New omnipod but slight pain

carak1987

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Hay guys.

Well I had my omnipod training and left with my fitted omnipod yesterday. Now I'm thinking this is just because it's new and I'm. Not used to it and it's on site that I've never even injected.
I have placed it on the inside.but back of my arm. More for comfort whilst sleeping purpose. Now it is comfortable and mainly doesn't hurt but if I press it, it feels bruised or if I move my arm funny it feels bruised. Is this normal? This has only been my concern so far. I'm just wondering if it's because it's on a totally new site so it's a little delicate. The actually cannula stung when it went in for about 5 mins. But it is just a little above my scar from my contraception implant (which is removed) so I'm wondering also if it could be inner scaring from that. Any advice would be great. Tia
 

himtoo

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hi there @carak1987
hopefully others will come along with their experience

Mine is that when i press against some of my pod placings they do feel tender , other no tenderness at all.
pod today.jpg


here is my pod just now and there is a little bit of redness right at the cannula

hopefully your DSN told you that if either your bloods really misbehave ( like high teens) for a few hours and pump corrections don't work
then you can always do a pen correction and get the pod changed early ( i panicked and didn't do this the first time it happened to me)
but i have been reassured by my DSN it is just like for people on tubed pumps -- they can get a bad set site and will need to change earlier than normal.

ours are fixed at 72 hours max -- but can be changed early if things not right
 

carak1987

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hi there @carak1987
hopefully others will come along with their experience

Mine is that when i press against some of my pod placings they do feel tender , other no tenderness at all.View attachment 20078

here is my pod just now and there is a little bit of redness right at the cannula

hopefully your DSN told you that if either your bloods really misbehave ( like high teens) for a few hours and pump corrections don't work
then you can always do a pen correction and get the pod changed early ( i panicked and didn't do this the first time it happened to me)
but i have been reassured by my DSN it is just like for people on tubed pumps -- they can get a bad set site and will need to change earlier than normal.

ours are fixed at 72 hours max -- but can be changed early if things not right



Thank you for your reply. My bms have been quite normal all day bar my newest one which is 12.9mmols. But I ate my sons dinner and had 2 chocolate digestives. And had a small bolus of insulin. So I'm assuming not enough insulin. Also I didn't extend it which I have done since getting the pump and it seems to help keep them down. I don't know whether to change it early although I'm am changing it tomorrow at 4pm per request of the omnipod lady as she said apparently it's better to change before Tea instead if dinner time Monday. I suppose it's alot of trial and error. I'll see how it is when I change it tomorrow onto the other arm. If it's. The same I don't know what to do. Lol
 
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noblehead

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The actually cannula stung when it went in for about 5 mins.

It can sting when the cannula is inserted and feel sore for a while after, but unless the pain is really bad and uncomfrotable and your bg levels are high (which you say they are not) I wouldn't change it.................but it's entirely up to you.

btw, it helps if you change your pods as early as possible in the day, I change mine in the morning as it gives you time to take action if there's a issue with the pod/infusion site.
 

carak1987

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It can sting when the cannula is inserted and feel sore for a while after, but unless the pain is really bad and uncomfrotable and your bg levels are high (which you say they are not) I wouldn't change it.................but it's entirely up to you.

btw, it helps if you change your pods as early as possible in the day, I change mine in the morning as it gives you time to take action if there's a issue with the pod/infusion site.


Ah ok. The lady on the eduction course said it's better to change at tea time ha but I suppose you guys who wear them etc and use them know more how they work etc
 
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carak1987

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Am I right in thinking the insulin on board is what is still working in my system? Like my expert meter had active insulin! As I have just received checked my blood sugar and is 13.8mmols my iob is 9.4 units so I don't wanna do a correction if I still have the insulin in my system. I had an extended bolus on my last meal which has just finished
 
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catapillar

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Yep @carak1987 the IOB is the active insulin from your last bolus. It should trickle down from the end of the extended bolus to the end of whatever you have set for your insulin duration period.
 
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carak1987

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Yep @carak1987 the IOB is the active insulin from your last bolus. It should trickle down from the end of the extended bolus to the end of whatever you have set for your insulin duration period.


