# At last!  DSN called re: new pump!



## Pattidevans (Oct 29, 2021)

Had a phone call from the “Pump DSN” at the diabetes centre yesterday regarding replacing my Spirit Combo on which the warranty runs out next month.  She has made an appointment to see me on 23 November to run through the pros and cons  of the two pumps on offer, which are the Medtronic and the Omnipod.  She’ll show them to me and go through their features.  Unfortunately I barely got a word in edgewise during the phone conversation, so I don’t know which models are on offer, Medtronic 640 or 780 and whether the Omnipod is the Dash or not.  Srill, it does give me a basis to start some research.  

I’d be Interested to hear from people on either of those pumps.  I’m leaning towards the Omnipod, I gather it has a handset but am I right in thinking the handset isn’t a meter?


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## Matchless (Oct 29, 2021)

Hi Patti i have been on the omnipod dash since june the first 4 to 5 wks the freedom from tubes was brilliant and using the pdm that has no cgm saves getting the pump out for a bolus and settings ect but i did have a problem with several pods witch turned out to be the pdm at fault witch hear in france they replaced in  2 hrs by post since then i have been making miner basal adjustments and has been fine since, i did have medtronic 640g before which is a good and easy to navigate settings ect but is a heavy pump mine came with a contour next link CGM which you can bolus from that saves getting the pump out   and it  does have a good variety of cannulas   with different tube lengths i hope i have given yo a small insight to both pumps,


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## Pattidevans (Oct 29, 2021)

Mmmm thank you, that's interesting.  I have been on a Roche Combo for 8 years, it has a pdm which is also a meter, so only one thing to carry., but I do like not having to get the pump out to bolus.  I hear the Omnipod customer services are quite good here.


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## trophywench (Oct 29, 2021)

Hoo flippin Rah, Patti.  At the very least get a free dummy Omnipod by ringing them and asking, to see if you are allergic to their adhesive.  I wasn't BUT they cover a skin area twice as big as Roche cannulas so that's different for starters and I didn't like that cos I have long had a finite amount of flesh which absorbs insulin well and already find replacing them every 2 days to be exceedingly tedious.


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## Pattidevans (Oct 29, 2021)

Jen, I've already had the dummy pump.  Do you think they will send another?


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## Matchless (Oct 29, 2021)

trophywench said:


> Hoo flippin Rah, Patti.  At the very least get a free dummy Omnipod by ringing them and asking, to see if you are allergic to their adhesive.  I wasn't BUT they cover a skin area twice as big as Roche cannulas so that's different for starters and I didn't like that cos I have long had a finite amount of flesh which absorbs insulin well and already find replacing them every 2 days to be exceedingly tedious.


i use cavilon on more sensitive sites which works fine i fill with about 120 units of fiasp which  lasts 3days and some times i go the extra 8 hrs if its not convenient to change on time,


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## SB2015 (Oct 29, 2021)

Hi @Pattidevans from another ex combo user.

I am using the Medtronic 780G.  It weighs about the same as the combo, but you do need to access it.  I have got over that by stuffing it in my bra at the front if wearing a dress, or under the strap at the side if wearing a skirt or trousers.  This drove me potty at the start. It it is fine now.

I am using it in a closed loop with the Medtronic sensors, and would not want to go back on that now.  I ran it in manual for about a month at the start to get used to the change over.  They are very intuitive and much the same as the combo.  You can enter a glucose value from your Libre for bolus decisions if you are comfortable doing that, which we weren’t able to do with the Combo.

if there are any questions, ask away


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## SB2015 (Oct 29, 2021)

…..  and I generally change my sensor every three days.  The cannula patch is much the same as for the combo.  Similar choices of 90 or angled.  There is one very similar with an inverter device.

I find the support excellent, and my supplies arrive in good time.


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## trophywench (Oct 29, 2021)

It is true there are 3 inches between my breasts when lying flat on my back whilst naked but not between the underwires on my bra whilst dressed.  Likewise, not enough room under the sides of bras, hence not options open to me.  I have to have pockets!  With dresses, this involves opening the inner seam of the pocket(s) leaving a gap wide enough to get the business end of the tubing through, to attach to the cannula.


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## mark king (Oct 29, 2021)

That's good news @Pattidevans I've only had one pump the Omnipod but I was always anti the tubes and wires of the older style pumps but i have been very happy with the Pod.

They wouldn't send me a 2nd trial pod when I asked.
As I'm retired and daily about the house I tend to only keep my phone and L2 reader with me.  If I'm out for a meal or overnight I take my pod PDM with me then.

I'm male but the Pod fitment is easy peasy but of course I have none of the issues Jenny mentions.    
My skin is perfect after Pod use but I do use a adhesive release spray to unstick it so it peels of simples.

Good luck do let's know which way you choose and why.

Best


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## Pumper_Sue (Oct 29, 2021)

Matchless said:


> i did have medtronic 640g before which is a good and easy to navigate settings ect but is a heavy pump mine came with a contour next link CGM which you can bolus from that saves getting the pump out and it does have a good variety of cannulas with different tube lengths i hope i have given yo a small insight to both pumps,


The 640 weighs 135gms with a battery and cartridge full of insulin


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## trophywench (Oct 29, 2021)

Pumper_Sue said:


> The 640 weighs 135gms with a battery and cartridge full of insulin


compared to similar Combo at 130g.


