# Adults with pumps - genuine questions



## Copepod

I realise this this isn't so much of an issue through the winter, but what do pumpers do when nights are warm enough to need to sleep naked? And what about other activites in bed? It seems to me that MDI is so much easier for uncomplicated nights, especially as I can achieve acceptable HbA1c values, so not sure I would consider using an insulin pump. But I'm interested to hear adult pumpers' opinions. For cold nights in sleeping bags / tents / mountain huts, members of MAD (Mountains for Active Diabetics) have devised many fleece pouches etc.


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## Mand

Hi Copepod

Although my son wears pj's in bed, he often does not attached pump to them. It just lies in bed beside him so it would not actually matter whether he wearing anything or not.

As for the intimate side of things, obviously, this does not effect us yet but from things i have read it would seem that you could detatch it during 'events ' and just re-attach yourself afterwards. Hopefully someone with experience in this area will be able to help you further. 

Happy New Year to all!


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## Copepod

*sharing bed with pump; canoeing / kayaking*

I've moved my thread and Mand's answer (thanks Mand) so as not to divert the source thread. 

As well as bed, what about getting pumps wet - I know some have to removed for swimming, which is OK if it's just a short session, but what if you're swimming for hours eg wetsuit in sea. What about if canoeing / kayaking? Not expecting to get immersed, but the potential for capsize is always present, and I never paddle for less than 1 hour at a time, often all day, with only a short lunch break ashore. 

Still keen to hear answers from adults with pumps who share beds (not sure if my partner, or cat who sometimes gets under quilt despite our best efforts, or my moving around lots in bed, would be more of an issue) and go canoeing / kayaking.


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## Mand

Hi again Copepod

We took my son bodyboarding in Cornwall in October. We tested his blood just before getting changed just to check how he doing. We then detached his pump and put in a safe box in the car and got him changed into his wetsuit. Because each time his blood was within range at the start, we gave him some sweets to eat (knowing he would be expanding lots of energy) and my husband wore a special waterproof pouch around his neck containing a few Dextrose. After an hour in the water my husband took my son out of the sea and gave him a couple of Dextrose. He stayed in a futher 30 minutes max. Once he was out, dry and changed and re-attached to the pump we checked his blood again. If he was a little high we did not correct as we knew his blood would continue to come down more due to so much exercise. If he low or on target we gave him soemthing to eat to keep him steady. We had no problems at all.
Sorry for essay but hope it helps. 

Mand


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## Copepod

Thanks for the answer Mand, it does help, but doesn't really solve what I'd want to do. 30 mins bodyboarding in a wetsuit wouldn't be an issue, as I've already done lots of boarding & swimming in a wetsuit, usually for far longer than 30 mins at atime, with glucose gel pouches secreted in various places - swimsuit shoulder straps are ideal - and fortunately, never needed to eat them, as I find them disgusting. However, it seems impossible to either have a waterproof pumps or to disconnect for the hours kayaking / canoeing / gorge exploring (OK didn't mention that before, but it is something I do most years, usually without advance warning / planning) I was talking about. The more I think about it, the more a pump seems like a restriction, and far less convenient to my vaguely interesting life than MDI. Anyway, with a pump, I'd still have to carry a spare set of insulin(s) and pens / syringes.


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## Northerner

Copepod said:


> Thanks for the answer Mand, it does help, but doesn't really solve what I'd want to do. 30 mins bodyboarding in a wetsuit wouldn't be an issue, as I've already done lots of boarding & swimming in a wetsuit, usually for far longer than 30 mins at atime, with glucose gel pouches secreted in various places - swimsuit shoulder straps are ideal - and fortunately, never needed to eat them, as I find them disgusting. However, it seems impossible to either have a waterproof pumps or to disconnect for the hours kayaking / canoeing / gorge exploring (OK didn't mention that before, but it is something I do most years, usually without advance warning / planning) I was talking about. The more I think about it, the more a pump seems like a restriction, and far less convenient to my vaguely interesting life than MDI. Anyway, with a pump, I'd still have to carry a spare set of insulin(s) and pens / syringes.



I suppose if it's unplanned it's a problem, but wouldn't it be possible to go back to MDI for the duration? I know it would probably be tricky, what with the need for basal insulin and then switching back, but if the pump gives you flexibility most of the time and is better overall for your levels then why not combine both regimes?


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## Mand

I understand what you mean now, Copepod and i really not sure about your dilema. 

It will be interesting to hear what others have to say because i would have thought that if you are active all the time that the pump is detached then your blood sugars wouldn't rise because the activity would be keeping them down even though you have not got any background insulin during that time so you could be detached for several hours????  I really not sure.

I am hoping someone can answer your original question as it would help me too!


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## Patricia

Hi there

Er, well the only comparison I have is that E can leave his pump off for two hours or so without ANY consequences while swimming or doing something majorly active. In fact he could probably go longer, just never has...

There *are* waterproof bags for pumps which seem to work really well, though as Bev will tell you there are several stories of people having ripped the bags while doing an activity...There is also a general feeling that several pumps are all but waterproof -- one advertises as such -- the Roche? Tracey? Animas? Viki? Certainly the medtronic apparently *is* waterproof, but they don't call it such because of the risk of it not being so if the screen becomes cracked, which has happened...

