# Any watersports (ocean) pumpers out there?



## Pedro (Oct 3, 2010)

Hi all,

I've been T1 for 25 years and am about to switch from MDI to pump therapy.  My biggest concern is how this will work with my watersports involvement.

I've been kitesurfing and surfing for years now and am heavily involved with the national circuit.  As such, I spend large amounts of time in and on the sea.  I spoke with a brilliantly optimistic paddle boarder from Bournemouth a few weeks back, but her approach is simply to disconnect for an hour when she hits the water.  This is simply not an option for me due to length of time I spend in the ocean each session.

I'd love to hear from any other pumpers with relevant experience.

Some of my key questions are around:

  1. Length of time I spend in the water (2 or more hours)
  2. Wearing a pump under a wetsuit and harness
  3. Risk of dislodging infusion sets when getting wetsuit on/off
  4. Level of waterproofness of certain pumps, e.g. Animas and Omnipod
  5. Hygiene of infusion site, particularly with regard to bacterial infection from seawater, e.g. sewage outfalls etc

Any hints, tips, case studies would be very gratefully received.

Thanks in advance,
Pete.


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## Copepod (Oct 3, 2010)

I can't help much, as due to my activities, which often involve being in water (sea or fresh) and / or wetsuits for long periods of time, I have never thought that a pump could suit me, and MDI is ideal. It's very different leaving a pump on the side when swimming in a clean swimming pool to paddling and kayak or clambering on rocks in a gorge for several hours. I reckon that even getting into a wetsuit without disturbing a pump would be a challenge, despite some good designs of cannulae and choice of sites. Some pumps advocates think I spend time thinking up reasons why not to have a pump!

However, as a marine biology graduate, I can advise about sewage in marine environment etc. In the short term (ie until disposal of sewage at sea ceases - I've been saying that for over 20 years, slightly longer than I've had T1D), I'd suggest trying to avoid parts of coast where there are short sewage pipes, particularly after heavy rain and when winds and tides direct contents towards where you are kitesurfing / surfing. You probably already know about Surfers Against Sewage? http://www.sas.org.uk/ can give information about local conditions. Marine Conservation Society also campaigns on the issue - see http://www.mcsuk.org/


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## Twitchy (Oct 3, 2010)

Hello,

I can only give a limited comment, as my pump is not water proof, but...

Re dislodging canulas putting a wetsuit on/off - I'm not convinced this would happen - the nearest experience I have with this is wrestling with a too tight (post babies fat I'm afraid! ) swimming costume & rash vest type top, before/after waterbabies sessions in a pool with the kids.

Re sewage - I can totally understand where you are coming from on this - the pool we use for waterbabies is chlorinated, but being a bit of a paranoid realist, I suspect the water / kiddy effluent ratio gets quite scary as the day goes on!  The good news is the infusion set (& I suspect they might all be like this) is self sealing (allegedly) when connected or once you remove the tubing/pump end. Personally when I take the kids in the pool I remove the pump as it's for 1 1/2 hrs, and put a 'knee' type plaster over the top of the canaul & cap, just for a bit of 'belt & braces' paranoia really!

I suspect your best bet might be to see if the Diabetes UK website has any pages comparing the different insulin pumps to check which claim to be waterproof, and then contact the manufacturers to get the official specs - that might at least give you a starting point.  I would just say at the very least it's worth giving it a go & seeing if you can address any of these potential problems - I was initially very resistant to the idea of pumping but the leap forward in control is actually soooooo worth a bit of extra planning & effort.

Hopefully someone else can give you some more relevant experience! 

All the best,

Twitchy.


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## Northerner (Oct 3, 2010)

Hi Pete, I found a couple of stories from pumping surfers that you may find encouraging:

http://www.diabeteshealth.com/read/2009/08/07/6306/surfing-with-type-1/

http://www.minimed.com/pumptherapy/whypumptherapy/patientstories/scottdunton.html

The first article mentions a waterproof housing for the pump, so might be worth investigating whether this is readily available.