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## Pattidevans (Oct 30, 2021)

Thank you everyone for your comments, all taken on board.  @SB2015 I’d love to do the looping, but I can’t see me being funded for the sensors and from previous research re costings I am even more unlikely to be able to fund them myself.

I don’t seem to have any problems with adhesives, neither from cannulas nor from the Libre.  I do use Cavilon under the cannulas.  I started that when I had a box of duff sensors that had barely any sticky in them, but Roche replaced them.

I am definitely leaning towards the Pod.  We go on holiday quite a lot and despite being 75 I still enjoy sunbathing  and swimming (Hubby says I’ve not yet got to the stage where I frighten the wildlife when wearing a swimming costume).  The tubed pump is a veritable PITA and stops me going in the sea as much as I would like due to the hoo ha of taking it off, putting the plug in etc and worrying about BG levels due to the time it’s off.  Plus it’s awkward to wear with a costume.

At present I just carry my phone when I go out as it reads the Libre.  I take the PDM +lancing device and strips only when we are eating out.


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## Pattidevans (Oct 30, 2021)

Continued:  Sorry... iPad charge ran out and have had to fire up the Laptop.

I've really not got much room in my bra (like @trophywench) being a bit top heavy.  I've hardly worn a dress or skirt for the last 8 years as it's so much easier to stick the pump in the pocket of my trousers, so I'm looking forward to being able to wear a dress more often.  Wedding invitations are coming in thick and fast this year... another arrived this morning.

Yes.... so leaning towards the pod... and that will lead to opening up more places to put it i.e. not practical to put cannulas with tubing on my arms and I find legs and back awkward.  Obviously I shall be shown the actual pumps on 23 November and have the pros and cons explained.

Glad to hear any more comments and I'll definitely let you all know what transpires!

Just edited to add that  I currently only fill my Combo with 140u to last 6 days, so presumably I could adjust that for the 3 days the pod lasts?


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## Matchless (Oct 30, 2021)

Pattidevans said:


> Continued:  Sorry... iPad charge ran out and have had to fire up the Laptop.
> 
> I've really not got much room in my bra (like @trophywench) being a bit top heavy.  I've hardly worn a dress or skirt for the last 8 years as it's so much easier to stick the pump in the pocket of my trousers, so I'm looking forward to being able to wear a dress more often.  Wedding invitations are coming in thick and fast this year... another arrived this morning.
> 
> ...


just thought say my diabetic nurse said you donot have a 4 year contract because its a throw away after 3 days so you ycan change your mind at any time and go for another pump which was a plus for me if something better came along .i would check as i am not in the uk.


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## Bloden (Oct 30, 2021)

What’s pdm @Matchless ?


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## helli (Oct 30, 2021)

Bloden said:


> What’s pdm @Matchless ?


“Personal Diabetes Manager” or remote control for the insulin pump.


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## Bloden (Oct 30, 2021)

Ta! @helli


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## Pattidevans (Oct 30, 2021)

Matchless said:


> just thought say my diabetic nurse said you donot have a 4 year contract because its a throw away after 3 days so you ycan change your mind at any time and go for another pump which was a plus for me if something better came along .i would check as i am not in the uk.


One thing the nurse said on the phone was "You need to make the right choice as you will be stuck with it for four years".  So obviously it's different here!  I think the hospital enter into a contract with the manufacturers to get better prices.


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## trophywench (Oct 30, 2021)

Yeah, all the ones I could have in a different part of England to Patti, still a 4 year contract.  Oh - and I think it's the CCG that enter into the contracts not the individual hospitals.

@Leo - as the only people you are allowed to see re your diabetes say the CCG looks after your D, ring them, repeat what you have been told and ask them why they will not allow you to see someone properly qualified and equipped to assist you especially as you work for a hospital that can??


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## Bloden (Oct 31, 2021)

trophywench said:


> I have to have pockets!  With dresses, this involves opening the inner seam of the pocket(s) leaving a gap wide enough to get the business end of the tubing through, to attach to the cannula.


Sounds like a palaver, but I spose you get used to it!  I’m veering towards the Omnipod as my first pump to avoid tubing / clothing issues LOL.


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## helli (Oct 31, 2021)

trophywench said:


> I have to have pockets! With dresses, this involves opening the inner seam of the pocket(s) leaving a gap wide enough to get the business end of the tubing through, to attach to the cannula.


When I had a tubey pump, I did not alter my dresses. I used a pump belt. Either around my waist or twice around my thigh. 
I found the HidIn belts suited me best.


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## Inka (Oct 31, 2021)

@Bloden I use a Hid-in belt too. I often wear dresses. I also use a Tubigrip on my thigh to hold my pump. That’s really convenient too. For me, tubed pumps are much better clothes-wise because you can move them about according to what you’re wearing whereas a patch pump is stuck there and personally I feel that would be a pain and I’d feel it was dictating my clothing a bit.

