Had my final in person training today with my trainer. Now we will connect by phone and whenever I have an issue…My question is this: Is pump training an ongoing Thing or is it just to get you set up, started, and understanding the basics of pumping, and how to program your pump?
I think it depends on what pump you get. When I got my new Accu-chek Spirit, they sent a trainer out to my house twice, and she spent hours both times getting me set up & comfortable doing all the features. I also have her phone and email, so if I have any questions, I can contact her. The added bonus with this trainer is she’s an RN and CDE and a d-mom. She even offered to go to my next endo appointment with me, but I didn’t take her up on that. I’ve had this brand of pump for more than 25 years, and each time I’ve upgraded, the training has been stellar.
I’ve been pumping with the same company for 19 years. Every time I upgrade, the rep meets me at my endo’s office for a session to get comfy with the new bells and whistles.
So, yeah. Like @MarieB said, it all depends on the pump you get. My RN/CDE is also an expert on my pump features as well. I know I can always count on her to help if I have questions.
Pump training for me was usually an introductory one-on-one meeting with a pump company sales person or even a pump company certified diabetes educator. It was a familiarization session with the pump. I always read the published manual, too. For me the real training was when I set up the pump and started using it. For many years I just used the basic pump functions like a carb or a correction bolus as well as the employing a custom basal schedule.
While gaining familiarity with the pump hardware and software is essential for successful use, even more important is your understanding of how to control your personal metabolism. Without a guiding overall strategy for controlling blood glucose the pump is merely a fancy syringe. I’ve used more advanced pump techniques in the last few years like pre-bolus, super-bolus, extended bolus, and temp basal rates. I use these techniques every day and constantly customize how I respond to dynamic changes. Combining a pump with a continuous glucose monitor or strategic purposeful finger-sticking and acting on real-time trends is the real secret of effective pump use.
Like any skill, the training never really ends as there’s always something more to learn.
I have the Medtronics Minimed Paradigm Revel 723…and to be honest I LOVE IT!!! Like I told my trainer this morning…“I should have done this 6 months ago” and “the only way anyone will take my pump is over my dead body…” she got a laugh out of that…I feel 110% better than I have felt in 6 months…I can pretty much do anything with the pump I need to, so I feel that the trainer thought I was good to go…we will only connect now by phone or if I have an issue…
The last two I am familiar with because my Paradigm Revel 723 includes those features. But I am not immediately seeing how a pump would implement a “pre-bolus” feature. What the heck does it do? Set up the bolus and also set an “Eat NOW!” alarm?
I have not really used a “super-bolus” but I am also wondering how that is done. Does the pump help with the arithmetic by projecting your basal settings ahead for a specified time?
Yes, I can relate. Whenever someone asks about the benefits of using a pump, that is essentially the only point I have to offer. Others usually go through a list of pump features or talk about not having to inject as often, et cetera. For me the one thing which sold me on the pump was that very shortly after starting to use it I simply felt much better than I had in years. Hard to try to quantify that though.
That really depends on the person using the pump, no? I have never really gotten too much out of Medtronic’s training sessions. I attend them when required mostly because I believe it never hurts to give a listen and see if something you didn’t think about is mentioned. But I do not recall ever coming away with the feeling “Wow! I never thought about that!”
And of course, somehow my training fell through the cracks for my first pump. I guess it was assumed by my doctor’s office that I would just let the pump sit in its box until my next appointment with my educator at the time. I can’t for the life of me imagine why they would think that, but maybe they did.
So when the pump & supplies showed up, the “Yeah! Whoopee! A NEW toy!” side of my brain kicked in and I started using it the same night. To her credit my educator did not start screaming at me when I walked in wearing the pump. But she did look very surprised.
When people talk about all the training hoops they needed to jump through, sometimes including a “dry run” of pumping sterile saline for several days, I can’t empathize. I can understand the caution, but only from the neck up.
But everyone is different. Some people are just uncomfortable with technology, I guess.
Others seem to go far beyond apprehension, expressing concerns of the device killing them while they sleep. It’s almost as though they view the device as potentially possessed by spirits whose good graces one needs to cultivate. In that context, consulting an experienced shaman to help placate the spirits certainly seems reasonable. Maybe?
We use super bolus’ and of course we prebolus often, but it’s not a pump feature. We just do them manually.
To the original question, I agree, it varies. When Caleb started pumping, over eight years ago, we had an initial training session, but it wasn’t anything I didn’t already know from prepping via the user guide. That was it.
