Please view and offer advice!!

[MushyPeaBrain]

So today I have decided to post my documented set change in the hope that somebody might spot something to help.

At about 3pm I realsied my Inset was not functioning quite right. I knew I had to change it but have become nervous and anxious about any set change due to serious high levels each time. I phoned a friend and we discussed options. We decided to try another contact detach, as the needle shouldn't fail, and put my basal on 100% increase (so double my usual basal) to cover stress and any basal adjustment needed.

So hubby watched the whole change and supervised air bubbles. After doing change we noticed a single sausage bubble in end of tube. The early bolus I did and extra basal should have covered this.

Straight at set change 4pm BG was 8.5 Bolus 0.95 +100% basal begins

5.20pm BG 9.3 Bolus 2.5u to try and stem any further rise

6.30pm BG 12.1 Bolus 1.5U

Now running scared set not working. Not sure what to do. Set seems stuck down but one wing is raised - could this mean the needle is not in me far enough?

No air bubbles in sight in tubing.

Please help!!!!!!!

 

[SophiaW]

I've tried searching the internet to see if anyone else has experienced this problem that you're having but no luck yet. Do you think siting the cannula somewhere else might help, maybe instead of your tummy on your upper leg or arm? I think you're going to have to get your DSN and pump rep together, watch a set change and see if they can help. I can't think of anything else to suggest. Not sure if there are any other Animas users around to offer suggestions. This must be so frustrating for you

 

[donnellysdogs]

Just been thinking Mushy whilst in bath about your levels raising again after the set change.... if your previous set was not acting 100% properly-then you are going to possibly go up for at least 4 hours-no matter what corrections you do.....

Not only that been also thinking that, but on set change over days whilst stress is happening, then you may have to do (temporarily) an increased basal rate 2-3 hours BEFORE a set change over....(depending how your settings/acting time are with you).

If you are increasing basals, you will probably find that you have to increase your bolus, so that you are keeping within the 50/50 or 60/40 ratio's that DSN's and John Walsh advises to be kept to.

I myself have found in the last two weeks that I have had to dramatically increase my basals and bolus ratio's in line with the basals....I have had a steel set that appears to have 'leaked' blood and gunge out of it over the white sticky area within the last two days that caused me extra problems....however, for some reason (full moon coming???) I have struggles to keep my levels down, when previously I have struggles on some occasions to keep them up.

Doing a fasting for a non set change day (over the period when you do set changes), and doing the same whilst on a set change day may well help. The more I have read of your postings, makes me think that at the moment-pre changeover you need to increase your basals, and bolus for the time prior to set change.

If necessary tonight, you may well have to alter your bolus to give yourself extra in line with your basal rates. You should see movement downward within 3-4 hours, but certainly it may take this time before you see any levels coming down, if your set wasn't 100% prior to changeover.

Where are the ANIMAS Pumpers???? and SET users??? for advice??? I can only give you advice from what I have experienced, by no means a HCP, but wish that there was another ANIMAS user that could perhaps give more expertise on sets/changes using your pumps.......and sets....

 

[MushyPeaBrain]

UPDATE BG 7.30pm 12.0 Holding!!

BG 8.30pm 10.2

Therefore set is working and Donnellysdogs is right that it needed more time to kick in. Of course it didn't help that I was starting at 8.5.

So my plan is to do 100% basal increase 2 hours before next set change plus bolus a shot when set goes in. I also need to try and check my carb ratios and basals, although fasting and constant bloodtesting are very difficult right now with a new baby!

I am still annoyed that Animas KNOW the contact detach is not as well made as the Inset and lets air into itself. They told me that the second I detach I must put the protective cap on to stop this. Obviously not going to solve my issue during set change but why don't they just make it better quality like the Inset is? :evil:

 

[ebony321]

Just a quick thought..

Is the animas compatible with other manufacturers sets?

i've been looking hopelessly at your posts as i use the accu-chek combo so i've little knowledge about the set your having problems with and wish i could help!

It's just so intruiging why this happens during your set change, i frequently shower completely detached from my pump and cannula, then sit for 20-30 mins before i'll hook myself up again, but i never have experienced such highs afterward!

It's great that your finally getting your BG's stable after, but like you said, you should have to do these basal increases and boluses to correct the problem.

but at least animas know there is a problem and are more likely to change something if they know there is a problem.

All the best!

 

[SophiaW]

Ebony, we use the same sets as Mushy is using and don't experience this problem at all so I'm not convinced it's a fault with the sets unless Mushy has a bad batch or something. We regularly disconnect the pump to prime out bubbles or for swimming, bathing etc and never have a problem like this. We put the end caps on if Jess is swimming or bathing but I can't say we rush to get the cap straight on. We don't get air into the tubing from disconnecting and we've never had unexplainable high readings after set changes like this.

