Getting to grips with my pump

[RuthW]

I got my pump about 9 months ago. I hesitated for years before getting it. I had all those doubts about being attached to something, whether it would be worth it (I'm not in the UK so I had to pay for it myself), etc, etc. I finally plumped for it after months and months of trying to control my diabetes on MDI and failing. The next option was 5 injections a day (minimum, because I was as Tim2000s puts it a "sugar surfer") so I plumped for one.

Then I did tons of googling (actually I did a bit before buying it, of course) and found this forum, plus a few more sites. One of them was run by an Australian nurse who took paying clients for pump training. One of the things she said on her website really struck me. She said about 70% of pump users give up on them in the first year. She said she believed that this was because pump users don't use all the features of the pump, so they don't get all the benefits.

I believe that she's probably right. I have had my pump for nine months, and only in the last month have I finally cracked the use of extended boluses. Until this month I never cared extend a bolus more than about half an hour. This month, it finally dawned on me (thanks to Tim2000s talking about it in another thread) that the odd random spikes I was getting around midnight were due to high protein and/or high fat meals causing a late spike. I could stop that spike by using a FOUR-hour extended bolus (being less of a scaredy-cat, in other words).

Score 1, the pump.

The other thing I found this month was that I can, of course, record my AFTER meal blood sugars on my pump. Just use the bolus wizard but stop before administering any insulin (anyway, it usually suggests 0.0). This means the pump keeps better records for my consultant (and me). Not necessary to cross-check with my blood sugar meter.

Score 2, the pump.

While discovering the pump's memory capacities, I also realized that if I page down at that point in the bolus wizard (I.e. When it's recommending that post-meal 0.0 units), it also tells me explicitly exactly how much active insulin is in my system. I mean I knew the great "wizard" knew that. I just hadn't realized how to find that info before. I thought the Wiz was keeping it "under his cap."

Oh, big score 3 for the pump.

It's so great. Today, before I left the house for my daily walk, I could check how much IOB I had and predict how many carbs I would need much more accurately than ever before.

I'm in love with the Wizard.️

 

[noblehead]

Good post @RuthW, to get the most from a pump it is important to know about and use the bolusing options available, I've been pumping now for 8 months and wouldn't want to go back to MDI.

 

[CarbsRok]

Lol @RuthW good morning you have now woken up to the joys of pumping. Very pleased for you.

 

[RuthW]

Yes, I mean I immediately appreciated the obvious things like fine tuning of basal rates, TBR, and setting different bolus ratios. I particularly love being able to bolus in fractions of a unit, for example, on the advice of the Wiz. And super-boluses are just, well, super. But I keep finding new features, or finally mastering their use in respect to my own needs.
My next plan is to really master optimal use for both anaerobic and aerobic exercise. I'm pretty good on the latter, but I want to do more of the former without too many peaks - without ANY peaks, in fact.

 

[tim2000s]

Morning @RuthW, having finally gotten my hands on a pump, whilst I'm finding there is a bit of time to take to get things sorted out, the immediate benefit is not having basal insulin run out and result in a 7am-9am rise and already the use of a multi wave bolus on a pasta meal, which was brilliant! And that's in two days. The other great thing is the remote button press to bolus. Having the Libre running alongside really does make all of this a lot easier though, as the realtime feedback is hugely beneficial.

 

[iHs]

I think it took me about 1-2yrs to get used to a pump and dealing with all the problems that arise from occlusions and dodgy cannulas kinking and the need to keep bg testing to make sure that the settings I had selected, were still ok. I definately had no intention ending up in hospital with DKA because of an insulin pump and have always made sure that Ive always got a back up in an insulin pen if need be.

I dont eat pasta that much and only eat pizza at events where there isnt much to chose from food wise. If I can, I keep to basic eating and go for a lot of vegetables to fill my dinner plate and leave the other stuff alone. I tend to use the standard bolus most of the time.

 

[RuthW]

Congratulations! I'll be keeping close eye on your progress with varying rates before during and after sport! I'm sure most things will come easy to you because of all your sugar surfing with MDI. Don't you just love boluses in fractions of units, though? They're the biz! I wonder how I managed all those years without them.