As for other nighttime activities, my assumption has always been that a disconnect is in order...

Clearly the adult wearers are actually *having* said fun  this holiday, as we haven't yet heard from them...

Not that I'm not...Oh dear, getting into trouble...better bail out!


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## Einstein

A lot of it comes down to how ruggedised the pump genuinely is. If it's just water resistant for 30 minutes in 3m water then it doesn't expand much to being wet for much over an hour of surface swimming, whihc would be no use if I was doing endurance swimming with one. 

A water resistant bag wouldn't add any protection to the LCD and you still have to get the tube out of the bag, at which point is a waterproof bag going to keep it dryer or wetter in the event if it leaking? I'd put my money on wetter, as even out of the water it's still going to be in water and it's going to be standing not moving water.

On the other activities, it's something that's crossed my mind - do they make a gold case for any of the pumps? In which case a heavy chain.. and you can wear it around your neck as some bling  I'm coming up with no more suggestions beyond that! Except how heavy are pumps? Oh and do they do longer tubes?


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## tracey w

Copepod said:


> Thanks for the answer Mand, it does help, but doesn't really solve what I'd want to do. 30 mins bodyboarding in a wetsuit wouldn't be an issue, as I've already done lots of boarding & swimming in a wetsuit, usually for far longer than 30 mins at atime, with glucose gel pouches secreted in various places - swimsuit shoulder straps are ideal - and fortunately, never needed to eat them, as I find them disgusting. However, it seems impossible to either have a waterproof pumps or to disconnect for the hours kayaking / canoeing / gorge exploring (OK didn't mention that before, but it is something I do most years, usually without advance warning / planning) I was talking about. The more I think about it, the more a pump seems like a restriction, and far less convenient to my vaguely interesting life than MDI. Anyway, with a pump, I'd still have to carry a spare set of insulin(s) and pens / syringes.



I  think you may be right Copepod, I was told never to disconnect my pump unless bathing etc. I was told to keep on during exercise, but dont, I find i need to keep topping up glucose during exercise. I was also told that due to the difference on pumping than mdi, if the pump fails, or is disconnected potentially you  could be in dka in 3 hours. I believe the animas pump is waterproof and does not need disconnecting.

Regarding your other concerns, you need not be, my pump is part of me and does not cause any problems whatsoever. You can disconnect during sex if you wish, depends how long you are going to be disconnected for, is same as exercise situation.


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## Copepod

Thanks for all the answers. My reservations about the pumping system seem confirmed - never had a pen failure, but always have a spare pen plus syringe with me, and would have to carry that even with a pump. Plus, much of what I do would risk damaging a pump - you should see that state of my digital camera and mobile phone screens  The risk of DKA in 3 hours is a real concern - background long acting insulin means it would take longer than that, even if I ate with out bolus insulin. 
Re bed activities - probably not too much of an issue, in a well established relationship to introduce a pump & disconnect when appropriate, but I'm really not sure how a new partner would react, and I'm sure I would occasionally forget to reconnect before sleeping - which would mean DKA within 3 hours, long before I'm due to wake up. 
Anyway, as I achieve perfectly acceptable HbA1c results on MDI, I'm not contemplating a change. Just wanted to raise some issues that would affect me, and I doubt I'm the only one.... Even if such issues aren't relevant for children starting on pumps, they will grow into some of "my" issues. I hope they'd have the support / confidence to change to MDI in teenage years / young adulthood, if appropriate to theie lives. Thanks for some frank (or as near as frank as is reasonable!) comments


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## tracey w

Certainly did not mean to scare you with the DKA thing, or anyone else for that matter. Not saying it would happen only that it could happen as the pump nurse advised me about this when starting on the pump. As long as your testing regular it shouldnt be a problem.

I dont see why you would need to change really as you seem quite happy and stable with mdi, if I was then i wouldnt have considered a pump either. Not all of us are so lucky with our control unfortunately


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## Patricia

The DKA stuff is worth noting: E went very high and ill after 3 hours with cannula bent, but AFTER a full meal with no insulin. Another time, he was 'only' at 17, and not ill, when set had been pulled out, possibly for several hours, in the middle of the night (eg no food to digest). Similarly, when another bent cannula happened just  before Christmas, he was 'only' 22/24 for a few hours, didn't feel ill, and had no ketones...but had known enough not to eat with such high numbers, until we could figure out what had happened. I guess what I'm saying is: DKA is not inevitable with a pump failure -- it's a possibility only.  ALSO, since there's always a pen (be prepared!) available, then bgls can be lowered within an hour and a half of a real problem developing, usually...

But, like others say, you sound remarkably well controlled Copepod -- good on you. I suspect that the disadvantages of the pump, as you point out, will seem less so to youngsters who started on it early, and could find their own solutions etc...?

Best.


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## Copepod

Thanks, Patricia, I'm adequately controlled, and MDI suits me fine. 
I guess I'm more concerned about children starting early on pumps (when parents do most of the care), who may miss out on the chance to learn to manage MDI to suit their lives, leading to problems later in teenage years / young adulthood with new partners, caving, kayaking, gorge exploration, long distance swimming etc. Even if not everyone wants to get wet, muddy, squashed etc as often as me, surely virtually everyone wants a loving relationship that involves physical aspects?


