# HELP-emergency. Can't use my pump



## Amberzak (Jan 2, 2017)

My back connecting thingy of my pump broke. I couldn't get the cannula off the black thing. I don't think I have a spare. I think I used it. I can get a new one tomorrow, but what do I do tonight? I don't have any background insulin in the house.


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## Pumper_Sue (Jan 2, 2017)

No idea what a back connecting thingy is, but if you can't use your pump and only have quick acting then you will have to use that to get you through until a replacement can be got, or if a hospital near then go to them for background insulin. Mind you hardly worth it for one night.


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## AJLang (Jan 2, 2017)

I'm sorry to hear this Amberzak. Is it possible to still use the same cannula even if it should have been changed today?  If I don't have background insulin my BG levels go up very quickly so Personalky I would contact out of hours for a prescription background insulin and pick it up from the late hours pharmacy. In the meantime I would inject short acting insulin every hour as near as possible to the amount that I would have each hour on my pump for basal, plus obviously Bolus for any food. I would do this because my BG levels go up very quickly without background insulin. You may be able to inject the short acting every two hours to cover basal requirements. Please let us know how you get on.


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## Amberzak (Jan 2, 2017)

I meant black think. I went to change the Canular and everything because it ran out.

So a friend gave me a Lantus pen. I was on levemer before and before that lantus. How much do I take? My friend is on 48 units. I was on 38 units levemer


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## AJLang (Jan 2, 2017)

Amberzak I wouldn't want to suggest a Lantus dose. If it were me I would use the same amount as my current 24 hour basal on the pump I.e. I would add up the basal doeses that I have in a 24 hour period. For me that would be 28 units but I know that my basal dose is quite high.. This would probably lead to higher than than normal BG levels as pump basal is Usualky lower than MDI basal  but should be manageable. However I am not a medical professional, I am not suggesting what you should do this I'm just saying what I would do. Please also remember that you will still have Lantus in your system when going back on the pump so in the morning you must get advice from your DSN about how to manage that,


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## Amberzak (Jan 2, 2017)

Thanks an. That makes sense. 

Yeah. I know when it comes to going back on the pump I'll need to do a temporary basal rate.


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## Pumper_Sue (Jan 2, 2017)

Amberzak said:


> I meant black think. I went to change the Canular and everything because it ran out.
> 
> So a friend gave me a Lantus pen. I was on levemer before and before that lantus. How much do I take? My friend is on 48 units. I was on 38 units levemer


what your friend has done is illegal and very dangerous. I am shocked s/he even thought about giving you their prescription  No one on the forum can or will suggest a dose to you. Please do not take the lantus because if anything goes wrong your friend could end up in jail for manslaughter.


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## HOBIE (Jan 2, 2017)

Just test & use a syringe to give yourself insulin out of the reservoir. Good luck


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## Northerner (Jan 3, 2017)

I hope you have managed OK overnight Amberzak, I know it can be very worrying {{{HUGS}}} For what it's worth, I think I would have probably set my alarm for a couple of times in the night and done some small corrections with novorapid if necessary (making sure not to stack the insulin by making overlapping corrections). Job for today - make sure you have back ups of all your insulin and equipment!


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## Amberzak (Jan 3, 2017)

Background insulin goes off and considering I have had the pump for a year and a half, I don't like to waste background insulin that I'll never need. I'm working this morning so I didn't want to wake up all night. Otherwise I would have done that. I've also been very tired from this tutoring. 

But I'm very sensitive to lack of insulin. Just having the pump unplugged for two hours caused my sugars to go to 17. 

This morning my sugars were perfect. 5.7.


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## AJLang (Jan 3, 2017)

Amberzak well done on waking up with such a great BG level this morning. I've found a link that suggests what to do with regard to Lantus if you need to go back onto injections eg because of pump failure. I think it is similar to what I said that I would do. The information is at the end of the link. 
I do note that it has been written for children in case anyone comments.
http://www.nhslothian.scot.nhs.uk/S...aediatricDiabetesHandbook/n.insulin-pumps.pdf


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## Northerner (Jan 3, 2017)

Amberzak said:


> Background insulin goes off and considering I have had the pump for a year and a half, I don't like to waste background insulin that I'll never need. I'm working this morning so I didn't want to wake up all night. Otherwise I would have done that. I've also been very tired from this tutoring.
> 
> But I'm very sensitive to lack of insulin. Just having the pump unplugged for two hours caused my sugars to go to 17.
> 
> This morning my sugars were perfect. 5.7.


I would still get some lantus for a backup. If you are worried about waste then you could send it to the charity that takes in-date insulin a few months before it is due to expire and get some more for yourself (it usually lasts at least a year in the fridge, but check dates). You should view back up insulin and equipment as part of the expenses of pumping, because it is a necessary safeguard 

Glad you managed OK!


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## Amberzak (Jan 3, 2017)

Northerner said:


> I would still get some lantus for a backup. If you are worried about waste then you could send it to the charity that takes in-date insulin a few months before it is due to expire and get some more for yourself (it usually lasts at least a year in the fridge, but check dates). You should view back up insulin and equipment as part of the expenses of pumping, because it is a necessary safeguard
> 
> Glad you managed OK!




Thanks northerner. True. very true. Thanks for that.


