To Pump or Not to Pump?

General
1

I've been thinking about the pump for the past few months, and after joining this site and reading about what everyone has to say about them, I'm starting to look more and more into getting one.  I've always wanted the freedom of having a pump and wanted better control over everything, but I have a hard time letting go of what I have and moving on to the "new thing."  Just to give you an idea, it took like years just for my doctor to convince me to go on humalog from the old novalog/nph combo.  He's been wanting me to switch to the pump but it never really phased me until recently. 

So basically I wanted to get real accounts of life with a pump as opposed to the exaggerated testimonials generally found on other websites.  I was wondering what you guys found to be most challenging or what took the most getting used to.  Of course I want to hear about what you love about your pump as well as which features you particularly like about the specific pump you use.

I know this is a lot, but this is a big decision and I want to get all my facts straight before I make a commitment.  I'm actually going to the doctor next week I believe, so I'm planning on talking about it with him then as well.  Thanks for your responses!

2

Brian,

I just started on a pump about 2 1/2 months ago, so I'm not sure that I will actually be the expert on the subject...

As excited as I was to start, I must admit it was a little weird at first.  I'm glad that I start in the winter time when I am mostly wearing big sweaters, so the pump is pretty much hidden most of the time.  Honestly, I think you have to get used to it yourself before you can feel at ease explaining what it is to others, especially those who really don't understand what type 1 is all about.

That being said, switching to the pump was one of the best things I've ever done!  I love the flexibility that it offers.  If I make last-minute plans when I'm away from home (for example, if I meet someone at a store in the afternoon and they invite me to their place for dinner), I don't have to worry about going home to get my insulin.  Or falling asleep on the couch at night, watching TV... not a problem!

I also like that when I test my blood sugar, if it's a little high and I only need one unit of insulin to bring it back down, it's just a matter of pressing a few buttons and it's done!  I know with injections, I used to just skip an extra shot in a case like that one, which would result in my BG remaining high.

I really haven't used many of the features of my pump, the Animas 2020, yet, but I'm glad they're there for when I do want them.

Before I got the pump and even knew much about it, I wondered about simple everyday stuff like going to the bathroom ("Where will I put this thing?") and getting dressed in the morning (pretty much the same question).  Luckily, I have a friend who is the mother of a child pumper so I was able to ask these "stupid" questions to her.  Now we laugh about them!

One extra bonus:  I never have to wear a watch anymore - the time is always on my pump!


Anyway, if you have any specific questions or concerns, feel free to ask away!  And good luck!

Nads

3

Brian-

I've only been on the pump for about 9 months, so you may want to take the advice of some of the more experienced pumpers over mine.

However, I'm going to give my list of pros and cons. I am currently using the Deltec Cozmo insulin pump.

 

Pros:

  • The Cozmo is a bit smaller than some other pumps.
  • There is an attachable meter, so instead of carrying around a separate meter and having to program your blood sugar in for a bolus, the meter is right on it, so it reads right on the pump. Also, because of this, you only have to carry around a container of test strips and a finger poker, and you’re all set for testing supplies.
  • The Cozmo has a corresponding infusion set that is made by the same company. It’s called the Cleo 90 Infusion device. Personally, I think this is very nice because each infusion set is pre-loaded and everything, so all you have to do is apply the adhesive to your skin, and push it in. I know there are other injectors for infusion sets also, but you usually have to load the set into the spring-loader manually. With the Cleo, it’s all ready to go.
  • You can disconnect for up to two hours.

 

Cons:

  • If you do choose to use the attached meter, it makes it a little bit fatter, which can add bulk if you are putting it in your pocket.
  • Occasionally, the Cleo infusion sets go in the wrong way or are not installed properly in the loader, resulting in (1) pain (not terrible, but pretty bad for a minute or so) and (2) a “Blockage Detected” warning on the pump within a short time, which means you have to do another site change.

Personally, I really like the Cozmo and think it's a great pump. But I can't speak for any of the others out there because I have not tried them out.

I hope this helped at least a little bit.

|†~*Sarah*~†|

        <><

 

4

Oh, and also, the pump offers so much more freedom than shots. Before starting on it, I had to give myself my Lantus shot every night at 9pm, and I hated having to fit my plans around that or stop what I was doing in order to give myself my shot.

