Real life advice for a new pumper :)

Diabetes Technology Insulin Pumps
1

So I FINALLY get to start using my Accu-chek spirit combo IP this upcoming Tuesday. I realize it will probably take some time to get the insulin levels correct, so I'm prepared for a rocky few weeks/months.

ANYWAYS!

What "real life" advice do you have for a new pumper? For example:

Do you use medical tape to keep your site held to your body?

Where do you keep it when you sleep?

What do I do with all of the extra tubing?

--Does it matter how I orientate the tubing?

What "extras" should I add to my 'betus bag? (Already carrying a meter and the fixins', applesauce packets for lows [15 carbs each], insulin pens, extra needle tips, etc)

How does showering go? o.o

For those who exercise, do you find that it the site falls off more easily from sweat?

How should I explain this new device to my college professors/peers?

Do you carry extra vials of insulin with you?

So many questions! I think you get the gist :P The diabetes clinic I'm going to learn how to use the pump at is very friendly and knowledgable, I just want some REAL personal insight :) If you could comment with any little quirks that only a pumping diabetic would understand, I would greatly appreciate it! Thank you!!

PS, I've bought a Spibelt to carry it around it for right now. Any suggestions for other useful carriers?

http://www.spibelt.com/products/spibelt/non-logo-spibelt

I opted out of the diabetic one, I thought the little hole in the back would squish the tubing against my stomach.

2

Before you tl;dr the best thing i learned was be patient. i had switched to the pump to help tighten my already pretty good control and the first 1-3 months were very frustrating as I learned which sites worked best for me and got used to using temp basals and what not to help with bad days.

I use the animas ping, so my experience may be a little off from what you need… But here goes…

  1. I don’t use medical tape, though I have in the past and when I’m really frustrated with tape peeling I wish I did… But I still don’t, so clearly it doesn’t bother me that much.

2)I clip my pump to my underwear when I sleep. I’ve heard about other people just tossing it in the bed with them, and I’ve done it once or twice with no pump issues but it did wake me up every time I rolled over (but I’m a light ish sleeper)

  1. I let the tubing do what it wants, but I get the shorter tubing. In the past I’ve had trouble with angry doorknobs and metal chairs, but as long as I’m aware of my hips things seem to be fine. Others tuck the extra in their waistband and I vaguely remember being told by the CDE to do that, too, but eh…

  2. my diabetes bag is shamefully unprepared… On a good day I carry one vial of insulin, an entire set change including a reservoir, an extra bottle of test strips, and a bottle of glucose tabs. On a regular day probably just the test strips and the glucose tabs…however, I do always carry a bag of syringes as a kind of fail safe. I’ll never take them out to use in a non emergency, so they’re always there and if I do have an emergency I can use them to suck insulin out of my pump and inject it into me. Not ideal, and I’ve never had to do it, but my boyfriend seems ok with the compromise. :stuck_out_tongue:

4.5) I disconnect when I shower. Since I use the belt clip, I’ve got nowhere to put it when naked so I disconnect at the site and go about my business.

  1. yes. My sites get less sticky when i exercise. I’ve found the best “trick” is to not do a site change right before the gym. That way, he adhesive has has time to stick to me and dry a bit. Otherwise I sweat it right off. I also hold off on showering until it seems dry and stuck again…no use making the problem worse.

  2. as I said before, if I’m having a super prepared day I do have a vial of insulin on me… But not usually.

  3. for explaining, I loooove talking about my devices (I wear a dexcom, too) so I’m not sure if my experience is useful if you want to be discreet, but I email/ speak with all of my professors before a class and tell them what it is, why I have it, and what the alarms may mean, and then tell them not to worry, just please don’t think it’s a cell phone. I do this with anyone who may be in a supervisory position, like a manger or TA. As for friends, it usually comes up around food or drinks so I don’t try to hide it and answer any questions. If anyone asks why I carry 3 cell phones/a pager/have tubing sticking out of my pants (people usually think it’s headphones) I pull everything out and show it to them and explain all the gadgets.