Now, I choose what to wear first, then can put my pump wherever fits. I wear the Hid-in most, but also use the Tubigrip and a bra bag which clips to the side of my bra and let’s the pump sit comfortably and invisibly on my side. My pump is controlled by my phone so I don’t need to take it out now, but prior to this pump, I used the same holding methods and had no issues whipping it out to bolus.

@Pattidevans When I’m having a beach day, I sometimes just use a basal insulin via pen that morning plus a pen to bolus, or, I can just push away with the bolus insulin via pen if I’m only there a few hours. I used to remove my pump when at the beach but found I didn’t really need it, so now remove at home and take my pen(s).


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## Pattidevans (Oct 31, 2021)

helli said:


> When I had a tubey pump, I did not alter my dresses. I used a pump belt. Either around my waist or twice around my thigh.
> I found the HidIn belts suited me best.


I think it depends on your figure as to whether you can comfortably secrete the pump in a belt under clothing.  I don’t have much of a waist, on the other hand I have small hips and bum and a bit top heavy.  I find it difficult to get dresses to fit anyway, let alone having more bulk around the waist.  Not all solutions fit all problems.  I must say I haven’t tried it round my thigh.  I’ve made little pockets I pin inside dresses that hang about 6” below my waist towards the side so the pump hangs where it would sit in trouser pockets.  But for me the most important thing about a pump wherever you secrete it, is not having to get it out of your clothing in public to bolus.  So a PDM is important.  Of the pumps on offer to me one doesn’t have a pdm the other does.


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## Pattidevans (Oct 31, 2021)

Inka said:


> @Bloden I use a Hid-in belt too. I often wear dresses. I also use a Tubigrip on my thigh to hold my pump. That’s really convenient too. For me, tubed pumps are much better clothes-wise because you can move them about according to what you’re wearing whereas a patch pump is stuck there and personally I feel that would be a pain and I’d feel it was dictating my clothing a bit.
> 
> Now, I choose what to wear first, then can put my pump wherever fits. I wear the Hid-in most, but also use the Tubigrip and a bra bag which clips to the side of my bra and let’s the pump sit comfortably and invisibly on my side. My pump is controlled by my phone so I don’t need to take it out now, but prior to this pump, I used the same holding methods and had no issues whipping it out to bolus.
> 
> @Pattidevans When I’m having a beach day, I sometimes just use a basal insulin via pen that morning plus a pen to bolus, or, I can just push away with the bolus insulin via pen if I’m only there a few hours. I used to remove my pump when at the beach but found I didn’t really need it, so now remove at home and take my pen(s).


It’s not the odd day though @Inka.  We were in Greece for 5 weeks earlier this year, (followed by another holiday later in the year), so I would have had to revert to pens for the full 5 weeks as I was on the beach nearly every day.  I don’t want to do that.  As we always say, everyone is different and so I am leaning towards the pump with the pdm (the other on offer doesn’t have one) and there are places I can put it under clothing that will suit my body shape better than either a belt or trying to hang it from my bra. I somehow can’t imagine that being comfy for me, though I do know it suits many women.


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## trophywench (Oct 31, 2021)

I have more than one bra hanger and can use that OK IF the top garment is loose enough to accommodate the bulk and does not have a fitted waist and I'm not going to sit in any easy chairs as being so very short waisted the bottom of the pump digs in me uncomfortably.  Also tricky getting it placed exactly right so the bit where the top of the pump where the tubing sticks out, doesn't dig me in the armpit - the luer lock fitting on that end of all Roche pump tubing is ruddy hard!  No way Pedro could I use a Spibelt, the bottom of my ribcage is far too close to my waist for comfort.


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## Inka (Oct 31, 2021)

Pattidevans said:


> It’s not the odd day though @Inka.  We were in Greece for 5 weeks earlier this year, (followed by another holiday later in the year), so I would have had to revert to pens for the full 5 weeks as I was on the beach nearly every day.  I don’t want to do that.  As we always say, everyone is different and so I am leaning towards the pump with the pdm (the other on offer doesn’t have one) and there are places I can put it under clothing that will suit my body shape better than either a belt or trying to hang it from my bra. I somehow can’t imagine that being comfy for me, though I do know it suits many women.



Ah, lucky you!  I’ve never been in that situation and usually go to U.K. beaches so 5 weeks of sun is rarely a thing. Also, I can leave my pump safe at home in the cool.

Yes, we all have different body shapes and that affects things.


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## trophywench (Oct 31, 2021)

Well, see, once you're retired and have previously made excellent financial provision for yer old age whilst you were working, you can be on holiday 365 days of the year if you wish!  We normally have liked to go to more northern Europe for a few months a couple of times a year but have been restricted in that in recent years due to either our own health probs, the pandemic or 'government actions'.  No way now could my OH travel that far for that long wearing a face mask


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## Inka (Oct 31, 2021)

I hope my retirement is as nice! I need a ‘fingers crossed’ emoticon here! I find it hard to envisage that with the current financial situation : /

Perhaps I’ll flog my pump to fund a holiday  (yes, yes - I’m joking, NHS!)


