Pump Day!

Yesterday my son started pumping! He is so excited about not getting shots. I love the tslim x2 so far but we have a couple issues. I was on the phone with Dexcom and Tandem all day yesterday. They seem to be passing me back and forth. When I try to link his ipod and pump to dex, they both stop reading numbers within 30 minutes. They work independently but not together. Dex says since the Ipod works, it’s a Tandem issue. Tandem says since the pump works, it’s a Dexcom compatibility issue. Tandem says you can’t use and ipod with a receiver…which I know is false because I have used his ipod and dexcom receiver together many times. Dexcom says there is no compatibility issues on their end. By the end of the night, someone at Tandem told me that they would have to speak to a supervisor…who left 20 minutes ago. Now, I am supposed to get a call back tonight. The Dexcom/Tandem partnership is a mess! I can’t get definite answers. Everyone I have talked to is completely lost. I absolutely asked about using the pump and Ipod together before starting the pump purchase and was told by the rep that they would work fine. I am disappointed. Good news…he does have a high enough insulin requirement to use Tslim! We figured his initial basal by taking 80% of his total daily dose and dividing by 24. We used that number as a starting point and adjusted up and down accordingly. The pump is easy to use and I love having his Dex numbers on the pump to calculate corrections. We started with the t30 infusion sets and were able to insert in his thigh. He ran high yesterday but I expected that since he didn’t get his basal the night before and we were playing catch-up. Hopefully we will get this Ipod thing figured out. I refuse to buy my 11 year old an Iphone. I just won’t. I asked Tandem what devices were compatible with the Dex and Pump (maybe a watch?) and they told me Dexcom has a compatibility list on their website. LOL Ipod touch 6 is on that list so…I am just lost.

There should be no difference (well - for purposes as discussed) between an iPod Touch and an Apple iPhone. We are running the Dexcom G5 Mobile App version 1.7.2 (one back from the latest) from an Apple iPhone 7. This is against the Dexcom G5 transmitter.

At one point, we were running the Apple iPhone at the same time as the Tandem t:slim X2 (with G5 integration update) both against the Dexcom G5 transmitter with no problems.

At another point we were running the Apple iPhone at the same time as the Dexcom Receiver both against the Dexcom G5 transmitter with no problems.

If you want any troubleshooting assistance, post back and perhaps we might have any suggestions based on exactly how you are linking up.

We have used an Apple iPod 5 touch in the past but that was before the Tandem t:slim X2 so we only ran the iPod and the Receiver together - both against the G5 transmitter.

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I know there should be no difference. I tried telling them that. I have ran his Ipod since we got the Dex5. I have had the Dex receiver and Ipod connected at the same time. Tandem insists that you can only run a phone, not an ipod which makes it a Dexcom problem. Then they pointed me to the compatibility list which includes Ipod6. Dexcom says there is no compatibility issue with them so it must be the pump blocking out the Ipod. They are all clueless. At first, Dexcom had me turn of blue tooth and forget the Ipod then reconnect. That worked for a few minutes then said lost signal and then 3 question marks. 3 dash marks where number should be on pump. They then said it was a sensor issue and Tandem deals with sensors now. I replaced the sensor. Same problem. I told Dexcom I am at the end of my 90 day transmitter period. It ends this Saturday. They told me it could not be a transmitter issue and to not replace the transmitter until Saturday. Tandem is supposed to call me at 5…we will see.

Tandem is just wrong on this.

This is correct as the Dexcom G5 Mobile App has OS and device compatibility checking built in. The Dexcom App will not run on an incompatible OS or device.

Well that just makes no sense. Obviously the sensor does not transmit anything. Sounds more like somebody trying to give you busy work and when you call back a different support person would pick you up.

You will be able to run the transmitter longer. If you want to swap it out as a test that is one thing so as to prove whether or not the transmitter is an issue. You can run an extra 2 or 3 weeks from the transmitter past the 90 day mark.

My suggestion would be to get everything running using the existing transmitter against the Dexcom Receiver and the Apple iPod. Alter the Dexcom Transmitter ID in the Tandem pump so it can not connect. Wait 24 hours for the Tandem pump to completely clear. You will see the pump display revert from the cgm interface back to the standard non-integrated t:slim interface.
Then in the middle of a sensor session and with the iPod running and delivering proper cgm data, swap the Dexcom Receiver out for the Tandem Pump. See if the pump picks up mid-session without knocking the iPod.

If you want help in how to swap the receiver for the pump let me know.

This would be what I would try although perhaps you already have done this.

BTW - Which iOS are you running on the iPod Touch 6? Is it still one of the 10.x operating systems or have you already downloaded the recently released version 11?
(Which I don’t even know if the iPod Touch 6 supports it but figured worth a question.)

Also which version of the Dexcom G5 Mobile Application are you running on the iPod?

You don’t by any chance have the Dexcom receiver still running do you? You need to completely turn it off before linking your pump and other device.