Hope that was useful… :wink:

3

Hey Ashleypfuntner!
Welcome to pumping!

I do not use medical tape to hold my site to my body, I do know that a lot of people do use a tegaderm type of material to help there sites stay on more easily.

I just put my pump under my pillow when I sleep. I know that some people clip it to their pj pants.

I like to orient the site so that the tubing is facing where I am going to be wearing the pump the most. Orientation is less important to me though because I use a long tubing length. I tuck the extra tubing neatly into my waist band so that it is less likely to be snagged on things but will give if it does get pulled.

I would add an extra infusion set or two and a battery to your bag.

My pump is not water proof so I have to remove it when I shower. People have different views on what to do about the missed basal while the pump isn't connected. I personally just correct if I am high after and I'm usually not. I shower pretty fast I guess lol. I know that some people pre-bolus for the insulin they will miss.

I exercise a lot and the sites don't fall out that much from exercising unless it is really hot and I sweat a lot. I have found though that if i swim for a really long period of time, they do fall out. This happens a lot if I have just put in a new site.

I usually don't tell professors unless it comes up. I go to a small school with small classes so it does usually come up in conversation because it relates to so many things. I do tell a professor if it is impacting my work in their class at all. If one were to ask or a student were to ask I just explain it. All of my friends and teammates know about my diabetes and know what to do if i were to go really low. I normally say this when someone asks about my pump "yah i have diabetes so my body doesn't make insulin. The pump gives me the insulin that I tell it to deliver." they usually ask more questions, just be friendly about it and answer any questions they might have. Most people seem to think it's pretty cool.

I do not carry vials of insulin with me. I live on campus so it's easy to get back to my room and get more if i need it.

I hope this helped! Let me know if you have any other questions!!!

4

This was really useful! Of course I read all of it too, I tend to make super long posts, so I feel ya :P. As for the gym question again, how long should I wait when changing a site before heading out to the gym? I don't find that my stomach actually sweats that much, but, I figure it probably doesn't take much moisture to make it less sticky.

Also, explaining that the pump is not a cellphone, LOVE that idea! I'm not too shy about my T1 needs, I just wasn't sure how to really explain something like this to someone who might know little/nothing about it.

Thanks so much :)

5

I shower quickly too, so I'm hoping this won't be a problem :P The idea of a truly continuous basal is still mind boggling to me.
I've made it through a few college courses without needing to tell my professors, I'm a little more worried that my work/attention will be impacted considering I'm starting the pump this upcoming Tuesday 8/20 and start classes again on 8/26 x.x So I'm sure this will be a crazy journey. I still run into the issue of "Ohhhh, so did you eat too much sugar?" from peers xP So we'll see how a pump explanation goes :)

6

Oh! One more question, when you tuck the extra tubing into your pant band, does it pinch or squish the tubing? I'm weirdly concerned about this, lol.

7

No I just do it neatly. Like, wrap it around my hand gently and then tuck it in like that. I haven't had a problem with it getting pinched or squished.

If you feel like the pumping process is making school difficult while your figuring it out I would talk to the professors. It's been my experience that they are pretty understanding about it. I would also just test more frequently so that you catch things early enough to do something about it before you don't feel well (with highs mostly).

8

I try to do all of my site/sensor changes after a shower, and that seems to work well for me. I never actually tested how long to wait before heading to the gym - I did it enough times to notice a pattern and changed my habits :stuck_out_tongue:

9

Hi and congrats on your new pump! It is definitely an adjustment and it does take awhile to get the settings right. My suggestion is to keep great records and tweak your own numbers not wait for a doctor to suggest doing so. Also definitely read Pumping Insulin by John Walsh and every page of your pump manual. You'll end up returning to the manual for specifics but it's good to have the overview.

