My Pump Start: The Good, The Bad, The Ugly

I had my training for my Animas Ping on Monday, June 28th.  I survived my first ten days on the pump!

The training went pretty fast.  For me, it was more of a matter of just getting hooked up.  I wasn’t looking for a lot of help from them.  I had talked to the trainer before going in and she told me what she had my targets set at – 110 during the day and 120 at night.  I have my high alarms on the Dexcom set at 120 so did not like her targets.  When we went to set stuff up at the training (I already had stuff set but she wanted to change it to her settings), she asked me to humor her so I did.  But as soon as I left, I changed it to 85.  I wasn’t going to shoot for a higher target just because I am on a pump now.

As typical for starting on a pump, she had one basal rate.  I knew that wasn’t going to work because I had 3 different basal rates for my Levemir.  My afternoon rate for Levemir was 70% lower than my morning rate and my evening rate 50% lower than the morning one.  Of course, I started running really low in the afternoon on her rates so I changed what she had or I would have really been crashing.  I am still trying to get those set right and have been doing lots of basal testing.

With the first set that I had in, I started going high at 2 ½ days.  Because I was having trouble getting my basals adjusted, I thought that was the problem.  The next morning when I changed the set out, I started going low again.  I Googled problems with Apidra in pumps and I found that a lot of people can’t get three days out of the insets so I have a feeling I am one of those people.

Changing the insets has been real fun!  I killed one at training and pretty much kill at least one every time I change one out.  I am on inset #10 and day 10 of the pump.  The supply company sent me 30 to last 90 days.  You don’t need to be a rocket scientist to figure out that isn’t going to work.

I have neuropathy in my hands so that is presenting a problem for me.  I am trying to get samples of other ones to see if I can find something easier to use.  I have the Insets by Unomedical right now.  Once I get them on, they are great but it is just getting them on that is the problem.  I am also hearing from other people that don’t have neuropathy and they had problems with sets in the beginning.  Hopefully, this will pass quickly!

Dexcom lowYesterday was the day from you know where!  First, my pump started beeping about 5 AM that I was out of insulin.  I looked at my Dexcom only to see “low” on the receiver – the Dex won’t give you a number if you are below 40.  I immediately grabbed my meter to find out my BS was 25.  My alarms died last Friday night so with the holiday weekend, Dexcom could not send one out until Tuesday – I have always had bad timing.

I came downstairs to change the site.  I have the visual guide saved on my computer so am trying to do the site changes using that.  Of course, I killed the first one.  When you go to pull the inserter thingy up, I have a hard time getting it to click into place and then end up pulling too hard and pull it apart.  I went back upstairs to get another one and managed to put the second on one.  I checked and by then, my BS was 114 so I dosed for my coffee and drank my coffee like normal.

I always check my BS after drinking my coffee and when I checked, it was over 200.  I wasn’t sure if it was going up because of being stressed out trying to change the site, a rebound from the low or a bad set.  I took some more insulin, waited and checked again.  This went on for about an hour and every time I checked, my BS was higher.  I finally decided to yank the set and by then, I was in tears.  I am glad I yanked it because the cannula was bent.  I put a new one in, number 3 for yesterday!  The new one worked and my BS started coming back to normal.

My carb ratios are not working and will need changed but there is no point in trying to figure out those until I get the basal rates fixed.   I really like the food database.  I added the foods I eat on a regular basis to my favorites list.  I go in and select Boost and it comes back and tells me exactly how much insulin I need based on what time of day it is and what my BS is.

I wasn’t sure how the Combo Bolus (extended bolus on other pumps) would work with gastroparesis and thought that probably would not really be a good thing to use.  I only tried it once and my BS started going up so I took some insulin & cancelled the rest of the bolus.  With gastroparesis, it is impossible to figure out when your food is going to digest so I can’t see that working for me.  Some days I eat lunch & my BS starts going up an hour after I eat.  Other days, it could be 4-5 hours until the same lunch digests.  I think that trying to do the Combo Bolus would be like playing with fire.  For meals, I will continue to do what I have been doing on MDI and take insulin as my food digests.  A friend of mine that uses a pump gave me a suggestion that I have tried and it does help – when my BS starts going up, crank up the temp basal.  I have been doing that with a small bolus and my BS doesn’t get too high and I can turn off the temp basal as soon as I start to drop.

My Dex average for the first seven days of the pump was 95  so I can’t complain about that.  I knew that there would be a learning curve and was kind of nervous about screwing up my control really bad in the beginning.  Although not perfect, I was pretty happy with my first week and can only expect things to improve. Other than the problems with the changing the sites, I really love the pump and I can tell it is going to be a huge improvement in managing my blood sugar.  And yes, I have become one of those people that says, I should have done this sooner!
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Comments

  1. Kelly – I don’t like using the automated infusion sets – not because of the reasons you are experiencing – but more for the fact I have issues with the cannula. I had Animas send me some samples of their Contact Detach (8 mm stainless steel straight infusion set – http://www.diabetesexpress.ca/product_info.php/cPath/37_61_95/products_id/572 – it’s like a pen needle when you think about it – but 27 gauge instead of 32 gauge). What I like about these is I can see exactly where I’m putting it, easy to handle (I don’t have neuropathy in my hands … yet – you never know with having been diabetic 43 years – the wrath of God may occur one day). Anyway, no irritation at the infusion site – when I remove the infusion set – you wouldn’t even know anything had been stuck in you.

    Now, they say with the Contact Detach – or any stainless steel infusion set you should change it every 2 days. I am a rebel without a cause – and leave it in for 3 days. Though I think that perhaps when I went on my pump holiday back in April – I was experiencing some higher BG’s then normal – and perhaps that was due to leaving the infusion set in for 3 days (the other thing now that I’m having it full force – is the peri-menopause business – which has meant more insulin then I’ve taken in years).

    • Thanks Anna. It was funny that you posted about this today because I came home to a UPS package at my door from Animas. They were sending me some sample Inset 30s to try & she included some of the Contact Detach ones also. I will try those next. As long as I can just stick it in, I shouldn’t have a problem – after 26 ½ years, I shouldn’t be a chicken about needles, right! I will keep you posted how it works out.

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