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Another problem with my pump...any advice?

F

Fryertown2012

Member
Messages
22
Location
Solihull
Type of diabetes
Type 1
Treatment type
Pump
I have the Spirit Combo Pump and I am having issues when disconnecting and then reconnecting the pump. I follow the guidance provided in the manual and when showering or swimming I disconnect, put into stop mode & place the protective cap on the infusion set which is still attached to my body.

When I come to reconnect I remove the cap, bolus 2 units through the pump to check the insulin is coming through onto the back of my hand and then reconnect. However I keep finding huge air bubbles in the infusion set after performing this & therefore having to disconnect & put a new infusion set on.

Does anyone have a similar problem or do you know....
- Am I following the correct procedure?
- Should I be using a brand new protective cap each time - even though they don't supply you with that many?
- When bolusing before reconnecting, what is the correct way of doing this? I have been taking the pump out of stop mode and using bolus advice function as if I am having 15 carbs or should I be using the infusion set priming function?

Im really worried about it as I shower before bed & I know the advice is not to change your cannula before bed but I have no option when this happens & due to my lifestyle I do not have any other option therefore any advice would be greatly appreciated.

Thank you in advance.
 
I'm not sure if the Spirit Combo works in a similar way, but I use the Animas Vibe and when I'm having a shower I just disconnect and put it in a plastic bag. For me, that's very effective in preventing issues with air bubbles being sucked back up the tubing.
 
You don't need to use them caps as the cannula is self sealing anyway and you don't need to change your infusion set you need to prime it and tap it on base of your hand or what I do tap it on something firm like a table until the bubbles have gone mine usually take about 25 units to prime also check if you have screwed the tubing on tight
 
Hi

The only time to put pump in Stop mode for swimming, showering etc would be if you were disconnecting for 3hrs or so esp if the hourly basal rate is less than 1u per hour. Theres really no need tbh so leave the pump in run mode as only a tiny drop of insulin will come out the set needle whilst the tube is dangling loose. If you do want to prime some insulin through the tube to get rid of air bubbles, use the Prime function and not the bolus sdvice as the pump will think the bolus will be a correction when its not and its also not given to cover carb.
 
As others here, I never use stop mode for showers etc, if you leave it running it effectively keeps it primed.
I am careful when changing the full set with priming + tapping on palm very carefully, and as iHs says, do not use bolus to prime, because that affects the calculations for later boluses.
 
Thank you for all your replies!

In terms of the air bubble it is in the infusion set (so the cannula half attached to me) so I cant prime it and tap, I have to remove and put a new one on which is why I thought it might have been caused by the cap. When I normally change the pump set or cannula I do use the infusion set priming mode but wasn't sure when just checking the one half of the infusion set.

So it seems I don't need to put the pump in stop mode for shower so I wont do that going forward!

Ihs & mojo - Do you put the cap on when showering?

Any tips when taking it off for an hour or so to go swimming? I am really anxious about disconnecting now....

I have contacted Accu Chek but still waiting for a response...

Thank you!
 
I only put a cap on when in bath and come in filthy from my job.

There are a lot of bubbles on the first initial join up when putting the connectors together. If you get these out any disconnections and tejoining will be minimal with bubbles.

If you hold the short cannula tubing in one hand and gently tap the connector whilst doing your initial primes for new sets then you will see a huge amount of bubbles that come through. Keep tapping the connector whilst priming until no more bubbles come through.

Then when you detach and reattach after that you will not be able to tap the connectors but there will be minimal problems.

This is not mentioned in their manuals, although I have previously told accuchek that they should put something in to their training details. The joining of the connectors on any priming need the connectors to be tapped lightly continuously to get rid of airbubbles. This should minimise bubbles when you detach and reattach.


Loving life
 
Hi again

I take it that you are using the Rapid D set. When I used it, I didnt bother to look for any bubbles in the tubing when I disconnected from the dangly bit. I jist left the pump on my bedrooom pillow on top of my underwear and just let the tube dangle over the side of the bed and didnt worry. When in tbe shower, I used one of those blue rubber blanking covers over the connector bit as I didnt like to chance getting a load of shower soap in the swivel connector. I always use a blanking cover over all my sets even though its not always necessary. Some peeps worry about air bubbles and some dont.... Have a go at not doing anything and then see if yr bg levels change or stay the same... Insulin pump tubes are a tube inside a tube which is incredible to see.
 