I don't need or use any kind of tape; in 2 and 1/2 years haven't had any tape come loose, but we all have different skin types. I tried leaving it under the pillow but in no time me and my cat were tangled in tubing. I now wear sleep shorts in summer and thermals in winter and clip the pump to them. I bought both a spibelt and a tallygear belt but no longer use either one. I just use the clip attached to my waist and occasionally I just clip it to the middle of my bra (my bras fit too well to have any space in the middle to tuck socks like some people describe. As for the tubing I prefer the longest length as it allows me to lay my pump on dresser or bed and get dressed and in general makes me feel less tethered. I barely think about the tubing and generally just tuck it loosely into my waistband or like now when I'm wearing sleep shorts under my sundress I don't worry about it. Tubing is one thing everyone worries about ahead of time but becomes a non-issue. No harm at all is done by bunching it.

I live in a very small town and don't work full time anymore so generally all I carry is glucose tabs which are always in my bag and my meter especially since it's a meter-remote for my Ping and I bolus from it. I keep batteries for pump and meter in my meter case. When I go somewhere overnight of course I carry extra infusion set(s) and insulin in a frio as well as syringes in case of emergency and extra test strips.

I'm a bath person and even though the Ping is waterproof it would feel too weird to wear it so I disconnect. I don't worry about bolusing for that short time. Recently at the beach I disconnected to swim and reconnected to sunbathe.

As for explaining, my tendency is to tell people more than they are interested in, rather than less so I restrain my desire to talk about D and my pump! I teach so I briefly explain to my students (college age) that I am Type 1 and may test and chew glucose tabs. (15 carbs would make me high, btw - I use either 2 or 3 glucose tabs). If someone is interested and especially if they or a loved one is D and on insulin I go into more education.

Enjoy your pump!

10

Opsite Flexifix is great tape to hold stuff down. I don't bother w/ the sites most of the time, as the angled sets I use (Silhouette on Medtronic, although I think there's a counterpart on the Animas pumps...) stick very well. I mostly use the tape for the sensors but have used it on the sets a few times when it's been really hot and/ or muggy and it'll hold them down. The sensor kind of sits in a bubble and I've used a spare lancet to lance it out a few times when it was really hot, but the thing stayed stuck.

Re the shower and where to put it when I don't have clothes on. I have a medical alert tag (shaped like a guitar pick...) and replaced the cheapo beaded chain with a cheapo linked chain and the clip will hang on that pretty securely while I'm getting ready. Sometimes it's handy too with stuff like suits, where you want to tuck a shirt in without a clipped pump messing up the shirt w/ sweaty gunk off of the clip or pulling the shirt out of alignment or whatever. The pump can hang on the chain and then I reach in to fish it out through the buttons or whatever.

I don't usually bring extra junk with me. I work about 15-20 minutes from my house. One time a set pulled out failed during a long run, like about 10 miles out (we run out and back so no alternative at that point but to run back...) and the pump was fine but I was running high by then so I've tossed a set in my car but it's been there since 2011, I dunno if the goo is fried or frozen or both.

I don't worry about explaining it. If it bleeps or buzzes while I'm doing something, I'll just shut it up or see what's going on. I don't think that it's rude. If someone's organ failed, e.g. a heart attack or barfing or something, I would expect them to "pause" whatever we were doing to deal with it.

11

I also wanted to say in response to your earlier post, don’t feel bad about testing 10+ times a day. I test 13-15 times AND wear a CGM. I like to think it’s my obsession that got me through university :stuck_out_tongue:

12

I was so excited when I got approved for a pump, I suppose I didn't think some things through, like tube length and what not. These will be things I must consider for my next refill! I have a mini dachshund and a cat as well who cuddle with me at night, so I can see just letting my pump float around in the bed be a tangled nightmare! :P

I really should jump on board the glucose tab train, I've heard such horrible things about them that I've tried almost everything to avoid buying them! Occasionally I will run into a situation where I'm say, 90BG and 15 carbs will bring me way too high and it causes a dilemma!