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## bev (Oct 3, 2010)

Hi Pete,

My son (Alex) is 12 and has the medtronic pump which alledgedlly isnt waterproof (but this isnt true - however we havent taken the risk of putting it in water).

Alex has been in the sea wearing a wetsuit and his canula stayed intact and untouched. You get a little plastic part that you plug into it to stop any danger of letting anything in. You can use 'tegaderm' over the canula if you are really worried - but if a 12 year old very adventurous and proper boy has done it without incident I would think you will be fine.

Alex has also been wakeboarding and fell off many times - no problem with the canula. He has also been mountainboarding and fell off many times and was was wearing his pump as we set his basals down to 50% which stopped any hypo's and meant he could do this for the whole day.

Alex goes bike riding on 50% and often falls off doing boy type tricks and never had any problems wearing his pump.

Lots of people (children) I know do take the pump of for 3 or 4 hours at a time - but this is very individual and it could be that you would only find this out by trying it. You can take the pump off and go back to it every 2 hours or so and give yourself a bolus to keep you going and to replace missed basal.

Animas is waterproof and if your really worried you can buy an 'aquapac' to make you feel even more secure.

You can put the canula anywhere - so you could for example put it in your arm and this would give you many places to store the pump as you can get different length tubing. You need to buy a 'spibelt' as these keep the pump in place without any movement and stop the pump from bobbing up and down if your run etc. You can make access easier into a wetsuit by putting the canula on your chest and I have seen a lady who put the canula on her breast and said it didnt hurt.

Pumps are extremely robust and very rarely do they get damaged with any form of sport - in fact I have never heard of it and I know hundreds who use a pump. I have seen 2 year olds throwing themselves down hills and trees landing on their pumps - and never been a problem. I have also seen teenagers doing very active play fighting and throwing each other around and never seen the pump become dislodged.

I hope I have helped to put your mind at rest because if your sporty the pump really is the best way of keeping levels stable and avoiding both hypos' and hyper's.Bev


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## Twitchy (Oct 3, 2010)

Gosh Bev, I feel like a right crumbly old coward now, with my sticking plaster for the pool lol!!   I need to get braver, evidently!


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## SacredHeart (Oct 3, 2010)

I'd check out the Animas 2020 - a major sales point for them is its robust nature and suitablility for watersports. There's a video on their website where they interview a girl who does rowing, which you might be interested in watching


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## Mel (Oct 4, 2010)

*Water sports*

hi 
My daughter has an animas and is a competitive swimmer , wears the pump the whole time often fo rseveral hours in water , no problem with cannulas coming off,
She aslo water ski's worn it for that too, and no problem with the wetsuits either.
The "skin" and new film fo rthe screen is pretty good for protecting the pump from sratches and scrapes from rocks and sea water etc.
You just have to remember to change the battery cap every three months instead of six.


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## Pedro (Oct 5, 2010)

Thanks very much for all the feedback, it's greatly appreciated.  The tips about covering up canulas are good to know.  From your responses, and bits I've read elsewhere, it looks like the Animas and Omnipod are the best bets.  I have to confess that the Omnipod appeals due to size and lack of tubing.

I actually did a trial run yesterday using surgical tape, plastic tubing and an old guitar tuner (humour me, it's roughly the same size as a pump) to simulate getting my winter suit on/off over the hardware.  Not a great result I'm afraid, as a 5/4/3 suit is just too thick and inflexible (compared to a spring/summer suit) to get on/off without wrecking everything.  Also incredibly uncomfortable; probably bearable for short periods but certainly not an option if I was on a long distance paddle (4 hours +).

On that basis I think I'll be going for the Omnipod.  Just got to persuade the PCT to stump up the cash now!  That said, total cost of use over two years doesn't look to be much more than a regular pump.


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## Pedro (Oct 27, 2010)

For those who might be interested - in watersports or waterproof pumps in general - I had a trial on the Omnipod last week with a saline filled pod. 

