Pumpin' 4 Doomies....

[Cinnabon]

Hello everyone...
I believe the questions will commence now. I invite you all over to my house to sleep over for the next 2 weeks, as I get accustomed to this pump. I give all of you the right to SMACK me, as I will become VERY annoying. I waive my right to press any charges against any of you..LOL.

1) As I will be waking up in the middle of the night to check my BS, I may become Hyper, do I automatically deliver a Bolus in he middle of the night?

2) Are there more chances of becoming Hyper than Hypo? of course, taking into consideration the TEST,TEST,TEST protocol.

All the reminders that you may have as when you started pumping, even those moments that you say now "Wish I would have known that!", PLEASE SHARE!!

[Clint]

hey cin... you have a PM...

I havent run into any gotchas... just test and make sure you do your bolus'.. other than that, pumping for me has been far easier than MDI ever was.

[daddyo]

Cinnabon you willdo fine, take it one day at a time. and you will have no problems. ;) yes you may go Hyper but you will corect that with time, Usualy, for me anyways, the lows are when you are first dialing in your basil rates, but they are easy to fix with time and testing. I did alot of testing to see how I would react to the insulin at diffrent times to see if the boluses were correct you'll get though it :thumbsup: Hang in there

[Cinnabon]

Thinkin of this too.....

My usual insulin shot was the 9pm (N). Now, since my pump will not start working till 12am, Shouldnt I Bolus 3 units over the next 3 hours.. 9, 10, & 11pm?

[duck]

Hello everyone...
I believe the questions will commence now. I invite you all over to my house to sleep over for the next 2 weeks, as I get accustomed to this pump. I give all of you the right to SMACK me, as I will become VERY annoying. I waive my right to press any charges against any of you..LOL.

1) As I will be waking up in the middle of the night to check my BS, I may become Hyper, do I automatically deliver a Bolus in he middle of the night?

I do...BUT: Do you know what your correction factor is? Let me know.


2) Are there more chances of becoming Hyper than Hypo? of course, taking into consideration the TEST,TEST,TEST protocol.


I was dialed-in pretty good by the time I went on, but for whatever reason, I was more high the first month than low because of bad insertion sets, etc (my fault).

[duck]

Thinkin of this too.....

My usual insulin shot was the 9pm (N). Now, since my pump will not start working till 12am, Shouldnt I Bolus 3 units over the next 3 hours.. 9, 10, & 11pm?


When were your last shots over the last 24 hours?

[Cinnabon]

When were your last shots over the last 24 hours?


Lastnight:

Before dinner6pm: 8 R

9 pm: 12.5 N

Tonight he told me to take the 8 R but no N tonight.

[middnite03]

so I gather you had your meeting with a new pump trainer, and your starting on insulin right away?? no saline, and you'll be starting at midnight???

My usual insulin shot was the 9pm (N). Now, since my pump will not start working till 12am, Shouldnt I Bolus 3 units over the next 3 hours.. 9, 10, & 11pm?

No, that NPH that you take at 9pm is actually your basil insulin, that is built into your basil rate. so dont bolus. What basil rate were you set at from the trainer, and what carb ratio were you given???
from a prev post you take 15 n in the morning and 12 at night right?? that 27 units a day of basil.

take 20 percent from that 27 units and devide by 24 hours and you get...


20 percent of 27 units is 21.6 devided by 24 hours is .9 units an hour set as a basil rate, so starting off you err on the side of being a little high then low, you should be on a .7 to .9 basil rate to start off,
at least these were the numbers given to use as a formula by my endo and pump trainer, what does everyone else think???

and 2 tell me this trainer was with you for at least 2 to 3 hours showing you all functions of your pump???

[duck]

Your NPH should be nice and cleared out in about an hour...Somehow, I think that alone will make you feel better.

Check your blood sugars at 9, 10,11 and midnight...If they start to take off, take your correction bolus.

Cinnabon, do you know what your correction factor is?

[Cinnabon]

Unfortunately Duck,

I dont. I am set to see a NEW doc on 7/5.

[middnite03]

if you do not know your correct factor, how did the pump trainer input it into the pump?????? did he set up the bolus wizzard for you??

[Cinnabon]

No saline.
My basal rate is 1.0 units / hr.. Bolus ratio is 10:1
He was here for a lil less than 2 hrs. He is due back everyday till Saturday were I can request more visits then.

If you have the MM 715 book it states on Pg 32 ch. 3

4) The start time for your first basal rate is midnite (12:00A ti 12:00A)

[am1977]

Hello everyone...
I believe the questions will commence now. I invite you all over to my house to sleep over for the next 2 weeks, as I get accustomed to this pump. I give all of you the right to SMACK me, as I will become VERY annoying. I waive my right to press any charges against any of you..LOL.

1) As I will be waking up in the middle of the night to check my BS, I may become Hyper, do I automatically deliver a Bolus in he middle of the night?

2) Are there more chances of becoming Hyper than Hypo? of course, taking into consideration the TEST,TEST,TEST protocol.