Thanks for all of your insight Zoe :)

13

I feel like I'm extra sensitive to highs and end up getting horribly sick when I go above 220 (max) so I do everything possible to avoid it! I'd rather be safe than sorry, ya know ;) CGM is the next thing on my list of handy diabetic "tools" for sure! Even though I'm sure us obsessive testers will do what we do best, no matter what :)

14

I prefer "kick-■■■ testers" to "obsessive testers." "Obsessive" seems like it's giving ammo to our ***ENEMIES*** at the AMA/ Medicare/ insurance companies with conflicts of interest inducing them to restrict the number of tests "covered" for people with diabetes.

15

Hahah! Good point! xP

16

Hi Ashley! Here are my answers after 11 years of pumping. (Not super long, but long enough!) I have never used extra tape for my pump, but like acidrock said, I also use the Silhouette/Comfort infusion set which is angled and less likely to pull out than the straight sets. If you are using a straight set, you might consider tape, but I never used it when I used those, either :). I also just throw my pump into the bed at night. I think it would drive me crazy to have it clipped to me…it’s the one time of the day that I don’t have it clipped somewhere and I love that little bit of freedom (even though I’m sleeping, haha!)
During the day, I just use the belt clip that comes with the pump and wear it clipped to my waistband, tubing gets tucked in…doesn’t get tangled or anything. I just shove it down my pants :slight_smile: that also keeps it from getting yanked out by a random doorknob or drawer pull…this happens! :slight_smile: I like the long tubing because if my pump does fall to the floor or something, it’s long enough that my site doesn’t get pulled out. Sometimes I take off the clip and put the pump in my pocket. The pump comes off for showers, nowhere to clip it, and if you’re taking longer than a 10-15 minute shower, I’d like to know how you have the time :stuck_out_tongue: I don’t find that a brief respite from my pump for that short of time affects my blood sugars. I also haven’t found that exercise affects my site’s stickiness, but I don’t usually go longer than 45-60 minutes, so I can’t attest to longer periods of time.
As far as school goes, I was still on injections through college, so I didn’t have a pump to explain to people, but now, I don’t say anything unless someone asks, or I see a fellow pumper. I don’t ever wear my shirts tucked in, (strange?) so no one ever sees my pump. If they see the bulge at my hip, I’m sure they assume it’s a cell phone or something like that. If they ask, I’m happy to tell them. Everyone is carrying around some kind of mini-technology today, so I doubt anyone would notice at school unless they are staring at you :slight_smile:
I don’t carry extra supplies with me unless I am away from home overnight. If I’m low on test strips, I might throw an extra vial in my purse, but nothing else. I also buy huge bags of skittles at Sam’s Club/Costco and fill a sandwich baggie to keep in my purse for lows. I’d much rather eat five skittles than a glucose tab! I am close enough to home most days that I’d be able to get to what I need for a site change, etc. but if I was going to take something with me, it would be an infusion set. You don’t need to change your reservoir/tubing to change your site. Just clip your current tubing to your new infusion set after you change. I think you’ll love having a pump! Keep us posted on how it’s going, and good luck!!

17

You make a pretty good point. My house is literally 5 minutes away from my college and thats really one of the only places I go during school time, so lugging around all the extras might just be extra work :P
Have you ever ordered anything from americandiabeteswholesale.com? I'm new to figuring out which sites are legit and which are scammy (I figure you wouldn't post a scammy one, but I would just like to hear if you've had a positive experience from them!)

18

I never wear a tucked in shirt either :P I really like the skittle idea, because I have heard some pretty awful (taste wise) things about glucose tabs!

Oh, and I guess this is one more question for anyone else who stumbles upon it; Do you really have to change your site every three days? Or is it like the lancet situation where you have to change that every single time before you test :P I like to stockpile some stuff if I'm able to :)

19

It's a good idea when you place your order to ask for an assortment of sets, that way you can try them all out and see which you like. Most companies will give you samples, but I didn't think once or twice was enough to get an idea.

I think the people who say how bad glucose tabs taste expect them to taste like candy. I don't eat sugar at all due to an ED, so I think of glucose tabs as "medicine". They are precisely measured and fast acting source of glucose to bring up a low. Just curious why would you treat a 90?

20

Oh, yeah, Shelby reminded me, my favorite pants are my cargo pants because I can just toss the pump in the pocket!