Question to all those on a Pump

Hello!
So I've just come back from the hospital from my clinic appointment and it seems that they want me to go on the pump, or at least explore the possibility.
The thing is, I'm not so sure I want to go on one. I'll be honest and say that I'm not all that clued up on them but I know the basics on how they work, how often to change the cannula etc.
To me though the pump seems as though it may limit my freedom and I can't help but think that multiple daily injections offer me more freedom that a pump ever could. Of course I could be wrong, and that where you lovely people come in..
Can you please tell me of your stories with the pump? Any hang-ups you had about having them and whether they were an issue or not? Do you love it? Do you hate it? Have you been on one and then gone back to daily injections? Any and all information would be greatly appreciated!

Many thanks,
Katrina.

Pumps are wonderful! It does all of the calculations for you and keeps track of the amount of insulin on board. You can also take tiny amounts of insulin instead of having to take whole units. It is also very easy to bolus on the go - I don't need to stop and take a shot. Pumps don't limit freedom - they expand freedom!

The one drawback is that if your canula site, or insulin, or anything else fails, your BG goes up very fast. When in doubt, check your site!!

Katrina - I agree with Kim. Paradoxically, I found the pump to offer more freedom, not less. The ability to easily "shoot up" in any social situation makes it incredibly convenient. I never find myself away from home having forgotten my insulin source. It takes a bit of a learning curve but once you master the basics, I think it makes life much easier.

I've been on a pump for 25 years and would not go back to multiple daily injections. The pumps ability to "remember" when and how much insulin I've taken is invaluable. When I was on MDI I sometimes couldn't remember if I took my meal dose or not. In those situations I risked double dosing or missing a meal dose entirely. There are some inconveniences, to be sure, but I find the advantages far outweigh them.

I love my pump but then I am somewhat needle phobic so that I had to say a little prayer before each shot. But aside from that the pump gives me much more freedom to skip meals and sleep late; it also makes it possible to dose to the number of carbs without rounding and to correct minor highs. I'll fix small problems with a .2 or .4 unit correction. The best I could do with pens was a .5 unit correction - and that isn't even guaranteed to be accurate.

Good luck making your choice

Maurie

I agree with everything everybody above said and I'll add a personal note to the "more convenient". I went to a group I plan on attending in the town I moved to recently and started to feel a bit off. I tested my blood sugar and found I was indeed high and used the meter/remote for my Ping to bolus a correction. I really wasn't dying to announce myself to my new group of friends by pulling out a vial and syringe or even an insulin pen. Nobody noticed a thing.

I was very late to the pumping game. I was too afraid that I'd rip out infusion sites left and right. Also, the stories of insertion that I had heard early on icked me out. I went for more than 30 years without one. A couple of years ago I saw the OmniPod and after getting a CGM I went for the OmniPod. It was the best decision(s) I've ever made. The CGM allowed me to tighten up my A1c in less than a month. It was very helpful when I was on MDI because the Lantus can sometimes have an uneven absorption. When I got the pump I brought my A1c down to 5.5. Since then I've eased off a bit and I'm still managing a 6.5.

I would recommend pump therapy based on my own experience. But like all things D, your mileage may vary. I thought the idea of being attached to something all the time would be a total pain, but with the OmniPod, there's no tubing so you're free of that worry. But some of the traditional pumps have some bells and whistles that can make them a much more attractive idea. Some of them allow much smaller dosing increments and if you're very sensitive to insulin, that can be important.

I've been on the pump for a couple of years now and I couldn't imagine life without it. IF you can get a CGM at the same time, go for it. Frankly, I think the CGM is a fantastic tool. The pumps do all kind of things for you (figure your dose or your correction bolus, etc.). I would say: don't fear the pump. It's a great tool for better control.

I have been on the pump for 6 years now and would not give it up. I felt the same way as you. I was concerned about the freedom of wearing the thing and the prospect of site failures. In six years, I have only had one site fail to the point that I had ketones (pulled it out in my sleep). The freedom is great. I never forget my insulin and barely notice that I am wearing it. I can bolus anywhere. I stick it in a pocket, clip it to my pants, or wear a spi-belt when exercising or if I need it hidden.

Control is also great. I would never have taken a shot if my BG was 6 or 7. With the pump I just bolus a tiny amount. My A1Cs have never been better.