All the reminders that you may have as when you started pumping, even those moments that you say now "Wish I would have known that!", PLEASE SHARE!!

Hey I love sleep over parties :D Do we get to have a pillow fight, eat pure junk, and stay up all nite? :-

Getting serious here...to answer your questions...

I do bolus when I have a hi in the middle of the nite, but like others have mentioned it is good to know what your correction factor is. Most likely it will be 1 to 50. 1 unit brings you down 50 points...but this may not be the case for you. This is something to ask your trainer or CDE or doc about.

Yes, it is wise to test even more when pumping...especially in the beginning. I think it's pretty common to experience far less lows....which is a good thing :thumbsup: . However, to prevent hi's, it's best to really get down your carb counting and watch your portion sizes.

Just one other note...don't expect that you will have perfect blood sugars. I think I did or at least more stable blood sugars and that wasn't the case. Ultimately, thinking that way is just going to set you up for disappointment. You will have highs and lows, but once you get your basal and bolus rates down, you become experienced with carb counting, and you get more into a routine, things will fall into place and it's quite possible that your control will improve.

Good luck, I hope pumping is everything you hoped it to be :)

Andrea

[middnite03]

ok i looked that page up :) LOL that means that the first basil program starts at midnight, not that you should start using the pump at midnight :) if he came out today, he should have told you not to take your am shot this morning, and start the pump program as soon as you hooked up...

the midnight start means that there are different basil rates for different times of the day, and that "day" starts at midnight, for ex..

my program is this..

12am - 3am .9 u/hour
3am - 8am 1.3 u/hour -this is for the dawn highs.....
8am-7pm .9 u/hour
7pm-9pm .2u /hour -my usual workout time.
9pm - 12 am .9 u/hour

when I asked why so many changes, I was told that I have to be de-programed after so many years of MDI, and learn how to think like I am on a pump. there is no doubt that it will take time, and your sugar's will be a roller coaster for a while, did he leave a number to get a hold of him 24/7 in case of an emergency????

[Cinnabon]

Ok... Im getting the feel for puling it out again.....

[duck]

Ok... Im getting the feel for puling it out again.....


Whaddya mean?

[duck]

If you're saying you're gonna give up on it, relax. You can indeed put it off again, like I have said before, it will be there when you get back, LOL. But we all need to wade in at some point. However, it may be better to "hook up" to it during the day since you seem a bit nervous about it. I was nervous too when I went "live" on my pump a while back...but just think, in about six weeks or so you'll look back at this time and laff at yourself and ask "what was the big deal anyway" just like most of us do.

In any case, we're here for ya, either way! :top:

[Clint]

I agree with duck.. it really isnt a big deal. I was a bit nervous too but frequent testing helped relieve my fears.

Like duck said, we are here for you.

[daddyo]

Cinnabon: I think the hard part for you is you realy were not on MDI's like most people that start the pump. so that being said, The NPH you were taking was your basil, now that is covered by pump automaticly when your trainer set it up. Now the only bolus you need is correction when your suger is high and you know after 22 years what it takes to get it back down, but remember, your on fast acting insulin now, not Regular, so the amount you take will be less, and it last for a shorter period of time, about 3 to 5 hours for most of us, and peaking at about 2 hours, maybe 3 YMMV. so start at half of what you would take, and ck your suger every hour if after three hours your not down to were you whnt to be figure out how much you need to get to the number you want. those two boluses together are probaly what you should have taken the first time + or minus it's a guessing game at first, but you'll catch on, after that you will have to bolus for every thing you eat or drink that has carbs, and that you just half to learn for yourself because we are all differant. If you want PM me I will give you my phone number and talk you through some of this I'm not working right now and have plenty of free time to asist if you want. Hang in there and don't give up. For me it has changed my life, only for the better, for some they like the way they handle it. It's only an opinion, you can use it or not,but a least give it a fair try. And don't foget the basil you are on is only a starting point, it takes alot of testing, and fasting to get that to the proper level. Remember when you learnd that in pump training that I hope you read on line or at least the CD take care let us know.

[Cinnabon]

Im Alive.......

I made it with very normal blood sugars through the night. Feeling VERY :sleep: .. , I know its a normal thing. Now Im about to eat breakfast..
Will I be taking a meal bolus according to my meal?

[Clint]

yes, use the bolus wizard and it will adjust your dose according to your BS and the amount of carbs you are going to eat

[Cinnabon]

Ok...

I cant begin to thank all the responses for all my questions....
So here is another one.... LOL
I wasn't very hungry this morning and I decided to just have 1 cup of milk w/ espresso(13 gm carb.) My blood sugar at the time was 56 and I did not bolus for this. Now 2 hrs later Im at 101. Good-- bad???

[Clint]

I say thats good... now test in about an hour and see where you are at.

In fact, if you tried to use the bolus wizard with a BS reading of 56, it may not have allowed you to use it... I cant remember for sure though.. its been awhile since I last tried that...

good work!

[middnite03]

thats a great reading, now how were your sugars throught the night?? were they that low all noght long, or just thos morning??