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## rossi_mac

Thats a very good point / question / thought copepod.

I guess it will be hard to get full stories just yet as most pumps are for the children (?) I know adults have them but again not a subject people would be willing to say too much on here maybe a bit personal, but the growing years would make it very, I was going to say interesting but I think I'll say difficult but I don't know owt about living with a pump, maybe you can just un plug it it you get lucky or in the mood.

Each to their own but I hope I haven't offended with my simplistic view! I do like to read about how you pumpers get along and think it is a good thang, one day It may suit me down to the ground.


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## Einstein

I think it's the concern for me too Patricia, knowing the basics of why you're on or doing something.

It must be difficult for a younger child to communicate in a way to explain to a parent they aren't well because of diabetes, because diabetes can make adults unwell in exactly the same way, to a point where we can't describe the symptoms in a way that most other adults will understand.

However, with cannulas kinking, pulling out, on top of the not knowing in the future the basics of basal/bolus regimes, how to correct and ultimately being dependant on a machine to take care of so much of this for you, must be better supported by the 'back to basics' of how to manage your condition without your pump.

If a pump breaks down, how long does it take to get it repaired or replaced? I recall discussion many moons ago about the NHS only covering the pump for 'n' years for repair, do you then automatically get a replacement or do you have to apply for funding again? But how long say around this time of the year would you be without a pump for?

One of the manufacturers years ago used to supply you with a second pump as a spare, but I also think they had a closed unit which meant there was a finite life of their pump. I am now going back 6 years or more?

With seeing what children go through from a pumping regime in terms of testing, working through potential faults and then making the decision to revert to a pen (and then the panic of how many units!?) must make for some pretty daunting times.

My control has been pretty reasonable, six months ago I hit a wall and my HbA1C hit 9.2% the highest since diagnosis, nearly 10 years ago, in November it was back down to a slightly more acceptable 7.2% now to get that final 1% off it.

I've had reasonably few problems while on MDI, I would love to reduce my daily injection routine from 5 injections, for numerous reasons, even at 6'3" and an ex-rugby player I run out of 'new and interesting' places to inject or test. I also have the issue of dexterity in my hands and it's been suggested that perhaps a pump could be considered at some point if pens become ineffective.

But, I have for many years and am getting back to having pretty good control on MDI, so I have the baseline knowledge. To me, along with some others pumping looks to be more complex, sure it's just a case of getting our heads around it.

The deal closer for me would  be the integration of realtime BS monitoring into the process, so I can fit and forget.

With such a process you'd also be able to get a positive feedback if something had kinked or the levels were right off the scale.

Interesting stuff though. Thank you for the insight.


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## Sugarbum

There are so many issues here, I dont know where to start! Its a very healthy debate but obviously no correct answer so in short I guess its what ever works for you...

MDI clearly works well for you Copepod, physically, mentally and in all aspects of your life. For others this isnt so, myself being one of them. But thats not to say pumps are better or MDI, I am not trying to slate either one of them.

In the 6 months I have been pumping I have had one canula fall out, one kinked canula, no DKA, no keytones, most importantly to me- no regrets aside from wishing I had been given it earlier. I struggled beyond belief with MDI when I was recovering from my broken back last and this year. The touch of a button, rather than injecting with the problems I had at the time would have been a godsend, but luckily I didnt know any better.

Pumping has given me a stability in my life to manage diabetes the best way I know how. It is good to hear positive reflections of MDI as well from others too, neither should be thought of negatively but I believe it can only be what works for you is best.

Einstein: to answer one of your questions, when my pump broke I recieved a replacement the following afternoon delivered to an address 100 miles away where I was staying that night. Not bad, pretty accomodating. I only carry a syringe and a vial of insulin aditionally to my testing kit so nothing too dramatic.

With regards to dexterity, pushing the pump buttons is easy. Drawing up the vial into the reservoir could pose a problem? 

Visually there might be problems for some. My mum wears vari (?sp) focals and cant clearly see my medtronic screen at all even with the backlight. When I saw Vikis Animas it was much better and clearer font, a definate advantage. Brighter and steps ahead of what I have. Hope that helps.


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## Einstein

Sugarbum said:


> Einstein: to answer one of your questions, when my pump broke I recieved a replacement the following afternoon delivered to an address 100 miles away where I was staying that night. Not bad, pretty accomodating. I only carry a syringe and a vial of insulin aditionally to my testing kit so nothing too dramatic.
> 
> With regards to dexterity, pushing the pump buttons is easy. Drawing up the vial into the reservoir could pose a problem?


 
Thanks for this, on the dexterity concern, the reason I asked about the volume of insulin consumed each day and the capacity of the pump, was to indentify how often it would need to be refilled. 

Given it will comfortably last five days probably much more, it would be possible for me to ask my partner or the nurse to fill it for me, perhaps keeping a spare cartidge in the fridge, assuming the changing isn't too tricky. 

But then it would also be timely every five or so days to change the cannula. Again, I'm assuming on changing every five days? And I know I can't fit a cannula myself now.

