[wastcougr]

Hey everyone,

So...got my pump started yesterday and so far I'm very, very excited. Only a couple of hiccups so far (I forgot to NOT take my Lantus the night before, and I forgot my vial of Novolog when I left the house - had to make a special trip back to get it before the appointment to start the pump) but otherwise... I just have a couple of questions that I forgot to ask the trainer. I know you all will help me out!

First, is there any secret to taking out the cannula after its 3-day lifespan? Do I just pull it out?

Next, do any of you use the bra attachment to carry the pump? I can't imagine how that would work...without it being blatantly obvious that something was there.

Next, what do you all carry with you at all times? One of everything? Even syringes or a pen for emergencies?

Finally, how often do you test your blood sugar? If one of them is high, do you treat every one with a correction bolus? Even if you're not eating?

Ok, I think that's it for now. I'll think of more, I'm sure.

Thanks again, everyone, for your help through this. It's taken me YEARS to finally start this after it was first suggested by my doctor, but I'm glad to be a part of this elite group.

[kansas]

First of all, congrats on starting on the pump.. It has helped me tremendously!

As far as the cannula goes.. just take it out, rip it off.. no big deal there (I wondered the same thing when I started too )

I just have the clip on my pump (like to attach to the waistband, jeans pocket, whatever), and if I decide I want to carry it in my bra, I just attach it front and center.. it rarely shows unless the shirt is cut lower in front or if the shirt is fitted...

On a daily basis, I only carry a syringe and insulin in case something goes wrong. But, I also have the freedom to leave work at anytime. However, if I am traveling out of town for a prolonged period of time, I will take one of everything... just in case!

I do check my blood sugars the recommended before and after meals. If you're high after meals, check too see how much insulin is still active.. (meaning in your system..) You can do that by starting the bolus procedure but entering no information.. when you get to the "estimate details" screen.. scroll down to the bottom and it will show you how much insulin is still active.. if there's nothing there, go ahead and correct.. this step saves you from giving yourself too much insulin and from potentially going low

Good luck with everything and enjoy your pump!

[Subby]

Cannula: yep, rip it out. No art to it.

Bra: no idea.

Supplies: I have a small leather bag (about size of a thick novel). In it I have spare insulin, syringe, set, reservoir, tegarderm which I use under the set, wipes. Basically, everything for an emergency and a change of set. This just sits in my normal bag that goes everywhere with me.

If I don't want my bag with me, insulin and pen/syringe is the minimum you want on you. This is in case your pump get a no delivery and you need a bolus to cover. I would still take my pump supplies with me if I expect to be gone more than a few hours, covering a long time on injected rapid boluses would not be easy or fun.

For this, I stick a penfill and syringe in my tester case, virtually forget it's there.

Testing: I typically test 6 - 10 times a day. Wake, before meals, 2 hr after and bedtime are the important ones in my book. Then basically any time things are different (like exercise) or I think things have not quite gone to plan (which unfortunately is common for me).

As for corrections, there are times when they are not such a good idea. The comments above about IOB are useful, get used to having an idea and checking what is in your system and what is likely to happen. A better handle on this will come with time and practice.

If you have just had a bolus and a meal in the last hour or so, you might have spiked but it might be coming down. Unless you severely spike or eat few carbs, your IOB after a meal will probably mean that a correction is minimal or non-existent anyway (depending on pump, too). It makes sense to let the bolus/meal run a certain amount of it's course before attempting to make a correction. Personally I'd correct at maybe 3 hours on from a meal if I'm feeling things really got away. Apart from that, anytime.

Have fun!

[Jan B]

Congrats! Kansas and Subby answered so well, I can't add a thing. Oh yeah . . . once I had a bent cannula (I knew because my bg was 300+) and I was away from home for a few hours. I was very happy I had another (and inserter) in my little supply bag in my purse.

[wastcougr]

Everyone,

Thanks so much for answering my novice questions! I'm still curious what others have to say, of course, so if you feel inclined to answer, please do.

I love the idea about looking at the IOB and then determining if a correction bolus is needed.

As for the supplies, I already felt like I had to carry a beach bag with me everywhere; now that I've got the pump going, I think that idea is going to get reinforced. I was thinking about just keeping one of everything at work, in the car (with the exception of insulin or anything else heat-sensitive), and one at my parents'. Those are the places I find myself most often, and then carry a pen cartridge and syringe with me at all times.

OH! I remembered something else I wanted to ask you all... Yesterday, when I was learning how to use the Sof-Serter for the first time, I pressed the two buttons to release the mechanism after it was cocked and nothing happened. This happened 3 times before the CDE and MiniMed rep figured out what the problem was. The issue was that I wasn't focusing the force of pressing down on the right part of the buttons. Has anyone else found that device to be sensitive as far as where you push down to make the mechanism insert the cannula?

[Keezheekoni]

I usually just insert my canulas manually. I hate the way the Sof-Serter works. I'm used to the Cozmo Cleo's. I loved those.

As for your other questions... I just pull it out, no I don't use the bra attachment. I like the belt clip and just keep my pump on my waistband, much the way we used to carry pagers around.

As for supplies I keep with me, I have a see-through plastic make-up bag that I keep my meter, strips, lancet, vial of novolog, and the two extra pieces of the reservoir in. I don't carry any extra sets, tubing, etc. Unless I'm going away from home for more than a couple of hours...then I throw an extra set, IV Prep, and reservoir into that same make-up bag. But, I'm a stay at home mom, so I don't go away from home all that often...

I typically test 12 times a day. More if I'm extremely low or high. I will do corrections if, two hours after eating, I'm not where I expect to be. For lows, I test every 15 minutes for an hour.