If you turn off the receiver at a particular point in time, you can brick your receiver.
I just had mine replaced due to this as it was only 11 months old and still had 1 month left in its warranty.

Rather than turn it off, I would suggest to bump the transmitter id in the receiver up by 1 such that the receiver is no longer able to communicate to this particular transmitter.

This was also the approach Dexcom Support directed me while I was working similar issues through with them.

Although they neglected to mention not to turn the receiver off and then I did turn off the receiver at (apparently) the wrong time and it was bricked. (And then replaced - so still two thumbs up for Dexcom Support!!!)

Also note that if the receiver is still on and connected to the G5 transmitter. And subsequent to that, you try to connect the pump (receiver still on, connected and in range) then you will get a very specific message on the pump. I forget but I did see it and it was obvious.

Thanks for all the advice. I ended up deleting the transmitter from both devices and switching sensors out (just in case). Started running the pump CGM first and then joined with the Ipod. It worked perfectly all day yesterday. I wrote an email to Tandem customer support telling them everything that happened and got a call back last evening, from the man who was supposed to call me at 5pm Tuesday, apologizing because he “got too busy”. My email must have reached his supervisor. I have never had an issue with Dexcom support. They answer the phone right away and usually do everything to help. The last man I spoke to Monday was Tom. He was rude and condescending. I really was blown off by both companies. I think you’re right, everyone wanted to pass the ball because they didn’t know how to help and didn’t want to admit it. I’m just happy everything is working. So far, we have significantly increased his daily insulin requirements and aren’t quite down in target range. We are working on his breakfast spike. Pump day 1 he spiked to 339. Today was 180…big improvement. I love the precision. I love how easy Tslim is to use. I love being able to adjust his basal throughout the day. Technology is amazing. Thanks everyone for the support.

So very glad you’ve got it figured out!
I am not a huge technology person. A computer sees me coming and it figures out fun ways to torture me. That being said, I do have a t:slim and I do have a Dexcom G4. But I have the older one, so they do work together. So I go old school and have the pump do the pumping stuff and I use the receiver for the receiving stuff. I know, I know, I can have everything work together but I am very happy with my little receiver.
A side note here and this helps support my thoughts that high tech is not always necessary. I have spoken to many who have gone back to receiver vs phone due to the fact they have so much time that drops out. One of the CDE that I work with and know outside of diabetes tells me that’s why she uses her receiver. So many patients have huge gaps in readings. Same with one of the doctors I know who uses a Dexcom and went back to his receiver. Just because there is high tech out there doesn’t mean that is the way to go. My 2 cents worth.

@Sally7 - One of the recent enhancements with the G5 is a 3 hour data backfill. So if your Phone does get a data drop out, when it reconnects, it will pull back up to 3 hrs of missing data. While this does not address data “at the moment” that is not there, it does address looking back in time. Often times, I find that what I am really interested in is the last 1 ~ 2 hrs to see what is going on. So for example if the app locks up or whatever and you reboot or restart and then it starts working, it will (generally) pull down (from G5 Transmitter on-board memory) up to 3 hrs of missing data and let you see what is going on in terms of the recent trend.

The Dexcom Receiver (as currently available) while it does not suffer from “lock-ups” as phones and apps do from time to time - also does not have the 3 hour data backfill capability.

That being said, I like to run our G5 Dexcom using BOTH the Dexcom app on the iPhone (which then re-transmits to an Apple Watch) as well as going to the Dexcom Receiver. When Tandem releases the Predictive Low Glucose Suspend (PLGS) for the t:slim X2 (launch goal Summer 2018) then we will have to stop using the Dexcom Receiver as the X2 will “take its spot”.

Stick with what works! We’ve never had a problem with his Ipod before getting his pump. We use it so it sends his blood sugars to me when he is at school and when he’s in bed. He will sleep right through a low alarm but his ipod sends it to me. I would rather disconnect the cgm from the pump before I would lose the share capability on the ipod. We use his pump numbers when he is awake and home. Works for us. I know people have managed diabetes for a long time without cgms but after a 31 soon after coming home from diagnosis…I really didnt sleep at night until we got dexcom. I am a worrier and Diabetes hit and threw my safety OCD into overdrive. They have both worked perfectly since I got it figured out…thank God! We don’t have gaps in readings with his ipod but I did connect my android phone to him at one point and if I had too many apps running or too much going on with the phone, it would disconnect. I am absolutely loving the TslimX2 combo. Loading a new cartridge gets kind of sticky sometimes but I dont have any previous pump to compare it to. Yesterday I was trying to change sites…filled syringe, extracted air from cartridge, removed air from syringe and then went to fill the cartridge and the plunger wouldn’t budge. The port on the cartridge and clogged my needle. Ugh… But I got a new cartridge and filled with no problems. Its just the beginning and I am actually enjoying the pump learning process.