Accident with pump.

[Lisaw]

Hello all. I am new to this forum but have read the threads in this section with interest - it is great to read about other people going through the same things as me.

I have been Type1 for 22 years and started on a pump about six weeks ago. It is going OK, but I have found that after an initial period of really good BS I kind of went back a bit and now I am struggling to get my basal levels correct again. I am sure I will get there though.

The reason I am posting is because I have had a slight accident with my pump and wondered if anyone else had any experience of doing similar.

I use the Accu-chek spirit and last week when I was changing the cartridge I got an error E10 - cartridge error. I have had that before and usually taking the cartridge out and reseating it makes it ok. This time though, when I was taking out the full cartridge, the bottom part of it got stuck on the piston and so the whole full lot of insulin fell out into the insides of the actual pump. I cleaned and dried it as best I could, but there were parts I couldn't reach to dry and I could see that there were droplets of insulin inside it. I have been told that insulin crystalises when it dries so you have to be very careful as it can stop the pump functioning properly.

I rang the accu-chek helpline and they were fairly unhelpful, just saying that it might stop it working yes and the only way to find out was wait and see.

Anyway, it worked ok for a couple of days then last night I was in bed when the alarm went off with E4 - occlusion error. The handbook is a bit vague about this but one of the reasons for this alarm is if the piston is not working correctly. I tested at this point and was 14.4 so I changed cartridge and infusion set fully and took a correction bolus. Two hours later I tested again and was 17.6. I took another correction bolus and again two hours later I was still 15.4. Eventually, after about 15 units of correction insulin, I got down to 5.4 but it was after about 10 hours and I can't see how that can be right? An hour before the occlusion error I was 7.4 so it wasn't like it had not been working and I had been running high for ages.

I am panicking now that my pump is broken and I guess my question is, has anyone else experienced anything similar and what was the result? It would happen on the bank holiday of course. I will ring my DSN tomorrow and will test loads in the meantime.

 

[jopar]

Having you changed your battery?

E-10 can occurr when your battery is getting low of power, and not enough power to move the piston road (E-6 mechanical error) also can be caused by lack of power battery..

Battery life is dependant on how much work the pump is doing the more insulin and cartridges changes will deplete the battery quicker than some-one only requiring to change their cartridge every 7-10 days etc..

If insulin (or mostiure) has got into the cartridge/piston compartment, it can't come into contact with motor or eletronic guppings of the pump.. You can with caution clean any mositure or insulin in the cartridge compartment with a lint free cloth, but you do need to take care though.. But before comencing ring accu-chek for further advice..

It may well be, that the insulin that went into the cartridge compartment is cause some stickyness, I would try taking out the cartridge, and shunting the piston forward and backwards, if any tried insulin on the piston thread should fall away, then if try to blow this out or gently tap to tap out the remments..

I would suspect E-4 is a totally separate thing completelty, occulsion errors, can be hard to pin point the actual fault, ranging from presure on the infusion set (I've done this a couple of times with my waistband being over the infusion set) The canular becoming bent, easier done with metal cannulars, more so with the 90 degree angle ones, as these can sometimes catch the underlying muscle and bending.. To a blockage in the tubing...

It take 3 units (if I remember correctly) not being delivered to build enough presure to set the alarm off (which for me is a lot of missed insulin) so BG's can raise about... As to your suggles of getting your BG's back some of this well be due to high IR at hgher BG's... If you are correcting a BG higher than 12/14mmol/ml it is a lot better to use a injection correction bolus then using the pump..

I tend to find that with anything higher than 12mmol/ml that a correction bolus combined with a TBR works a lot better to stablise my BG... I find the TBR sorts out my IR and helps avoids stacking corrections insulin..

You need to remember that with pumps you haven't got any long acting insulin in your system, and the quick acting will be 60% depleted at 2 hours mark so BG's can raise pretty quick and bringing it back to normal is also effected by the time factor of insulin not being delivered, which can effect the correction bolus as you may need to incorparated some of the missed insulin into the correction factor..

It is always unsettling when you get the first error alarms, mine was E-6 menchanical malfucntion, battery needed replacing (went half way through a cartridge change) But contact Accu-chek and ask to speak to the rep for your area if you feel that the customer services isn't settling your concerns..

 

[Lisaw]

Thanks for that. My battery has only just been changed, so I would hope it isn't that but if I get the error again I will change it to be sure. That's a good idea about moving the piston forward and back a few times, that would hopefully clear anything sticky, wouldn't it?

My DSN never said anything about using my pen still if I go high, but it's funny because at 5am when I was absolutely shattered and still high, I did think of doing it. I just wasn't sure if I was supposed to.

Thanks for your help, I am probably panicking unduly but I was scared I had broken it!

 

[DiabetesTom]

Injection based boluses are much more better in my opinion anyways; always works where the pump doesn't.
If your out of the old stuff(if you had fast acting previously) then ask your DSN either U100 Syringes or some prefilled pens. I much prefer pens especially when in public.