The amount of pre-pump training one receives tends to vary from practice to practice and, perhaps even more so, from country to country. I think the folks in the UK go through a much more elaborate routine training process than many of us in the U.S. do. Perhaps @Buckley83 or @jjm335 or @Hartlijn or others might share what their pump training was like and how useful they felt it was for them.
IIRC, some practices in the U.S. also seem to take pump training very, very seriously, spreading the training process out over several weeks to a month. But my impression is that how much and what form of training one gets in the U.S. is a lot more hit and miss … much like the U.S. health care system itself?
The use of pre-bolus, especially waiting for the CGM bend, and super-bolus are not inherently built into the pump. These two techniques illustrate that the education of the pump wearer about the overall control of their metabolism is much more influential on the outcome than is educating about the latest bells and whistles built into the pump.
I think real gains can be made with an over-arching education process that uses a pump as one of the tools in the box. Curiosity, persistence, trial and error testing, an appreciation for the nature of carbs, proteins, and fats are all necessary for a good outcome. Limiting diabetes education to the pump hardware/software is like showing a potential sculpter how to use a hammer and chisel without any aesthetic training.
I’ve been wearing pumps for 28 years and after the first one always started using it as soon as I received it. The training process has always been casual with me and often consisted of a trainer phone call to me to see how I was doing and if I wanted a face to face session.
The best education I’ve received has been from other diabetics that paid attention and documented what they did. Maybe other countries like the UK take a more comprehensive approach but I suspect that most of the techniques I reguarly use are seldom covered. These include waiting for the bend pre-bolus, mealtime super-bolus, a small early pre-bolus (like Dana Lewis), and dosing based on not just carbs but also protein and fat to name a few.
It was really Interesting how My training started…First, off I am paying for my pump out of pocket, so when it was delivered, (Medtronics overnighted it to me), I started practicing and playing…a few days went by and the trainer called me and scheduled trianing for a week or 2 later. So I was told in the beginning that my endo could get me started so I called and she said said how her office used a certain person to do the training and she would call him to see if we could expedite it. When she called back, she said that I was to be in her office the following Monday to start training, (this was on Friday mind you), to make a long story short I was in training all of an hour and walked out at the end of the first session pumping away…That was a week ago today and I am still wondering why I waited so long to get the pump…My BGs would run in the mid to upper 200’s and spike at times to well over 350, I was taking 37 Units of Lantus at bedtime and 14 units of Humalog with a sliding scale for coverage, but was injecting in upwards of 20 units of Humalog 6 to 7 times a day becasue I was not getting my sugars controlled the way they should have been, (probably should have been on more Lantus)…After 3 days on the pump my BGs averaged 140 to 150 and a now a week later they are averaging 100 - 120…Best $6400 I ever spent!!!
Congrats, @weaver3. The pump is an amazing tool. Glad it is helping you.
Thanks Terry…My only regret is that I didn’t know about IP’s 10 years ago when my mother was diagnosed T2. I would have had her on a pump before she could say no…Maybe she’d still be with us if I had known about them…
I had “pump training” for about an hour, back in 1996. Reading the manuals pretty much explained how they pump work. John Walsh’s book Pumping Insulin took care of the rest. I don’t see the point of “ongoing” training. Once you learn to ride a bike, you don’t keep asking your dad to hold onto the back of the seat for you.
I agree it is hit and miss. I would have been happy to get the starter kit at home and just started on our own bc the required training, to me, provided no added value. Then there are practices that seem to take their patients hostage and train them over a series of weeks and months. I realize some people may need hand holding. Not all do.
I had a full training session with first pump I had - the Asante Snap - as part of their 1-month trial. I had already read the manual, so the 4-hour session was done in less than 90-min, half of which was discussing additional reading, like Walsh’s Pumping Insulin. The followup was two weeks of logs and phone calls to adjust settings, answer questions, etc. When Asante went out of business, I read the manual and using started it. Still, Omnipod sent a trainer to me endo’s office who confirmed that I knew what I was doing and gave me a few tips.
I wasn’t totally happy with Omnipod and still had the opportunity to try the Animas Vibe (using that now). Animas had a trainer call me, who, it turned out, was the SAME CDE that originally trained me on the Snap. She and I talked on the phone to make sure I was comfortable with the Vibe. As a result, I did not schedule a face-to-face session that time. So far, I think that was a good decision.
As @Terry4 said, aside from pump features and settings the devil is in the details and knowing how your metabolism and insulin absorption work and learning how to manage the ups, downs, and everything in between.