Considering - but have 4 questions

Diabetes Technology Insulin Pumps
1

I have been wondering about the pump and hearing and seeing how much people love it I'm debating. Can it really be that great? I have an A1c of 7 so why bother.

But here are my questions:
1.Sleeping - tied up? seriously?
2.Sex - What do you do with it and doesn't a tube stuck into you get in the way? I'm married and my husband doesn't freak out about any of my diabetic things but this is one I'm not sure he would appreciate as much.
3.Swimming - what about the summer? What about bathing suits and the lake?
4.Dresses - Where do you shove it when you are wearing your fabulous tight fitting party dress? (BTW my boobs aren't big enough to put it between them so please don't suggest that).

Is it really better than injections - now I don't have anything tied to me and can run around everywhere. And the cost? isn't it super expensive?

Thanks,
Amy

2

1. I don't notice but I am very sound sleeper since I started working out a lot.
2. Disconnect if you want. If it's going to take a while, you can prebolus a couple clicks, like .2, .3 or so U to "cover" the missing basal.
3. when I swim, it kills my BG, I don't do it that often but just take the pump off and pack a spare set in case it falls off.
4. I'm not sure about that, there's thigh things. Some people report they don't work that well but there's compression sleeves for running and I have used them and they'd have no problem holding up like 1/2 dozen pumps.

3

Hi, I debated a pump for a LONG time...back and forth, and just one day im like Im fed up with MDI, and just the lack of flexibilty, not being able to precisely dose like you can with a pump. My A1c before going on my pump was 6.6...on a pump I have gone to 5.5, and I dont super low carb either. I average around 30 carbs a meal.

To me the advantages of being on a pump far outweighs any negative. I don't even notice mine when sleeping. Most of the time I just attach it to my pajamas and call it a day. I have a 32 inch tubing so it gives me a LOT of flexiblity

Sex, you can either toss it to the side...IF u want to wear it while engaged in activities or unhooking from your pump temporarily too.

Swimming, all depends on what pump you are looking out. I dont care much for swimming anymore so mines a Minimed...but the Omnipod is tubeless and waterproof too. So that kinda solves a lot of your dilema's. I'd check out the Omnipod group if u were interested in that particular one.

Dresses, well I dont really wear dresses. BUT they do make like garters specifically for your pump. With a longer tubing 32 inch or so that could work nicely.

4

I’m not diabetic, but my 13 year old son is.

  1. sleeping - my son hooks his pump to his boxers & it doesn’t bug him at all; really thought it would but he even lays on it at night and it never bothers him - no tangles either
  2. sex - no clue, since my son is 13, I don’t even want to think about it! If it were me, think I’d disconnect.
  3. swimming - my son takes his off while swimming; he tests frequently and hooks up to bolus; he tends to run on the low side while swimming or playing in the water; he doesn’t mind his site showing but if it were me, I’d place my site where it doesn’t show in a swim suit
  4. dresses - if you only wear your fabulous tight party dress on occassion, you could always take a day off from the pump and use MDI for the day; we had to do this recently when my son left his pump in his gym locker overnight and it wasn’t so bad; shot of lantus, humalog shots for food, & a reduced basal when he hooked back up (we underestimated lantus dose so he was a smidge high), then, after lantus left his system, back to normal

Good luck with whatever you decide.

5

1.Sleeping - tied up? seriously?
I just put it on my pajamas, it takes a while to get used to sleeping with a pager on but I think nothing of it anymore
2.Sex - What do you do with it and doesn't a tube stuck into you get in the way? I'm married and my husband doesn't freak out about any of my diabetic things but this is one I'm not sure he would appreciate as much.
My hubby knows how to disconnect and that's all I need to say about that :)
3.Swimming - what about the summer? What about bathing suits and the lake?
I don't really like swimming but I just put the infusion set under an area that will be covered by my suit
4.Dresses - Where do you shove it when you are wearing your fabulous tight fitting party dress? (BTW my boobs aren't big enough to put it between them so please don't suggest that).
I tend to not buy tight dresses for that reason, I buy a-lines or cocktail dresses that flare out at the bottom, that way I can use my spi-belt to keep the pump close to me but not inbetween my chest

Honestly, once you see the huge benefits of pumping, these concerns are trivial. I have my good days and bad days on the pump too, but I went back to MDI once and I don't see myself doing it again because the pump is so much easier to work with in term s of being predictable. I can keep track of insulin on board for example, with MDI I would sometimes shoot up and not keep track of the time I did it. Hope that gives you some insight.