I hope this helps!

Hi Katrina, I understand your feelings of reluctance because I was the same way. I resisted going on a pump for 25 years. I've now been on OmniPod for about 2 months and wish I would have done it long ago. The reason I went with OmniPod is because it gave me more of a sense of freedom than a tubed pump - not wanting to be attached to tubing is the main reason I waited so long.

As a new user, I will say that, for me, being on a pump requires more time and attention. But that's because I can now adjust in tiny increments and adjust basal rates around the clock. So I'm more attentive to it because I feel like I'm more in control of the insulin that's being delivered now.

With MDI (Lantus/Humalog), once I gave the shot, I was stuck with it. If I ran low all day, all I could do was eat. With a pump, if hormones kick into gear and I'm suddenly low or high all day, I can adjust the basal on the fly temporarily until I figure out if this is a pattern.

Pete mentioned the benefits of a cgm and I whole heartedly agree with him. I would not go to a pump *and* cgm at the same time though. I would do one then the other after you get used to the first. Otherwise it could be frustrating with information overload.

Good luck to you! Remember too that if you try a pump and don't like it, you can always go back to MDI. It doesn't have to be a permanent decision.

Agree agree about the OmniPod. It's my first pump and I love it. Much MORE freedom, not less.

Best advice I can give is read everything about all the different types of pumps and make your choice based on what is best for you. Your doc may push you to one pump or the other, but don't let them win necessarily. YOU have to live with it so YOU have to be comfortable with it.

I would still be on MDI if I had not seen the OmniPod advertised. I wouldn't have gone on a tubed pump, I think.

One thing I wanted to add was that the usual things that make people reluctant to get a pump are the ones that end up being non-issues. Like "being attached to something all the time". I use the 43" tubing so I can just put my pump down to dress and it helps feel less "attached". I just tuck the tubing into my pants or skirt. I have to pat my waist at times to make sure the pump is there.

Ok, I'll be the oddball here - I started pumping back in 2004. Towards the end of last year, I was getting more and more sick and tired of being tethered to something all the time (tubed pump - Animas Ping). I got a hold of Omnipod and received my first shipment of pods the beginning of Jan of this year. I was in heaven! Still pumping, but no tubing - I felt "free". But, it was short lived. Not sure if it's because I'm thin, or bad genes (my Mom and Grandma always bruised easily), but I was bruising/bleeding with almost every pod. I would have great control for one pod, then crappy control for the next (using sites I knew worked well with my Ping). I gave up after a 350 reading and went back to MDIs. Been on them for close to a month, now (I'd have to check). I take my Lantus shot in the evening, so it doesn't interfere with what time I get up in the morning. At this point, I do feel "free". That's not to say I'll never go back to pumping. But for me, right now, MDIs are working well.

Don't wait. For 40 years, I was frustrated with my lack of blood sugar control despite great efforts. I, too, thought about being "connected", intimacy issues, pump failure, ect. But, after four years benefiting from this life changing technology, I'd fight to my last breath if any one tried to take it away. Remember, if you don't like the pump, you have the option to return to MDI's. I look forward to reading your future posts once you have tried the pump.

Putertech makes a really good point. If MDI are working for you, there's no real reason to change unless you just want to. If it's not broken, no need to fix it. It really is such a personal decision. I was successful on MDI for many years. If I had not been having control issues from old lady hormones, I may still be on MDI.

In my opinion, for someone with good control on MDI, going to a cgm potentially has greater value than going to a pump. The cgm opened my eyes to what was going on between finger sticks and the relationship between different foods and insulin timing. The cgm has empowered me to make much better decisions with food choices.

Wow!
Thanks for all your responses!
I guess my issue isn't with calculating or forgetting insulin. I have trouble with my sites and always have done. I bruise and swell so easily and I thought maybe a pump would help with that?
But my main issue is living life in general - not necessarily the food side of being on a pump. Exercising, working, showering, swimming, being intimate with my boyfriend... it seems like these are just a number of things that cause issues? Like I said I'm not 100% sure of how they work. I don't want a pump taking away that last bit of freedom and spontaneity in my life.
Generally my BGs are stable except when my hormones are causing me problems or when I'm stressed, nevertheless my sites are an issue - even though I do rotate them. But I'm the type of person that can take months for a scratch to heal and my injection sites are constantly uncomfortable because they don't have time to heal before I have to inject again.
Do you find that being on a pump helps with site soreness/swelling/bruising?

