabetes in a long
time. She’s a tough cookie!
Danna
Mom of Lucy, 14, diagnosed 1/17/04
May 27th, 2007 at 1:13 am
Hi, Danna, welcome! (And welcome to Lucy, too, of course!)
I have had mine sting a few times, too. I am still relatively new to the pump (about 2 months), but have noticed if I don’t allow the prep wipe stuff to dry before inserting, it stings. So, now I find my site, wipe it, then allow it to dry while I assemble the insertion tool spring loaded thing, take the paper tabs off the needle/catheter mechanism, and pull back the insertion tool. Usually, if I take my time doing that, the site is then dry, and the stinging, if not gone, is far less.
Also, when it does sting, I just wait a bit (I am usually running late for work by this time), and the stinging subsides within a few minutes to a half hour.
Finally, as far as crying goes….. I don’t know about anyone else in the group, but every once in a while, I crumble under the challenges of dealing with diabetes. It is kind of a carthartic process. Keeping a positive attitude is vitally important, however, we are only human, and need to be vulnerable at times. When I become overwhelmed with everything, diabetes, work, school, kids, house, car, parents (81 and 86), and whatever else life sends my way, I crumble, find my feet on solid ground again, and start anew with that new foundation.
Please feel free to visit with us in good times and challenging times, Danna. I have learned a tremendous amount from other members of this group. They have been helpful, informative and realistic.
Again, welcome!
Joan
May 27th, 2007 at 10:23 pm
Hi Danna,
I’ve been pumping for almost 3 months now, using a MiniMed Paradigm
pump and Quick-Set infusion sets. I think the Quick-Sets are similar
to the Insets. They’re both inserted straight in at 90 degrees, and
have a built-in circle of adhesive.
I was told that if you have an unusual high reading, you bolus with
the pump and then check again in an hour. If your number hasn’t gone
down, or if it’s gone even higher, you should take another correction
using a syringe (or pen) and change the set. So far I haven’t had
any problems with this. None of my cannulas have been bent when I’ve
taken an old set out.
I can’t remember if my trainer told me I had to pinch before
inserting. I remember being taught that when I was first diagnosed
in 1987, for giving injections with a syringe. I never did it. Most
of the time I don’t do it when inserting an infusion set, either, but
I’m an adult who needs to lose weight, so it might not matter. I
have enough padding on my belly so it hasn’t been a problem. I do
occasionally remember to pinch and haven’t noticed a difference.
Whether I pinch or not, I do often feel the needle going in and
sometimes my eyes do tear up. That happened with shots sometimes as
well, if I hit the wrong spot. With me it seems to be an automatic
reaction. I shed a few tears and then grit my teeth and wait for the
stinging to go away. The site might sting for a few minutes after
insertion but then the pain/soreness goes away and I feel nothing at
all. One time it kept hurting and wouldn’t stop. When I looked at
the site maybe half an hour after insertion, I saw that the center
hub was filled with blood so I had to remove it & insert a new one.
When you insert a new site but you already have your reservoir &
tubing filled, you will need to fill the cannula again because it’s
empty right after insertion.
If your daughter’s sites are still hurting for a long time after
insertion, maybe she could try a different set. I have only used the
straight-in Quick-Sets so I don’t know about any others. I do know
that the angled sets have even longer introduction needles and longer
cannulas, so they might not work.
–
Liz
May 28th, 2007 at 8:49 pm
Do you use those I.V. Prep wipes? I get a box of them from MiniMed with my
supplies every 3 months. I didn’t use them at first because I thought they
were just regular alcohol swabs. Someone told me that they’ll help the
adhesive stick better, so now I always use one. Someone told me that if
you insert the set while the wipe is still wet/sticky, that the set
adhesive will stick better. I’ve inserted both when the wipe was wet & dry
and it stung almost every time. I haven’t had any trouble with the set (MM
Quick-Set) coming unstuck even during this awful hot & humid weather.