Pressing a button I can do, the other comes down to alarms and if it just sounds or vibrates as well. If it vibrates, fine, if it's an alarm when Bruce would need to be trained to this sound...

It's not a bad service on supplying a new unit, especially considering you're so far away from home. Was that delivered by a courier or someone who could change the pump over for you and configure the new one?

It would appear from this that each manufacturer is responsible for their own support/service. Which is good during their warranty of say 12-36 months, what happens after that? This is where I did hear the NHS begin to expect the user to sign up to a maintenance contract on the pump directly with the manufacturer. 

Has anyone got this far or asked the question yet?

Sorry, more questions!


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## Sugarbum

Haha! Dont apologise! Its all very relivant and important stuff.

I havent been requested to sign any contract. I was "advised" to put it on my house insurrance, but this was not a mandatory spec from the PCT. If my pump breaks after the warranty I am informed that I always will get a replacement, also an upgrade in 3 years anyway. Keep in mind though I feel as if I am spoiled by an excellent pro-pumping team and great consultant. I go to a well funded hospital so I feel supported in that capacity. As we know well from various threads, this differs hugely between forum members....

I refill a reservoir and replce a canula every 4 days (approx). There is a larger reservoir size than the one I use so maybe they change less frequently? (Im sure Adrienne could clarify that for you!). Once mastered, it is easily done. I would expect this to be reasonably easy for a healthcare professional to do this for you on a home visit. Mine takes a matter of minutes, if that. Obviously, you are best placed to think of contingency plans....but if for some reason you have high levels and especially with keytones, a set change is advised and also may need to perform an injection as done in MDI. There is the potential for this to happen whenever, wherever.....(such is life!). Only once have I needed to do this in 6 months but I know some of the parents have needed to resort to this on more frequent occassions.

The supplies are for 3 months with medtronic. Everything is delivered by courier service to whatever address work/home/UK address that you like. 24 hour contact service line (manned by the USA at night, but at the price of your local call). All good in that respect. The delivery guy (as good looking as he is) is only a courier delivering medtronic supplies, nowt else.

Alarms- dependant on the make and model of course, but I have an audiable alarm and an option of vibrate like a mobile phone (alarms flash with the backlight as well). I dont find the sound ones particually loud, but then I also find the alarms are rare! Generally there isnt a lot to alarm about! It would be worth finding out what animas users and roche users think of theirs. Im sure an intelligent dog like Bruce could be trained to change the set and reservoir, no?! 

I have a friend on animas. When he goes abroad he gets a second pump on loan to take with him! Thats service with a smile surely?

I know this is digressing, but I look forward to the future when there are no inhibitions like dexterity to using a pump. A voice activated control? The technology has been around for years. I would love to see it develop in such essential areas of technology.

Medtronic have recently expanding in their Watford location (my DSN told me to apply for a job there, hundreds going!!!) and I think we can expect the rapid uptake in pumps in the UK to show a huge improvement in services from these companies and it is a very cometative game. I really think the future looks bright in this respect.

Hope you and Bruce have a happy new year David


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## Northerner

Sugarbum said:


> ...I havent been requested to sign any contract. I was "advised" to put it on my house insurrance, but this was not a mandatory spec from the PCT. If my pump breaks after the warranty I am informed that I always will get a replacement, also an upgrade in 3 years anyway. ...



Slightly off the topic of this thread, but I was reading on a US site that insurance companies there won't replace a pump until it has actually failed, which can leave the user with a difficult period of time whilst they negotiate for supply of a new pump. They generally also have to pay for consumables, or at least co-pay, so suffer more if they have to change things earlier etc. So much for their superior health care!


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## Einstein

Not sure Bruce can change the cannulas, would never be sure he'd washed his paws and under his claws properly. Also dread to think what my little angel would do to me if he could adjust the controls 

The nurse is happy to visit to inject me on days where I can't manage, my issue is I've been ferociosouly independent all my life, I don't want to have to depend on people now. When I do it's not for me.

But having the consumables changed once a week isn't to much of an issue for me.

A daft question here, is Novorapid compatible with pumps or doesn't it matter which bolus you're on?

Plenty to ponder on. Hopefully will never need to make the decision, but much appreciate the facts.

Northerner, it's a shame he have such a postcode lottery, being where I'm located has always served me well in terms of finding the best healthcare. The level of care in the NHS has never been my issue, the harmonisation of the standard is the problem.

As we've covered elsewhere, splitting into regions is all well and good, delivering local control. That's where the problem also kicks in, priorities for different PCTs. If the NHS took a long term pragmatic look at conditions such as diabetes and made the right technologies, training and resources available to all diabetics then the return in the medium and long term will be considerable.

But they don't, they won't, they will pay all the lip service we want to listen too, but on the ground for many of us the level of service often hasn't changed, less still improved in the past 5 years.

My healthcare team are great, I'm so lucky, from GP to all consultants, but there have been battles I've taken on, that others won't and that is wrong, I shouldn't have to battle for what I have right to, and others should have the same offered to them.

The most significant diabetes care related factor for me was the repeat dispensing prescription serice - where I agree with my GP the next six months worth of repeats, take the full set to my chemist and then go and collect them on or around the 13th of each month.

