# Pump advice needed!



## Catharine (Apr 24, 2012)

Hey everyone, 
It was mentioned to me a while ago about perhaps being put on a pump. At the time I thought hell no that sounds awful. I kinda still think that, but am now starting to think health wise it could be what I need.. 
How do you all find it?
I have concerns about things like going swimming, wearing a nice dress, exercise, my daughter jumping all over me (it), and sex. Does it not get totally in the way?
And also the cannula? Is it much like doing an injection? I'm not great with needles!! 
Sorry for all the questions and sounding so negative but I really would like to hear some actuall real life opinions rather than those of a professional who has never used one! 
Thank you in advance for your help  xx


----------



## everydayupsanddowns (Apr 24, 2012)

Hi Catharine

You are not alone in worrying about pumping would be like. I was pump-averse for many years before deciging I had to give it a go to see if it would work for me. 

My experience is that it took some getting used to wearing something 24/7 (around 6 months for me - around 6 days for other people).

Most of the concerns I had about attachment evaporated very quickly and the convenience, precision and extra options of doses/basals were *amazing* even in the early days. It takes some effort to get it set up right, and 'set up right' is always a bit of a work in progress - isn't everything with D?!

It's not a perfect system, and D is still a right royal pain some days but with Artoo it at least seems possible to keep a tight rein on BG levels without inevitably suffering way too many hypos.

In the first 6 months compared to untethered MDI of a few years ago:
Total no hypos down by 50%
Nastier hypos (less than 3) down 75%
Nastier highs (over 13) down 90%
Average BG almost the *same* (but no longer the result of wildly swinging BGs)

Wrote this after 2 months http://www.everydayupsanddowns.co.uk/2012/01/pumping-for-two-months-little-bit-of.html

Now 6 months in attachment is no problem *at all* (if Artoo would ever be, ahem, in the way I just disconnect). In fact these days I really *like* the convenience of having insulin on hand all day every day available at the push of a button.


----------



## RuthieG (Apr 24, 2012)

Hi

I was a bit anti-pump beforehand too as I was well controlled and it sounded to weird and too strange being attached to something all the time.

Anyway at 3 months pregnant I took the plunge and I pretty much like it, but there are downs to it too. 

In terms of getting used to being attached and things like sex, excercise and things jumping all over you (you - kids, me - dog (until Aug!!)) it is fine. You can detach it easily (very easily) so that only the cannula is left. I have had a shower, bath, played netball etc etc all with just the cannula on and by being detached for that time (an hour max) my bloods have been fine. I got used t it loads quicker than I thought I would.

It is weird being attached to a tube all the time and you feel a bit 'medical' whihc I never had when using pens, but nobody can see it really. You have to trial and error where best to clip it, but I for one keep it attached to the middle of my bra and it is easy - it felt too exposed on the belt loop.

Babysaurus on here hasn't found it as positive so it might be worth seeoking out her posts to see what the downsides are a bit more clearly. 

I am getting my first post-pump HbA1c results today....!


----------



## Catharine (Apr 24, 2012)

Thank you!! That's really useful. I'm a little less scared of it now... 
And I'm glad it's working so well for you. 
The more I think about it the more I'm starting to think I should go for it. 
Do you find other people have an opinion about it? 
x



everydayupsanddowns said:


> Hi Catharine
> 
> You are not alone in worrying about pumping would be like. I was pump-averse for many years before deciging I had to give it a go to see if it would work for me.
> 
> ...


----------



## everydayupsanddowns (Apr 24, 2012)

RuthieG said:


> I am getting my first post-pump HbA1c results today....!



Good luck Ruthie! Hope it's a good one. Mine went up slightly in the first 3 months (not unusual apparently) what with all the basic setting up amnd testing of ratios etc.


----------



## everydayupsanddowns (Apr 24, 2012)

Catharine said:


> Thank you!! That's really useful. I'm a little less scared of it now...
> And I'm glad it's working so well for you.
> The more I think about it the more I'm starting to think I should go for it.
> Do you find other people have an opinion about it?
> x



In the end I just decided that no matter *what* I did on MDI (and my control just before starting on the pump was pretty good with an A1c of 6.3) I still had problems that needed fixing. And no matter what I did on MDI I still wouldn;t know how much better (or not) it would be for me on a pump without trying it.

I figured that if I didn't like it I could always give it back (sounds terrible with all the people struggling to get a pump for years).

At this point I'm converted, though it's not all marvellousness all the time obviously.


----------



## HOBIE (Apr 24, 2012)

Hi, I would NOT like to go back to 4 injections a day.  Push a couple of buttons & then eat. At first few weeks it needs to be set up for you.   I am off to a medtronic meeting tonight with about 50 others in Durham. Lots of support from them.  My thoughts "if you get chance ! have a go"     Good luck


----------



## Catharine (Apr 24, 2012)

Hiya, 
Thanks for the reply!
So is an hour the max you can leave it unattached for?
Does it not show having it attached to your bra? Having a lump show through my clothig is one thing that seems a bit offputting... 
It's really interesting hearing how everyone else copes with it. 
Good luck with the HbA1C today!! xx




RuthieG said:


> Hi
> 
> I was a bit anti-pump beforehand too as I was well controlled and it sounded to weird and too strange being attached to something all the time.
> 
> ...


