# First appointment with nurse about pumps



## PhoebeC (Aug 17, 2022)

Hi All,

I have commented on a few other peoples posts. I am seeing my DSN next week in person about pumps. 17 years on MDI I have never been offered or even spoken to about pumps with a medical person. I rasied this with her a few weeks ago.

I use libre 2, Fiasp and lantus as background. Still newish to Fiasp, but much better than the novo. My prebosal was 40 minutes or more before meals. Fiasp is much quicker, so more in range and feeling better for it.

But we are struggling to get my basal at night right, with big drops at 2-3am lasting over an hour, my mensural cycle has a huge impact on my levels, and it takes 2 - 3 days to get my basal levels right again. I think a pump may be a good idea for me.

On MDI I never even get less than 53mmols HB1AC (7.0) that's my best, 70% range is normal for me, 80% is good and better than that is very rare. Less hypos now on libre which is wonderful.

My nurse suggested the Tslim and ypsopump as these link with the dexcom G6. That's what she said? I know the Omnipod5 can work with the G6 so I am going to ask for that to be considered. I want a pump patch if possible.

I liked the Omnipod sample, it was small and no issues wearing it. 

The tube with ypso's demo is very long. It has no supporting guidance with it and I am not happy with the lack of support so far. Loads with the Omnipoid. Does the tube for the cannula need to be this length? 

I also got the Medtrum to try as a sample, another patch pump. So far so good. 

I am unsure what questions to ask my nurse. What I want is better control, no hypos overnight, more freedom from injections (I don't mind the injections themselves) and something that is small and simple, not loads of parts. 

I have read all of the posts on here about the 4 pumps mentioned. But I am open to suggestions etc. 

​


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## Inka (Aug 17, 2022)

@PhoebeC Pump tubing comes in a variety of lengths eg 30cm, 60cm, 100+cm. I general use a moderate length tube. It gives flexibility moving the pump about and for cannula sites.

If I were you, I’d make a list of all the pump choices you have (even the ones you think you don’t want) and collect information about each one, circling big pros and big cons. Also, watch YouTube videos on them. I don’t have any of the pumps you mention (mine is a Dana) but of the ones you’ve listed, I’d probably go for the T Slim.


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## SB2015 (Aug 17, 2022)

Whichever pump you go for @PhoebeC the facility to change the basal rate hour by hour gives you much more control, and I now for me this reduced the frequency of hypos for me , so I hope that it works for you too.  

I have only had tubes pumps, and as @Inka says there are a variety of tube lengths available.  The tubed ones gives the flexibility to choose where to put your pump at any time.  The patch ones mean no tubes.  There are pros and cons for each pump, and until you have used one it is difficult to know what will suit youm and I suspect that once you have settled into using the facilities on whichever pump you choose, you will find it far more flexible than MDI, and there will be people on here who use each of them.

Having used a closed loop system now, I would only choose that have the facility to use that, so of your list I know that the t-slim does that.  I am not sure about the others at present. 

I think @Inka’s suggestion of a comparison chart with what you think you want is a good plan, but don’t reject others yet.  I ended up choosing a completely different one from what I had planned Once the looping was on offer.


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## Pumper_Sue (Aug 17, 2022)

PhoebeC said:


> My nurse suggested the Tslim and ypsopump as these link with the dexcom G6. That's what she said? I know the Omnipod5 can work with the G6 so I am going to ask for that to be considered. I want a pump patch if possible.


Will it also link with the G7? Tslim will be as soon as it's out. No idea how long the G6 will be made for so take that into consideration.


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## PhoebeC (Aug 17, 2022)

Pumper_Sue said:


> Will it also link with the G7? Tslim will be as soon as it's out. No idea how long the G6 will be made for so take that into consideration.


Thank you, very good point.

I contacted Onnipod about linking to sensors as the current doesn’t but the 5 will, there’s no date for that yet in the UK as it needs CE testing.