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## Amberzak (Jan 3, 2017)

AJLang said:


> Amberzak well done on waking up with such a great BG level this morning. I've found a link that suggests what to do with regard to Lantus if you need to go back onto injections eg because of pump failure. I think it is similar to what I said that I would do. The information is at the end of the link.
> I do note that it has been written for children in case anyone comments.
> http://www.nhslothian.scot.nhs.uk/S...aediatricDiabetesHandbook/n.insulin-pumps.pdf


Thanks AJ. That's great advice. Thanks. 

Yeah. I was pretty impressed with the sugar levels. I did give myself a small amount of quick acting before I went to bed too as I was high. 

They are slowly rising this morning but I don't mind that when I'm awake.


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## mikeyB (Jan 3, 2017)

The main thing in this sorry tale is the use of somebody else's insulin. Never ever use other people's prescription medicines, _particularly_ insulin. Has it been correctly stored? You have no idea. Is it in date? Odds are, you didn't check. It's a legal nightmare if anything goes wrong - your friend is effectively prescribing a prescription only medication illegally, and would be responsible in law for any problems arising. I understand that this was done with the best intentions, but the road to hell is paved with good intentions.

Furthermore, as AJ said, Lantus lingers for longer than you might think, so when you restart the pump there is a danger of hypos. 

You should always have Levemir and a short acting insulin in the fridge to use in such an emergency, but I'm rather taken with AJ's suggestion of using hourly short acting, with frequent testing. I did that one night away when I'd forgotten to pack my Lantus, and it worked rather nicely.


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## everydayupsanddowns (Jan 3, 2017)

mikeyB said:


> You should always have Levemir and a short acting insulin in the fridge to use in such an emergency, but I'm rather taken with AJ's suggestion of using hourly short acting, with frequent testing. I did that one night away when I'd forgotten to pack my Lantus, and it worked rather nicely.



That's always been my emergency fallback in case of complete pump failure. I take a syringe with me for 'just in case' trips and would draw up from reservior and use that if necessary. When I first switched to pump I covered a small gap in basal with 2-hourly rapid acting doses so I know that works, though would be a bit of a pain longer-term (I would simply average my TDD basal into 2-hour segments as AJLang suggested earlier). I also have a vial of Lantus in the fridge if I needed to be without pump for any longer.  Vials are cheaper than pens, I think, and I just replace it when it runs out of date which it has twice in the whole time I've used a pump.


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## trophywench (Jan 3, 2017)

Have to say, I was always confident that I'd just grab a syringe and use insulin from the pump reservoir - until I discovered that the neck of the Combo pump reservoir was longer than the needles on the syringes!  I just had to scrap that reservoir and draw up from the vial in the fridge.  And as was suggested jabbed a small amount every few hours day and night until the replacement pump arrived.  Bit of a drag, but no really a prob.  Using cartridges in the Insight, again I'd just get a new one out of the fridge if I needed to.

However quite recently my DSN told me off for doing this - ie not bothering with long-acting - despite me saying that the technology of an insulin syringe was a skill both me and my husband had in our repertoire and could both fall back on if we needed it - and instantly gave me a form they use specially for 'emergency' supplies for pump users.  They actually prescribe Flexpens though - one of Novorapid and one of Levemir (which I was on anyway before) plus a box of pen needles - because the Flexpens are now available in singles whereas cartridges for refillable pens, aren't available singly.

I have yet to present it to the GP surgery though - must do that!  LOL  A bit like the Hypostop kit though - they last about 5 years in the fridge.  When they go out of date - I remove the sharp and stick it in my disposal bin after squirting the sterile water down the sink - and take the vial of actual G back to the chemist for drugs disposal.  (they won't have sharps - and it seems silly getting them to get rid of water!)  I fully expect the Flexpens to be the same!


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## HOBIE (Jan 3, 2017)

Panic over ?  Pleased you got sorted


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## Flower (Jan 3, 2017)

I hope things are back to normal for you now Amberzak.

I've used fast acting injections every couple of hours when my pump has needed to be replaced and it has worked ok, it's a bit of a nuisance testing and injecting small amounts through the night but I'd rather do that than revert to long acting insulin.


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## Amberzak (Jan 3, 2017)

I'm genuinely impressed with how well the background worked and how relatively easy it is to go back to the pump. Pump is on me now at a very low rate.


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## Matt Cycle (Jan 3, 2017)

mikeyB said:


> I'm rather taken with AJ's suggestion of using hourly short acting, with frequent testing. I did that one night away when I'd forgotten to pack my Lantus, and it worked rather nicely.



This was explained to me by my fabulous DSN when I went on basal/bolus in 1987 with Actrapid and Ultratard.  She said just that - take hourly or 2 hourly Actrapid with plenty of testing although that was using crummy BM strips.


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## trophywench (Jan 3, 2017)

Many folk nowadays don't even remember Boehringer Manneheim - so why the hell do HCPs still say 'I'm going to do your BM' ?  They never were doing our BM.  They always did our BG, using a strip made by BM !


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## grovesy (Jan 4, 2017)

trophywench said:


> Many folk nowadays don't even remember Boehringer Manneheim - so why the hell do HCPs still say 'I'm going to do your BM' ?  They never were doing our BM.  They always did our BG, using a strip made by BM !


I think it is bit like the Hoover and Biro thing.


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## trophywench (Jan 4, 2017)

grovesy said:


> I think it is bit like the Hoover and Biro thing.



LOL - many folk of course, actually had Hoovers.  However the only actual Biro I've ever seen, was my Dad's !  Good ole Lazlo!


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