Same here (including the running late for work part!), although the only
time mine stung for more than a few minutes is when I found out it was
bleeding.
–
Liz
May 29th, 2007 at 7:41 am
Nicole,
Welcome to the group! : )
I was on Lantus/Humalog for years and years and years and years and years and years and ………….
Well, I think you get the message. Anyway, I was VERY reluctant to start on the pump, thinking I was going to be LOSING control of my diabetes more than gaining it.
As with all else in diabetes, it is an individual thing. However, it was the best thing I, personally, could have done. When I was doing the injections, I would have NASTY lows, very unpredictably. I have had the pump for 2 months, and have had only 1 low that was worthy of having my husband find the smarties. My control has been tremendously better than with the shots.
We went canoeing last week, and I had to leave my pump in the car. What a hassle! Taking shots, carrying all the junk needed to do the shot, wondering if I ate enough or too much… argh. Then, the next morning, I had a major low, because of the Lantus hanging around longer than expected. That was a smartie morning, and I would only eat them if my husband promised I could tickle him later. That kind of stuff hasn’t happened while on the pump. Thank goodness.
The only good advice I can give on the pump is it is a personal decision. I truly regret not going on it 20 years ago. There are those who LOVE it, and those who are not so sure about it. I was not too sure about it, but gave it a try, and will never go back to shots.
Nicole, I hope this gives you some additional insight. I am sure there will be more members of the group to share as well. We are not a quiet bunch!
Warm regards,
Joan
May 30th, 2007 at 1:51 am
Nicole,
I don’t take injections anymore, except when I am doing water sports for more than an hour. Otherwise, I put an insertion site in, and leave it there for 3 days. With the pump, I am able to set a basal rate, say 1 unit per hour, which is delivered OVER that hour, not at one time. When it is time to eat a meal, I figure how many carbohydrates I will consume, and tell the pump to give me 1 unit for each 15 grams of carbs.
The fun thing with the pump, besides only being stuck once every 3 days, is it ‘remembers’ how much I took the last time, and approximately how much of that insulin is still in my system, then adjusts the amount recommended to dose. If my sugar is getting low, and I am not due to eat soon, I can suspend the infusion (suspend the basal) so I don’t go low. It will remind me I have temporarily turned it off so I don’t forget to turn it back on when my sugar gets a bit higher.
Anyway, that’s it in a nutshell. A pump educator can inform you much better than I, as can many of those in this group. I am still new to it.
The catheter must be changed every 3 days. This, to me, beats the heck outta 5 or 6 shots a day like before.
Nicole, it would not hurt to read any literature you could obtain to judge for yourself.
One last thing, then it is off to the grocery store….
I sent a prayer of thanks to Him for saving you from cancer, and that He will help guide you in the challenge of diabetes.
Regards,
Joan
May 31st, 2007 at 3:18 am
Hi Nicole,
I’ve been pumping for three months now. In the beginning my blood sugar
was running high but I finally got them down by changing my basal rates and
other settings. I had a few pretty good weeks, and now all of a sudden my
numbers have been running too low so I’ve been changing rates again. With
diabetes, things that work for awhile all of a sudden seem to stop and you
need to make changes whether you’re on a pump or injections. It’s just
easier to make the changes on a pump. Even when I was on Lantus I’d have
high readings, but raising the amount of Lantus I took might fix those
highs but cause lows at other times. With a pump, you can change your
amount of basal insulin over the course of a day. You can’t do that with
Lantus. If it decides to start working like crazy at a certain time,
you’re stuck with it.
The pump only takes short acting insulin (Humalog/Novalog) but it replaces
both your long & short acting injections. You set the pump to give tiny
amounts of Humalog/Novalog every hour, and those tiny amounts throughout
the day replace the Lantus (or NPH, Ultralente…). Before a meal, you can
take a dose (called a bolus) of insulin to cover the meal. Doing this with
the pump is very easy,. but first you’ll need to know certain numbers:
- how many grams of carbohydrate will be covered by one unit of
insulin. Some people might have a 1:10 insulin: carb ratio which means
that one unit of insulin will cover 10 grams of carbs. If you eat
something with 33 carbs, the pump can give you 3.3 units of insulin. The
dosing is much finer than you can get with a syringe or pen.