The pump is great in that you don't have to try to awkwardly give yourself an injection when you eat with your friends.

|†~*Sarah*~†|

        <><

 

5

Sarah..  My daughter Charisma is all on the Cozmo.  We had the same problem with the Cleo infusion sets so we switched to the Comfort Short sites.  They are amazing and we never have any blockage or improper insertions.  They go in easy and come out easy.

6

Hi Brian:

My daughter Charisma was diagnosed in March of last year and by June we were pumping.  She uses the Deltec Cozmo and we love it.  The ease of site change is amazing and the features are great.  We have the blood glucos monitor attached to the pump and that makes it alot easier.  We have found that it is so much more convenient for hiking, swimming, and just going on road trips for the day.   She has the freedom to eat when ever she wants. 

It has some great features for extended bolusing for hi carb foods (i.e. pizza, pasta, etc.) which will release the insulin slowely to prevent the  highs. 

We also found this great website that sells pump packs that you can attach to your belt that are small enough were they look like a cell phone case and can hold your pump, pricker and trips and test strips. 

I recommend the pump to people who are conscientious of their diabetes.  You still need to take care of yourself the same way. 

 

 

 

7

Thanks guys..I'm going to start looking into various pumps and everything more in detail this weekend after all my exams are over this week (oh the joys of college!).  I'm not too worried about hiding the pump unless I'm at the beach where I wouldn't have any pockets to put it in.  Which brings me to my next question..I know most pumps can be removed for up to two hours to go swimming, shower, etc, but what do you do when you're at the beach?  Usually when I'm at the beach with my friends we'll go in the ocean for a little, come out for an hour, go back in, and not have any set "schedule."  So if I were to detach for a couple hours then reattach, how long would I have to stay attached for before I could detach again?  Also, is sand an issue for you guys?  If I did go on a pump it probably wouldn't be until the summer so I wouldn't have to worry about that and school all at once, and in the summer I find myself at the beach at least once or twice a week. 

Another question I had was how long are your needles that go into your site?  And how difficult is it to replace/change sites?  ok that was two questions, but they kinda relate :)

8

There are options for you out there. The idea of the on again off again thing could be frustrating. The hookups are just for the basal. If you are active and such at the beach you might not have to worry so much about the on again off again. You still need to be careful, but once you are set to use the pump again you could always reattach and test and do what you need to get your sugar under control, if it is high. It might take a little time, but the concern is always with the high. My nurse trainer told me that you could do the on again off again test and bolus method if you want. Over the summer I had a trip planned to go white water rafting and I was not really all that keen on bringing my pump with me all day, for fear of water/smashing/loss, again in talking with the nurse from my endocrinologists office we talked about a pump free day.

I would just spend the day w/o my pump; I would start my morning back in the old method of shots. This way I would be covered. Since I was an NPH user, she said to take the morning dose and than when the rafting trip was done I could go back on the pump if I so chose, but to make sure it was 6-8 hours after the NPH shot in the morning. Than just monitor to make sure any random lows happened. The pump free day was nice, even though I was only a month in at the time, but you realize how much you miss pumping when you go back to the "old way". Even with the change to pumping I was encouraged to have an up to date bottle of NPH on hand just in case there were pump issues and had to go off the pump. It was just a back up protocol and I only ever did that once other than the rafting trip. That was due more to pharmacy issues and no more insulin, so I needed to stretch what I had left and went to needles for a day until the pharmacy found the insulin they misplaced.

The site needles vary in length. I started with the quickset infusing set for my paradigm pump, that needle in total was probably a little longer than if you were using normal size syringe needle, not the short needle, but again it does not all go under the skin. The canula is either 6 mm or 9 mm, so a little more than that in length most likely goes into the skin. I use the silhouette now, which goes in a differ angle, so again the needle is longer than on the quick set, I am guessing about an inch or slightly longer, no ruler to judge. Again the whole needle does not go in the skin, it is just the angle of how it is inserted that makes the needle longer. At least for me, I rarely if ever run into site pain with the infusion sets.

Hope this helps. Any other questions just ask.

9

The cannula, the part that stays in and through which the insulin gets pumped to get into your body, is 6mm, 9mm or in the case of the Comfort Short infusion sets that I use, it is 13mm long.  I think the regular Comfort infusion sets have a 17mm cannula.  That was also one of my big questions before I started pumping:  how do I know which one is right for me?  Don't worry; your nurse educator will assess your particular case and recommend whatever is best for you.

