# Bubbles :(



## Unicornz (Mar 30, 2011)

This is the second time in a row that I change my cannula and I spot one or two massive airbubbles at the end of my reservoir. They're not near the tube and I haven't really seen any massive effect on my levels but I'm still quite worried about this. I'm 100% sure they're not there when I put the reservoir in, so where do they come from 

Has anyone else had this problem? How can I fix it? I change my cannula every 2-3 days.


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## shiv (Mar 30, 2011)

Sometimes I get small bubbles appearing - I changed my reservoir this morning and it was bubble free when I put it in, and now it's got some small bubbles.

I just prime them out, as if I was changing the reservoir.


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## Unicornz (Mar 30, 2011)

Good idea I'll try that next time! Although I don't usually notice the bubbles until I take my reservoir out of the pump...


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## shiv (Mar 30, 2011)

It might be worth having a look at your reservoir a couple of times a day then  I try to check mine twice a day - hopefully that will stop any bubbles causing problems!


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## Unicornz (Mar 30, 2011)

Can you just take it out like that? Learn something every day  does priming the bubbles out work the same as priming when you put in a new reservoir? God I feel like such a newbie right now lol!


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## shiv (Mar 30, 2011)

Yep you can take it out! I've read that you should disconnect when you re-insert the reservoir, just incase it accidently pushes a little bit of insulin through the cannula.

I prime bubbles in the same way as I would a new reservoir - I rewind the pump, flick all the bubbles to the top, and hold the tubing upwards so I can see the bubbles being primed out.


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## Ergates (Mar 31, 2011)

I was amazed at how much gas in solution there is in an insulin vial.  Shiv posted about this video which solves the problem completely:

http://www.youtube.com/watch?v=OwbelFCNGz4

The last time I did a fresh vial that had been out the fridge for a day, and it fizzed like a coke bottle.


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## shiv (Mar 31, 2011)

Personally I do the opposite to the video - I push air into the vial (whilst it's standing up normally, so you don't push it through the insulin), so when I connect it to the reservoir it pushes the insulin back out into it. Works for me!


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## Unicornz (Mar 31, 2011)

Yeah that's what I've been taught too


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## Ellie Jones (Mar 31, 2011)

I do the same as Shiv, taught to not to push the air through the insulin!

But another thing to check is that the connection is tight as somethimes you can get a bit of leak back via this..

Another trick I do is that when I disconnect my pump for my bath I don't turn it off and leave it running, stops the air being sucked back up the tubing!

But at the moment during the day we face quite a temperature range, as the insulin changes temperature it can release more oxgen from the liquid and not reasorb it


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## Ergates (Apr 1, 2011)

shiv said:


> Personally I do the opposite to the video - I push air into the vial (whilst it's standing up normally, so you don't push it through the insulin), so when I connect it to the reservoir it pushes the insulin back out into it. Works for me!



Oh yeah, I also do that.  All this is for is to replace the volume of insulin you're removing with air so that it's not hard to remove the insulin.  Standard drawing up of syringe practice, I think?

I'm still amazed at just how much gas bubbled out of the insulin in my last vial.  It was literally like a coke bottle being opened, only with not quite as much foam.  If I'd used that without degassing, I'd have had loads of air in my reservoir with a day or so as it came out of solution on its own.  (I don't have any problem with getting rid of all bubbles at the filling stage).

@Ellie, yes, I don't turn my pump off either when I'm in the shower, same reason.


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## Unicornz (Apr 1, 2011)

Ellie Jones said:


> Another trick I do is that when I disconnect my pump for my bath I don't turn it off and leave it running, stops the air being sucked back up the tubing!



I'm sorry this might be a very stupid question but isn't it possible that if you don't turn off your pump you could miss a basal? I usually take quite long baths and I've always suspended my pump because I'm scared it will give a basal when I'm in the bath, am I being stupid?


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## shiv (Apr 1, 2011)

Well, it's not attached to you - so you're missing it anyway! It's only going to drip out the end of the tube when it's not attached. It doesn't really matter if you do or don't suspend it - it's not attached to you so you won't be getting any insulin. If you suspend there's a chance you could forget to restart it.


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## Unicornz (Apr 1, 2011)

Hmm I thought that if you suspend it it won't give you any insulin until you restart it and then there is no chance to miss the basal because you will get it when you restart it. But when you don't suspend it and it gives a basal you will have to wait until the next basal before you get any more insulin? 

If that makes any sense at all  I might be wrong but I though that's how it worked!


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## shiv (Apr 1, 2011)

Lol my brain is now confused!!

When you restart a pump after suspending, it doesn't give you the insulin you've missed during the suspension. Does that make sense? It will just start giving it to you again at whatever rate is due when you restart it.

Basal is flowing continuously - I think a 'shot' of basal is given every few minutes, I really don't know the technicalities behind it, you could ring Medtronic and ask how frequently the waves of basal are sent out. But the chances are you have missed a tiny amount of basal that more than likely won't make much difference to levels (obviously everyone is different, so don't take that as gospel) - if you wanted to, you could work out how much basal you will miss whilst in the bath and give yourself a bolus for that. Personally I don't do that as I don't normally spend more than 30 mins in the bath.


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## Ellie Jones (Apr 1, 2011)

When you disconnect a pump and suspend it, sometimes you get the insulin in the tube either suck slighly back into the resiviour or leak out slightly, creating a air bubble at the beinging of the tubing when reconnect.. 

Keeping the pump running when it's off, means that the insulin is still being pushed through so avoids this...

I don't bolus for my missing basal at bath times, as I found taking my pump of for the length of time for my bath doesn't effect my levels...


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## Lauren (Apr 15, 2011)

Ergates said:


> I was amazed at how much gas in solution there is in an insulin vial.  Shiv posted about this video which solves the problem completely:
> 
> http://www.youtube.com/watch?v=OwbelFCNGz4
> 
> The last time I did a fresh vial that had been out the fridge for a day, and it fizzed like a coke bottle.



Just watched the video, seems like a really good tip!

Just one question, how come the vial doesn't explode or implode without air in it? It seems to defy physics!


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## shiv (Apr 15, 2011)

You're not taking every single last particle of air out of it I guess!

I have heard of people smashing their vials that way though (by sucking too much air of out it). I do the opposite to the video and push air into the vial (but holding it the right way up so it doesn't get pushed through the insulin) and I push enough in so I can feel resistance as I hold it.


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## Lauren (Apr 15, 2011)

I think I will just do it the way my Medtronic rep told me to. I don't want any exploding vials!


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## Ellie Jones (Apr 15, 2011)

Vials don't explode or inplod because of the rubber seal, will give before this will happen!  All what really happens is if you take the air out the rubber will pull back into the bottle until it either breaks the actual rubber or the rubber is torn off the bottle/metal seal!

And if you pump air into the vial the rubber will expand and pop!

When I was first diabetic vials and syringes were the only thing available, I was taught to inject equal amount of air into the  vial as the insulin I was taking out!

This is what I do now when I fill up my cartridges


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## Lauren (Apr 16, 2011)

Ahhh that makes sense


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