Baaaaaaa! Bubbles

[SophiaW]

Yesterday we did a set change and the cartridge for some reason had lots of tiny bubbles. I struggled to get them out, it took hours. Finally when I thought they were all out we did the set change in the evening and everything looked good.

Jess' bedtime reading was 4.3 mmol. At 6am the pump started making noises and it said occlusion problem. Looked at the cartridge and it was full of tiny bubbles again. Reading was 15.3 mmol. Knocked them all out, primed the tubing and did a bolus. Had breakfast and did the school run.

Before dropping Jess at school I checked the cartridge one more time and more bubbles had appeared, argh! Told Jess to meet me at the medical room at 10am (snack time) so that we could change the cartridge over. I went home to prepare another cartridge and this time, like all the other times, there were very few bubbles. I knocked the visible ones out and it looks much better than yesterday's cartridge.

Went into school at 10am, her reading had come down to 7.7 mmol and she said no alarms had sounded. I still changed the cartridges over anyway. Looking at the old one, it's once again full of tiny bubbles. I really don't know what went wrong with yesterday's cartridge but I don't want it to happen again.

 

[ebony321]

What a nightmare!!

I get my pump a week today and i'm worried about things like that, but reading that you have problems but kept calm and solved it gives me hope :lol:

im sure this time next week ill be flooding this place with questions

 

[ams162]

hiya sophia

oh not what a pain like u say be nice to know why it did it, we have not had any alarms go off yet so cant help with advising what went wrong however i did have more bubbles in the last set change we did i like u took longer than normal to get them out but no probs with pump alarmimg once i had set it up bubble free. seems strange they kept reappearing though i will keep an eye on ur post to see if anyone has an answer for why this may have happened. glad all is ok with new set

anna marie

 

[SophiaW]

New cartridge seems to be working great Perhaps there was a break in a seal somewhere that I couldn't see. I'll probably never know but next time I get that I'm going to just start a whole new cartridge rather than fuss about trying to fix it.

 

[sugar2]

Eccck! I have only had this happen once. I assumed that it was a "bad seal" at teh bottom ofthe cartridge, that was slowly bleeding air into the cartridge. Fortunaetly, it han't happened since. I do get "Big bubbles" quite a lot, which I have to prime out, These occur as I put the cartridge into the pump, and fasten the stopper.

 

[iHs]

What a nightmare!!

I get my pump a week today and i'm worried about things like that, but reading that you have problems but kept calm and solved it gives me hope :lol:

im sure this time next week ill be flooding this place with questions

Ebony

When you pick up yr pump make sure that you take a vial of insulin with you that's at room temperature.

The pump rep will instruct you on filling the cartridge. I saw mine a few weeks ago and the technique was demonstrated by injecting downwards into a vial, holding the plunger firmly down and then quickly tipping the vial upwards and then letting the plunger fall back on its own accord. The rep made it look very easy but didnt use a vial of insulin. Instead the technique was demonstrated using a vial with nothing in it so it's difficult to say whether air bubbles would have appeared or not. So make sure you take some insulin with you.

 

[donnellysdogs]

I have not yet mastered big or small airbubbles.

I automatically reprime after 4-5 hours after putting in a new cartridge, and normally after 24 hours too, making sure I bang the pump as i am priming. This is the only way I get stability for 6 days continuous.
Due to other things occuring over the weekend I forgot to reprime Sunday night before I went to bed and this morning I woke up to levels at 19.....I never get these high levels when I reprime after 24 hours, so I can only put it down to an airbubble having got all the way through the tubing. I went to bed at 5.0 so I cannot think of any other reason why I woke up to such high's. I of course immediately checked the connectors, lueur, set etc, and I did not have any alarms go off. After I reprimed anyway this morning my levels came down as normal.

Every time I reprime at these times, I am staggered at the amount of bubbles that I can't see in the cartridge but have accumulated at the lueur connector.

I did a posting on this when I first went on the pump as I was so fed up with getting high's everytime i did a cartridge change, and this was the only way of managing the bubbles.

My cartridges are absolutely clear of bubbles when I load them in the pump, and it didn't matter when I took the cartridges or insulin out to get them up to room temperature whether I kept the cartidge out till I used it or whether I took the cartirdge or insulin out 2 hours or whether it was cold.

Because my foods are so routine, it was just so idnetifiable that these problems occurred 5 hours after a new cartridge and 24 hours after, so now I reprime before they can occur (normally)......

Some people have problems, and some people don't it seems. Even my rep sent me off with a huge airbubble in my cartridge on the day I started, assuring me that big bubbles won't get in the tubing......but they do......does everybody else keep their machines facing down when they sleep or are they horizontal?? IF they are horizontal, then airbubbles can move.....

 

[SophiaW]

I have discovered that if I disconnect the luer and then reconnect it then there are bubbles trapped in the neck of the cartridge where the tubing connects (luer). I did this once when I wanted to change the tubing but not the cartridge. If I connect only once and do not touch it after that then bubbles seem to be far less of a problem. Like you I also remove the cartridge after 24 hours and knock out a few bubbles (and prime) which inevitably seem to accumulate inside. It's quick and easy and seems to ensure problem free delivery of insulin.

If your alarm doesn't sound is it that you have the occlusion sensitivity set to low? Jess' pump is set to high.

 

[donnellysdogs]

I'm on a accuchek combo pump, and I didn't know that settings for occlusions could be adjusted for this pump....and no, I had a spate of occlusions when I was using flexilink plus sets, and I know how frequesntly they can go off and how loud and how often. Since going over to the rapid d sets, I haven't had problems with occlusions at all. When I have troubles with bubbles, I never get an alarm. However, that is just my experience. I have only ever seen bubbles in my actual tubing once as well, and boy-they were long gaps of air. I have only assumed that because of the stability of repriming when I do and banging so much whilst doing it, that this is the reason. The one day I haven't done this procedure due to having other worries over the weekend my levels went sky high overnight, and came back to normal as soon as reprimed, banged and correction and a 250% basal, everything back to normal by dinner time.

