Tag Archives: insulin pump

You do NOT want to see this message…

This is not something you want to see displayed on your insulin pump:

This is what popped up on my Animas Vibe pump about a week ago. Immediately, a number of thoughts (all bad) came to mind…

– Does this mean the pump has failed?

– Can I fix it and start pumping again?

– Animas is out of business in the USA… If it’s broken beyond repair, what then?

– What about backups? Do I have enough basal insulin, and syringes or pen needles, to get me through until I get another pump?

I’ll be honest, I thought immediately that the pump was toast, and that I was too, because I knew that Animas is no longer selling insulin pumps in my country. I thought that a failed pump meant I needed to find a new insulin pump manufacturer, and probably, a fight with insurance for replacing my pump before the warranty was out.

Like a complete novice, I called the number on the back of my pump. As I expected, the old Animas number rolled over to Medtronic customer service. We went through some initial getting-to-know-you items, like name, contact number, and the serial number from the back of my pump.

Then I was asked to describe my issue. I covered the error message you see above, and after an extended silence, I was told that indeed, my pump was kaput.

But… good news! Medtronic was able to send a new Animas pump my way in about 36 hours. But… bad news! That meant a full day and a half on MDI, or multiple daily injections.

Ordinarily, this wouldn’t concern me. But when I go the MDI route, it involves a certain amount of longer acting insulin, injected to replace my pump’s basal rate. In my pump, it’s fast acting insulin (Novolog) all the time.

In this case, my basal insulin was Lantus. While using Lantus prior to starting on my insulin pump eight years ago, I encountered some of the worst, the scariest lows I’ve ever had in my life.

So I kept a close watch on my Dexcom CGM, and I did have a couple of lows that, while not super scary, occurred at times when I typically wouldn’t encounter a low just using my fast-acting insulin of choice. In this scenario, I was glad to have access to a tool like my CGM, to give me near-real time numbers and trend data. It helped me ensure that I wasn’t flying blind with my blood sugar numbers. I was far less likely to be surprised.

Nevertheless, I was thrilled to come off the Lantus and start pumping again. Same model pump, same color. There are two important things to note here, especially since I haven’t mentioned these two yet:

1. Make sure you have backups in case of pump failure. I started to run really low on pen needles. I needed to reuse a couple of them, and that’s not always a safe practice (and in case I really have to tell you, never reuse someone else’s pen needle or syringe).

2. Make sure you note your pump settings (basal rates, insulin/carb ratio, correction factor, etc.). Hey, my pump was broken. How could I get all of the settings that have been in there for two years? I had them on my iPad at home. I carry the iPad whenever I travel too, for this reason as much as any other. When it was time to set up the new pump, I was all set to go with the information I needed.

The moral of the story here is that shtuff happens. How we deal with it is sometimes scary, but dealing with unexpected things is kind of what we’re good at. After all, our lives depend on it.

Not exactly MacGyver, but good enough.

Tuesday, I was able to overcome a potentially panic-enducing episode of my own doing. I’m not the most handy guy in the world, so getting over this was a big deal for me, even though it’s probably not to you. Let me explain:

I walked out the door and headed to work without checking the status on my insulin pump. That means I left for work without noticing that I had about 7 units of insulin left in my reservoir. Not nearly enough to last through the day until I got home.

I don’t generally keep extra insulin lying around my desk at work, so I had to come up with something, or inconvenience The Great Spousal Unit and ask her to make a special trip downtown, which is way out of her way. To make matters worse, my Animas pump has one feature that I absolutely detest: when the pump says zero units left, it stops pumping.

The problem is, when the pump says it’s at zero units, there are still about 20 units of insulin left in my reservoir. Now that’s enough to last me through the day at work. What to do?
Reservoir
Well, I don’t recommend that anyone do this on a regular basis. It is far from an exact science. But it beats wasting insulin, or potentially going a few hours without any. Here’s what I did: once my pump went to zero units and gave me a no delivery alarm, I pulled the reservoir out, and every hour, carefully pumped more insulin in using the plunger underneath the reservoir. You know… syringe style. Once the plunger reached a certain point, I had to use a pencil to push it further and continue to pump insulin.

Like I said, this is not an exact way of delivering insulin, and I do not recommend it if you can avoid it. In addition to regular hourly bolus amounts, I checked my glucose levels about every hour and a half to make sure I wasn’t too high or too low. But in this case, this practice solved two problems for me: I did not need extra insulin or to leave work early to get extra insulin, and I did not waste 20 units (or more) of perfectly good Novolog.

My old insulin pump had a 300 unit reservoir. My new pump has only a 200 unit reservoir. This isn’t a huge concern for me. I can manage with either. However, one of the features of my previous pump that I took for granted (and wish I had back) was the fact that I could fill the reservoir, prime the pump, go until the pump said zero units left, and still keep pumping for hours, because it kept pumping until the insulin was gone, not until the display said zero. The “Load Cartridge” feature on my new insulin pump already takes about fifteen units away from a full reservoir, and I take about ten more to prime (it’s long tubing). Then the pump quits when it says zero units, even though there are always 20 units or more left in the reservoir.

All’s well that ends well. When I got home from work, my pre-dinner BG check resulted in a reasonable 115 mg/dL.