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## PhoebeC (Aug 17, 2022)

SB2015 said:


> Whichever pump you go for @PhoebeC the facility to change the basal rate hour by hour gives you much more control, and I now for me this reduced the frequency of hypos for me , so I hope that it works for you too.
> 
> I have only had tubes pumps, and as @Inka says there are a variety of tube lengths available.  The tubed ones gives the flexibility to choose where to put your pump at any time.  The patch ones mean no tubes.  There are pros and cons for each pump, and until you have used one it is difficult to know what will suit youm and I suspect that once you have settled into using the facilities on whichever pump you choose, you will find it far more flexible than MDI, and there will be people on here who use each of them.
> 
> ...


Yes closed loop would be great and I haven’t ruled any out yet. Only the start of the journey for me.


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## nonethewiser (Aug 18, 2022)

PhoebeC said:


> Thank you, very good point.
> 
> I contacted Onnipod about linking to sensors as the current doesn’t but the 5 will, there’s no date for that yet in the UK as it needs CE testing.



Look forward to that when it's approved.

Agree that making list of questions before is good idea, easy to get side tracked & forget what you wanted to ask.


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## Bloden (Aug 18, 2022)

I was offered Tslim and Omnipod Dash. I had pretty much decided I wanted a patch pump, but signed up for the Q and A sessions for both systems (my DSN sent me the links). These were invaluable. I also had a look at videos on YouTube - watching pump users actually using their pumps and commenting on them was very informative. After doing the research, I didn't really have any questions for my DSN! 

I'd love it if the Omnipod was linked to a CGM (I also haven't ruled out closing the loop, but want to walk before running!) and had a phone app instead of the PDM, but I'm hoping that the Omnipod 5 will arrive soon. Otherwise, I'm very happy with my choice of pump. 

Good luck @PhoebeC.


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## Matchless (Aug 18, 2022)

when my medtronic 640 time was up ( 4 years ) i went for the omnipod dash for about 6 months but had alot of leaking pods ( tunneling ) allso with patch pump you have  limited number of sites on your body ,after that i drew a short list of the T slim and ypsomed pumps when i had them to see and handle i went for the ypsomed because it had more pluses than minuses than the t slim mainly the insulin cartridges were much more easy to fill and change also can use prefilled fiasp insulin cartridges  and you can fill the self fill cartridges well in advance and keep in the fridge allso the orbit cannulas makes it so easy to connect in difficult places to get to on your back , also  its very small and light and i am loving it so good luck with your choice  .


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## PhoebeC (Aug 24, 2022)

Hi All,

Little update after yesterday. Had a really good chat with my nurse, it was great to see her in person (haven't met her yet) and we talked about a few different things including, the impact my period had on my levels (my pregnancy/birth experience etc), rugby and my weight training, and pumps.

I am generally 70% in range, less hypos now since faisp and not as long in hyper, so I am between 5 - 12 most of the time. So she is happy with that, I would like it better. How the hypos I do get, because my bakground chnages so requrenlty are impacting my life/sleep.  

She said that there are 2 options for right now, we can go with the omnipod without a looping CGM, we agree that would be good for how active I am / plus rugby. But it would be better with a CGM, so we can use that for now and wait for the new version which will work with 
Or the Tslim with the dexcom CGM as a loop system. And we went over the benefits of this, I know most of us rave about how loop is best and they would never go back. 

She even said we might be able to try both for 3 months, and see what is better. 

Both of these she has on the shelf already, with no user assigned. The consultant who approves pumps has just got back off leave, she said she will speak to them this week and get back to me next week. Much faster than I thought. 

I feel really positive about this. 

Also she gave me a 0.5 unit pen, as we think that will help too. And I got to pick the colour ha! I have never had that option in 17 years, I also I didn't care but went with the red  as every pen has been blue I have ever owned.

Thanks for all your support as always.


