Not want a pump? Why?

[tpaz]

hi everyone,

I've been reading a ton online, and from family experience it seems everyone is encouraging me to try out a pump. Cgm isn't covered where I live, but a basic pump would be. I have to admit I'm hesitant. I feel like. I may rip it out, or go into water with it by accident, and I have no idea where I'd put it. I work in an office and wear nice, figure fitting dresses, so no belt loops for me! The idea of being connected to a hose makes me feel weird. Is it weird or do you not notice after a while?

I currently use MDI with pens, but making sure I have them all the time is becoming a chore. I always have to carry a purse, cant just bring a small wallet. Also making sure the pens aren't in the heat or sun, or I'm only out with one pen that jams. Most frustrating is when we're going to a long walk in our neighbourhood, and my husband wants to stop for a meal or an ice cream, and I have to sit there and watch him eat. I can have a bit or two - but sometimes I want the whole cone!

Can some of you share your experiences? What made you switch over? Has anyone had bad experiences on a pump? I should say that my a1c is great. 5.5. Not trying to brag, just stating that MDI is working (although I'm in the honeymoon phase, but probably towards the end).

 

[CapnGrumpy]

What made me want to switch was a frustration with the number of injections I was having on MDI to keep decent control, and starting to feel like a pin cushion. Also, lots of T1s that I know were very positive about them. Third reason, I kind of like knowing how stuff works and wanted to have a play with one.

What worried me was: Having a pump attached to me all the time.
What if it gets wet?
Will I pull the hose off in my sleep and go really high?

I was offered the chance to give one a try for a bit earlier this year and haven't looked back.
Having something attached to me - well, I was already using a CGM, and I actually find my Dexcom more intrusive than a pump cannula.

Getting wet? Some are rated as waterproof, but these things are designed to deal with life's day to day knocks and last at least 3 years, so not a major concern. For showers etc, just unhook it for a bit.

Pulling the hose off? The cannulas stick well and having seen someone unclip their pump, lift it up, and drop it without it becoming detached, this made me happier (I've since repeated this myself).

Stuff I hadn't thought about a the time: Being able to set a temporary basal rate (or suspend completely) for exercise - much less eating to be able to excercise.
Micro bolusing - sitting at 6.5mmol, maybe I'll have 0.2 units and nudge myself down to 6mmol. Can't do that on pens.

For when you wear a dress (slightly outside my personal experience, you understand) many women keep pumps in their bras and bolus using a separate handset that works as a bolus calculator. Bands that go around he thigh are also available, so no one would even know it was there.

 

[Charisma_1630]

I have found since starting the pump I have had to carry more supplies around that I did before. You stated that an issue for you is carrying around the Pens all the time but I just wanted to let you know you still have to do this! I've already had a pod failure and saw my sugars rise quite quickly before having to inject, so in a way it's even more important to carry them around than before when you still had the long acting on board as back up.
As well as pens I now have to carry around insulin vials and spare pods so be prepared to not have that problem solved ;-)

 

[azure]

I often wear dresses, both fitted and loose. I put my pump in a bra bag which clips onto the side of my bra strap and hangs under my arm, or I simply slip the pump in a Tubigrip on my thigh - totally invisible

People talk about 'the hose' but it's just a very thin piece of tubing and I don't even notice it. It tucks into or under my clothes.

My pump gives me freedom and makes me feel normal. The ability to have precise basals according to need is wonderful. I'd never give my pump back!

 

[CapnGrumpy]

People talk about 'the hose'

Yes, sorry, that maybe wasn't the most helpful description. Before trying a pump, that was one of the things that put me off a little - the tubing (along with visions of garotting myself with it in my sleep or it coming off).

Now that I've using one a few months, they really are quite discrete and I wouldn't go back to MDI.

 

[azure]

Yes, sorry, that maybe wasn't the most helpful description. Before trying a pump, that was one of the things that put me off a little - the tubing (along with visions of garotting myself with it in my sleep or it coming off).

Now that I've using one a few months, they really are quite discrete and I wouldn't go back to MDI.

It's a common name @CapnGrumpy But unjustified in my opinion. A tubed pump also has the benefit of being able to move it round according to what you wear/are doing.

 

[Snapsy]

This might sound odd but I like the feel of wearing my pump - it's like a portable hug! The only bit I feel out of the whole set-up of pump, hosepipe* and cannula, is the elastic belt which I wear around my chest, and as I say, I quite like the feel of it. It doesn't interfere with anything I'm doing, and speaking of the hosepipe, recently I've started having it longer and looser which means I'm even less aware of it under my clothing. It's very thin, flexible and strong.

This morning was funny - I'd forgotten I had the pump 'free range' in bed overnight, rather than in my pocket - got out of bed and found it dangling off me when I set off for the bathroom! No harm done to the cannula or the pump, a moment of amusement for the husband.... all well.

@tpaz , I had all of the concerns you listed, and more, when I was considering whether and how I'd cope with a pump. I'm staggered at how very, very much more straightforward it is than I'd imagined. I was really very careful with everything to start with as I was (unnecessarily as it turned out) fearful of pulling the tube and hurting the cannula site, so I got through yards of Micropore taping everything down! Over the course of a couple of weeks my pump and I decided we would be much more comfortable with each other if we just let each other get on with it. And we're an excellent team, me and my pump.

8 months on from my pump start and I am absolutely settled and sorted. In fact I've felt this way about it since the beginning of the year (within 3 months of starting), which isn't long at all.

I have the Insight, and I love it.