For exercising I wear a spi belt which holds the pump tight to your body, so it does not move (check out their web site for details). For showering, swimming and ... I disconnect the pump. It can be off for up to an hour and I don't have any issues. If it is more than an hour, I just bolus and take it off again.

I used to have huge pump bumps where I would inject. These are gone now. I change my site every four days and the site only leaves a small red mark which fades in two or three days. Occasionally I hit a blood vessel and get a bruise, but that is rare. The key is to find an infusion set that works for you. For me the Insets are the most comfortable, but others have different experiences.

I love my pump. I had the same reservations as you, but to be honest it's given me MORE freedom, not less. Because of my pump, I can eat more freely, can sleep in late, and can engage in physical activity in a less-regimented manner. On shots, if I wanted to go for a run, I had to plan accordingly a day in advanced. With my pump, I just turn down the basal rate and go.

A pump is not perfect and there is definitely a learning curve, but it's well worth the effort. You should read "Pumping Insulin" and watch YouTube videos to gain a better understanding of how pumps work (just go to YouTube and search for "insulin pumps.").

Remember that a pump is NOT permanent. If you don't like it, you can go back to shots at any time.

For me, the pump has allowed me to be a person who just happens to have diabetes - IOW, I get to live my life the way I want, with way more spontaneity than I ever had with MDI.

Exercising, working, showering, swimming, being intimate can all be accomplished pretty easily and can vary with the pump and activity.

When I change sites, it is at least 12 - 16 days before I get back to that general part of the body again. I rotate between my left and right sides, upper or lower stomach, back and buttocks.

+1 for all of that. Love the pump, love the CGM even more. Before the pump, I'd forget my insulin at home, take the wrong amounts, have to eat lunch at EXACLTY 12pm every day and dinner at EXACTLY 6pm. Now I eat when I want, what I want

(When I say "when I want", I really mean "when my kids let me")

I have a Minimed (MM) Paradigm 522 with the CGM display built into the pump. They aren't integrated functionally, but at least I only have one thing to carry. The infusion set that I use disconnects about 4" from my stomach. If I wasn't so comfortable with it, I'd consider switching to another infusion set.

Once I learned that the cannula was just small tubing that wouldn't pull out, I was set. (I see a ton of positive responses, I hope you get some negative too, since I know there are people out there that have stopped using a pump. It would be good to see both sides of the story)

1) Soreness/Swelling: You might actually bruise worse on a pump, but less frequently. Not sure, I've been lucky to have some non-fatty/non-muscle area in my abdomen to use. Your clinic may be able to help you test that out. I suspect this will be your deciding factor. But if you are bruising now, it can't be too much worse with a pump, just different. The needle is thicker and longer. Who knows, maybe the fear of the infusion set could help you find better insertion sites or techniques.

2) Exercising: The pump can help here because you can set it to deliver a slower rate of insulin during a workout. You can't go back in time to take less insulin with that shot, and you can't control when that lantus will work.

3) Working: If you wear pockets or are good with a needle & thread, you can easily hide the pump in something.

4) Showering: Most pumps are detachable. Not sure how the omnipod works here.

5) Swimming: If you swim a lot, this may be a difficult point. I usually take a little extra insulin before swimming, then go back later to take more.

6) Intimacy: Take a look at the Minimed Quickset Infusion set. It disconnects right at the skin for short periods of time. No more difficult than removing a belt or watch when ( .... )

7) Spontaneity: This is a "perspective" thing. Most pump users will tell you that the pump gives them freedom to exercise and eat when they want, just taking a quick bolus to eat or turning down the basal rate to burn some calories. But how you perceive the responsibility of a pump will affect your own opinion.

8) BG readings: How are your A1C's? If your A1C's are good, and you have a good structure around your insulin timing and absorption rate, why change?

The big three in the US (AFAIK) are the Animas Ping, the Minimed Paradigms, and the Omnipod. Here are a couple quick links to compare the various infusion sets, so you can see how/where/if they disconnect. The Omnipod doesn't disconnect, so if you plan to swim for more than an hour, it seems you need to toss that away and start with a new pod when you are done.