6

Hi Amy ...happy to read about your interest in pumping ! I have been pumping since 2001 .Pumps are costly , hence our advocacy with the Governments , around CAN $ 7,000.00 .Monthly pump supplies approx $ 250,00 ; having Extended Health Benifits helps a LOT . I paid $ 400,00 for my Metronic Veo , rest covered by PBC . I like the flexibility with the gadget, even flying through time zones ( feel very comfortable travelling by myself ) ...for me it takes more hours , than MDI ...then I remembered NPH :( ; Lantus and Levimir unavailable in BC when I changed to pump .I use about 20 u of insulin daily and being able to bolus small amounts has served me well .
1) attach my pump to nightie bottom ..need to keep pump in the area of the CGMS sensor ...( watch for cats/kittens not chewing on tubing under blankets ...I have heard of horror stories of this type :))
2) well, you know our ages ... do I need to say more, ha, ha ?? I do know a lot of pumpers your age ...most of them have children , born while Mom or Dad live with a pump :)
3) swimming ..I plan to swim in Waikiki ; did last year in the Condo pool in Maui and disconnected the pump , poke finger prior and after . I did not go into the ocean , plan this time with fewer high waves . Have you ever heard of Scott Dunton , pumper and well known Surfer, originally from Hawaii ?? ...and Seb Sasseville , Canadian who does Iron Men .
4 )I don't wear tight fitting stuff but I have a fav. black dress with seams up front ( had this made prior to pumping ) ; seamstress added a zipper and I get to hook pump onto my slip and panties ...it works ! Also a cotton long dress , which comes to Waikiki , with a pocket ...seamstress made a hole in pocket and I can hang pump on panties . Brides wear their pump in their hairdo :)

7

Thanks AustinMom - I thought that once you were on the pump you had to have it all the time. I didnt know you could take a break for a day. that really helps.

8

Hi Nel, Yes the cost is a big one. I'm just not sure that it would be better than my current regimine but everyone says it is. I might "try" it out and see how I go. Still thinking.

9

You might not have the same control as you do on your pump, but if it’s a special occassion, I think that’s probably okay. Your endo or CDE could guide you through it, but I know a number of people who take “pump vacations” - some because they’re going on a trip to the beach where MDI might be better, some just to keep all the MDI stuff fresh in case you need it. The pump does all the calculations and such for you, so stepping back and having to do it manually once in a while keeps that skill fresh.

Good luck!

10

Cost is a biggie. Depending on your insurance you can expect to pay $200-$2,000 (more than likely mid range) just to get the pump. Then anywhere from $10-$200 (more than likely mid range)monthly for the supplies.

Every question you asked I have gotten from patients wondering about a pump. I responded the same way everyone above has responded to the questions and once the people had their pumps and were using them I haven't heard one complaint or had any further issues with this type of thing from those people who did decided to get a pump. It seems like these are important issues but quickly become secondary once you start wearing the pump.

Also, for swimming, all you need to do is give a little bolus for your basal, disconnect, swim, and all you have to do is come back at least every 4 hours for another "basal" bolus. If you eat or need to correct you can add all of it together, bolus, and be fine to disconnect and go back to swimming. The infusion sets sticks out so little you would be able to put it under your swimming suit without too much of a bulge. Of course there is always the option to go back to shots like AustinMom suggests. Every time I do that I can't wait to go back to the pump.....

BTW- I spoke to a lady who stated she also has small breasts but uses the clip on the pump to clip to the middle of the front of the bra. She said it works great. I didn't check her out to see if it "bulged" because I didn't want to be rude but thought I would throw that out there.

11

I had no problems with the thigh thingy. I was not used to wearing what can be described as closely related to compression stockings so it itched and was a little bothersome that way but otherwise it seemed to work great. Maybe my legs are so muscular it held it up good? :-)

12

I would absolutely NEVER go back to needles! I switched to the pump 10 years ago and never looked back!