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## helli (Aug 24, 2022)

Something to bear in mind (although I am not sure how much it would influence my pump choice) is the rumour that Dexcom are in talks to acquire Insulet who manufacture OmniPod. 
It may mean that OmniPod looping moves forward faster and they may be quicker to adopt the new Dexcom. It may also affect the relationship with other pump manufacturers. 
On the other hand, it is only a rumour.


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## rebrascora (Aug 24, 2022)

helli said:


> Something to bear in mind (although I am not sure how much it would influence my pump choice) is the rumour that Dexcom are in talks to acquire Insulet who manufacture OmniPod.
> It may mean that OmniPod looping moves forward faster and they may be quicker to adopt the new Dexcom. It may also affect the relationship with other pump manufacturers.
> On the other hand, it is only a rumour.


That potential takeover may also impact the talk about Omnipod 5 linking to other sensors like the Libre. Can't see Dexcom encouraging that option to potentially benefit their rival, which would be a shame as a pump with the option to link to different sensors would be more attractive to many people for a variety of reasons.


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## Matchless (Aug 24, 2022)

Be careful not to go for a any pump that does closed loop you must choose a PUMP against the pros and cons FIRST then a reliable CGM sensor second ,goode luck with your chose.


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## PhoebeC (Aug 24, 2022)

Matchless said:


> Be careful not to go for a any pump that does closed loop you must choose a PUMP against the pros and cons FIRST then a reliable CGM sensor second ,goode luck with your chose.


Thank you, yes I will be careful. Like you say the pump is the most important bit abs a CGM is a nice extra.


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## PhoebeC (Sep 7, 2022)

Update from nurse, the consultant wants to see me, appointment is 20th October which is quite a wait but fingers crossed


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## Pumper_Sue (Sep 7, 2022)

PhoebeC said:


> Update from nurse, the consultant wants to see me, appointment is 20th October which is quite a wait but fingers crossed


It's about 6 weeks so no time at all


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## PhoebeC (Sep 7, 2022)

Pumper_Sue said:


> It's about 6 weeks so no time at all


Yeah one option was next week but I just missed out ha! That’s why it seems longer off


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## everydayupsanddowns (Sep 9, 2022)

PhoebeC said:


> Update from nurse, the consultant wants to see me, appointment is 20th October which is quite a wait but fingers crossed



Sounds positive @PhoebeC 

Sorry about the wait to see the consultant, but it all sounds very promising!


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## PhoebeC (Oct 11, 2022)

Spoke to a different consultant last week, this was already a booked appointment, I had a letter about 6 months ago about it, he said if I had the other booked for 20th and no urgent issues then to wait until 20th.

He also said I needed my bloods for 20th Oct, but maybe he isn't aware of how busy the NHS is everywhere as I phoned about bloods immediately ( I WFM so I can do any appointment) and the next appointment is 21st, my nurse did not say bloods would be needed, I have already had this year.

I have emailed my DSN just to check if bloods are needed.


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## rebrascora (Oct 11, 2022)

Yes, getting appointments for blood to be drawn is not always possible at the drop of a hat these days. I managed to get an appointment at a totally different GP practice about 9 miles away that now must be linked in to facilitate these situations. The appointment was a Saturday morning and my consultant appointment was the following Tues morning and amazingly he had all the results back including cholesterol and HbA1c which I was really impressed at, considering that it had just left one working day (Monday) in between for the lab work, unless the labs are now working Sundays, but even so, it was still really good going for a 2 day turn around. They must be pretty efficient round here!


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## rebrascora (Oct 11, 2022)

The great thing is that Libre provides so much more great information that HbA1c is almost redundant.


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## PhoebeC (Oct 11, 2022)

rebrascora said:


> The great thing is that Libre provides so much more great information that HbA1c is almost redundant.


Yes, my team have told me that in the past.

I don’t want to move back my pump appointment.