[Cinnabon]

these have been my reading so far:

10:00 PM 77
12:00 AM 137
1:00 AM 159
3:00 AM 138
6:00 AM 66
7:00 AM 89
8:00 AM 66
9:00 AM 56
11:00 PM 101
12:00 PM 81

[ksa01]

these have been my reading so far:

10:00 PM 77
12:00 AM 137
1:00 AM 159
3:00 AM 138
6:00 AM 66
7:00 AM 89
8:00 AM 66
9:00 AM 56
11:00 PM 101
12:00 PM 81


It seems as though you're doing pretty good for just starting out. When I started, my numbers varried much more than this.

When I first looked at these numbers, my first reaction is that your basal rates may be a bit high and may need to be adjusted. I say this because you dropped so much during the night (159 to 56 at breakfast) and actually started out the morning with a hypo (assuming you didn't bolus durning the night). If you have no active insulin from an earlier bolus and you go hypo, your basal rates are set too high. When your basals are set correctly, you shouldn't see that drastic of a change. This is what will enable you to be more flexible if and when you choose to eat.

Are you speaking with your doctor regularly so he can help you make these types of adjustments?

It takes a while to get your basal rates correct. At first, it's a lot of trial and error. Keep up the testing and record keeping and you'll figure it out.

[ang]

i'd have to agree that 56 (according to my canadian conversion to 3.1 mmol/L) is a low. and there was quite a drop from 10pm to 7am. you may need to lower your rate a little. but i would wait and see what tonight brings. other factors such as stress (possibly a bit of lingering NPH, although not likely) may have been affecting your sugars as well too. my pump rep told me that any change you make wait 3 days before changing anything at that particular time again.

other than the sleepless night last night, i hope you enjoyed your first hours as a pumper.

[Cinnabon]

Can someone tell me if after changing an infusion set (insulin, and resor.) does the insulin simply p/up (continue)right from the time you disconnected?

When you set different basal rates how soon do these changes take place?
(instantly, the next day?)

[duck]

Can someone tell me if after changing an infusion set (insulin, and resor.) does the insulin simply p/up (continue)right from the time you disconnected?

When you set different basal rates how soon do these changes take place?
(instantly, the next day?)

As far as your pump is concerned, it doesn't know when you're disconnected--it will happily keep pumping your basal until it either runs out of batteries, runs out of insulin or until you stop it/suspend it. So if you are changing your set/reservoir etc., you should suspend/stop your pump. My Cozmore has a "Load" feature which suspends the pump automatically when I am changing my set...My 508 didn't have a "load" feature, so I had to suspend it to make it stop the basal rate. But if I were to disconnect either, they don;t know that they are disconnected--Does that make sense?

When you change your basal rates, the change is instantaneous. But: If you make a change that affects a basal rate that starts at 9PM, and you do that at noon, obviously the "change" won't take "effect" until 9 hours later...

[Cinnabon]

Thanks Duck
yea, the MM rep that finally saw me didnt mention the Suspend thing as you change the set but I do know how to do it. Wouldnt Suspending cause all other features to diabale?

Yes my basal rate #1 starts at midnight.

[duck]

Thanks Duck
yea, the MM rep that finally saw me didnt mention the Suspend thing as you change the set but I do know how to do it. Wouldnt Suspending cause all other features to diabale?

Yes my basal rate #1 starts at midnight.

Let me say that I don't know the ins-and-outs of the 715--But the 508 when you suspended, it just stopped all deliveries including basal and bolus. On my Cozmore, there is a "Stop" command, and that does the exact same thing, it stops both bolus and basals.

So let me ask about your basal rate...Do you have more than one? My basals are as follows, starting at midnite:

Midnite: .8
5AM: 1.1
10AM: .8
12:30 1.0
3:30PM .9
Total: 22.15 units basal

I recently added the 5AM basal rate since for about two weeks I was waking up at 6AM normal but running high (in the 200's without breakfast) at my 8AM check...My "new" job has me getting up much earlier than I ever have consistently, and I think I have sort of created an artificial dawn phenomenon for myself. My weekend morning sugars are a little lower, so I am going to beging fudging with that soon and either lower or remove the weekeday 5AM basal.

It gets a bit confusing, doesn't it Cinn? :laugh: :fisheye:

[Cinnabon]

Yes it does...and with the great luck I have had, Im trying to make it as simple as possible. This is what I have:

12 am - .9
6 am - .85
8 am - .9

[Cinnabon]

1 down and 80 gazillion to go!!!!

I changed my site this morning (still sweating) and got it right!!!


:****mate:

[koblenz]

Hi Cin. Sorry I haven't been around to offer words of encouragement, very busy at work.

I changed my site this morning (still sweating) and got it right!!!

I know how you feel. I only started 7 months ago, but I remember those first nervous, sweaty site changes as well. It gets easier, and you get much faster at it. I remember it took me like 30 minutes to do the whole process at first... now I am down to under 10 minutes.

In a couple of months, you will look back and laugh at yourself... as I did. You will think "why was I so nervous and apprehensive...???". Oh, wait, I still laugh at myself.

Anyway, keep up the good work and you can do it!