For others I am sure there are many other changes and improvements they've seen - or I hope so.

Of course I'd like to see this online, so I can have a maximum number of x, y and z drugs prescribed over the next six months, then order them a week in advance online from my pharmacy, then I wouldn't end up with a spare box of needles or Novarapid every six weeks. That saving would be considerable for the NHS and to track all prescriptions electronically, well, surely it will pay for itself in countering fraud?

Sorry, off topic!


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## Copepod

Thanks for all the discussion. I wasn't trying to find problems with pumps, to say they weren't as good as MDI, but I don't think people think that, just to raise some issues that genuinely puzzled me - and it seems, several others. Always good to keep up to date with treatment options - a bit like when I found glasses for short sightedness didn't suit me (around 14 years old), so started on hard contact lenses, and only changed to hard gas permeable some 8 years later. For others who need the comfort of soft lenses, there are many types, from daily wear disposable to "leave in eyes day & night for a month". For me, the cheapness & lower infection risks of hard gas permeable lenses which last me at least 2 years, plus minimal solutions, suit me fine. Perhaps there's a theme here... old reliable, trusted technology, with fewer costs / resources - for me, costs are still important, whether it's me paying for my sight aids or the NHS paying for my insulin, pens, blood testing consumables etc. If I, or anyone else, need more expensive kit, then they should have it, but I don't feel it's unreasonable to try the cheapest options first.


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## Sugarbum

Hi,

Just to pick up quick on Einsteins question, yes Novorapid is compatable with a pump. I use it in mine. Its great having the one insulin for background and bolus. I get 4 vials on prescription and that is enough to last me 3 to 4 months. Its great to move away from the services of my pharmacy for just a bit 

Lou


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## Einstein

Thanks Lou,

Makes a few options more interesting to consider. But I still feel there is a lot of messing around to switch from MDI.

My problem is I don't like change. So moving from a combination I know is hard going. I do not understand why the manufacturers of Novarapid won't allow other pen manufacturers to make their pens with with their insulins.


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## Becca

Hi 

Coming into this late but reading all the replies with interest.  Rose is on a pump and has been for the past 2 years.  Before that she was on 3 injections, then 4 and then 5.  Without a doubt the best control we have had has been from the pump.  We also got our little girl back for that i am eternally grateful.  

The pump will be up for renewal in 2 years time, for which a replacement will be ordered before the 2 years is up so it should just be a switch over.  We have only ever had one motor error and then the pump (through talking to medtronic USA) were able to sort the pump out over the phone.  We would have had to inject novorapid overnight (i wanted to do this rather than use Levemir) as the new pump would have been with us in the morning if needed.  My friend's little boys pump broke last week (22nd)  They were able to get a loan pump from the hospital for overnight and the new pump was replaced the next day.  

The pump, for us, gave us back our family, it isn't like that for everybody but for us i am very very grateful that the PCT fund it.  As for when Rose gets older, it will always be her choice of whether she wants to continue with the pump or not and we will support her with whatever the decision.  As for now, she doesn't want to give it up and we know she is getting the best control that we can give her with the best technology for her.  As parents, we cannot hope for more.


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## Patricia

Great thread Copepod, thanks!

Thought it also worth throwing in that pumps have been used for many years in the States, albeit not with the same technology -- but they've been there for 20 years or more, in some form or another. So many of these questions have been addressed in various ways by adults and children alike, and tested over time, to boot. There are numerous US based sites that talk about pumping in all its glory, at all levels...

It's not desperately unusual for people to move around between pumping and MDI, depending on the situation and feelings. Many teenage girls move to MDI in the summer months, for bikini reasons! And many long-term pumpers move to MDI for a break from feeling 'tethered'. How the control is, I'm not sure...but I'm sure that with lives which are more likely to be out of routine (eg university etc), or battling with hormones, the pump offers the most flexible control.

For us, the pump has seen my son grow and eat and grow and eat...and go out with his friends without fear of going mega high if he wants a snack, etc...It *is* an intensive regime, and probably 'harder' than MDI... We have made sure however that he does know and understand the basics about ratios/correction factors and total daily dose stuff, should his pump malfunction when we are not around. And of course he has to know how to carb count, and always to test regularly. This is crucial. We are also going to train the first aider at school in this: being unable to calculate an insulin dose without the pump is of course very dangerous. And it's always worth doing a quick calculation with every dose -- it turns out that E does this anyway. I can see him quickly confirm his own estimation...every time.

BUT like Einstein said some way back: what we long for is the whole shoot bang. CGM and a pump working well and in tandem. An artificial pancreas. Bring on the day. It will come. Then -- while like now we will be utterly dependent on technology, and thereby much could go wrong -- the 'return' for this high price will be a whole different degree of freedom...

xxoo


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## Copepod

Thanks Patricia and all others who have contributed so wisely to this thread - I guess I'm hoping for an artificial pancreas, too, totally reliable, incorporating continuous blood glucose monitoring, all in a small, waterproof & robust package! Until then, I reckon MDI will do me and many others fine, just as pumping suits many others.


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## Admin

Copepod said:


> I guess I'm hoping for an artificial pancreas, too, totally reliable, incorporating continuous blood glucose monitoring, all in a small, waterproof & robust package!