1. I just lie it in bed next to me. Sometimes I get tangled from tossing and turning, but a little tug wakes me up and I just re-adjust.
2. Either leave it on or unplug. Anyone that is close enough to be intimate with you won't mind! Sometimes the pump is the last part to come off in a striptease ;)
3. I wear tankini's and just clip the pump to the bottoms. Then when I want to swim, I disconnect. I never swim for long, so I rarely need a correction bolus.
4. You would be surprised at all the places you can find to hide a pump. Lately I've been sewing pockets inside dresses for the pump, but upper thigh works too. My fiance knows the last question before we leave the house is "can you see my pump?". 9/10 times the answer is no.

I promise you'll love the pump! There will be a small adjustment period, but you won't regret it.

13

Hi Amy,

You pose some interesting questions that I believe most people have when they are considering a pump. For me, the pump is the best thing I have ever done for my diabetes and myself.

Sleeping - I usually clip it to my boxers or lay it next to me in bed. It never bothers, I think my S/O got tangled up in it once, but we had a good laugh and hug over it.

Sex - I usually suspend it and take it off. The pump can be away from a person for up to an hour without effect; or at least that is what the book says. My S/O knows how to run the pump, and usually takes it off from me, right after I have taken off something she is wearing. (It is a good idea to teach your partner the basic operation of your pump, in case something goes wrong and you cannot manipulate it.)

Swimming - I don't swim. I do have an Animas Ping and the pump is warrantied waterproof to 12 feet deep for 24 hours. I am told that many swimmers use an Animas. If you take the pump off for a swim, remember to use a plug in the infusion port to keep it dry. Use the plug when showering, too.

Hiding and placement - I have no idea how to comment here, but there are many places that sell devices that deal with that very issue. There are clips, pouches, holders, etc., that are sold all over the internet to deal with the issue. I like the Animas Ping because it can be controlled by the meter, and the pump seldom needs to be touched.

I was taking seven shots each day before the pump. It was a hassle and I had poor control. I would be hard pressed to go back to MDI. As far as the cost, yes, they can be expensive, but I believe that most insurance companies pick up the bulk of the cost. For me, the results override the out of pocket cost.

Good luck in your choice. I think you will love the pump.

Be well.

Brian Wittman

14

Hi Amy: Why use an insulin pump? Because it makes your life better, much much better. There are so many reasons why! Better control, fewer nighttime hypos, easier to manage exercise, who wouldn't want all that? I believe that we should be using the best available technology for ourselves, and the insulin pump trumps MDI any day.

1) Sleeping. I wear these adorable heart boxer pump shorts from PumpWear Inc. (link)
2) Sex: I use a velcro belt pouch so I don't have to disconnect (but beware because sex can cause lows)
3) Swimming: I have the Animas Ping (waterproof) and I wear a tankini. Just had a fabulous Caribbean vacation with lots of snorkeling.
4) Dresses: Someone else will have to answer that question.

Bottom line for me, yes a pump may have some additional hassles at times, but I want to take the best care of myself possible so I use the pump. Thankfully my insurance is good so cost is not an issue for me (for which I am extremely grateful).

15

For me, yes, the pump has been that great. But it doesn't meant that it's "that great" for everyone. There are plenty of folks who find it far more beneficial to stick with MDI. I think it depends on what you're looking for, your lifestyle, what you need, etc. Everyone is different and I think it's great that we have options.

Onto your questions.

1. When I sleep, I don't even notice the pump anymore. I did for the first few weeks, but once I got over the fear of ripping it out, it just became a nonissue. I clip it to my shorts or just let it float around in the bed. No pump accidents so far.

2. I disconnect for sex. Like everything else, you (and your partner) get used to it. In fact, asking if I'm disconnected has turned into a kind of, um, pre-sex joke (as in, "So, uh, are you disconnected?") If you have a good relationship, your partner will understand. First and foremost, you need to do what you need to do to keep yourself healthy.

3. Yeah, this part does annoy me a little. I love to swim, and I do disconnect when I want to go in the pool. However, I can really only stay disconnected for about an hour. The Ping is waterproof, but I still would not trust it being submerged in water. Many people find that, if they are careful, they can disconnect for upwards of 2 hours (with some testing inbetween, but you would do that anyway!)

