Jump to the Pump

[rsagoo]

Hi all, my 3-year old son was diagnosed with T1 in January, and this Wednesday he went onto pump therapy.

We went for the Animas Vibe which after the feedback from the forum here and reviews seemed to get favourable reviews. Wednesday morning was a 1 on 1 with the Animas rep, a lovely woman who went through everything on how to use the pump, options, setup. We did all the setup as she talked us through.

Our son was with us during the training, if your child is young something to distract them helps. As he usually has an earlier lunch at 11.30am she sped things along so that he would be up and running on the pump in time for lunch. He was resistant at first to put it on, but when he saw lunch was here he just us to hurry and so he could eat. I applied the cannula on his upper back while my wife set up the insulin. We had already ordered a pump pouch from funkypumpers and used that right away. As we have already setup the tie blocks, ISF, IC, Basal, etc, all we had to do was a quick BG test, then add the carb info into the pump, along with his BG and then it calculated the insulin dosage and press GO! And then he could eat.

After lunch, training resumed with mainly talking about lows, highs, care for the pump, etc. What is scary is the highs, as you no longer have the Lantus, if for some reason the insulin is not reaching him he can go very high in a space of hours.

Training was finished by about 3pm, but as he is young we stayed over night, to be honest we felt ready to go home, but to have the staff on hand is a reassuring.

That evening he had hypo's before dinner, bed, during the night and in the morning. In the morning we had finished our own fruit juice and asked the nurse for some, which we gave him. When testing him again he was even lower, it was sugar-free juice

His basal was lowered, but his number of lows could be as he still had lantus in his system from the night before (even though it was halved).

He's been amazing through everything, he has wanted to remove it a couple of times, and he also wants to help put his 'medicine' in himself which can be a struggle. Removing the tube from the cannula can be a bit tricky at bath time and is causing him some discomfort when we do, but we will need to improve our technique on this.

The pump itself feels rugged and 'kid proof', the interface is fairly to navigate, it's no iPhone user experience but it does the job well. the tubing doesn't feel like it will kink easily and gets tucked away easily into his pants. He's been sleeping with the pouch on and hasn't complained, even sleeping on his tummy with no problems.

We've only been using the ezCarb and ezBG options so far, will try the combo option to give 30% insulin before meal, and 70% slowly over a couple of hours.

There's a lot to take in, in short space of time, but the feeling we have is that it'll be easier or give us more confidence to go out a bit more with him (we've only been out twice since being diagnosed).

Well that's it so far, it feels positive but it's going to take a while to be fully adjusted and confident.

@SteveOsborne, just tagging you in as you asked for my feedback.

All the best

 

[Juicyj]

@rsagoo Thank you for taking the time to write this and share it with us, this is great for other parents to understand more about the pump and first visit/setting up. He will adapt so easily to this and you will get more confident as time goes on to help him manage. Well done, here's to a new successful pumper !

 

[noblehead]

Great post @rsagoo

Your son is doing great and you deserve some praise too, hope his good progress continues.

 

[1Sarah1]

Hi @rsagoo great info. My 2yr old went onto medtronic a few weeks ago after being diagnosed in Dec. I decided on this as I also have one for 6yrs now.

Just something to mention when you are doing a set change my daughter really hates it as it can hurt (from my experience too) so I have to get someone else to hold her. You can get lift off wipes to help remove it. Had one time where the cannula hadn't gone in but didn't pick it up quickly as she isn't speaking yet and had been a bit ill and wasn't sure her ratios were right. She is a difficult eater so I try to bolus 10 carbs before meal then work out what the balance is as several occasions she hasn't eaten (same with injections I guess).

I did test in the middle of the night a few times as she drops from about 3am (luckily up with baby twins anyway!) to check overnight basal was right.

Hope your son is doing ok.

 

[rsagoo]

Hi @rsagoo great info. My 2yr old went onto medtronic a few weeks ago after being diagnosed in Dec. I decided on this as I also have one for 6yrs now.

Just something to mention when you are doing a set change my daughter really hates it as it can hurt (from my experience too) so I have to get someone else to hold her. You can get lift off wipes to help remove it. Had one time where the cannula hadn't gone in but didn't pick it up quickly as she isn't speaking yet and had been a bit ill and wasn't sure her ratios were right. She is a difficult eater so I try to bolus 10 carbs before meal then work out what the balance is as several occasions she hasn't eaten (same with injections I guess).

