# Anyone use Roche flexlinks?



## Pattidevans (Dec 21, 2013)

Is anyone around at the moment using Roche Flexlink cannulas?

I received a box of them in the post this morning so I could try them out.  It was infusion set day, so I decided to try one.  I got it inserted with no problem and had already calculated how much insulin I'd need for 6 days and had filled the reservoir without a problem and had it all set up, primed the tubing etc.  The last thing  was to prime the already inserted cannula with 1u insulin.  I'd assumed you could do this through the pump menu, but I couldn't alter the pre-set priming feature from 25u.  On the Rapid D links I've been using you have to prime the whole tubing with the cannula attached before putting the cannula in and stop the priming when insulin is dripping out of the needle, so it doesn't matter if you over-prime a bit.  I couldn't figure out how to do the 1u with enough precision that way, so I rang Roche who told me to go to the handset/bolus advice/enter 15g carb (which is my ratio) without first testing and then bolus the 1u it comes up with.  Is this how everyone does it?

Thinking about it in retrospect, you'd obviously do that again when you change cannula but when you've had a shower and detached the tubing from the cannula do you have to prime the cannula with 1u again?  I'm sure I've seen a thread about this but I can't find it just now.


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## AJLang (Dec 21, 2013)

Hi Patti
I think of priming the tubing as a completely separate activity from priming the cannula.
For the cannula priming I go into the handset, select pump option, left click until I get standard bolus button  select that with the right key, use the up arrow to take it to one unit and then press the right key to select.  Does that make sense? The standard bolus button is also available on the pump itself.  Alternatively you can do as Roche suggested to you.
I do this every time I use a new cannula - if I am doing a complete infusion set then I will prime the tubing first reattach the pump and then prime the cannula.

With regard to the bath I just disconnect the pump and reconnect it after pump/shower - you should put the cannula cap on when disconnected from the pump - I don't reprime the cannula when I reattach the pump.  I may have a slight correction if I've been in the bath for a while to make up for the missed basal in proportion to how much of the basal I've missed. Eg if I was disconnected for an hour I would correct for the one unit of basal that I've missed because my basal is approx one unit an hour.


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## Pattidevans (Dec 21, 2013)

Hi Amanda & thanks for responding so quickly.


> For the cannula priming I go into the handset, select pump option, left click until I get standard bolus button select that with the right key, use the up arrow to take it to one unit and then press the right key to select. Does that make sense? The standard bolus button is also available on the pump itself. Alternatively you can do as Roche suggested to you.


I had tried ringing my nurse, but her phone was switched off.  She rang me back within an hour.  She said the reason for putting 15g carb in that you aren't going to eat is because if you don't the pump assumes it's IOB whereas the Roche pump doesn't count insulin injected for carbs as IOB.


> With regard to the bath I just disconnect the pump and reconnect it after pump/shower - you should put the cannula cap on when disconnected from the pump - I don't reprime the cannula when I reattach the pump. I may have a slight correction if I've been in the bath for a while to make up for the missed basal in proportion to how much of the basal I've missed. Eg if I was disconnected for an hour I would correct for the one unit of basal that I've missed because my basal is approx one unit an hour.


Ahh thanks for that.  I normally only have a shower so it's disconnected only about 10 - 15 mins.  I think the last bath I had was when I was planting bedding plants in tubs and got a real back-ache from lifting and carrying.


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## Pumper_Sue (Dec 21, 2013)

Here's a link Patti https://www.accu-chek.co.uk/gb/products/infusionsets/flexlink.html I know you already have the answer but thought it was useful anyway


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## AJLang (Dec 21, 2013)

Pattidevans said:


> Hi Amanda & thanks for responding so quickly.
> I had tried ringing my nurse, but her phone was switched off.  She rang me back within an hour.  She said the reason for putting 15g carb in that you aren't going to eat is because if you don't the pump assumes it's IOB whereas the Roche pump doesn't count insulin injected for carbs as IOB.
> 
> Patti thanks for that it solves the problem I had with regard to doing corrections after the cannula change with regard to the IOB not being correct. That's really helpful, thank you.


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## Maryanne29 (Dec 21, 2013)

I use the Flexlink. I was taught to prime the cannula last, when it is inserted and the pump is on and ready to go. If I just change the cannula, I reconnect the tube to it and using Standard Bolus on the pump menu, enter 0.7 units. This has worked well for me since I started.


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## Pumper_Sue (Dec 21, 2013)

Hi Patti, found this on another forum  http://www.tudiabetes.org/group/rocheaccuchekspiritinsulinpumpusers/forum/topics/filling-cannula


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## Pattidevans (Dec 22, 2013)

> Here's a link Patti https://www.accu-chek.co.uk/gb/produ.../flexlink.html I know you already have the answer but thought it was useful anyway


Thank you very much for the links Sue.  Interestingly that link does the same as the (3) manuals I received with the cannulas - it fades out with "prime the Cannula with 1u" with no explanation of how!

I was also interested in the tudiabetes thread to see that a member used the "prime" function and then the Accuchek rep came in and said how dangerous that was.  I concur which was why I didn't want to do it.  You would think, with a piece of kit this sophisticated they could do something to avoid the clunky work-around.  For example, why not make the prime function adjustable - or even only give the option of 25u or 1u.  I rather think the Flexlink cannulas may have been brought out after the pump and therefore they discovered the technology needed adjustment only later on.  The tenderlink has to be managed the same way.  However, you'd think they could be more specific as to how to prime the cannula on the website which has the ability to be altered with minimum fuss and bother unlike printed manuals.

Amanda I'm glad that bit of info has helped you .  I was reading in Pumping Insulin how different makes of pumps handle IOB differently and it didn't make a lot of sense at the time, but I now realise how important it is for you to understand how your own pump handles it.  Specially when we're dealing with such tiny amounts of insulin.  Pages 103 to 107 in Pumping Insulin deal with the matter.  Apparently Animas pumps deal with it differently to Roche ones.


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## Pumper_Sue (Dec 22, 2013)

Hi Patti, with the animas pump to prime all you do is go to the prime setting and hold down the button to prime as much as you want. The fill cannula is on the same menu I'm not to sure how high you can go for a prime but I just press button until I reach the 0.70u for the cannula amount needed. end of story.


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## ingrid (Dec 23, 2013)

Maryanne29 said:


> I use the Flexlink. I was taught to prime the cannula last, when it is inserted and the pump is on and ready to go. If I just change the cannula, I reconnect the tube to it and using Standard Bolus on the pump menu, enter 0.7 units. This has worked well for me since I started.



Hi Maryanne, if you are using FlexLinks, you need to be priming the cannula with 1U. (0.7U is for TenderLinks)


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