Pump Vacation Anxiety

Type 1 and LADA
#1

Hello Everyone,

I have been on a pump for 16 years, since I was 13 years old and was at my endo today and she recommended a pump vacation. Well, she recommended I try MDI - as it wasn't available when I went on a pump all those years ago. I will be travelling to Europe for 6 weeks in September, and offered the suggestion that I do injections on my trip instead of using my insulin pump.

My first thought was - Are you crazy? I did take the prescription and the lovely new pens she offered.

I have been doing some research on the topic, and find varying responses to the idea. Right now the idea makes me a bit sick to my stomach, I honestly have never taken my pump off for more then a couple hours in 16 years.

Anyone have any tips, tricks, or comments to make this anxiety about going off my pump any easier?

Thanks!

#2

People certainly do take pump vacations for various reasons and I'm sure people on here will give good advice as to how to go about it. But I'm puzzled by your post in that you don't seem to particularly want to take a pump vacation. Could you maybe explain why you are doing it? Is it just because your doctor suggested it and if so did you ask him/her what the reason is? Remember our doctors are there to help and support us by making suggestions based on their expertise. But ultimately we are the true experts on our own bodies and Type 1 care. So if you really don't want to take the pump vacation you can say, no thanks! For me traveling in Europe for 6 weeks doesn't seem like the best time for an experiment or for having to find places to pull out pens and take shots! If I were interested in trying a completely different approach to my D management I would rather do it on my home ground, when I could focus attention. That's just me.

#3

I was using an Animas pump for 10 years and switched to MDI last month. I was having a lot of site issues as well as highs that would not correct. I love the switch and don't anticipate going back to my pump any time soon. I probably will go back eventually but my sugars have been so good it won't be soon. I'm having less lows, less highs and easier to correct. I was very nervous switching but it went really well. Good luck!

#4

I will be doing my pump vacation at home - and seeing how it goes possibly not bringing my pump on vacation with me.

And it isn't that I don't want to, it wasn't something I had considered or heard of before this morning. Just wrapping my head around.

#5

Thanks for the explanation, Bree!

#6

If I were you, I would take this pump holiday thing. This is because if something were to happen to your insulin pump causing it to stop working, you need to be able to manage using pens until it can be fixed or replaced however, in my opinion - although trust medical professionals over me as I have not yet been trained as a doctor, on holiday it would be best to use the pump as it gives you better control. Personally, I find that a change of activity, weather and schedule alters my blood sugar thus I would feel more comfortable using my pump. This is, of course, if you aren’t intending on spending the whole time in the pool. If you are, this would be a prime opportunity to take a pump holiday.

#7

Sometimes you can get a spare pump to take with you. Then for further backup, you'd just need plenty of insulin and syringes. If your endo is concerned about getting through security at airports, there are a lot of threads on TuD discussing the issue.

#8

From my perspective, your first reaction, "Are you crazy?" was the appropriate one.

A few questions that might be appropriate for you are:

1 - Do you ever use the temporary basal rate function on your pump?

2 - Is your I:C ratio the same throughout the day?

3 - When you bolus, do you always bolus in half or full units, or do you frequently find your bolus amounts are in tenths (2.3U, anyone)?

4 - Do you ever use the extended or multi/dual wave bolus function on your pump?

5 - Are you having difficulty with your infusion sites (more frequent replacement and/or absorption/scarring/infection issues)?

6 - Do you have Dawn Phenomenon?

If you are not using the temporary basal rate, extended or multi/dual wave bolus and you don't have DP; if you are having issues with infusion sets; if you are always bolusing in full or half units, then I might agree with going on a pump vacation.

Otherwise, I just don't see it.

Also, FWIW, MDI was certainly available 16 years ago. The range of insulin choices for basal insulin were perhaps more limited, but still ... did your endo tell you that???

#9

Good points, Mike. I'm back to my original question for Bree and her doctor: Why?

#10

Also, not to be cynical, but is there any chance your endo was visited by the drug rep who was touting how easy the new pens are to use and how they might benefit a long-term pump user who might want a pump vacation? With the result that one or more prescriptions for that reps product(s) might be written??

I only say this because I had something similar happen on my last visit.

#11

Thanks for the discussion.

I think my endo actually was just thinking about the logistics of bringing all my pump supplies, since I am going for 6 weeks, realistically I was/am packing about 3 months worth of supplies. As well as my loaner pump which I had already signed up for. She just mentioned about how much supplies I would be bringing and it may be easier to do MDI.

And no my endo did not tell me MDI was not available, in Canada Lantus or Levimer were not approved, so our only option before going on the pump was NPH and Regular insulin, I was actually diagnosed on a trip to the states and I was started on Humalog at diagnosis, but had to fight very hard to stay on it back in Canada as it was a "new" drug at the time.

I do use a few features on my pump, but mostly for shift work and my I:C do change but again for shift work when I am switching between days at nights. Basically I can give myself a couple extra units of Lantus when I am going to be up all night working. I do have a Dexcom so my sugars are going to be closely watched. And although I have been on my pump for so long, I have never had any issues with sites, I rotate between all available sites. I do of course use the tenths of units for my bolusing - I am a bit worries about that part.

Just still comtemplating!

#12

Thanks for the reply, Bree. Good info and sheds some light on your question and why the endo gave you the option of MDI. Of course, you will need lots of needles to carry with you, and two different insulins, so it may not be that much of a space savings.

Will you be moving around a lot, or is there a place you could store supplies once you arrive at your destination?

#13

I went backpacking through Europe for 3 months while on my pump. At the time I would not have felt comfortable switching to MDI especially with the additional exercise, different foods, etc.

The supplies really weren't an issue, but I would recommend being careful where you leave them or having a back-up plan. I actually picked up some additional supplies from Medtronic in Germany as well.

Good luck!