Thank you. Sorry! I'm getting slightly confused with the new jargon and the ways it works. I came out understanding it and now it's just trickling out my mind ha ha
 
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catapillar

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Thank you. Sorry! I'm getting slightly confused with the new jargon and the ways it works. I came out understanding it and now it's just trickling out my mind ha ha

Don't be sorry! That feeling sounds ever so familiar :)

So, I looked up how it works, cos I wasn't sure but: If you take your blood sugar and you are 14 but have 5units IOB and you tell the PDM you arent eating it will suggest a correction bolus with the aim of bringing you back to your target blood sugar using your correction factor (so let's pretend it does that calculation and decides you need 8 units to get back to target blood sugar) the PDM will take off any IOB from a suggested correction (so it will do correction of 8 needed, less the 5 IOB and suggest you do a bolus of 3).

With the omnipod IOB is subtracted from the bolus suggestion for any correction bolus. So you don't need to worry about IOB for correcting. But obviously, still check that the correction the PDM is recommending actually looks sensible and safe to you!

But, if you are doing a new carb bolus (so you've eaten dinner and you have IOB and then you decide you want a pudding) it doesn't subtract the IOB from that new carb bolus - you will have to do that little bit of maths and maybe think about reducing the bolus.
 
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carak1987

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Don't be sorry! That feeling sounds ever so familiar :)

So, I looked up how it works, cos I wasn't sure but: If you take your blood sugar and you are 14 but have 5units IOB and you tell the PDM you arent eating it will suggest a correction bolus with the aim of bringing you back to your target blood sugar using your correction factor (so let's pretend it does that calculation and decides you need 8 units to get back to target blood sugar) the PDM will take off any IOB from a suggested correction (so it will do correction of 8 needed, less the 5 IOB and suggest you do a bolus of 3).

With the omnipod IOB is subtracted from the bolus suggestion for any correction bolus. So you don't need to worry about IOB for correcting. But obviously, still check that the correction the PDM is recommending actually looks sensible and safe to you!

But, if you are doing a new carb bolus (so you've eaten dinner and you have IOB and then you decide you want a pudding) it doesn't subtract the IOB from that new carb bolus - you will have to do that little bit of maths and maybe think about reducing the bolus.


Yeah well I rechecked and it was 14.6 so I did the bolus correction and it wanted to give me 0.55 units so I changed it to 2 units. My bms are quite hard to bring down and takes a little more insulin to do it. But I'm only on day 2 so I'm not worrying. My Dsn will help me out when she rings me Monday. They been pretty much brill till I ate my dinner at 13:30 and messed it up by eating more that what I put insulin in for lol
 
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catapillar

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But, if you are doing a new carb bolus (so you've eaten dinner and you have IOB and then you decide you want a pudding) it doesn't subtract the IOB from that new carb bolus - you will have to do that little bit of maths and maybe think about reducing the bolus.

Ps. Thanks @carak1987 for prompting me to look this up because that last bit totally explains what I've been doing wrong! :)

Yeah well I rechecked and it was 14.6 so I did the bolus correction and it wanted to give me 0.55 units so I changed it to 2 units. My bms are quite hard to bring down and takes a little more insulin to do it. But I'm only on day 2 so I'm not worrying. My Dsn will help me out when she rings me Monday. They been pretty much brill till I ate my dinner at 13:30 and messed it up by eating more that what I put insulin in for lol

Just be aware that you might be a little bit more responsive to insulin on a pump (it's something to do with pooling of insulin I think - so my total daily dose has gone from ~30 on MDI to ~20 on a pump and that's the only change, I've not changed food or activity). So if you've given yourself a much bigger correction than it wanted to you might want to set an alarm to check in a few hours that it isn't dropping you more than you wanted. And, if your adjusted correction works perfectly, you might want to have a chat with the DSN about changing the settings for your correction factor on the PDM.
 
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carak1987

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Ps. Thanks @carak1987 for prompting me to look this up because that last bit totally explains what I've been doing wrong! :)



Just be aware that you might be a little bit more responsive to insulin on a pump (it's something to do with pooling of insulin I think - so my total daily dose has gone from ~30 on MDI to ~20 on a pump and that's the only change, I've not changed food or activity). So if you've given yourself a much bigger correction than it wanted to you might want to set an alarm to check in a few hours that it isn't dropping you more than you wanted. And, if your adjusted correction works perfectly, you might want to have a chat with the DSN about changing the settings for your correction factor on the PDM.