  Me too!! Me too!


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## katie

Copepod said:


> ... to "leave in eyes day & night for a month"....



I want these!! then i'd feel like I have perfect vision, I love waking up feeling like I have good eyesight when ive fallen asleep with my contacts in.  I would like to have GP lenses too, but I have a feeling he didn't prescribe them because of a specific problem with my eyes?! not sure.



Copepod said:


> Thanks Patricia and all others who have contributed so wisely to this thread - I guess I'm hoping for an artificial pancreas, too, totally reliable, incorporating continuous blood glucose monitoring, all in a small, waterproof & robust package! Until then, I reckon MDI will do me and many others fine, just as pumping suits many others.



Ive always said i'm only have children when the mechanical womb comes out, but then I got Diabetes.  Now i'm waiting for the articial pancreas.  Surely it isn't going to be that long till the first models appear!


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## Copepod

Katie - until the artificial womb is invented, other species have some very good options for rearing offspring - male midwife toads carry tadpoles on their backs, male seahorses carry babies in their pouches, male emperor penguins look after their eggs and young through the winter months while females go back to sea to feed. 
Re contact lenses - well, worth asking your optician - even if gas permeable aren't suitable for you, it might be worth knowing why?


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## tracey w

Einstein said:


> Not sure Bruce can change the cannulas, would never be sure he'd washed his paws and under his claws properly. Also dread to think what my little angel would do to me if he could adjust the controls
> 
> The nurse is happy to visit to inject me on days where I can't manage, my issue is I've been ferociosouly independent all my life, I don't want to have to depend on people now. When I do it's not for me.
> 
> But having the consumables changed once a week isn't to much of an issue for me.
> 
> A daft question here, is Novorapid compatible with pumps or doesn't it matter which bolus you're on?
> 
> Plenty to ponder on. Hopefully will never need to make the decision, but much appreciate the facts.
> 
> Northerner, it's a shame he have such a postcode lottery, being where I'm located has always served me well in terms of finding the best healthcare. The level of care in the NHS has never been my issue, the harmonisation of the standard is the problem.
> 
> As we've covered elsewhere, splitting into regions is all well and good, delivering local control. That's where the problem also kicks in, priorities for different PCTs. If the NHS took a long term pragmatic look at conditions such as diabetes and made the right technologies, training and resources available to all diabetics then the return in the medium and long term will be considerable.
> 
> But they don't, they won't, they will pay all the lip service we want to listen too, but on the ground for many of us the level of service often hasn't changed, less still improved in the past 5 years.
> 
> My healthcare team are great, I'm so lucky, from GP to all consultants, but there have been battles I've taken on, that others won't and that is wrong, I shouldn't have to battle for what I have right to, and others should have the same offered to them.
> 
> The most significant diabetes care related factor for me was the repeat dispensing prescription serice - where I agree with my GP the next six months worth of repeats, take the full set to my chemist and then go and collect them on or around the 13th of each month.
> 
> For others I am sure there are many other changes and improvements they've seen - or I hope so.
> 
> Of course I'd like to see this online, so I can have a maximum number of x, y and z drugs prescribed over the next six months, then order them a week in advance online from my pharmacy, then I wouldn't end up with a spare box of needles or Novarapid every six weeks. That saving would be considerable for the NHS and to track all prescriptions electronically, well, surely it will pay for itself in countering fraud?
> 
> Sorry, off topic!



Hi, Just a couple of answers from my pint of view, I know others have responded. I have the roche, spirit combo.

Cannulas generally need changing every 2/3 days depending on type of cannula, as far as I know there arnt any that will last or advise to use for 5 or more days. It is unadvisable to leave drawn up reservoirs in the fridge, have been told this many times, something to do with plastic absorbtion (dont quote me though). As far as I know (but i could be wrong), my pump has the largest reservoir which lasts approx 6 days, yes it would last longer but as you change cannula every 3 days, they tell you you must change the set (reservoir) on the sixth day also. Hope that makes sense. Re the cannulas there are different types and some have inserters to help people with dexterity problems.

I was told to put my pump on house insurance which I did, incase it gets lost or stolen ( I know but apparently does happen!), if it fails roche will send me a new one the next day, all my consumables are apid for by the pct, i get supplies every 3 months. Roche are very helpful and basically i can order whatever i need, i asked for a couple of skins and expected to pay myself but they said the trust pay for everything!

I was told i would have my pump for 4 years and then i can replace with whatever i want at that time, no need to apply for funding again etc.

Hope this helps, x

Also, yes I believe they do novorapid vials, I use humalog


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## Cate

Hello )

I've only just signed up to this site, but have been pumping since June 2004.  Since then, I've got married, had a daughter, and am currently 28 weeks pregnant with our 2nd - so I guess you could say that a) I'm an adult pumper and b) we've had an active life in the bedroom!  

Personally, I don't detach my pump unless I'm in the shower/bath/swimming pool/similar - or occasionally if our little girl climbs into bed with us in the night and needs carrying back through then it's easier just to disconnect and plug back in when I get back in bed (within a few minutes normally).  You can select different tube lengths for your set, I use the shorter one (60cm I think) which is long enough for it to rest on the bed alongside me during the act, alternatively I've been known to hold it in one hand if we're being a bit more active...