[SGT Shoutmore]

Here ya go, my regmine is fairly similiar to others as you will see, but here we go.

1. I remove my infusion set (cannula) in the shower, I squeeze it slightly to insure no puss comes out, if so, infection control. If not, I move on to cleaning the site with betadine and allow the water to wash everything away.

2. I'm a guy, so, no bra attachments for me, but, men and women can use a necklace to hang the pump from. Especially handy when bathing or changing clothes.

3. I have a fanny pack that I carry: 3 Syringes, 6 alcohol wipes, extra test strips, 1 reservoir, 1 infusion set, 2 Tegaderm strips, my glucometer with supplies, 4 sugar packets, 1 glucogon kit, several wrapped pieces of hard candy, copies of my prescriptions for syringes, insulin, needles, pump stuff, and of course, a bottle of insulin (Remember to remove from pack and keep cool when returning home for the evening to prolong life of bottle, use this bottle to refil reservoirs from so you are not wasting insulin by keeping secondary bottles exposed to warmer temps. I also keep a card with emergency information on it. That is my "KIT".
Restock as necessary.

4. I test from 4 to 12 times a day, depending on what is going on and how I am feeling. I test before I drive anywhere, before and after any kind of physical activity that can even be considered medium and for longer than 5 minutes. I test when I don't feel "odd" but SHOULD.

My pump is programmed with my TARGET BG RANGE, anytime my meter tells me and my pump is above target range, I use a corrective bolus that my pump suggests to place me on target while factoring in Insulin On Board. Even if I am not eating, I bolus for the high with a corrective bolus. My goal is NORMAL A1C levels, of which I have obtained through this practice, this allows me to live a more normal life and expect some longevity. And there you have my ritual in a nutshell.

Note: You will have tons more questions are that is very normal, places such as this are good to ask them. You will also feel slight anxiety as you are not used to this new machine doing for you what you did on MDI, that too is normal, there will be much excitement too, it is in many ways a new toy, until you see it for what it is, it is your mechanical pancreas. You will soon get very comfortable with it and see it as a part of you, even though it is plastic and full of gizmos. I am 4 months into using my first pump, I am happy I have it.

[Subby]

Ah, a couple more points about the supplies issue.

I also carry a spare battery, very small to take and handy to have, you can change over the second you get a warning and be done with it

I suggest that after a few weeks when you get a real feel for the essentials of pumping and drop away the extraneous bits and pieces, you put together a little pump supply bag and see if it's not quite small and easy to keep with you. I was suprised how small it all is once you streamline things, so it's surely worth a go.

You know, the biggest item that made it a pain to keep on me was the quickserter. Once I discovered that manual insertion was easy (if you've been on injections, it's a cinch) and that I get better results from manual insertion the removal of the quickserter made the whole package really minimal for me.

YMMV, as with pretty much anything diabetic.

[xMenace]

Originally Posted by Keezheekoni

I will do corrections if, two hours after eating, I'm not where I expect to be.

Same here. But the point on expectations is crucial. Are you having one of those off days? Are you sick? Stresssed? Was it a high GI meal? Bad set? Bad absorption? Was there a new supernova? More often than not, correcting will send me low. One has to spend lots of time learning how they behave to get a good feel for what best to do.

[davef]

Christi,

I can't offer any advice on pumps, but I did want to say congratulations on getting yours, it seems to be wonderful for people using them. Hope it works even better than you expect and gives you extra freedom, enjoy and congrats.

[shabbie]

First, is there any secret to taking out the cannula after its 3-day lifespan? Do I just pull it out?

just pull it out, actually pulling the sticky tape is more tricky for me, just nice and easy does it or i end up removing a layer of skin with it!

Next, do any of you use the bra attachment to carry the pump? I can't imagine how that would work...without it being blatantly obvious that something was there.

never used a bra attachment. i do use a make shift thigh holster, using a tubular bandage folded over, i wear my pump on my leg (outside of thigh) when i wear nice summery clothes. otherwise i just clip it to my waist band at the small of my back ~ it doesnt get in the way and no-one really notices it either

Next, what do you all carry with you at all times? One of everything? Even syringes or a pen for emergencies?

i only carry my test kit and insulin pen with spare needles....thats all.
when i travel to visit family i take everything with me, couple of spare set changes, even a spare insulin pen just in case!

Finally, how often do you test your blood sugar? If one of them is high, do you treat every one with a correction bolus? Even if you're not eating?

initially i was testing 10-12 times daily, i now only test 4-6 times daily as things are pretty stable and predictable for me.
my corrections are calculated exactly the same as on mdi, you dont need to eat to correct a high. im quite happy to correct between meals, of course you must take into consideration any bolus insulin you have still working when you take your next reading for the next bolus

most of all just relax and enjoy the freedom pumping gives you i know i do

[kgm0612]

Congratulations & Welcome to the "Pumper's Club", Christie. I also forgot my vial of Novolog the morning of my pump training and had to drive 20 minutes back home to get it!

Karen

[RLK]

Christi-
I do pretty much the same thing that everyone else does. The only exception would be the spare bottle of insulin. I don't carry one unless I'm away from home overnight. But I do carry a prescription for a single vial of Novolog along with my set change, syringes, extra strips, etc. That way, I don't have to worry about keeping the vial fresh, or accidentally "cooking" a vial in the car while I'm doing site visits for work or whatever. If something goes wrong with the insulin in my pump, I can always run to a nearby pharmacy.

[Beowulf]

I do everything mentioned above (except the bra thing since I'm a guy). Plus, I carry some glucose tabs in my little kit that I take with me everywhere. Only had to use them a few times in the last 4 months, but it's good to know that I have something very close to me if the occasion arises.

Beo