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## Pattidevans (Oct 31, 2021)

I worked for 51 years with only a 3 week break in employment.  I was exceedingly fortunate that for much of that time (except when self employed) I worked for companies that offered company pensions, as did my husband.  Regrettably we never had children.  So yes, we can now have a comfortable life, not extravagant, but pleasant.   Of course things may change with the current financial climate and costs rising alarmingly.   Meantime we mean to take advantage of every opportunity we have to go on holiday.  So, it is rather a consideration for me when choosing a pump.  I have previously kept my pump in a pump frio whilst sunbathing.... I think there will be ways around keeping a pod cool.

@trophywench would Pete have to wear a mask whilst driving?


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## trophywench (Oct 31, 2021)

Pattidevans said:


> @trophywench would Pete have to wear a mask whilst driving?


Well, no - so depending on what transpires over the next few months, both with ourselves and the entente cordiale, it should be a possibility in 2022.


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## Pattidevans (Nov 1, 2021)

trophywench said:


> Well, no - so depending on what transpires over the next few months, both with ourselves and the entente cordiale, it should be a possibility in 2022.


That’s something to look forward to Jen.  J has been saying he misses driving holidays in France and he’s plotting something for next September.


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## everydayupsanddowns (Nov 1, 2021)

Exciting times for you @Pattidevans 

I will watch your pod journey with interest. Be interesting to see how it works out for you. I’m another for whom a pod has never really appealed, so tricky to comment really.

Shame there are so few options with remotes / handsets really. Roll on the launch of a few more phone apps that can control pumps like the one Tandem have been promising. 

Hope it all works out well, and goes ahead with no hitches or kerfuffle


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## Pattidevans (Nov 1, 2021)

Thank you Mike, will keep everyone updated.



everydayupsanddowns said:


> I’m another for whom a pod has never really appealed, so tricky to comment really.


Hmmm well, I presume you don't wear dresses LOL!


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## trophywench (Nov 1, 2021)

Pattidevans said:


> Hmmm well, I presume you don't wear dresses LOL!



.... or bras ......


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## Pattidevans (Nov 24, 2021)

Had my appointment yesterday.  I was offered the Medtronic 640G (no mention of the 780).  To be honest it felt like half a brick in comparison to my Combo, both larger and heavier, or alternatively I could have the Omnipod Dash.  The DSN talked through the pros and cons of each pump and answered my questions.  Julian had come with me so I asked if he could come into the appointment and I was glad this was allowed as he brought up a couple of queries that I wouldn't have thought of e.g. regarding the insurance of whichever pump for which I would be responsible.  Plus at the mention of holidays the DSN told me that Omnipod would lend me a handset to take with me, which was an advantage as far as I was concerned as my Combo handset had malfunctioned on a holiday earlier this year. Though I did have the handset from my old pump with me - along with the old pump.  I was able to pair the old handset with the current pump.  However, I'd not have that back-up next year.

I thought the set up and application of the cannulas on the Medtronic somewhat clunky and unecessarily complicated plus an awful lot of plastic waste was generated.  Whereas Omnipod have a system where you send used pods back for recycling (part of which process fuels their manufacturing needs for electricity).

I'd noted from another thread on this forum that it was possible to change your mind within the first 90 days if you didn't like the Omnipod.  However, the DSN cautioned that it was necessary to read the small print on this matter as in fact it isn't really possible to "back out" unless you return all the gubbins within 30 days and she explained that in reality I would have just 5 days to make that decision, given the processes the hospital would have to go through to return things within the 30 days.

So, to cut a long story short I decided on the Omnipod - to be truthful I was already leaning in that direction even before the appointment and I didn't hear anything during the appointment that put me off, whereas I could see disadvantages to taking the older Medtronic model.

I should get the new pump early on after Xmas and then I will have a long video conference with the DSN plus a rep from the manufacturers in order to set the pump up and get me running with it.

@trophywench something she told me was that I should have been changing my Combo pump every 3 days, rather than what I swear I was told 8 years ago, that was to change the cannula every 3 days and the pump every 6.  Anyhoo been doing it that way for 8 years and for the remaining time I shall continue.  Thought!  If that is the case then why supply cannulas without tubing?


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## helli (Nov 24, 2021)

trophywench said:


> .... or bras ......


What difference does underwear make to having a patch pump?


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## Pattidevans (Nov 24, 2021)

helli said:


> What difference does underwear make to having a patch pump?


I'll let @trophywench elucidate on that one!


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## Pattidevans (Nov 24, 2021)

Pattidevans said:


> I'd noted from another thread on this forum that it was possible to change your mind within the first 90 days if you didn't like the Omnipod. However, the DSN cautioned that it was necessary to read the small print on this matter as in fact it isn't really possible to "back out" unless you return all the gubbins within 30 days and she explained that in reality I would have just 5 days to make that decision, given the processes the hospital would have to go through to return things within the 30 days.


As someone pointed out to me elsewhere, my DSN has misunderstood the process.  You have 30 days after the 90 day period to return the item.


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## mark king (Nov 24, 2021)

Pattidevans said:


> So, to cut a long story short I decided on the Omnipod


@Pattidevans I don't think you will be disappointed. 

Best


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## trophywench (Nov 24, 2021)

Great!  Exciting and scary at the same time.