*hosepipe is a term of endearment in my own pumping life. It makes me laugh! I do of course mean the tube!

 

[noblehead]

The idea of being connected to a hose makes me feel weird.

There are tubeless pumps, Omnipod is one.

I currently use MDI with pens, but making sure I have them all the time is becoming a chore. I always have to carry a purse, cant just bring a small wallet.

If you move over you still need to carry back-up pens/syringes in case of a pump failure.

Most frustrating is when we're going to a long walk in our neighbourhood, and my husband wants to stop for a meal or an ice cream, and I have to sit there and watch him eat. I can have a bit or two - but sometimes I want the whole cone!

Not sure what your getting at here @tpaz, but even on a pump you have to carb count and bolus for a meal/snack.

I should say that my a1c is great. 5.5. Not trying to brag, just stating that MDI is working (although I'm in the honeymoon phase, but probably towards the end).

If it ain't broken don't fix it, you sound as if your plodding along just nicely. There has to be a clinical need for your consultant to agree to you moving to a pump, either covered by the NICE criteria or the ABCD recommendations, here's some info to read:

http://www.inputdiabetes.org.uk/alt-insulin-pumps/is-it-provided-by-the-nhs/

Good luck.

 

[Snapsy]

Hi again @tpaz ,

Speaking of the HbA1c issue, mine was 44 (new money) this time last year when I was being considered for a pump, and I didn't fit the NICE guidelines.

However, my team at the diabetes centre, having spent a great deal of time with me over several months, agreed that my quality of life was being significantly impacted by my desperately intense - obsessive - level of control over my MDI existence, and as such the ABCD recommendations were taken into consideration. I am so grateful that these additional guidelines were on the table, because the pump was absolutely the right decision for me.

The link that @noblehead has provided gives both sets of criteria for consideration, so that's a really good place to start.

 

[Gemarky]

I've been on a pump for 13 years. The omnipod isn't available everywhere. I have a tube and it's no hassle at all. Although mine are not said to be waterproof I've accidentally swam for about 20 minutes and it's been fine so the odd accident will be fine. I've got the wire caught several times (especially on kitchen cupboard doors) but it's just like pulling a plaster off....no worse. As long as you check how much insulin you have left before you leave the house....which I often forget to do, There's no need to take more than a blood test machine and a spare cannula out with you. Mine takes AA batteries so that's all good too.

As for where to wear it....it's possible to hide it in lots of places and everyone finds their favourite.

None of these compare to the freedom you get......

Hope this helps.

 

[fletchweb]

I've heard both positive and negative comments about pumps from some of my type 1 friends. For the past 10 years health professionals have been trying to sell me on the idea but as my profession is a technologist, gainfully employed because of the frequency that technology fails, I just wouldn't trust the thing on a personal level. As well, I'd feel funny about wearing it while having sex - that may sound funny but ...
As well I'm an avid wilderness outdoors person and feel much better knowing I'm getting the proper dosage when injecting insulin instead of hoping my pump just delivered the right amount. The last thing I need is for the thing to malfunction when I'm hundreds of kilometers away from the nearest town.
My sister who is also a type 1 and was getting the some pressure. She looked in to it further because she was considering it. She decided against it because, according to her, many pumps use Teflon materials and she was worried of the health concerns with long term exposure to such materials. I have no idea if her concerns are valid but she felt quite strongly about that.
I guess you really have to evaluate whether a pump is ideal for the type of lifestyle you lead. If you're HA1C is within an acceptable range and if you manage okay with pens why bother ...

 

[catapillar]

I'm pretty sure @tpaz is based in Canada, so there will be different access requirements to consider.

Like you @tpaz i was pretty turned off by the idea of a pump. It just sort of turned my stomach the idea of the tubing or having something stuck to me all the time. But I decided that the benefits of a pump and a wider range of diabetic management tools from the pump far outweighed what I had decided was my own irrational antipathy towards the idea.

I've been on the omnipod for 3 weeks now and there's no way I'd go back to MDI.

On the superficial stuff, omnipod is tubeless so there's no issue with that, the pod itself is very slim and easily hidden, comfortable forgotten about. I've definitely worn it under body con dresses and it's not an issue at all.

On the more important stuff (and for the record, I don't think that other stuff, of wanting to be able to wear a dress isn't important, that's a big huge part of the reason I chose an omnipod over other pumps) I think I have more diabetic gubbins to cart round with me now I have a pump, back up pump stuff and back up pens. I still have to bolus for eating an impromptu ice cream! But I do think that has been made much easier - I just have to get the hand set out to bolus, I don't have screw a needle on do an air shot, expose a bit of skin (which can be a challenge in a dress if you want a quick absorption tummy shot) stick a needle in. I just test and press buttons on the hand set. It's much less of an obtrusive interference now.

I definitely do feel like my insulin can now be made to be much more flexible and adaptable to what I want to be doing. That's the best bit of the pump for me.

I only have good things to say about it. But equally, I think had I done it earlier when I wasn't actively desiring a pump I might have found it more difficult - it is a big change, there are adaptions to be made and a lot to learn. So, if MDI is working and you aren't especially keen on a pump, there's no obligation to get one. There's a lot to be said for if it ain't broke don't fix it.

 

[tpaz]

I still have to bolus for eating an impromptu ice cream!

@catapillar and @noblehead sorry to confuse, of course I would still bolus for treats! I just meant that it would be nice not to have to decide whether or not I want to bring a pen on me all the time, as a pump would always be on me

 

[tpaz]

Thanks everyone for your input! I really appreciate it