 

[tim2000s]

Congratulations! I'll be keeping close eye on your progress with varying rates before during and after sport! I'm sure most things will come easy to you because of all your sugar surfing with MDI. Don't you just love boluses in fractions of units, though? They're the biz! I wonder how I managed all those years without them.

I'm interested to find out about the sport aspect too. I already encountered the first bit of fun on Friday when I had to take the pump off for heavy lifting due to the need to wear a belt. Probably not a bad thing though as it effectively reduced my basal for later, which was probably needed.

 

[tigger]

I got a pump in July due to pregnancy and will keep using it until I have breast feeding established (around Feb/March) but then I will take a break. While there are great advantages in terms of control, I find the unreliability and often pain of canulas, never knowing whether my blood sugars are rising or dropping due to usual reasons of which there are enough to pick from or pump problems incredibly stressful. I also really dislike having it attached to me. I have used all the features you mention above and particularly find the bg recording mechanism good. But they don't outweigh the canula issues and the fear of ketoacidosis in the middle of the night.

 

[RuthW]

I got a pump in July due to pregnancy and will keep using it until I have breast feeding established (around Feb/March) but then I will take a break. While there are great advantages in terms of control, I find the unreliability and often pain of canulas, never knowing whether my blood sugars are rising or dropping due to usual reasons of which there are enough to pick from or pump problems incredibly stressful. I also really dislike having it attached to me. I have used all the features you mention above and particularly find the bg recording mechanism good. But they don't outweigh the canula issues and the fear of ketoacidosis in the middle of the night.

Sorry you haven't had such a good experience. So far I've been really lucky on the canula front. I only have problems if I actually yank on the tubing by accident, and sometimes not even then.

I do think starting with a pump while you are pregnant must have been very, very hard work. I would guess that once you've finished breastfeeding, it would be much, much easier.

 

[irrationalJohn]

I also really dislike having it attached to me.

Yeah. Some people have a really hard time with that. It's an issue that goes right past me as I've been using a pump for not quite 20 years now, but that doesn't make it less of an issue for those who feel as you do.

As for the cannulas, surprisingly some people who had problems rave about how much better (for them) the steel needle infusion sets are. Maybe they would be just as bad if not worse for you, but those who advocate them claim they are actually more comfortable (for them) than the plastic cannula sets were.

I find this hard to believe myself, but if you are really having that much difficulty you might want to give them a go if for no other reason than just to rule them out?

 

[tigger]

I've given them a go. I have trouble with the adhesive for the steel ones and last week I had the horrible experience of them failing to deliver insulin at the time but then managing to slow release it over the following 48-72 hours which meant I was nearly permanently hypo. The helpline claimed it was because I had too much muscle in my legs but it had worked fine the week before.....

 

[tim2000s]

Hmmm. @tigger, I found I had a similar experience with steel but not over so long a time. It was most disconcerting.

 

[Spicey245]

I bloomin LOVE my pump, only been on it since 28th Sept and I'm already using extended boluses (which are fabulous!!). I am on holiday at the moment and having a few hypos due to heat and exercising a lot more than normal but if that happens I just have sone sweets handy and put it on a temp basal rate for an hour, temp basal rates are great! ;-) I am SO happy I went onto a pump after 23 years on MDI. It is more work with blood testing and carb counting but I'm getting much better at guessing carbs in random meals now! ;-) I don't really mind it being attached to me either, it's a small price to pay for much improved blood sugar levels!

 

[RuthW]

Ha ha! Another convert! I find my pump so rewarding. I know people say they are more work, but I found MDI was hard work with no pay-off, just constant frustration. With the pump my insulin "does what it says on the tin". Which reminds me, time to change my set.

I only feel sad that I didn't wait a while and get a PINK one! They only had grey in stock and I thought, "Well, good, it'll be unobtrusive. But I regularly yank my jumper up to show my pump clipped on my waistband now. People say, "Oh, you've got diabetes?" And I go (jumper yank), "Yes, here's my pump!" I'm at risk of becoming everybody's mad auntie!

 

[yingtong]

I've been pumping for 5months and there is no way I would go back to MDI.I love my pump nearly as much as my wife!

 

[-Artemis-]

Same... I love my pump; I also use steel sets and love them too...