trick to reusing tubing?

[HollyB]

Our Animas rep told us we could use one set of tubing to two infusion sets (essentially reuse the tubing once) and sold us a "Combo" box of Comfort shorts that have half as many tubes as sets. BUT this is the 2nd time Aaron has reused the tubing, and the second time he's run high after a set change with the Comforts -- not way high, but he went up to 11 (about 200?) before bed last night and was still there when I checked him at 3:30 a.m. -- very unusual for him. I'm about to wake him up to check him this morning.

Anyway, it occurs to me that this might be something to do with reusing the tubing -- like maybe you could get an air pocket at the end you unscrew and reattach? Have any of you have experience like this, and if so is there some trick to keeping the tubing filled when you change cartridges/sets?

Thanks you guys!

[JediSkipdogg]

I think what you are suppose to do when reusing the tubing is to completely reprime it. During training they should have taught you to make sure no air bubbles exist. If you reuse the tubing with insulin in it and connect a new cartridge to it, there will ALWAYS be about a 1-2 unit air bubble created. That is why you are suppose to reprime the tube. I know some either just prime till the bubble is out or they pull the insulin back into the cartridge, disconnect the tubing, then fill with more insulin. That is so they don't waste insulin.

Now....there is a trick. Here is how I do it. This is not recommended though unless you think you can fully do it. Hold both ends of the tubing in your hand, next to each other, with both open ends pointing up. This makes sure the insulin just doesn't drip out of the tubing. Now, is the hard part, which takes practice, and is the not recommended part, I'll explain why in a second. Turn the cartridge you just filled with insulin upside down (without the needle anymore) and hold the opening directly above the end of the tubing where you would connect it to. Slowly push down on the plunger getting about 3 drops out to form a small little "insulin dome" on the end of the tubing where the cartridge connects. Without turning either end upside down, connect the tubing and cartridge. You have just prevented an air bubble from forming where the two connect.

Now, I said there was a catch. The problem is, when turning the insulin cartridge upside down, you are pushing any small air bubbles that may have formed into the cartridge and not out the opening and through the tubing. That is why for 99.99999% of the people out there, I don't recommend trying this and I recommend just re-priming the tube.

[David]

"Anyway, it occurs to me that this might be something to do with reusing the tubing -- like maybe you could get an air pocket at the end you unscrew and reattach?"

It's possible. Try priming the tubing before you connect to the new set. Watch for droplets of insulin coming out the connector. Also, don't forget to prime the cannula of the new set (I believe it's 0.5 units for Comforts).

David

[jeggeman31]

Anyway, it occurs to me that this might be something to do with reusing the tubing --

Here is one more thing you may want to think about also:
What you need to do to figure out if it could possibly be air bubbles causing this is figure out his Basal rate, and how long it would take that air bubble to to from the end of the tube to the site. If you changed the site, kept the tubing then in 30 min he spiked to 200 I don't think it is the air bubble in tubing. Unless he has a High basal rate and that air bubble went that far in that short amount of time. Also what part of the body is he putting the site at ? If it is in the same area each time, have him swap sides of the body. I found when I use my legs I run higher than when I use my tummy.

And for the record I re use my tubing for one to two weeks at a time.

[HollyB]

That all makes sense, thanks. Completely repriming seems like the safest bet for beginners.

Aaron actually had a nice normal reading after the set change (and was in the low 7s two hours after dinner), then went high late at night, stayed high until at least 4 am, and woke up at 9 with a perfect BG. I'm guessing either a) the Swiss Chalet fries gave him a really long-lasting delayed high BG (never happened before, but it's still early days for him and things change) or b) there was an air bubble at the end of the set that resulted in a temporary interruption of delivery.

I've been reading with interest the thread about combo boluses for pizza (the staple of the teen diet) and Aaron's going to start experimenting with it -- that should help with the a) scenario. And we'll reprime when reusing tubing.

Or -- here's a thought -- what about dripping a few drops of insulin left over from the OLD cartridge into the tubing, as JediSkipdogg describes? That way you wouldn't have to worry about bubblesin the cartridge?