I did test in the middle of the night a few times as she drops from about 3am (luckily up with baby twins anyway!) to check overnight basal was right.

Hope your son is doing ok.

Hi @1Sarah1 Thanks for the tips about the wipes, i'll order some straight away. We're doing our first change tomorrow, so nervous about his reaction.

You sound like you have your hands full! He's doing well thanks, sitting on my laps as i attempt to type this for the second time.

Thanks to @noblehead and @Juicyj for your kind words.

 

[azure]

Your son sounds very brave. It's a lot to get used to and he's only young.

Wishing him and you a smooth first few days of pumping It's strange to start with but soon becomes easier and second nature

 

[iHs]

Hi

There are many medical adhesive removers available. One of the most common is Opus Medical LiftPlus spray which can be tried as free sample before buying. I use it for removing steel needle sets and Inset 30 adhesive and Dexcom sensors. The Inset II can be inserted manually if need be by pushing out the white spring from the bottom of the plastic dome but best to unwind the tube first though so no need to fire the spring. Send me a PM if you would like a remover to undo the cross shape cartridge cap or a vial to cartridge adaptor which sadly Animas don't manufacture.

 

[rsagoo]

We did our first set change on Saturday, not the best experience. We made the error of preparing everything in front of him and he then kicked off, crying and screaming. But we got it done. His second set change this morning was a lot better, the wife prepped the insulin on the side while I detached the pump, put his cartoons on for distraction, and telling him we need to put 'fresh medicine' in his pump.

He was better with the Inset II, thanks for the offer @iHs , but at the moment he's sort of fine with the process of putting on the cannula.

So far we've placed them cannula's on the upper bum area. We will also be looking at placing it on the side of his legs, anyone had any issues with site placements on young kids or are those the best areas to rotate around?

As always thanks for any replies.

 

[1Sarah1]

Hi @rsagoo with my 2yr old I don't prepare it front of her-as soon as she sees it she gets upset. I put it in her thighs different leg each set change and rotate around. I have to have someone else hold her and distract her.
I'm not sure if yours is the same but I don't give her a bath for about 4 hours after as it comes off sometimes (my personal experience). I sometimes rub a bit of moisturiser/bio oil to help healing although not before i change it. I change it every 3 days and always mid afternoon or earlier so I can make sure it's taken.

 

[rsagoo]

Thanks @1Sarah1, from now on we'll definitely prepare everything beforehand, it does take 2 of us and 20mins to get it all done.

We'll be changing every 3 days in the morning on weekdays as we have to get his sisters ready for school before we go to work. We do the same as you and not bathe him till later of before bed to give enough time.

Good tip about the bio oil, small things like that get forgotten in the rush to get it done.

We haven't done the legs yet as he's comfortable with the upper bum, but will do next time so he gets used to it.

 

[iHs]

We did our first set change on Saturday, not the best experience. We made the error of preparing everything in front of him and he then kicked off, crying and screaming. But we got it done. His second set change this morning was a lot better, the wife prepped the insulin on the side while I detached the pump, put his cartoons on for distraction, and telling him we need to put 'fresh medicine' in his pump.

He was better with the Inset II, thanks for the offer @iHs , but at the moment he's sort of fine with the process of putting on the cannula.

So far we've placed them cannula's on the upper bum area. We will also be looking at placing it on the side of his legs, anyone had any issues with site placements on young kids or are those the best areas to rotate around?

As always thanks for any replies.

Hi

My msg to you was to address removing the cartridge cap a bit easier and also to make the drawing up of insulin from a vial into a syringe a more stable than just inserting the disposable luer needing into the vial and allowing it to fall lop sided instead of being held upright. No problems though..........the offer is there if you want it ok

To keep the Inset IIs firmly secured to the body, its possible to cut a template using a used Inset II and placing it on a piece of medical adhesive tape like Mefix and draw around the outside edge of the set and cut an oval and then place the tape over the set and that should stop the set from coming out or to use Tegaderm etc. I once had a set work its way loose out of my backside through going to the loo a few times at a dinner even. My bg went up really mega high so initially thought there was a fault happening but then noticed the pump tube hanging down my leg with the set attached to the end whilst in the 'ladies' so fun and games from me cursing the pump and other ladies in the loos asking me what had gone wrong as I stood by the sinks inserting another set (this time in my stomach) .