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## Pattidevans (Nov 25, 2021)

mark king said:


> @Pattidevans I don't think you will be disappointed.
> 
> Best


Fingers crossed Mark.


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## trophywench (Nov 25, 2021)

Pattidevans said:


> @trophywench something she told me was that I should have been changing my Combo pump every 3 days, rather than what I swear I was told 8 years ago, that was to change the cannula every 3 days and the pump every 6.  Anyhoo been doing it that way for 8 years and for the remaining time I shall continue.  Thought!  If that is the case then why supply cannulas without tubing?


You are correct, she was wrong.  Cannulas however often you need em (me 2, yourself 3 days)  Reservoirs and tubing, every 6 days.


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## everydayupsanddowns (Nov 26, 2021)

Pattidevans said:


> @trophywench something she told me was that I should have been changing my Combo pump every 3 days, rather than what I swear I was told 8 years ago, that was to change the cannula every 3 days and the pump every 6. Anyhoo been doing it that way for 8 years and for the remaining time I shall continue. Thought! If that is the case then why supply cannulas without tubing?





trophywench said:


> You are correct, she was wrong.  Cannulas however often you need em (me 2, yourself 3 days)  Reservoirs and tubing, every 6 days.



Perhaps she is more familiar with Medtronic where the whole kaboodle gets changed every 3 days?

Most pumps seem to work that way tbh, I‘ve never used a Combo, but reading your experiences often made me rather suspect I would frequently forget what I was supposed to be changing on which day with the 6 day / 3 day thing. Though I would have much appreciated the reduction in waste and wasted insulin with all those extra tubing fills and the dribs and drabs left in the extra reservoirs.


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## Pattidevans (Nov 26, 2021)

Ahhh.. you could well be right Mike.  She’s probably never been responsible for starting someone on a Combo.  I think I was probably the last person to get one from my clinic and it was at the time Animas stopped doing pumps, so there was only the Medtronic on offer.  At the time me being offered another Combo was a one off and there was a different pump nurse at the clinic.  I obviously didn’t need to be instructed in it and just set it up myself.

I know what you mean about confusion though.  I frequently ask Julian “do you remember what day I changed my pump” as he usually gets the insulin out of the fridge when he makes the morning tea.


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## trophywench (Nov 26, 2021)

I've been saying exactly that to Pete, practically for ever now and there's no escape for him for the next 4 and a half years......


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## Pumper_Sue (Nov 26, 2021)

I have a medtronic pump and only replace the res when empty which is 6 - 8 days cannula is changed every 2 or 3 days depending if I'm sore.


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## Pattidevans (Nov 27, 2021)

The DSN was saying that the insulin degrades when transferred from the glass vials into the plastic reservoirs. However @Pumper_Sue I have to say that like you, mine sometimes goes 7 days rather than the recommended 6, although I only usually fill it to 150u not the recommended 315u.  I find if I leave the cannulas in more than 3 days I sometimes get a small sore lump, so I try to remember to change every 3 days.


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## Pumper_Sue (Nov 27, 2021)

Pattidevans said:


> The DSN was saying that the insulin degrades when transferred from the glass vials into the plastic reservoirs. However @Pumper_Sue I have to say that like you, mine sometimes goes 7 days rather than the recommended 6, although I only usually fill it to 150u not the recommended 315u.  I find if I leave the cannulas in more than 3 days I sometimes get a small sore lump, so I try to remember to change every 3 days.


There's a lubricant in the reservoirs which is why they think it degrades. I use the 180unit reservoirs so six days is the norm for me at the moment. I've been pumping for 14 or 15 years now and have never had insulin go off in all that time, so will carry on as I am as against my religion to waste money even if it's not mine.


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## alisonmf (Jan 10, 2022)

Pattidevans said:


> Had my appointment yesterday.  I was offered the Medtronic 640G (no mention of the 780).  To be honest it felt like half a brick in comparison to my Combo, both larger and heavier, or alternatively I could have the Omnipod Dash.  The DSN talked through the pros and cons of each pump and answered my questions.  Julian had come with me so I asked if he could come into the appointment and I was glad this was allowed as he brought up a couple of queries that I wouldn't have thought of e.g. regarding the insurance of whichever pump for which I would be responsible.  Plus at the mention of holidays the DSN told me that Omnipod would lend me a handset to take with me, which was an advantage as far as I was concerned as my Combo handset had malfunctioned on a holiday earlier this year. Though I did have the handset from my old pump with me - along with the old pump.  I was able to pair the old handset with the current pump.  However, I'd not have that back-up next year.
> 
> I thought the set up and application of the cannulas on the Medtronic somewhat clunky and unecessarily complicated plus an awful lot of plastic waste was generated.  Whereas Omnipod have a system where you send used pods back for recycling (part of which process fuels their manufacturing needs for electricity).
> 
> ...


how is the Omnipod going???


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## Pattidevans (Jan 10, 2022)

Hi @alisonmf not got it yet.  I pick it up next Monday from the clinic and will have a 3 way training online session with the pump nurse and the Omnipod rep on Wednesday 19th.  