Last bloods only March, but I have been working on my health diet/exercise etc. so I would hope they are better


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## Leadinglights (Oct 11, 2022)

PhoebeC said:


> Spoke to a different consultant last week, this was already a booked appointment, I had a letter about 6 months ago about it, he said if I had the other booked for 20th and no urgent issues then to wait until 20th.
> 
> He also said I needed my bloods for 20th Oct, but maybe he isn't aware of how busy the NHS is everywhere as I phoned about bloods immediately ( I WFM so I can do any appointment) and the next appointment is 21st, my nurse did not say bloods would be needed, I have already had this year.
> 
> I have emailed my DSN just to check if bloods are needed.


Where we are our doctor's surgery does not do take the blood and we book at a local pharmacy, as long as you have the blood test form, who do them, appointments are usually available quickly.
I believe some of the Boots do them


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## grovesy (Oct 11, 2022)

In my area my local NHS has a number of hubs in the area for taking bloods, you need to book.


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## PhoebeC (Oct 17, 2022)

Just had a call the appointment has been cancelled and no new date yet  least it will mean I will have my bloods done but Ido think I need a pump, my background is never stable for more than a week and it's the not sleeping which most impacts my life.
Hopefully I will get a new date soon


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## PhoebeC (Oct 17, 2022)

grovesy said:


> In my area my local NHS has a number of hubs in the area for taking bloods, you need to book.


There's nowhere local here like that, or drop in centers. In Warrington there was a few places. I would still rather the care I get here though anyway


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## Leadinglights (Oct 17, 2022)

PhoebeC said:


> There's nowhere local here like that, or drop in centers. In Warrington there was a few places. I would still rather the care I get here though anyway


It doesn't usually matter where you have the blood taken, they all go to the lab and the results would go to your doctor / clinic.


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## PhoebeC (Oct 19, 2022)

Phone call on Tuesday 18th, my appointment on 20th cancelled. They called me back today to try and rebook only date they have is 16th Dec and we are in Mexico so now the only dates will be January and she is unable to book those now. Least I will have my blood but even then my bloods won’t be recent if they are 21st Oct. It’s annoying as I had stupidly started to think it would happen this year with the nurse saying she had both options in stock in the other room.


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## helli (Oct 19, 2022)

How frustrating for you @PhoebeC
Can you ask for the pump you want to be sent to you in advance of the appointment so that you can familiarise yourself with it?
This should ensure the ones in the stock room are not allocated to someone else by January.

If you can think of it positively, travelling with a new pump or experiencing Christmas together before you have got used to it could be traumatic. At least starting in January, should be a quieter month when you may be more likely to have the bandwidth to understand your pump and tweak it to your "normal" life.


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## PhoebeC (Oct 20, 2022)

helli said:


> How frustrating for you @PhoebeC
> Can you ask for the pump you want to be sent to you in advance of the appointment so that you can familiarise yourself with it?
> This should ensure the ones in the stock room are not allocated to someone else by January.
> 
> If you can think of it positively, travelling with a new pump or experiencing Christmas together before you have got used to it could be traumatic. At least starting in January, should be a quieter month when you may be more likely to have the bandwidth to understand your pump and tweak it to your "normal" life.


This is the “approval” appointment with the consultant so I don’t even know if I would have came out of it with a pump. Just now I don’t know for another few months.

Yeah I can see the positives definitely, but it was a light at the end of what was feeling like a never ending tunnel. It’s the constantly changing background requirements and the interruptions to my sleep. Not sleeping properly nights on end every other week isn’t ideal on holiday either in a situation where we are in a hotel. 

My husband booked the holiday, I wouldn’t have booked it based on my work in December, it’s mid rugby season so I’m missing a few matches and now this. I know I should be greatful but honestly it couldn’t have been a worse time. 

I sound like I’m just complaining, which isn’t me at all. I just wanted some relief from this situation which is out of my control.