[JediSkipdogg]

Or -- here's a thought -- what about dripping a few drops of insulin left over from the OLD cartridge into the tubing, as JediSkipdogg describes? That way you wouldn't have to worry about bubblesin the cartridge?

The problem is you have to keep the tubing side of the connector pointing up. Which means the cartridge side connector pointing down not allowing air to get out. If I could do a life in person demo, I would show everyone the perfect way to do it. As there is a trick to it to get it perfect that I can't really explain. I only do all that because I like having the insulin in the tube so it gives me an extra 14 units in the cartridge. If the IR 1200 gave a true 200 units, I wouldn't have the problem, and a 300 unit cartridge is just too much.

[poodlebone]

I reuse tubing all the time. I get the Silhouettes that have only 5 sets of tubing per 10 cannulas (same as Comfort sets). But, not only do I reuse the tubing I also keep using the same reservoir until it's empty, and then I change the reservoir & tubing. I use the same res/tubing for 3 or 4 cannula chnages. I have a 300 unit reservoir and I am not a teenage boy with raging hormones & higher insulin needs, though! My 300 unit reservoir lasts 10-12 days.

Since my tubing never gets disconnected from the reservoir I don't have to worry about repriming it, or about air bubbles getting in. I just insert a new cannula and hook back up to it. If I was going to attach old tubing to a new reservoir I would definitely ptime.

[Shotokan]

My 300 unit reservoir lasts 10-12 days.

Question: Is it risky to keep insulin in a reservoir for 10-12 days? I'm not thinking of how temperatures affect it. I have some vague recollection that insulin breaks down faster in a plastic reservoir than it does in the original glass vial.

[psilocybin]

Our Animas rep told us we could use one set of tubing to two infusion sets (essentially reuse the tubing once) and sold us a "Combo" box of Comfort shorts that have half as many tubes as sets. BUT this is the 2nd time Aaron has reused the tubing, and the second time he's run high after a set change with the Comforts -- not way high, but he went up to 11 (about 200?) before bed last night and was still there when I checked him at 3:30 a.m. -- very unusual for him. I'm about to wake him up to check him this morning.

Anyway, it occurs to me that this might be something to do with reusing the tubing -- like maybe you could get an air pocket at the end you unscrew and reattach? Have any of you have experience like this, and if so is there some trick to keeping the tubing filled when you change cartridges/sets?

Thanks you guys!

i always reuse my tubing twice...than i start a new one....maybe its a bad site

[psilocybin]

Question: Is it risky to keep insulin in a reservoir for 10-12 days? I'm not thinking of how temperatures affect it. I have some vague recollection that insulin breaks down faster in a plastic reservoir than it does in the original glass vial.

insulin is good for 28 days out of the vial..so you should be fine

[poodlebone]

Question: Is it risky to keep insulin in a reservoir for 10-12 days? I'm not thinking of how temperatures affect it. I have some vague recollection that insulin breaks down faster in a plastic reservoir than it does in the original glass vial.

Maybe, but so far I haven't had any problems. The insulin works just as well on Day 10 as it did on Day 1. I have only been doing this since last autumn, so have not yet gone through any summer days of 90 degree heat yet. I'll definitely start changing out earlier if I notice erratic BGs after a few days.

The pump companies will tell you not to do this because (1) they need to cover their butts in case anything at all goes wrong and (2) if you keep the same reservoir for 12 days instead of using 4, they lose money.

[spike]

The pump companies will tell you not to do this because (1) they need to cover their butts in case anything at all goes wrong and (2) if you keep the same reservoir for 12 days instead of using 4, they lose money.

Pretty much the same thing with insulin officially being good for only 28 days out of the fridge. (butt covering) :)

[psilocybin]

i heard its good till its expiry date while in the fridge...is this just for cartridges?

[Tim_Roy]

My nurse practitioner keeps reminding me to only leave sets in for two days at a time in the summer.

It can get up to 110 here in southern Nevada. Of course, I've got AC in my home and car, but there's lots of walks to the car, and the car tends to be about 140 degrees when I get in it on a hot day.