Also, in case you wondered or hadn't thought about it, the cannula is a flexible piece of tubing, so that no matter how much moving around or stretching (or "yoga poses"!) you do, you don't feel it at all.  I only use my stomach so far and every once in a while, I have to look down to remember which side my site is on!  LOL

As far as difficulty for changing your sites, it's something to get used to at first, and I can't say that I am a pro at it yet, but, similar to needles, you do get a hang of it.  Again, like needles, it's not all that pleasant, but it is necessary and you only need to change your site once every three days as opposed to XX number of shots every day!

 

10

hey brian

I am in no way experienced in this department... I just started pumping a week ago yesterday.

However, that being said... it was the best decision I ever made within the 9 months I have been diagnosed. Being in college, the pump just makes everything so much easier and flexible.

I can go to a 930 movie without having to leave at 10 to give a Lantus shot. I can eat pizza with my friends in the middle of the night... and I can sleep in longer! :D

The thing that has been a little challenging is that when you first get the pump, you have to test more often and use the results to the basal rates. I had to wake up at 4am for a few days just to test, but it was needed.

I did switch over to a pump while still in school, but it didn't phase me. My friends all supported me and were there to help if something went wrong. Plus my professors all know I am diabetic, as I'm registered through the disabilities clinic, so if something were to happen, I could just mention it to them and they can't deny me or refuse to let me do something. I like knowing that :D

Overall, the switch hasn't been too difficult. I'm something who hates change. It's hard to deal with and just feels like starting over, but this was in no way difficult. It was easy and came without any obstacles.

You might want to talk to your doctor to see if you could get a saline pump. This way you could test it out... see what you think and kinda play around with the idea. This also helps with deciding which pump to get.

Good luck!

11

Melissa, it's great to hear that your first week went so well!  Congratulations!

 

12

I have been pumping for almost three years and have gone "back" to injecting.  I was finding that I wasn't getting consistent absorbtion of insulin (perhaps using the same sites too often).  I had to have a medical procedure done and needed to go off the pump.  I put myself on lantus to cover basil requirements and noticed that my control seemed much better.  It's kind of a drag to always have to bolos meals (with humalog) but overall I am doing better so I've stayed off the pump.  There were too many incidences of bolos not working or levels going way up at night for no reason.  I was using the cosmo with the cleo sets and have read here that people have been having absorbtion problems, perhaps that's what was going on with me.  I wish you luck with the pump and please realize it takes some time to get used to it. 

13

Hey Brian, glad to see your considering the pump.   It will be a big change, and it may or may not be right for you. 

I have been using a minimed pump since 2004.  I started on the paradigm 712 and I now use the paradigm 722 (there was also a 715 inbetween upgrades).

I love the pump.  It set me free.  I love the fact that I only have to change the site once every three days or so.

There are some draw backs to having a pump.  One you should know about is that you will only be on a short acting insulin like humalog.  That means that if something happens to the insertion site, you only have about 2 hours before your going to start heading off to "DKA land".  So if that happens, you have to be on top of it, and be able to get it fixed, or at least be able to get a longer acting insulin in your system right away. ( your doctor will make sure that you know what to do). 

I have had some major problems with the pump, but that being said, I will never go back to shots.   I think the pump is the way to go, for me.

It may or may not be the way for you.

I think you should at least try it because you may really like it.  Thats just what I would do in your position. 

If you have any questions about living with the pump, Please feel free to ask me! 

you can ask me privately if you like.

I will try to help you in anyway I can.

 

Well best of luck with everything! 

Let me know if I can help in anyway.

John

14

P.s.  All of the minimed infusion sets come with insertion devices (auto injectors for the infusion set).  Between taking shots, pricking fingers, or injecting infusion sets, the infusion set (using insertion device) is the least painful. 

I dont know if cosmo or the other have them (because I have only ever used minimed).

Also the support from mimimed is great! The only time I have ever had a pump fail, I had a new one 22 HOURS later!!!

That's pretty good service. 

I am sure the other pumps have 24 hour support as well or they should, but that is something to check into.