There is always suck back in the long tubing from pump even if you leave it running. I always leave mine running but always have to prime the suck back air out before reconnecting, because the initial connection air bubbles have been primed out when 1st priming the reconnecting gives less issues...


Loving life
 
Cant say DD that Ive ever seen this problem myself but I think a lot of the trouble is down to how peeps fill up cartridges from the vial and getting rid of any bubble before the cartridge is put in the pump. The fatter the csrtridge is, the harder it becomes in getting rid of any air bubble. Tapping the pump is not going to do it as all thst does is create more bubbles. What does work is flicking the cartridge with a thumb nail and lining the bubble up under the neck and then pushing the bubble up the neck using the blue plunger and catch the bubble in a piece of tissue paper and then push on new tube already screwed in to the black tube adaptor and then load it in the pump and prime. The other way is to push the bubble up the neck using the plunger but attach the tube so that the prime iis partly done manually and not so much the pump. Bolus insulin is very expensive so every drop counts so there should be little insulin left in the cartridge when removing to re fill again (40 or even 20u is way too much to waste)
 
Sorry, but the cartridge bubbles has nothing to do with the air that becomes trapped in the connectors on initial joining. As soon as you get insulin to the connectors and flick them you will be surprised at the qty of air bubbles that will come through. I am lucky that my little cannula tube is always between skin and knickers as my sets are in my bum, so it doesn't move around.
It has nothing to do with cartridge bubbles at all.

I have also had 2 inner needles in the connectors that have actually bent and not joined together in the past 3 months. Now after 4 years using these connectors and no troubles, then the problem isn't me.





Loving life
 
So for me, I follow the instructions for accuchek combo... obsessively when filling the cartridge, first I warm for 1hour out of the fridge (I think less air is soluble in the liquid after it warms) then, yes some cartridge finger nail flicking before connection and pushing the blue plunger up to remove air(push air back into the phial). Then very carefully connect, and after putting into pump, and starting the prime, I tap the base of the pump on a flat surface (or palm), until the bubbles come out and stop appearing.

This is from memory and I am not doing it now, so may have forgotten some steps, but this approach works for me and I don't get bubbles during use
 
Try flicking the connector if you jave rapid d's. No good with flex links.


Loving life
 
Thanks for your comments and advice all. I don't have a problem when I'm changing the cartridge - I seem to have that bit sorted. It's only when disconnecting for a shower or swimming that I have the issue where a air bubble appears in the cannula tubing which is still attached to me so I cant just prime it out. It's just so frustrating as I am so careful and when a bubble appears the only way to get rid of it seems to be to change the cannula & put a new one on or to allow the air bubble just to go into me & potentially miss some insulin.

I spoke to Accu Chek & they said you only need to use the cap when swimming not when having a shower, so that's what I have been doing now but the bubbles are still appearing!!!! Accu Chek said when a bubble appears you have to change the cannula but as I shower just before bed this is not ideal as you are not meant to change just before bed. It just seems so strange that this has started happening & as I am a very anxious person due to other medical conditions this is really causing me stress!

Any further thoughts would be much appreciated...

Thanks again!
 
Two things that may work lol........
Only have a bath or shower on the day when a set chsnge is due so that you dont have to disconnect. Have a strip wash instead.
Get a longer tube and leave the pump outside the shower, again you wont have to disconnect
 
I never put mine into suspend, I leave it running and never fit a cap. And I don't bolus ! If their is a prob I prime as said bolus mucks up, the readings.
 
Fryertown.
There is effectively nothing that accuchek can do to get rid of bubbles in the cannula tube.. So the only option is to change the times of your shower/bath. Personally, I go to bed quite often and do set changes in bed.
A normal set change at any time should not really give you rises. Yes the advice is pre bolus because if you've had food and theres a problem you will catch it early. However, it really is better for you to change your shower time to stop the problems.
As said, I flick my connector when priming on first connection and have never had airbubbles in the cannula tubing if having to reconnect. Suck back on long tubing yes.

Have you tried more than one lot number to see if it happens with a different lot number? Sometimes there can be a difference.

Unless you are going to change your shower time or live with doing a set change pre sleep then there really isn't a solution.


Loving life
 
Fryertown2012, how are you filling the cartridges? You injecting air downwards into the vial or upwards?
 
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