After a conversation with the pump nurse when she phoned me to tell me it had arrived I am a little concerned as she said to me "I know you have probably 24 different basal rates set on your pump at the moment, but we like to start you with time blocks of so many hours at a time on the same basal rate".  I came off the phone rather taken aback.  Yes, I do have more or less 24 different settings, but time in range is 92% with only 1% below 3.9.  So if it's not broke why fix it?  I know I will struggle with what she's suggesting and it kept me  awake for a while until I thought "just do what they want and when you get off the phone set it back up how you have your current pump".


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## Bruce Stephens (Jan 10, 2022)

Pattidevans said:


> So if it's not broke why fix it?


I think just because simpler is better. So if the time blocks works OK, that'll be simpler than your current setup.

Configurations of lots of things get more and more complicated over time, and there's sometimes benefit in a general resetting of it all because sometimes some of those turn out not to be helpful (even if maybe they were for a period).

(It's also conceivable that the nurse doesn't fancy configuring all those detailed rates then writing them all down for your notes.)


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## Pattidevans (Jan 10, 2022)

Bruce Stephens said:


> I think just because simpler is better. So if the time blocks works OK, that'll be simpler than your current setup.
> 
> Configurations of lots of things get more and more complicated over time, and there's sometimes benefit in a general resetting of it all because sometimes some of those turn out not to be helpful (even if maybe they were for a period).
> 
> (It's also conceivable that the nurse doesn't fancy configuring all those detailed rates then writing them all down for your notes.)


It's taken a lot of effort to get where I am though Bruce.  I keep a very close eye on my basals and tweak as necessary.  I've been more or less left alone to get on with it for the last few years and yes, I admit, I don't want someone else fiddling with it!  Mostly anyone I have seen in the way of HCPs during that time has been very surprised  at my tight control.  I suspect your last sentence in brackets is more like the truth!


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## mark king (Jan 10, 2022)

Hello @Pattidevans 
 I think Bruce's "conceivable point" is probably correct as that's what they did for me in the first instance with my DSN stepping up the time blocks to a total of 9 now in a 24 hour period.  Some consecutive time blocks are the same value but are noted as 1 time block. But............ you can have 24 individual time blocks in any 1 day and that makes up 1 basal programme.  You can have 7 more different Basal programmes to cover differing settings for say exercise or holidays or gardening etc.  
Of course you can make correction changes to your Bolus dose to cover Hi's or for Lo's suspend your Basal programme.

For simplicity i am happy with the 9 time blocks and only have the one programme for every day but make corrections for Hi's or Lo's by Bolus correction or eat some carbs.
I'll think you will probably find that your T1 time blocks will be quite happy with the same Basal rate thus reducing the individual number of time blocks required over the 24 Hr period.

Best


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## Pumper_Sue (Jan 10, 2022)

Pattidevans said:


> Yes, I do have more or less 24 different settings, but time in range is 92% with only 1% below 3.9. So if it's not broke why fix it?


I used to have that attitude as well, then I ended up with the Animas pump so had no choice but to work things in a different way as only 12 blocks I could use I think not to sure on the number as over 2 years using the medtronic.

No idea what your DSN's problem is though because all you have to do is transfer the data over.
When I collected my new pump I had already written down my basal rates, correction factor, carb ratios and the cats mothers name and it took less than 10 mins to sort it out and I was off and gone out of the door.


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## Pattidevans (Jan 11, 2022)

mark king said:


> Hello @Pattidevans
> I think Bruce's "conceivable point" is probably correct as that's what they did for me in the first instance with my DSN stepping up the time blocks to a total of 9 now in a 24 hour period.  Some consecutive time blocks are the same value but are noted as 1 time block. But............ you can have 24 individual time blocks in any 1 day and that makes up 1 basal programme.  You can have 7 more different Basal programmes to cover differing settings for say exercise or holidays or gardening etc.
> Of course you can make correction changes to your Bolus dose to cover Hi's or for Lo's suspend your Basal programme.
> 
> ...


Hi @mark king I do know that on the Omnipod I can have 24  different basal settings, one for each hour.  It was one of the stipulations I had for a new pump (not that I was given much choice in reality).  My current pump has only 5 different basal programmes, but since I only really use one I wasn't  too bothered about that.  When you are retired most days are more or less the same!   i.e. no work days.

Because I have the different basal rates set i.e. ramping up from midnight (00:00 - 01:00) when it's set at 0.26u per hour, to 08:00 when it has risen by teeny increments  to 0.55u most nights I have a nice flat line.  If it's not a flat line I normally know why.  It goes on increasing, again by very small increments, until 12:00 when it has risen to 0.98u and then gradually drops to 17:00 when I am on only 0.10u per hour until 20:00 when it starts to increase again.  I'm happy with this and it does mean I'm not constantly stuffing my face, or putting in corrections.

I've been left alone to get on with it for years.  Now there is a new pump nurse who has only met me once to explain about the pumps on offer (a meeting where I hardly got a word in) she doesn't know me, hasn't seen my Libre records and wants to change my basals.  Basically I don't want to come across as cocky or know-it-all but the idea of  being forced to do something which goes so much against the grain is  causing me a lot of anxiety.  I'm not normally a nervous or anxious person and I take most things in my stride.  Even when I was initially diagnosed my attitude was that I was going to beat this thing, learn all I could about it and make it fit into my life... which I have.