15

I'm going to my doctor this Friday, so I'll talk to him about it then and get some more information about everything.  I guess we'll go through which pump would best fit me and my lifestyle.  I'll let you guys know how it goes!

And Brian, that's good to know about being able to go back on lantus for a day if you have to.  When you do that, do your sugars run higher for that day?  When I go to the beach my sugar tends to run lower anyway so that shouldn't be as much a a problem I presume. 

As for the canula, I'm aware of what it is.  I was put on a CGM censor a couple months ago and that's what they used to attach it to me.  It wasn't bad at all, I forgot it was there for a while  :) 

And Melisa, I'm glad things are going well for you!

16

The canula should be less than what you would get with the CGM, truthfully most of the time I do forget about it, which is nice. Well as I said, I only did the one day off, when I used the NPH, not Lantus. It went alright for me. I mean I tweaked it a bit since I was going to be active.

If you were to go to a pump that would be something to talk about during training, since I have no experience with Lantus, i can't really tell you what they would do. In the end, it can work and as I said, since you will be active and swimming at the beach you could be okay with the random pump disconnects.

If you do decide to go on the pump it can be a hard decision. But we are all opinionated here and you can get any opinion you want. My two suggestions are either the Animas Ping or the Minimed Paradigm 522/722 which I have. They both seem to be the better options out there and not many complaints seem to pop up on the forums.

17

I went to my doctor Friday and we talked about it so now I'm signed up for a pump preparation class sort of thing that the nurse educator at the hospital runs.  I won't be going until April or May, but I'm definitely going to I'm still excited.  My doctor said that by the end of the class I'll have my mind made up as to whether the pump is right for me or not.

18

Like everything else it takes getting used to.  Once you get used to it you will wonder how you went on without having it. You should ask your doctor if you can try it out for a week or so without any insulin in it. I don't know  if they would do that though.

19

Hey Brian,

I was put on the pump a little over three years ago, and i must say it has turned things around. Being a college student would have been hard with syringes or the Insulin Pen, not only is it a hassle but if you forget it, your in trouble. Thats the good thing about the pump, its always on you so you never have to worry about leaving it at home,or having to carry around a bulky cooler or package to keep your insulin. I use the MiniMed "Medtronic" Paradigm 715, I am currently on my way to upgrading to the CGM "Continuous Glucose Monitoring" system so we will se how that goes. As far as i am concerned the pump has done wonders for me.

 

20

I haven't seen very many bad things said, but I can say that I had a lot of problems with my pump that even if you have already made the decision to get it, it may help a little to know some of the negative aspects that might occur.

I was diagnosed with diabetes at age 4, and no matter what we did my blood sugars were never under control. We thought that maybe the pump would help to control that, so I started using it. I was still in school at the time, and during gym class and sports it was hard to deal with. It did help to keep my blood sugars at a somewhat even level during activity, but it also took away my concentration from my games because I was always worried that I was gonna do something wrong and end up either breaking it or pulling it out (which did happen, multiple times).

Another bad thing about it was that, with the kind I had, it could only be taken off for an hour at a time and then had to be put back on for at least ten minutes before it could be taken off again. I'm a swimmer, and the lake is like my second home during the summer, whether it be to go tubing or waterskiing, or just to swim and be in the water. The bad thing about that was that I had to watch the time constantly to make sure that I got it put back on and it was really a hassle during those times.

Also, if you're one of those that tosses and turns a lot at night (like me) it gets pulled out sometimes at night. For the first couple of weeks that I had my pump, I couldn't sleep very well bcz I was so scared of pulling it out and not noticing. Which can also happen if you're a clutz (also like me) and run into things....it hurts when something gets caught on it without you noticing and gets yanked out!

And one thing to be very careful of is to always change where you put it. With mine, I only put it in my stomach bcz it was easiest for me with school and sports. So after a while, I started getting very large lumps in my stomach that my doc said could be insulin pockets. If something were to hit an insulin pocket and rupture it, it could release all that built up insulin into my system and might even be enough to kill me. (which was eventually the reason I ended up switching back to injections).

On the good side, it did mean more freedom, and at times it was easier.

But it still didn't make life with diabetes a walk in the park like I had hoped it would. After having had the pump for almost 2 years, I switched back to injections and changed doctors and now have my blood sugars under better control than my parents and I had ever dreamed of achieving.