Yeah, they said that it will probably want changing. They are also going to look at setting different basal programs too as I work nights and 12 hour shifts on a busy hospital ward. So it's just waiting to see what they say. You have been very helpful thankyou so much
 
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himtoo

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Yeah, they said that it will probably want changing. They are also going to look at setting different basal programs too as I work nights and 12 hour shifts on a busy hospital ward. So it's just waiting to see what they say. You have been very helpful thankyou so much
aahh !! that is a really bit of important info-- they did explain you can set different basal patterns for different scenarios I hope.

when you start on a pump your DSN takes all relevant info from and about you to set initial basal rates -- your BG's will be a bit different / potentially all over the place as you adjust to your new regime.

this is the point not to panic --- cuz it will take time to get all of the settings on the pump to suit you --

agree with the other people on omnipod -- my DSN said always try to aim for morning changes cuz it gives you more time to sort issues if there are any during waking hours -- but if your normal pattern is working nights -- tea time may be better for you !!
 

carak1987

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aahh !! that is a really bit of important info-- they did explain you can set different basal patterns for different scenarios I hope.

when you start on a pump your DSN takes all relevant info from and about you to set initial basal rates -- your BG's will be a bit different / potentially all over the place as you adjust to your new regime.

this is the point not to panic --- cuz it will take time to get all of the settings on the pump to suit you --

agree with the other people on omnipod -- my DSN said always try to aim for morning changes cuz it gives you more time to sort issues if there are any during waking hours -- but if your normal pattern is working nights -- tea time may be better for you !!


Yeah I see alot of my Dsn's as I work on a diabetes ward so they keep a good eye on me anyway. So I will be sitting down to work it with them and get I right. Yeah, I do panic alot but I've chilled myself as I understand this is going to take some time and it's not an overnight thing. Yeah I'm not sure as when I work nights I don't want to be putting a pod on after a 12 hour shift and I go to sleep between 8-9.am so I think tea time should be better for me. I'll either be at work or getting ready to go work. I dunno what's best now ha ha I thought that if something goes wrong with the pump you just take off and start again with a new one. Then the suppliers will replace it when you ring for new supply.
 
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himtoo

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obviously your DSN had you in mind suggesting tea time -- other peeps were making suggestions based on what they had been told ( like me )
but working nights means your mornings are about 3pm ( i think )

i have been wearing mine for 10 months and only had to change early about 4 times so far
so about once every 2.5 months -- everything is normally totally smooth

it is just an extra layer of vigilance with BG's and taking decisive action rather than ignoring.
 
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himtoo

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OMG -- you work on a diabetic ward --- you are a superhero( ess) !!!!!!!!!!!!!:):):)
 
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carak1987

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obviously your DSN had you in mind suggesting tea time -- other peeps were making suggestions based on what they had been told ( like me )
but working nights means your mornings are about 3pm ( i think )

i have been wearing mine for 10 months and only had to change early about 4 times so far
so about once every 2.5 months -- everything is normally totally smooth

it is just an extra layer of vigilance with BG's and taking decisive action rather than ignoring.


I'll figure it out. I'll speak to them again Monday I think so we will see what they say. Think I'll stick with 4pm for now. I'm just happy not to be injecting. It feels awesome. I really hate injecting. Makes me depressed ha ha
 
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himtoo

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yeah 4pm would seem to be your equivalent to my 8am - if that makes sense

it felt really weird not injecting the first few days -- like I was forgetting or ignoring

and it still comes across me like a wave at some points cuz I don't have to do it anymore
 

noblehead

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Ah ok. The lady on the eduction course said it's better to change at tea time ha but I suppose you guys who wear them etc and use them know more how they work etc

By changing it earlier in the day it just gives you more time to rectify a problem and bring bg levels down before bedtime, nothing worse than taking correction doses for high bg levels and your frightened to go to sleep in case there's further issues or you end up hypo.

Regards to IOB, the Omnipod Pump only deducts it if you test your bg levels (or enter it manually) and your back into your bg target range, if you don't test or enter a bg value when bolusing it won't take into account IOB.