- you’ll need to know how long the insulin lasts in your body. After
taking an injection of Novalog, you might find that it’s still working 5 or
6 hours later. If you end up injecting 4 hours after one shot, you’ll
still have leftover insulin from the first shot overlapping with the
second, and you might end up going low later on. With the pump, it will
tell you how much insulin is still in your body.
- figuring the basal rates is probably hardest but once you get them set
it’s easier to tweak them and make small changes as needed. You can also
stop or reduce your basal rates if you’re going to be very active,
something you can not do on shots. If you’ve already taken Lantus and then
decided you’re going to go hiking, you’ll most likely end up with lows
during the activity. With a pump, you can stop the basal or reduce it over
the course of hours so that you won’t go low. If you’re sick and end up
needing more insulin, you can increase the rates to cover any highs you
might experience. You can set temporary basal rates for things like that
so your normal numbers won’t have to be reprogrammed.
If your numbers are good (daily BG readings + A1c) on Lantus/Novolog and
your routine doesn’t vary from day to day, then a pump might not offer much
help. But if you don’t follow any real schedules and have a hectic life it
can really help. You can always go to the different manufacturer sites and
request info if you’d like to find out more.
For the first 6 weeks I wasn’t too pleased with my pump but I like it more
every day now.
–
Liz
May 31st, 2007 at 4:01 pm
Thanks Liz. What scares me off is all that technical stuff mentioned before, about things being bent and not dry and what else…
Elizabeth Blake <Poodlebone@…
Hi Nicole,
I’ve been pumping for three months now. In the beginning my blood sugar
was running high but I finally got them down by changing my basal rates and
other settings. I had a few pretty good weeks, and now all of a sudden my
numbers have been running too low so I’ve been changing rates again. With
diabetes, things that work for awhile all of a sudden seem to stop and you
need to make changes whether you’re on a pump or injections. It’s just
easier to make the changes on a pump. Even when I was on Lantus I’d have
high readings, but raising the amount of Lantus I took might fix those
highs but cause lows at other times. With a pump, you can change your
amount of basal insulin over the course of a day. You can’t do that with
Lantus. If it decides to start working like crazy at a certain time,
you’re stuck with it.
The pump only takes short acting insulin (Humalog/Novalog) but it replaces
both your long & short acting injections. You set the pump to give tiny
amounts of Humalog/Novalog every hour, and those tiny amounts throughout
the day replace the Lantus (or NPH, Ultralente…). Before a meal, you can
take a dose (called a bolus) of insulin to cover the meal. Doing this with
the pump is very easy,. but first you’ll need to know certain numbers:
- how many grams of carbohydrate will be covered by one unit of
insulin. Some people might have a 1:10 insulin: carb ratio which means
that one unit of insulin will cover 10 grams of carbs. If you eat
something with 33 carbs, the pump can give you 3.3 units of insulin. The
dosing is much finer than you can get with a syringe or pen.
- you’ll need to know how long the insulin lasts in your body. After
taking an injection of Novalog, you might find that it’s still working 5 or
6 hours later. If you end up injecting 4 hours after one shot, you’ll
still have leftover insulin from the first shot overlapping with the
second, and you might end up going low later on. With the pump, it will
tell you how much insulin is still in your body.
- figuring the basal rates is probably hardest but once you get them set
it’s easier to tweak them and make small changes as needed. You can also
stop or reduce your basal rates if you’re going to be very active,
something you can not do on shots. If you’ve already taken Lantus and then
decided you’re going to go hiking, you’ll most likely end up with lows
during the activity. With a pump, you can stop the basal or reduce it over
the course of hours so that you won’t go low. If you’re sick and end up
needing more insulin, you can increase the rates to cover any highs you
might experience. You can set temporary basal rates for things like that
so your normal numbers won’t have to be reprogrammed.