*Omnipod system - three day trial with saline-charged pod*

I am thoroughly impressed with the system as a whole. The PDM (controller) is relatively intuitive - albeit a little clunky in design - and I had a reasonable grasp of it within a couple of hours tinkering. Setting up custom basal programmes is a breeze, with four programmes available and each allowing up to 24 segments to be set. The bolus functionality seems comprehensive, although a common food item library would be welcome, or at least the option to download one from a desktop client. While you can set your own favourite meals/carbs, it's a slow and somewhat tedious process given the lack of input options. I can't comment on the integrated glucometer as being a demo unit I wasn't allowed to use the blood port. It's a regular Abbott Freestyle system though, so should offer reliable performance.

As for the pod, it's a bit of a marvel! Smaller in real life than you might think and barely noticeable once it's been on for a few hours. I wore it on the back of my arm as I felt this would be the location most likely to annoy when trying to sleep. While I'll admit to struggling to sleep the first two nights, by the third I was out like a light; partly due to exhaustion I'm sure, but more due to having become accustomed to it. It also stayed put while showering and even got clouted on door frames a couple of times with no ill effect. Nor did it interfere when donning/doffing my wetsuits. While I didn't get on the water while wearing it, I'm confident it will perform perfectly during extended paddle runs or kitesurf sessions.

And what about the insertion process?  
It's quite a revelation; so fast that if not for the "snap' it makes when firing, I'd probably have missed it.  In fact, I jumped more from the noise than from any sensation - it really was painless.  I've no doubt you'd encounter the odd painful insertion over prolonged use, but I suspect this would give most (if not all) regular infusion set insertions a run for their money in terms of comfort, speed and lack of stress.

Overall I'm very, very impressed. All I need now is for my local PCT to get off their laggard backsides and progress the funding approval. If anyone's got questions about my limited experience of the system I'll answer as best I can.

Pete.


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## Northerner (Oct 27, 2010)

That's a great review Pete, thank you - I'm sure a lot of our members will be very interested reading it


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## Pedro (Oct 28, 2010)

You're very welcome.  Hope it helps.


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## bev (Oct 28, 2010)

Hi Pedro,
Thanks for this review. Apparently omnipods are being introduced in various clinics now - so it will be interesting to see how they take off. Personally, I feel they look quite bulky - but I think thats because I am thinking of it from the perspective of a child rather than an adult. It sounds like you have given it a good 'pratice run' without too many problems. Thanks.Bev


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## cally (Nov 5, 2010)

We went on a sailing holiday in the Aegean last year and I just kept my pump in a plastic bag in my pocket and I did get pretty wet at times. Pump was fine though. 
But I have never completely submerged it. If we do same thing again I will probably get an Aquapac.

I did spend a lot of time swimming and snorkelling and just took pump off to do this and put it somewhere cool. 
I found that as long as my blood glucose was at the higher end of normal when I disconnected I was fine for up to two hours or even longer as was very active. 
I just used to reconnect and inject missing basal if longer than two hours and/or  food bolus if I wanted to snack .

I was very concerned about this before we went and even considered going back onto injections for two weeks, but am glad I didn't as it really wasn't a problem.


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## Pedro (Nov 15, 2010)

Found out this morning that my funding has been approved for the OmniPod.  Wahay!  Can't wait to get started now.  Little do they know that I'll be going after CGM funding next .


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## Steff (Nov 15, 2010)

Pedro said:


> Found out this morning that my funding has been approved for the OmniPod.  Wahay!  Can't wait to get started now.  Little do they know that I'll be going after CGM funding next .



Excellent news Pedro really pleased for you.


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## bev (Nov 15, 2010)

Pedro said:


> Found out this morning that my funding has been approved for the OmniPod.  Wahay!  Can't wait to get started now.  Little do they know that I'll be going after CGM funding next .



Thats great news - good luck with the CGM funding.Bev


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