Sleeping - in bed it's just in the bed with us, I don't find it gets in the way as the tube is long enough to go over me when I turn over (yep, no night clothes in this house...not for adults anyway!).

Activity - I have been active for 8 hours (ran the marathon for Diabetes UK a few years back) and suspended my pump for the entire time with no ill effects.  I just tested my sugars regularly and was prepared to act if required - either by starting the pump again or by taking glucogel.  As it turned out I ate 4 packs of dextrose and tons of glucogel and didn't have to restart the pump once.

Pump failure: My first pump failed after 2 years use, obviously when we were staying with my parents in the wilds of rural France.  Despite being out of the country and in the middle of nowhere, Medtronic couriered a replacement to me within 24 hours.  For that 24 hour period I switched back to MDI, except with no long-acting insulin.  I just gave a correction of Novorapid every 4 hours (which is how long my novorapid normally works for).

My HbA1c has gone from around 9 in the pre-pump days, now it varies between 5.5 and 7.  I've had type 1 for 25 years and the only problem I've had is that since pumping caused such a rapid improvement in sugar levels, it caused proliferative retinopathy, so I've had extensive laser treatment and also a vitrectomy in one eye.  Despite that, I would never choose to go back to MDI - having tried them for 10 years, they just didn't work for me.

Oh and re pump replacement, mine was replaced last year, as its guarantee ran out.  My consultant wrote to the PCT recommending continuing pump therapy, that was agreed, and I went in to collect my new pump at my next clinic appointment.  It had some new features that I had to learn, so had a session with the DSN and dietician who specialise in pumps at the time.

HTH,

Cate.


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## tracey w

Cate, thanks, what a brialliant post. Helped me lots as been pumping around4 months now.

I too am a bit worried about the retinopathy as my levels ars so much better. Just wondering if the laser treatment has caused any problems with your driving liscence, thats if you have one of course?

x


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## katie

Great post Cate, thanks for the info


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## Admin

*Sleeping nakedish!*

Probably TMI - but I generally sleep naked!! You can have the pump beside you - or Roche (supply the spirit combo) supply a soft velcro strap that wraps around your body that you can tuck the pump into so not quite naked any more!
Copepod - as far as planned long water activity - it is easy to come off the pump and just do MDI for the day. 
Short activity - I go swimming for 40 mins and just disconnect.

They are not very sexy - I completely admit that - but hubby loves me and that includes pump! Mind you I got pump after being married and getting pregnant by him!! Not sure I would have been comfortable in the 'bedroom' in a new relationship with the pump but it has had no ill affects so far on hubby! I think if I was in a new relationship - I would disconnect which you can do, and just plug in again afterwards - and if you are particluarly strenuous/active in the bedroom!!

I think it is like anything - you just get used to it. I figured I would try the pump - and if I don't get on with it - I can always go back to MDI. It's not a life sentence - and I am having a few problems so far with odd levels!


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## Cate

tracey w said:


> Just wondering if the laser treatment has caused any problems with your driving liscence, thats if you have one of course?



Not especially - the laser affects your field of vision, so I notified the DVLA that I'd had it.  First time they didn't do anything different and just let me carry on driving, but when my license expired they sent me for a field test at a local optician.  This just tests that you can still see in a 120 degrees field when looking ahead.  Assuming you can (they don't tell you the test results at the time), they reissue your license - mine has always been for 3 years, but I guess they would make it less if they were concerned.

I've done about 3 or 4 field tests now I think, and always kept my license, even when I thought I wouldn't.

I did have my license taken off me at the end of 2008, because on renewal some numpty in the DVLA decided that I had untreated/untreatable double vision  but got it back last year after a fight!  (My GP and consultant wrote some *really* stroppy letters for me...)  No idea where they got the double vision idea from, but from what I've heard it's not the first time they've made mistakes!


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## tracey w

Thanks Cate, reassuring to know. Thats one of the main things that worries me , the driving as I usually end up having to drive long distances with the job.


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## Pigeon

Can I ask a strange question, does a pump make much noise? I appreciate that it would be designed to be discreet, but my boyfriend is super-sensitive to noises when he's trying to sleep, e.g. he can't have his watch in the bedroom as the ticking annoys him. Would a pump be annoying for someone who's so sensitive to noise?


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## Sugarbum

NO noise, unless you have an alarm which is rare (perhaps more frequent with the youngsters and the sensors?). You can switch it to vibrate and different volumes of the tone, none of which are loud really.

I cant imagine it would wake him, or you really! (BTW, I am making ref to the medtronic, I dont know about the others!) x


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## Lauren

What do you do with your pump say if you were on holiday and going in and out of the pool all day? Also if you were in a hot country would you have to keep your pump in a cold pouch (like the Frio)???


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## Sugarbum

I guess you could use a frio if you werent moving about so much (say you were lounging!), something I certainly would do is take it out with me in that kind of situation.

If you want to you can always take a holiday from your pump and return to injections- its very flexible and you do whatever you want to!

There other thing if you want to disconnect and feel confident enough is to keep it in your bag like you would your insulin pens and just connect it for a quick bolus and then take it off- easy!