Mushy, I'm glad your BG was finally holding and then coming down. But like has been said you shouldn't need to give extra boluses and increased basals because of a set change. It's really bizarre and I don't understand it.

 

[ebony321]

Ebony, we use the same sets as Mushy is using and don't experience this problem at all so I'm not convinced it's a fault with the sets unless Mushy has a bad batch or something. We regularly disconnect the pump to prime out bubbles or for swimming, bathing etc and never have a problem like this. We put the end caps on if Jess is swimming or bathing but I can't say we rush to get the cap straight on. We don't get air into the tubing from disconnecting and we've never had unexplainable high readings after set changes like this.

Mushy, I'm glad your BG was finally holding and then coming down. But like has been said you shouldn't need to give extra boluses and increased basals because of a set change. It's really bizarre and I don't understand it.

Ahhh, i see. It does seem very bizarre indeed!

Mushy - Have you tried 'youtubing' set change for animas? i 'youtubed' when i first got the pump, just to actually SEE someone doing it.

It could be of use if you can find a decent video?

You could also request if a Rep from animas can meet you at the hospital and watch you do a set/cannula change?

Just a few ideas

 

[MushyPeaBrain]

So might not be just the set change!!

When we brought our son home I had to reduce my basal and carb ratio as I was permanently hypo. The new settings seemed spot on and worked fine but maybe now they aren't and just happen to coinside with me changing to these sets. On top of that the huge amount of stress I am feeling over the pump and the UK adoption process will add to it all and I am no longer exercising at the gym.

Last night I ate dinner (fish dinner 30g) and an hour and a half later I was BG 16 :shock: This ratio is the same one I have always had but I used to go to the gym in the evenings too. I did an extra bolus and at midnight I was BG 11.

7am today BG 6.1 Set must be working!! Didn't eat just to see...

9am BG 8.4

So with my son I am getting up 2 hours earlier so I need to adjust my 5am basal as my DP has moved.

Basically I think I need t tweak everything and try to reduce anxiety. Tomorrow is next set change and I will use the temp !00% to cover the stress but hopefully as I get things fine tuned and stress less this can be reduced/stopped.

I do also need to account for the annoying single airbubble I get in the end after a set change. It's like it hides in the detach even after priming! Sophia the fact that you often have to disconnect to prime air says volumes about these sets. I have NEVER ever had to do this on Insets and I never used the clip when detached etc. Same insulin filling for me but only new thing the set and now I have air :roll:

 

[SophiaW]

The air I need to prime out is inside the cartridge and only happens after a cartridge change the next morning. It could be my way of filling a new cartridge but we always get a bubble the morning after a cartridge change the evening before. If I leave the air bubble then it works its way down the tubing and 24 hours later we start to get higher readings. If I prime out the bubble the next morning (12 hours after cartridge change) then I avoid this problem. Once that bubble is out of the cartridge we have no more bubble issues until the next cartridge change. The only time then that we disconnect the pump is for bathing and swimming, never do we have a problem of bubbles appearing like you have described after disconnecting. So that's what I meant about disconnecting often, for swimming, bathing and that one occasion for priming out air from the cartridge following a cartridge change the evening before. I also disconnect the pump from Jess when I want to review her history, make basal or bolus changes etc. We don't get bubbles in the tubing on these occasions either and during these short disconnections (not swimming or in water) I don't cap off the tubing.

 

[donnellysdogs]

Mushy

Although on a different pump, I too always have to prime 4 hours after a new cartridge. It used to be 24 hours as well, but currently my only problems with increased levels occur 5 hours after I change the cartridge.

However, saying that I can't recall how often you are changing cartridges....

I think you will have a better changeover if you bolus a small amount prior to set change and give yourself an increased basal rate for a few hours as well prior to changeover, if you have a routine that will enable yourself to do this safely. I think that as well as you having a good look at your basal and bolus rates, that you will find that the changeovers will get let bothersome for you.

I still haven't got an explanation for bubbles in tubing...but both Sophia and I have found that we get bubbles that will travel at certain times...I think this is less for me now as my pump is also facing down all night and all day. At night, mine remains at the top of my arm and so when I sleep the cartridge still remains upright, and doesn't ever go horizontal during sleeping hours. I think this has helped with my priming that I had to do 24 hours later because of the times that I do my cartrdige changes.

Hoping your levels have flattened down today.....

 

[MushyPeaBrain]

OK so next change and still very weird.

7am BG 7.7 Correction plus usual breakfast & bolus

11am Set temp basal at +80% to cover possible stress

12.15pm 5.8

Disconnect to shower so pump/set free for 45 mins

Set change, no air visable in tube. Bolus 1.5u to cover missed insulin

1pm Eat usual lunch 30g and bolus same ratio as yesterday which was spot on

3pm BG 17.8 :shock: :shock: :shock:

Now I know my food is peaking but to go from 5.8 to 17.8 with a temp basal in place. Nobody can make sense of this!!