I atttach a couple of screenshots of my logbook for yesterday which is typical.  The 3.8 in the evening was due to bolussing for dinner and then dinner being delayed as I was trying out a new recipe and decided it needed longer in the oven than the recipe  suggested.


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## Pattidevans (Jan 11, 2022)

Pumper_Sue said:


> I used to have that attitude as well, then I ended up with the Animas pump so had no choice but to work things in a different way as only 12 blocks I could use I think not to sure on the number as over 2 years using the medtronic.
> 
> No idea what your DSN's problem is though because all you have to do is transfer the data over.
> When I collected my new pump I had already written down my basal rates, correction factor, carb ratios and the cats mothers name and it took less than 10 mins to sort it out and I was off and gone out of the door.


Hi Sue

Did the Animas only have 12 blocks?  Goodness - I was offered that as a first pump and tempted as it was waterproof, but in the end decided on the Combo.

I've filled in a form I was sent with all the details that you've mentioned (basal rates, correction factor, carb ratios etc) and sent it to both her and the Omnipod rep.  To be honest there are a couple of blips where the basals have gone up and then down again the next  hour, but I can sort that easily by averaging the two for 2 hours.  Still, what I am doing is working.  I think she's used to starting new people on the pump and  wants to control it to start with, I'm just not prepared to spend a week or so with crap numbers whilst  letting her experiment.  I must stop getting myself worked up about it!


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## helli (Jan 11, 2022)

Pattidevans said:


> Hi Sue
> 
> Did the Animas only have 12 blocks?  Goodness - I was offered that as a first pump and tempted as it was waterproof, but in the end decided on the Combo.
> 
> I've filled in a form I was sent with all the details that you've mentioned (basal rates, correction factor, carb ratios etc) and sent it to both her and the Omnipod rep.  To be honest there are a couple of blips where the basals have gone up and then down again the next  hour, but I can sort that easily by averaging the two for 2 hours.  Still, what I am doing is working.  I think she's used to starting new people on the pump and  wants to control it to start with, I'm just not prepared to spend a week or so with crap numbers whilst  letting her experiment.  I must stop getting myself worked up about it!


When I started on my latest pump, I did all the setting up - the DSN and pump rep walked me through how to do it rather than giving me a preconfigured pump. If they show you how to do it, you can set up a new basal pattern with what you need when they have finished in the comfort of your own home.

BTW I remember my Animas having 24 blocks. My current pump has 48 (one block for every 30 minutes) and I use 10 of them.


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## Pumper_Sue (Jan 11, 2022)

helli said:


> BTW I remember my Animas having 24 blocks. My current pump has 48 (one block for every 30 minutes) and I use 10 of them.


I had the the Animas Vibe and it def had 12 blocks. I have just checked the manual (page25)


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## Pattidevans (Jan 11, 2022)

helli said:


> When I started on my latest pump, I did all the setting up - the DSN and pump rep walked me through how to do it rather than giving me a preconfigured pump. If they show you how to do it, you can set up a new basal pattern with what you need when they have finished in the comfort of your own home.


I'm picking up an unconfigured pump and then all the stuff is to be done via video conference.    I set my current pump up, exactly how the previous one was set up.... it's probably had a fair few tweaks since then.  My plan is exactly as you said, let them instruct me in how they want it and then alter it after the conference!


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## mark king (Jan 11, 2022)

Hello @Pattidevans reads like you know your body well, well done.
I too am retired which makes for more stable less stressful days.  Reading your reply to me above is exactly how I was when first diagnosed T1, I was not going to let it crush me, and I haven't.
I got the impression when I met the rep that she had a set way of expressing the pod details and would leave your nurse to tweak the pod after her instruction.  
I hadn't had a pod before so it was all new to me but once I'd had the principle explained setting up differing time blocks was exactly as she had explained only at a differing time block, easy peasy.
There didn't seem to be any reason for her to set up a pod for an individual with multiple time blocks as it would suck up her time unnecessarily, she just explained it once and left it to myself to repeat the steps to match my needs.

Best


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## Pattidevans (Jan 11, 2022)

She emailed me with a link to a lot of videos which explain more or less how to set it up and what it does, so I've been watching those.

Mark, can I ask what you do about priming the pump?  My current pump is filled by a  reservoir that you fill from the vial, but however careful I am and however slowly I fill the reservoir there are always bubbles (little teensy ones) that  I cannot get out of the reservoir.  So I put it in the pump and then prime the pump until all the bubbles have stopped coming down the tubing.  I was  thinking about that as I changed my pump this morning.


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## m1dnc (Jan 11, 2022)

When I started on the Omnipod (about 18 months ago) I had the three-way video conference thing. During that the rep explained each step of the set-up and then waited while I put my own numbers in and then moved on to the next step. The DSN didn't really get too much involved in that part. It would be a bit time consuming to input 24 time blocks so I can understand why the nurse would want to reduce them, and I would do exactly as you propose i.e. go along with the nurse and then put in your 24 blocks immediately the video is over.