 

[jkh]

If you what to avoid problems, taking the insulin out of the fridge 2 hours before you draw up a cartridge is pointless, it needs to be 24 hours. Then draw the cartridge up approximately 24 hours before you need it, remembering to lubricate, making it 48 hours in total. Knock the bubbles out before priming and priming removes the rest. I’ve only had problems with bubbles when I forget to follow the ‘rules’ an forget to take out the insulin from the fridge in time.

 

[donnellysdogs]

Might be a bit thick here, so you take your cartridge out of the fridge 48 hours to warm it up and this stops bubbles? I have tried leaving it out for 36 hours before and still had bubbles. I generally load up 3 cartridges a time,and put the other 2 back in fridge until needed. Next time I need another cartridge I take it out nowadays between 2 and 4 hours before swopping over. I always lubricate the cartridges before filling.

 

[jkh]

What I said works for me, that's all I can say.

 

[SophiaW]

The insulin vial is out of the fridge for 24 hours before I prepare a cartridge. Once it's out the fridge it stays out until it is all used up. Our pump rep said not to prepare a cartridge more than a few hours before it will be used, the cartridge never goes back into the fridge. She said we can prepare it during the day when Jess is at school with the plan to do the set change that afternoon or evening. She never said why I shouldn't prepare more than one cartridge in advance or why to limit it to the same day rather than the day or days before.

 

[MushyPeaBrain]

Sophia you are on the Animas 2020 like me and the reason that you shouldn't prepare the cartridge early is that the insulin has a limited life with the plastic and both degrade with a MAX use of 6 days. That's why insulin is kept in glass vials.

I have never had any problems with bubbles. I keep one vial at room temperature but still in it's box and in a closed cupboard. When I need to fill up I do the whole thing then and there as by now it only takes me 5-10 mins tops. I draw up about half a syringe of air and push it into the bottle with the bottle stood on the table (so the air does not bubble through the insulin). Holding the plunger right down I flip the vial over and let the plunger move down. I then push this back in slowly and redraw to full. Then I flick and flick and flick till any bubbles are gone. I always move the plunger slowly as this helps prevent bubbles. The top of the resevoir goes on only for seconds while I get my new tubing ready and then I attach very tightly and prime holding the pump upright so any air bubbles should prime out too.

Also with the animas syringes you must pull the plunger back and forth 3 times before you start to lubricate the resevoir and help create a better seal, although not past the number 2 mark!

Hope this helps

 

[donnellysdogs]

Interesting...does anybody else load up 3 cartridge for the accuchek combo at once-my rep and nurse said that many people do, and put them back in the fridge until needed, so that is what I do.....and yet it seems from this posting that most people only fill up one cartridge at a time....

 

[sugar2]

Interesting...does anybody else load up 3 cartridge for the accuchek combo at once-my rep and nurse said that many people do, and put them back in the fridge until needed, so that is what I do.....and yet it seems from this posting that most people only fill up one cartridge at a time....

I was told that I could do this...but I don't.

 

[Dustydazzler]

Yes as MushyPeaBrain said, I was also informed by my specialist that insulin degrades when it is plastic and should be disposed of after 6 days in a plastic vial. I draw up my cartridge when I need it and only do the one that I need.

 

[diabeticmumof4]

Had similiar problem, did a set change yesterday morning, all fine, no problems, went to bed last night on 8.6. This morning got up early luckily, and did a test, blood sugar was on 16.3. Did a correction, then checked my inset which seemed ok, however noticed on the tubing a couple of small air bubbles which I think might account for the sudden rise. I changed the inset, but my readings have been very slow, had to do several corrections, and I am now hoping that it will :? settle. I can't think what else could of caused this problem, it was fine yesterday, I wondered if i could of slept funny last night, and laid on the tubing. Do not know if this can cause air bubbles, appreciate any advice, don't want this happening again?

 

[donnellysdogs]

I can only speak for my own experiences....

I reprime after 4-5 hours, and again 24 hours after every set change. Today when I had my bath and took my pump off and left it running I looked at tthe tubing and saw that the insulin had 'suck back' and was an inch away from the connector, so I also reprimed then.

As I wear my pump on my arm and my sets on my legs, I have a lot of tubing. I have found that repriming for me at these time is the only way I can see steady levels so to speak. My levels used to go high after cartridge changes, now they stay steady with my other daily tests. I used to find that the bubbles were not still in the tubing with me, but must have actually gone through the tubing by the time I realised. I have only once seen bubbles in my tubing whilst I have been actually wearing my pump.

I wear my pump on my arm continueosly, so I know that even in bed it is pointing downward and not horizontal.

Best advice is to check back on your readings the day after cartridge changes and see if there is a pattern after so many hours to levels going up.....

 

[diabeticmumof4]

I have discovered that if I disconnect the luer and then reconnect it then there are bubbles trapped in the neck of the cartridge where the tubing connects (luer). I did this once when I wanted to change the tubing but not the cartridge. If I connect only once and do not touch it after that then bubbles seem to be far less of a problem. Like you I also remove the cartridge after 24 hours and knock out a few bubbles (and prime) which inevitably seem to accumulate inside. It's quick and easy and seems to ensure problem free delivery of insulin.

If your alarm doesn't sound is it that you have the occlusion sensitivity set to low? Jess' pump is set to high.

Just noticed you are on the same pump as me, is there an alarm that you can set to say the insulin isn't getting through? I am still learning my way around the animas pump, appreciate any advice?