I must say, I find it annoying at best, wasteful at worst for my pump manufacturer to stop my pump entirely when I have insulin left in the reservoir. So Animas, if I work on checking my pump status more often, can you work on that delivery of all the insulin in my reservoir? My solution was not exactly MacGyver-esque, but it was useful anyway. Let’s hope I don’t have to employ similar tactics in the future.
 

#DBlogWeek Day 3: Clean it out.

DBW2015
This is the sixth year of Diabetes Blog Week, started by Karen over at Bitter~Sweet Diabetes. All of us diabetes bloggers are given a subject to write about each day during this week, and after we publish each day’s installment, we’ll go back and link our posts on her site. Want to know more? CLICK HERE.
 
 
Welcome to Day 3! Today, we’re going to Clean It Out:

Yesterday we kept stuff in, so today let’s clear stuff out. What is in your diabetic closet that needs to be cleaned out? This can be an actual physical belonging, or it can be something you’re mentally or emotionally hanging on to. Why are you keeping it and why do you need to get rid of it? (Thank you Rick of RA Diabetes for this topic suggestion.)

There are two things that I really need to clean out from my diabetes life. These are two actual, tangible things.

One is my insulin pump. People who read this space on a regular basis may remember Decision 2014, when I tried nearly every insulin pump on the market in the USA. That’s because my pump warranty expired last year, and I really need a new one. The Medtronic Revel pump I have now is five years old, it looks five years old, and it’s starting to act a little cranky at times. So it’s definitely time. Why haven’t I chosen a new pump yet?
DSC00056
I haven’t chosen a new pump because… instead of finding the perfect pump for my life (and the next four years of my life), I wound up deciding that none of the pumps on the market in the USA is a good fit for me. I know I’ll never find the perfect pump, but I would like to see something a little closer to what I’m looking for. Until that moment comes, I’m going to wait. Well, at least as long as my current pump holds out anyway.

The second thing I really need to get rid of? It’s this thing:
Blue1
My grandmother found this in a drug store shortly after I was diagnosed. She thought it would help me keep my insulin cool when I’m away from home. And she was right. And I’ve kept this thing for 24 years.

It’s been to Florida and California, New York and Seattle, 22 states in all. It’s been to Jamaica, Ireland, England, and Belgium. It’s logged a lot of miles and kept my life-giving juice safe and cool. But… it is time to say goodbye to it.

I mean, did you look at that thing? It’s getting difficult to keep clean. It’s a little out of shape now too. It has definitely seen better days. So as soon as I can find something similar that will do just as well keeping my insulin cool and safe, this will be heading to the landfill like so much other medical device paraphernalia.

It’s not easy saying goodbye. But it’s a necessary thing sometimes. These two things have served me well during the time I’ve had them. But it’s time to let them retire. If you really want to know the truth… I’m looking forward to replacing them.
 
 
 

We’re not EVER perfect.

I feel kinda silly posting this on the same day that Scott E. posted something very similar over at Rolling in the D… But, what the hell? Here it is.

But be sure to go over and read Scott’s post too. You’ll probably get more out of it anyway.

This story is nothing that should shock you. But it’s something that happened yesterday, and I think it’s an important story to tell.

I suspect I don’t get a huge amount of viewers here, but I do recognize there are some. Somewhere between some and huge is where my viewership is right now.

Anyway… It’s easy as a writer, and the person who basically oversees everything that gets posted here (after all, it’s my blog)… It’s easy to make everything about my life seem perfect and special. It’s even easy to make it seem like those moments where I’m not perfect are not exactly my fault.

Well, yesterday, I woke up, remembering I needed to change my infusion set. I had about 5.5 units of insulin left in my reservoir. Of course, those of us with a Medtronic pump know that 5.5 units means that you really have (probably) many more units than that left.

Knowing this, I had breakfast without changing my set. And I had a couple of chores around the house to take care of, so I didn’t change my set after breakfast either. I also didn’t change after getting my hair cut, or even after lunch. It wasn’t until we were nearly out the door headed for a movie that I finally remembered to do my set change. At this point, my pump was probably showing something like this for five hours or so:

DSC00856

So apparently, just in the nick of time, I finally got that set change in. The reservoir had a little insulin left, because it was still pumping, but once I pulled it from the pump I could see there wasn’t much.

It wasn’t an epic fail, of course, but it’s something that happens in the course of day after day, year after year living the diabetes life. You’re bound to forget something now and then. You’re likely going to make a mistake once in a while. How do I know this? Because I make mistakes too.

Don’t let it get you down. Don’t let it make you feel like someone you read occasionally has his shit together, and you don’t. Because that is simply not true.

Instead, just pick up and move on. With diabetes, it’s good to be able to remember things. But don’t spend any time feeling bad about one thing or one day. Don’t ever let something from yesterday cloud the joy you’re seeking today.

By the way, we did make the movie. Monuments Men is a good one. Great acting all over the place.
 
 
 

Wordless Wednesday… Do As I Say, Not As I Do.

From the Do As I Say, Not As I Do Department…

DSC00856

I started the day with about 20 units left in my reservoir. I thought I would make it back home after work before that was all gone, but, well, you know how things happen… Sometimes things happen that are out of your control.

I wound up getting home about half an hour later than I expected. The good news is that my pump, though scratched and extremely dirty, was still pumping. Despite what the display in the photo shows.

I’ve since changed my site and reservoir, and given my pump a thorough cleaning. I promise.
 
 
 

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