As to your question about priming the pump to get rid of bubbles, the way it works with the Omnipod is that you take out the insulin from the vial with a syringe and then inject the insulin into the pod. You get rid of the bubbles when filling the syringe, and I was told that a little bit of 'champagne' at that stage doesn't really matter. Once the insulin has been injected into the pod, the priming process is fully automatic and you have no control. In any event, once the insulin is in the pod you can't see it anyway.


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## Pattidevans (Jan 11, 2022)

m1dnc said:


> When I started on the Omnipod (about 18 months ago) I had the three-way video conference thing. During that the rep explained each step of the set-up and then waited while I put my own numbers in and then moved on to the next step. The DSN didn't really get too much involved in that part. It would be a bit time consuming to input 24 time blocks so I can understand why the nurse would want to reduce them, and I would do exactly as you propose i.e. go along with the nurse and then put in your 24 blocks immediately the video is over.


Excellent!


m1dnc said:


> As to your question about priming the pump to get rid of bubbles, the way it works with the Omnipod is that you take out the insulin from the vial with a syringe and then inject the insulin into the pod. You get rid of the bubbles when filling the syringe, and I was told that a little bit of 'champagne' at that stage doesn't really matter. Once the insulin has been injected into the pod, the priming process is fully automatic and you have no control. In any event, once the insulin is in the pod you can't see it anyway.


That's exactly what I suspected @m1dnc so thank you  Having watched the videos I was wondering... when they say you can see the pink thingie which signified the neede has gone in... how on earth do you see that if the pod is on the back of your arm or on your buttock???


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## mark king (Jan 11, 2022)

Hello @Pattidevans as David [m1dnc] says above you clear the syringe before you fill the Pod. 


Pattidevans said:


> how on earth do you see that if the pod is on the back of your arm or on your buttock???


Well you can try balancing over a mirror not a pretty sight but I struggle / can't see it anyway even when I have the Pod on the front of my thigh it is too difficult to see it.  I just rely on the ping feel as I insert the Pod needle into my body and........... if my bg shows corrections for the carbs I've eaten.
So far so good.


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## m1dnc (Jan 12, 2022)

I agree with Mark. The pink thingy is very difficult to see at the best of times, and I too just rely on the feel of the cannula insertion. You can't really mistake it.


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## T1Nick (Jan 12, 2022)

Hi all - I've just come onto this thread so haven't read every entry but can fully endorse the Omnipod which I've been using for the past two years in conjunction with the Freestyle Libre FGM system (operated separately). I love the lack of tubes and cannulas etc with the Omnipod and find the PDM easy to use (I'm not on DASH yet). Changing every 3 days gets a bit tiresome but still much better than MDI and my "time in range" has never been better (always >80% and often >90%). My DSN also proposed the Omnipod at the start because there was no long term contract to sign up to. Having said that I have no desire to change it anyway. For me the small of my back is my preferred location alternating with my stomach area. I play a lot of sport and the back is just out of the way! My wife used to stick the pod on my back to start with but, with a bit of practice, I now manage to do it myself without problem. I never bother to check whether the cannula has inserted correctly as, to date, it always has. Anyway I'd know very quickly if there was a problem as my BG would show it!


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## Pattidevans (Jan 17, 2022)

Thanks @T1Nick that's very reassuring!

So I finally have the Omnipod in my sticky little grasp, having picked it up this afternoon.  Looking forward to the training session on Wednesday and my fears about being put onto "time blocks" have been allayed by the pump DSN as she has looked at the hourly basals I sent her - after I'd put them into some semblence of sense rather than the rambling order they had got into - I adjusted them a few days ago and they seem fine.  Apparently my "picture" does not follow that of a "normal" person  (well, I never conform   ), but she says that she's looked at my Libreview data and can see that I run a straight line. I'm still smiling about her comment at the end of the email..."your control is the sort of control I would wish on all my patients". Silly though it is - it is so nice to get approval rather than being ticked off all the time! Something the Endo does every time he sees my Hba1c which he says is too low.


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## T1Nick (Jan 17, 2022)

Excellent news - I'm sure you will love "podding"! Funny how Endo's like to comment on HbA1C levels being too low - I have had the same comment from mine! He seems to assume I must be having loads of hypos to be able to get it that low, which is not the case. In truth it was due to me treating Time in Range as a competition between me and diabetes and I liked to win. OK maybe I did get a bit obsessive at times - so last time I'd let the HbA1C go back up to 48 mmol/mol and he was happy! For reference before Libre and the pump it was as high as 75 mmol/mol - is this a similar experience for others?? If there was ever an argument that "diabetes tech" works, then I think I have it.
The function on the Omnipod controller I find really good is the option to "extend the bolus". I guess that, as an experience pump user, this is all second nature to you but, for me, it has been a revelation in helping ensure that the insulin release time matches the absorption time for the CHO I've just eaten.
Do let us know how you get on - always happy to answer any teething trouble questions!


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## Pattidevans (Jan 22, 2022)

Hi @T1Nick - funny how the Endo was the one to give me the Libre, but doesn't take any notice of the results which prove  I'm not hypo all the time!  Been on the Omnipod now  for 3 days.  I am about to report on that.


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