4. My boobs are pretty small too (A-almost-but-not-quite-B cup) and I have no trouble stashing my pump in my bra. I wear those not-really-bras (they kind of look like half t-shirts) and I put my pump between my boobs. The Revel (the pump I use) is small enough that no one notices. There are also leg holsters you can get, but I like between the boobs better (easier access).

Yes, pumps do cost money. They are an immediate expense (for the pump itself; insurance covers most of it, but I had to pay about $900 out of pocket) and then there are the monthly supplies (infusion sets, tegaderm, reservoirs, etc). Again, insurance covers these things, but it all ends up costing quite a bit more than just insulin and syringes.

If you can afford it, I would say give it a try. You can always go back to MDI.

16

Hi Amy!
I've been on a pump for 11 years now, here are my thoughts: the fear of being tethered is far greater before you start using one. After a while you mostly forget its there, or feel naked without it.

1. When I first got it, I would only wear sleeping shorts or pants with pockets, and tuck it in the pocket. Now I clip it to my waistband or just leave it next to me. I don't notice much, and sometimes I wake up a little tangled but it's no problem to untangle.

2. Sex- I usually leave it on if the site is in my stomach and the pump sits next to me on the bed. if the site is in a place like my upper butt or thigh, which is more likely to get in the way, i'll disconnect during the activities. The blood sugar lowering effect of the activity usually more than makes up for the short time off the pump.

3. swimming- I wear a tankini so I can clip the pump to the waistband, and the tank covers the sites on my abdomen. I'll usually take it off for the actual swimming, but I have an Animas which is waterproof, so I don't have to. I've worn it white water rafting and snorkeling under my wetsuit.

4. Dresses- I've done the pump in bra thing, but now I have a tummitote belt that works GREAT under dresses. I usually wear empire waist dresses anyways, so it's virtually hidden. wore it like this under my wedding dress too, and just went to the bathroom to bolus for dinner- which I needed to do anyways!
Tally gear

My thoughts on the benefits of the pump are that it is so flexible and portable. if I'm teaching a class during mealtime, it's ok if I'm not eating lunch until 1pm. If I go exercise or go on long bike rides, it's much easier to reduce the amount of insulin I'm getting to balance it out. and I don't have to carry a vial + syringes or a pen with me on the bike, or have to give a shot during a seminar at work if it's over lunch.

Right now I've got the best A1C of my life, 6.3%, and I attribute a lot of that to the flexibility I get from the pump.

Beth

17
  1. I put it in what I call “pump pjs” and lay it in bed next to me. The pjs are a flannel cover from t & j designs – it pads it, so it’s more comfy if I roll over on it. Which I hardly ever do.


  2. Take it off and lay it on the nightstand. I mean, socks aren’t sexy either, right? But youdon’t fret about wearing socks, you just take them off. (no need to push any buttons on it, either – you don’t need to suspend it. The amount of insulin that comes out is not enough to make a mess, unless you have huge basals.)


  3. Some people take pump vacations and go back to MDI temporarily. I just clip it to the side of my bikini bottoms and take it off when I swim. You might want a cold pouch for it if you’ll be in the sun and heat.



    Re taking it off – just reconnect for a minute envy now and then and give yourself a fixed dose to replace lost basal. No biggie.


  4. Thigh thing. Can’t remember where I bought mine… Online somewhere, though, google around. ‘insulin pump holder’, that kind of thing. Mine’s like a garter with a pocket, and I put the pump on my inner thigh. (my boobs aren’t big enough for that trick either…). Not 100% perfect – you have to classily reach up your dress to bolus – but it works.



    I LOOOOOOVE my pump and wouldn’t go back to MDI for the world.
18

i have the tubeless Omnipod so...

1) Can be uncomfortable depending upon the site, but no problems.
2) Can be uncomfortable depending upon the site, but no problems. Definitely had to have a discussion with the GF before deciding to go on a pump in general, but she was oay with it and haven't haven't had a problem since making the switch.
3) Omnipod is waterproof. No problems.
4) N/A.

19

PS ...about coverage : BC Pharmacare will kick in after one's deductable has been reached for reservoirs and infusion sets .Also remember you may qualify for the Disability Tax Credit ( regardless of pumping ) .
What is covered in BC : http://www.diabetes.ca/documents/get-involved/BC11.pdf