When you get into the swing of it, pumping is so flexible it is so easy to adapy to every situation...

Hope that helps x


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## purpleshadez

One concern I have is the max bolus. Whilst it is only a mild concern as it can be amended, the pump I've been given to "play with" was set up as if I was actually using it but the max bolus is set to 10. I know for a fact that there are times where this will not be enough, I regularly take more than 10 units so even taking into account a 25% drop there will still be the odd occasion that a higher dose is required. 

Has anyone else had an issue with this?


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## Sugarbum

It is easily ammended! I have that on my pump, medtronic veo. Its mainly I would guess for youngsters, or people getting used to it, stop any accidental large maths muck-ups!

certainly if I have pizza or past I need more than 10 units so it is set quite higher. <y inital concerns was that there couldnt possibly be enough insulin in this syringe for what I would need, and there is more than enough!

When do you start on insulin in the pump?


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## purpleshadez

Cool, I figured it was something like that but then had a panic when I told it to dose me for 14 units and it told me I could only have 10! Heh 

I start on the 16th of March. 1 whole week tomorrow


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## Sugarbum

Yeah 10 units is the factory settings!

Its not a problem, you change it to something like 20-25 so it never reminds you again (if you dont want to be reminded that is!)

Not long till you start- how exciting!


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## Cate

Lauren said:


> What do you do with your pump say if you were on holiday and going in and out of the pool all day? Also if you were in a hot country would you have to keep your pump in a cold pouch (like the Frio)???



I normally just detach it when I go in the pool and reattach as soon as I get out - test if I've been in a while, bolus if required and then detach again when I go back in.

In a hot country I haven't ever kept it in a cold pouch (don't own one) but do keep it shaded when not attached.  But I guess it's not quite the same as we normally stay at a house with a pool so I can just leave the pump indoors or under the shaded area next to the pool where it's cooler.


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## Lauren

Thanks guys for your replies - it makes more sense now. I was imagining that I could never have lazy days by the pool on holiday ever again! A bit dramatic I know...


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## purpleshadez

*Target Range*

Okay, so at the moment my target range is 7.0 - 7.5 which whilst still early days is working out quite nicely but I gather form reading other threads that a lot of type 2's may consider 7 to be too high. I was curious to what target other type 1's have.  Did you decide this yourself or with your DSN?


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## Freddie99

purpleshadez said:


> Okay, so at the moment my target range is 7.0 - 7.5 which whilst still early days is working out quite nicely but I gather form reading other threads that a lot of type 2's may consider 7 to be too high. I was curious to what target other type 1's have.  Did you decide this yourself or with your DSN?



Personally I like to be between five and ten millimoles per litres. I don't like going under five as that's getting a little too close to hypo for comfort I think.


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## randomange

purpleshadez said:


> Okay, so at the moment my target range is 7.0 - 7.5 which whilst still early days is working out quite nicely but I gather form reading other threads that a lot of type 2's may consider 7 to be too high. I was curious to what target other type 1's have.  Did you decide this yourself or with your DSN?




When I started pumping I had a target of 8, but that was mainly to err on the side of caution since I'd been having a lot of hypos.  That's since been moved own to 6-6.5, with a slightly higher target of 7 before bed.  I think it's something you need to discuss with your DSN, and decide what you're comfortable with.  I think targets tend to be different depending on whether or not you're on insulin, since then you need to be wary of hypos.


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## purpleshadez

I thought I'd already replied to this! Sorry, thanks for your comments, its really put my mind at rest  My DSN has said to aim for 7 for the time being so I feel comfortable with that.


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## stacey mardybum walsh

hi i started my pump yesterday so i have been talking to people online about it to get as much info as possible, one person says it makes her put loads weight on all the time so its got to the point she stops her pump.. I have been diabetic for a 11 years and not really had a problem with injections making me put weight on, but with the pump being 24 hrs insulin will it make me put loads weight on? thanks


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## Red Pumper

stacey mardybum walsh said:


> hi i started my pump yesterday so i have been talking to people online about it to get as much info as possible, one person says it makes her put loads weight on all the time so its got to the point she stops her pump.. I have been diabetic for a 11 years and not really had a problem with injections making me put weight on, but with the pump being 24 hrs insulin will it make me put loads weight on? thanks



Hi Stacey,

I see no reason whatsoever why being on a pump should make you put n weight.
The chances are that you will be taking in less insulin overall than you did when on MDI therapy.
In fact, I have lost 8lbs in the two months that I have been on a pump because I had had less severe hypos to correct and the pump allows you to eat when you want rather than having to eat to maintain BG levels.
You should have absolutely nothing to worry about.

Keith.


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## Red Pumper

Oh and wecome to the pump club


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## Shelb1uk

Hi Stace, Hi Owen 

Dont forget to post on me group girl hehe!

I have gained weight since my pump, but only because snacking doesnt involve a needle each time now, so it's my own fault...pumping as a diff way of dealing with diabetes will not make you put on weight, its down to the owner heheeh!!! x


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## SacredHeart

To everyone who has contributed to this thread, just a huge, HUGE thank you.

This has been a really good read, and has covered a few of the questions I had


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