If your numbers are good (daily BG readings + A1c) on Lantus/Novolog and
your routine doesn’t vary from day to day, then a pump might not offer much
help. But if you don’t follow any real schedules and have a hectic life it
can really help. You can always go to the different manufacturer sites and
request info if you’d like to find out more.
For the first 6 weeks I wasn’t too pleased with my pump but I like it more
every day now.
–
Liz
Nicole
June 1st, 2007 at 10:11 am
Dear Joan,
I sent a prayer of thanks to Him for saving you from cancer, and that He will help guide you in the challenge of diabetes.
Thank you Joan. You cannot imagine the warmth of the feeling I get when reading this line… Maybe it sounds stupid to people who do not believe, but this is something that keeps me going…
The catheter must be changed every 3 days.
Does that hurt a lot ?
Anyway, that’s it in a nutshell. A pump educator can inform you much better than I, as can many of those in this group. I am still new to it.
Well to me this is very clear… [INLINE]
Some things are bothering me. My blood sugar level is NOT well regulated. I stick to the injection scheme I was given at the hospital, follow the diet (high carbo but “slow” sugars : brown bread, pasta aso). My level has gone down, that’s true, but now hypo’s all the time.
I was a very active person before. TOO active probably. Now with this mess, I am in hypo whenever I undertake the most stupid thing, cooking f.ex. Sigh.
I miss being independant (whenever I thought of something, I took off in my car, now I wouldn’t dare to drive. Very tough for me), being socially active, working. I’m stuck at home. I don’t even dare to buy tickets for a concert, I don’t know if I will be able to go…
My life is a mess. Do you think this pump could help me get my life back again?
Thanks for your advice and take care
Joan Geohegan <smartblnde@…
Nicole,
I don’t take injections anymore, except when I am doing water sports for more than an hour. Otherwise, I put an insertion site in, and leave it there for 3 days. With the pump, I am able to set a basal rate, say 1 unit per hour, which is delivered OVER that hour, not at one time. When it is time to eat a meal, I figure how many carbohydrates I will consume, and tell the pump to give me 1 unit for each 15 grams of carbs.
The fun thing with the pump, besides only being stuck once every 3 days, is it ‘remembers’ how much I took the last time, and approximately how much of that insulin is still in my system, then adjusts the amount recommended to dose. If my sugar is getting low, and I am not due to eat soon, I can suspend the infusion (suspend the basal) so I don’t go low. It will remind me I have temporarily turned it off so I don’t forget to turn it back on when my sugar gets a bit higher.
Anyway, that’s it in a nutshell. A pump educator can inform you much better than I, as can many of those in this group. I am still new to it.
The catheter must be changed every 3 days. This, to me, beats the heck outta 5 or 6 shots a day like before.
Nicole, it would not hurt to read any literature you could obtain to judge for yourself.
One last thing, then it is off to the grocery store….
I sent a prayer of thanks to Him for saving you from cancer, and that He will help guide you in the challenge of diabetes.
Regards,
Joan
Nicole
June 4th, 2007 at 4:15 pm
Howard,
Just a few months ago I had no knowledge about the pump either. I got mine
rather suddenly and really had no input into it. The nurse
practitioner/CDE mentioned it during my second visit to a new endo, asked
me if I’d be interested and said she would send my info to MiniMed and I
wouldn’t have to do anything. The following week a big box arrived with a
pump, meter and all the supplies. I was afraid to open the
box! Eventually I watched the CD-ROM that came with it and checked out the
MiniMed site. When I finally went for my training with the nurse, I still
had no idea how the infusion set was going to be inserted & connected.
They might sound complicated, but they’re very easy to use. Some of the
terms might be different (for example: bolus instead of injection or shot)
but the ideas are the same as on MDI. I also joined a pump mailing list
and that has been a huge help.