----------



## Catharine (Apr 24, 2012)

That's btril, thank you! 



HOBIE said:


> Hi, I would NOT like to go back to 4 injections a day.  Push a couple of buttons & then eat. At first few weeks it needs to be set up for you.   I am off to a medtronic meeting tonight with about 50 others in Durham. Lots of support from them.  My thoughts "if you get chance ! have a go"     Good luck


----------



## Catharine (Apr 24, 2012)

I must admit I was thinking if I try it and really can't stand it I could give it back!
My control isn't good as I'm getting the early morning rising high readings so I think it would help that. 
I can imagine it isn't marvellousness (excellent word)! all the time, but then I guess it never will be with the nature of it all!!
x



everydayupsanddowns said:


> In the end I just decided that no matter *what* I did on MDI (and my control just before starting on the pump was pretty good with an A1c of 6.3) I still had problems that needed fixing. And no matter what I did on MDI I still wouldn;t know how much better (or not) it would be for me on a pump without trying it.
> 
> I figured that if I didn't like it I could always give it back (sounds terrible with all the people struggling to get a pump for years).
> 
> At this point I'm converted, though it's not all marvellousness all the time obviously.


----------



## RuthieG (Apr 24, 2012)

Nobody has every commented on it (unless I have myself) and it is 'nestled' in the centre so doesn't stick out. There are lots of options for where it can go so you can just try a few and see which you prefer. I think you concerns are the same as mine were but I have found it much easier to get used to than I thought I would. It is worth a try or at least an ask about it. 

I don't know if an hour is absolute 'max' but that was what the nurse mentioned and it seems sensible. If it got to 1hr and a bit though I don't think you need panic. 

Also I am still learning all the wonderful things it does. At the first set up meeting the nurse just gave me the basics and then she has shown me new features on it as time has gone on. This has been a good way to do it then I wasn't overwhelmed.

It is so much more precise than needles. you can split your basal down to 0.025 of a unit per hour and you can change this for every hour of the day if you need. This, to me, makes it so easy to tweak. So for instance I have a certain amount midnight-0300, another 0300-1030, another 1030-1300, another 1300-1800 and another 1800-midnight. When you think about it this makes so much more sense than one hit of basal (lantus or whatever) once or twice a day. 

Regarding my result today I think it may well have gone up a little since I got the pump because my hypos (which were far too frequent in pregnancy) have really gone down in frequency. I was at 5.3% last time and I will be quite happy if it stays under 6%. I will let you know what difference the pump has made to this.

It isn't scary to attach the cannula - well actually it is really scary at first - but when you think about it once every 2-3 days is better than 4+ times a day injecting.

Maybe ask the nurses and then see what you think. As my nurse said, if you don't like it you can always give it back. You aren't committing to it for life (although you may well want to keep it of course!!)

Ruthie


----------



## trophywench (Apr 24, 2012)

Well I'm sitting here at the desk typing with the pump in my trousers pocket and a fitted t-shirt on, the bottom of which covers up the bit of tubing that appears from down my trousers and disappears into my pocket.

I wear nowt in bed and the pump just roams.  I have a 'skin' on it so there are no hard edges and it's constantly warm to the touch.  I place it to the front of me whatever side I lie on and if it isn't where I left it in the moring I just feel along the tube.  For nocturnal gymastics, TBH we aren't all that gymnastic these days so I just stick it whichever side of me that my husband isn't.  If we were gymnastic, I'd remove it.  TBH I don't turn it off when I have a shower etc, I stand it on my bedside table with the end of the tubing draped over the shade, so it can drip (if it does, never found a puddle though) down through the hole in the top of the shade.  No air gets in the tube, so I can just re-attach it when I'm ready to do so.  (Of course, the lamp is turned off when I do this)

In a bikini, I have a holder for it on a nice comfy lanyard round my neck.  If I go for a swim, I remove it and leave it covered up under the umbrella.  Same as my meter is and my pen would have been, left, pre pump.

If you suddenly decide to do something like go for a walk or mow the lawn, you can turn it down or completely off, instead of having to think 'I am mowing the lawn today so I need to have less insulin/eat more' - well you still might need to eat more but once you've had long-acting insulin you can't turn that off, can you?  Same if I go hypo, no you can't stop boluses you've had, but you can stop it keep getting worse by the let's turn it off for a bit method.

And of course as you say - you can do quite a lot about those nocturnal hypo/hypers you can't really complately flatten out with MDI.

I was given one on a dry run for a week - attached to a cannula pumping nothing - before I was asked if I did want to go for it or not.  I got used to it being there 24 hrs a day after 3 days.  And you use so much less insulin.  That bit was a real surprise, even though everyone tells you that beforehand.