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## nonethewiser (Oct 20, 2022)

PhoebeC said:


> This is the “approval” appointment with the consultant so I don’t even know if I would have came out of it with a pump. Just now I don’t know for another few months.
> 
> Yeah I can see the positives definitely, but it was a light at the end of what was feeling like a never ending tunnel. It’s the constantly changing background requirements and the interruptions to my sleep. Not sleeping properly nights on end every other week isn’t ideal on holiday either in a situation where we are in a hotel.
> 
> ...



Any chance you can put your name down on cancelation list, done this before whilst waiting on appointment & got in sooner than date given, does mean you have attend at short notice but worth considering if doable for you.


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## PhoebeC (Oct 20, 2022)

nonethewiser said:


> Any chance you can put your name down on cancelation list, done this before whilst waiting on appointment & got in sooner than date given, does mean you have attend at short notice but worth considering if doable for you.


The appointment lady is phoning me back next week so I will ask.  Good idea.


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## PhoebeC (Oct 21, 2022)

19th Jan and I’m on the waiting list for any cancellations


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## PhoebeC (Dec 1, 2022)

Update - 19th Jan clinic is now cancelled. New appointment TBC.

I feel very deflated as I keep thinking there is lighter days somewhere ahead, I know the NHS are on their knees. But this would improve my life and health, in turn less demand on them in the future. I am sad.


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## rebrascora (Dec 1, 2022)

Really disappointed to hear this. Hope you get a new appointment date to look forward to soon.


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## nonethewiser (Dec 1, 2022)

PhoebeC said:


> Update - 19th Jan clinic is now cancelled. New appointment TBC.
> 
> I feel very deflated as I keep thinking there is lighter days somewhere ahead, I know the NHS are on their knees. But this would improve my life and health, in turn less demand on them in the future. I am sad.



That sucks really does, hopefully won't wait long after cancelled appointment.


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## Bloden (Dec 2, 2022)

Good grief! That’s a lot of cancellations. I hope you get a firm appointment asap.


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## Proud to be erratic (Dec 2, 2022)

PhoebeC said:


> Also she gave me a 0.5 unit pen, as we think that will help too. And I got to pick the colour ha! I have never had that option in 17 years, I also I didn't care but went with the red  as every pen has been blue I have ever owned.
> 
> Thanks for all your support as always.


Hello @PhoebeC,
Just catching up - I'm venturing towards a pump myself so reading up all that I can and seen the last post in this thread, so I know your plans have been stalled. Commiserations.

But I noticed your comment above and was curious. I presume you now have a red NovoEcho pen for Fiasp, which of course takes cartridges. Did your previous single unit pen also take cartridges? I ask, simply in case not - ie you are now dependent on only one means of delivering rapid insulin. I understand the reusable pens are pretty reliable and can (should) last for 4 or 5 years; but if your NovoEcho pen should fail, it's important to have a reserve. You can be sure if it fails it will be when everything is shut at the start of a bank holiday, or while on holiday in Mexico and its Fiesta season ....

Apologies if you are already alert to all of this. You've been managing MDI for far longer than me; but sometimes more recent tech and its consequences can pass by unnoticed. I'm still new enough to this malarkey to be downright curious about anything!


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## PhoebeC (Dec 3, 2022)

Hi @Proud to be erratic dont worry I am taking an extra novopen or 2 in my cases. 

Having a nightmare with my surgery issuing enough medication for me to take. Even with spares I will need around 100ish needles for 2 weeks. My prescription is 200 which is fine and covers the extra needed but they only gave me that. 

And we get back late 22nd and then it’s one day to get the stuff I will need over Christmas. Phoning them first thing on Monday and I wanted to pack my nine fridge stuff now but I’ve had to take a box out to use. I’ve got extra of everything else anyway, thankfully.

And a friocase ready and tested, plus sensor covers on the way. Got a tiny sharpes bin too which is packed.

Once I’ve shorted needles I will be excited xx


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