You also get used to having it with you all the time. By the second week
or so I’d forget all about it. Now I feel like it’s always been a part of me.
–
Liz
June 7th, 2007 at 9:36 am
Hi, Nicole,
I have the new paradigm pump. I don’t have much trouble with the insertion, and don’t use the numbing stuff. But, then again, I have plenty of extra belly ’surface area’ into which to insert the needle.
Just for your information, my A1C used to be over 10. Over the last 4 months, as of last week, it is a 6.7. I am happy as could be! The thought of going back to injections sends shivers down my neck, and I kick myself for not going pump earlier, like 20 years ago. : )
This is only my experience, as you know.
Thank you, though, for keeping an open mind. By the way, even if you do go with the pump, and if you hate it, you can always stop using it and tell the pump people to take it back. I do believe thay are very good about that.
Warm regards,
Joan
June 9th, 2007 at 5:01 pm
Hi Nicole.
I just upgraded to the latest Paradigm, the 515, from my old Paradigm 512. I’ve been on the pump for a little over two years, but have never used anything other than Minimed’s. So my view may seem a little biased lol…
3 Answers:
1) I have the latest Paradigm, as I said above. But the pump is only as intelligent as you are. It can do the math for you but you have to input the figures. It’s not an independant system that functions without user input, although it is very easy to use.
2) You hit it right on the head when you said it’s very personal. Only you can decide if you make the right choice. When I first started pumping, I contacted several different companies. My Minimed rep brought a pump from each of the other companies for me to play with. They all had similar features, so it all came down to personal choice. I liked how the Paradigm looked and felt in my hands, the ease of removing the reservoir and accessing menu’s. I also like the upgrades that Minimed offers, especially with the new pump scheduled to come out next year. It’s got a real time, continuous glucose sensor that communicates with the pump!! Very exciting!
3) I’ve never found the insertion to be overly painful; in fact, most of the time I don’t feel it at all. It’s really not that large of a needle, depending on the set one uses. Most of the cannula sets have a 25-27 gauge introducer needle, and an inserter can be used to minimize discomfort. Numbing the spot with ice is a quick and easy way of avoiding any possible pain (although really, it’s not that bad).
Hopefully that helped you out some. If you have any questions, feel free to throw them at me (even email me personally if you’d like).
Tiffany
–
www.candiddiabetes.com
Pumping with Attitude!
June 13th, 2007 at 12:01 am
If I didn’t have insurance I wouldn’t have even considered the pump. I’m lucky because my insurance covered the pump 100% and also cover supplies 100%.
I really don’t mind the tubing. Most of the time I have the pump clipped to my bra, so all of the tubing is under my clothes and out of sight. Since everything is hidden away, I don’t even think about being connected to something all day.
I’ve seen pictures of the new pump, the OmniPod. When the time comes for me to get a new pump (not for another four years, at least!) I wouldn’t even consider that. I have not seen one in person yet, but I know it’s got to be a lot bigger than having an infusion set on my body. The Pod holds the insulin and the motor, so it must be bulky in comparison. If something goes wrong when you insert it, you’d have to throw the entire thing away. I assume that it must be waterproof, otherwise you’d have to change it every day when you take a shower. I also don’t like that the controls are in the little PDA/meter. If you misplace it, you won’t be able to pump until it’s replaced.
As for calculations, they’re something you should know even if you’re on injections. Unless you’re just injecting random amounts before a meal, you should know how many grams of carbohydrate are covered by one unit of insulin. I have NO calculations on the pump. Once I entered my basic info, the pump does all the calculations for me.
I’m not saying everybody should be on a pump. Some people do great on injections and if they’re happy, there’s no reason to switch. But, if you have poor control and are willing to work a little bit, a pump can be a huge help. And if you have to pay for all of your diabetes supplies, the pump will only add a huge amount to that cost.
–
Liz