I have to change my cannula every 2 days - being diabetic for so long, the sites usually go off rapidly after 48 hrs so I have to do it or just wreck even more of my skin.  My canns have an inserter, and it looks (and sounds) a bit clunky but you can't see the needle going in and I find that actually a very positive advantage.  So I found out after 38 years a diabetic - that I am really a bit needle-phobic !!!  Never realised that before either.

Oh - and from the mid 7's to low 8's - my A1c has gone down just every so slightly LOL - first on the pump was 6.5 and the last one was 6.4.


----------



## RuthieG (Apr 25, 2012)

I agree with all above. I never turn mine off when detaching it for a shower etc and have never noticed a puddle.

And what Trophy said about using less insulin is definitely true. I don't know how it manages this but it does!


----------



## everydayupsanddowns (Apr 25, 2012)

You need to add you new (astonishing) A1c to your sig Ruthie.


----------



## RuthieG (Apr 25, 2012)

Oh yes - I will 

Ruthie 
4.8%!!!!!


----------



## Catharine (Apr 25, 2012)

RuthieG said:


> Oh yes - I will
> 
> Ruthie
> 4.8%!!!!!



Awesome well done  x


----------



## Ellie Jones (Apr 25, 2012)

Well most of the questions have been answered concerning night times etc.. So won't go over them again..

I don't have children (my first grandchild isn't due until end of september) but I do have dogs, and also worked with dogs...  My dogs are well mannered as in, four paws are kept on the ground!  But alas when I worked with dogs these weren't always well mannered but the pump survived well indeed..

Getting banged against Kennels doors on my way in and out of runs, Dogs jumping up at me, knocking it flying, Paws being caught on tubing, all the times it happen I think only once my cannula was pulled out, several stretched tubing though

So I reckon kids aren't going to cause to much of a problem!


----------



## NatB (Apr 25, 2012)

*Pumping*

Hi There sorry I haven't posted but been at work. 
I have been on the pump since Jan 2010 and although I am still up and down I would not go back to the five injections a day that I use to be on. 
I workout three times a week and swim every week with my children. I had my pump out for 1 and a half hours last Sunday and my levels only raised slightly abit later on. 
I understand about wearing the pump all the time but I really do forget 
 it's there. Wearing a dress isn't a problem as you can buy a pouch which clips onto your bra and you can't see it's as it fits snugly under your arm. You can buy the pouches in black and White. 
There are different cannulas you can try and one even comes with a little machine to put them in,however they are very small and easy to put in.
Good luck whatever you decide to do.


----------



## Catharine (Apr 26, 2012)

Hello everyone,
Thank you so much for all of your comments. 
I have been digesting them all!! 
I'm quite keen on the idea of the pump although having spoken to my diabetic nurse at the surgery she didn't seem as keen as where we live it means I have to be seen at the 'local' hospital which isn't very close and the people there are hard to get hold of if you have provblems... 
So... we have swapped Lantus (which I've been convinced for ages does nothing for me) to Levemir to see if that is any better.
Fingers crossed it does me some good! If it doesn't, I may have to move nearer a better hospital hehe.
Thanks again everyone!! xx


----------



## trophywench (Apr 26, 2012)

Catharine

Please tell me you are on twice-a-day Levemir?


----------



## Catharine (Apr 26, 2012)

trophywench said:


> Catharine
> 
> Please tell me you are on twice-a-day Levemir?



Erm... no?


----------



## Ellie Jones (Apr 26, 2012)

You can always do what I do..

My care is arranged as thus...

I'm under my pump clinic, who I see every 12-14 months one appointment 30 minutes long with my consultant and pump nurse at the same time..

My DSN at my doctor surgery does all the blood's and overseeing between main appointments..

I do feel that I need to expand, as writing my care it sounds as I'm being neglected...  The above is my choice but there's reasons for it though..

For the hospital

I instigated this, I haven't needed their input, and feel that I'm taking up valuable time which could be better spent helping diabetics who were struggling...  So I have a kinda of open appointment if I feel that I need to see my consultant or pump nurse, I can phone at any time to get an appointment/be seen...

My Surgery DSN

Well I've known her for a long time, and when I started my 4 year battle for my pump, she was supportive and helpful starting the ball rolling for me, even though she did explain pumps in my area is as rare as hen's teeth! And I really didn't want to cut her out of my care...  So she does the reviews between hospital appointments.. 

This works well for me...


----------



## everydayupsanddowns (Apr 26, 2012)

Catharine said:


> Erm... no?



Levemir's duration is often shorter than 24 hours (so is Lantus for that matter!).

16-20 hours is not uncommon on Levemir. This is a *good* thing though because if you take it in 2 doses approx 12 hours apart (to begin with while you see how it works) it will gove you the option of having two flattish basal rates.

So if you need less overnight and more during the day, you can do that. Or if you suffer from Dawn Phenomenon you can adjust doses to have more active overnight to counteract it.

It takes a bit of a while to adjust your basal to get it as good as you can, but the investment is SO worthwhile because if your basal is out, even by a smallish amount, your mealtime doses and corrections can really play up.

This method of testing and adjusting basal is well worth a read: http://www.diabetes-support.org.uk/info/?page_id=120


----------

