Seriously considering an extended pump vacation

I’ve been using the OmniPod for just over a year now. I started on it and the Dexcom CGM in June/July of last year.

I try to take a break off the pump when my backup Lantus is about to expire, so I’m on a pump break right now.

Before the Omnipod, I used a Medtronic pump. Of course, I was happy to be free of the tubes, but the Omnipod can be a real pain in the a$$ with the alerts, beeps, and screams. I’ve learned how to manage it, but when you get an occlusion or some other error or the darn thing falls off (I’ve had a few incidents where I cut it too fine next to a door and the pod rips right off), you can also end up wasting a lot of insulin if that failure happens just after you attach.

Anyway, what I’m finding is I’m not that broken up that I’ve not been wearing the pods for a couple of weeks. I did miss my Medtronic a bit more, but it’s probably because the errors were a lot less frequent. (Not sure about that 100%, but that’s my theory.

I’m sure I’m not the first person to consider this, but I’m thinking it’s time to take an indefinite pump break. If you’ve done this before chime in. I’d love to hear your perspectives on this.

Thanks!

Hi Regina,

I am an MDI user because I can’t afford a pump. However, even if I could afford it, I think I would like a CGM, but not a pump. I don’t like the idea of being attached all the time. I don’t like the idea of all that waste. I don’t want to be relying on technology. I am doing great on MDI and have an A1c that is very close to non-diabetic.

There is no rule that says you have to use a pump. If you are comfortable without the pump and doing well without it, then stay with what you are comfortable with.

I think that just might be exactly it. Now I have to get myself off of auto-ship for the pods.

I’ve used Medtronic pumps since '08 and taken 3 breaks, one intentional and 2 unintentional. The unintentional ones were when they got wet and sweaty,both "BUTTON ERRORS*. I think these may be repairable by sticking the pump in the freezer (to silence the bleeping, but the next AM, I stuck a battery in it and it seemed to have recovered) although I was too chicken to use it. The intentional pump break, I hedged it by setting basal to 0% for like 3 days before we left for a trip to Maui, but bolused with the pump and had really nice results. Then we got there and everything went bonkers, probably from my eating/ drinking/ winging carbs/ “chasing the dragon” while I was MDI. The diabetes part of me was relieved to get back on the pump and CGM when it was time.

I don’t mind being tethered at all and have had very few problems with anything. I blast through a couple of sticky site areas with 200% basal for a bit after insertion and that’s about it. It seems like way less work to me. I recall reading similar complaints about Pods in 2008, after my doc said “we work with Medtronic”, I poked around a bit to see what else was out there but didn’t really like what I read, but I know people who have them love them. Except for the bleeping and the knocking them off.

Good luck, Regina. This whole experience is a journey, and you learn what works best for you along the way. Regarding wasted insulin, I’ll suck insulin from the reservoir of a bad pod within about the first 24 hours of putting it on, although my failure rate has been pretty low the past couple of years. Beyond 24 hours, I just use fresh. I guess I’m pretty fortunate with my provider. She was open to whatever kind of pump I felt was right for me when I started pumping. I can’t imagine a practice that limits their patients to a certain brand of pump. That’s the tail wagging the dog, in my opinion.

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Amen to that. I got my first through Joslin and they were completely agnostic. I went with Medtronic but I had no idea that they were kinda the “default” pump–no one steered me to it. I liked a lot of specific things about various others that were demoed for me but the Minimed ended up seeming the best overall even though it had its own shortcomings (1980’s pager interface, for cripesake). Went through the same thing after changing to Assante Snap and then getting orphaned–I had an hour sit-down with a DBE and a box of different pumps she went through with me in detail.

I remove the insulin from the pod too when I can.

“I can’t imagine a practice that limits their patients to a certain brand
of pump. That’s the tail wagging the dog, in my opinion.”

I agree to that too. I’d not be okay with a doctor telling me what they do or do not work with. I’d seriously consider finding a new endo if I ever heard that from my doctor.

I think now what I want to work with might be old school multiple injections. Maybe I’ll get fancy and ask for an insulin pen or something.

I think I’m going to extend my experiment and use the other vial of Lantus, so that’s going to take me through New Years for sure. I have a trip abroad scheduled for work at the end of January, so that’s probably when I’m going to have to sit and think seriously about MDI indefinitely or going back on the pod. I actually think with all you have to deal with when you travel that MDI might be the better way to go. It might end up that I just do both. Pod when it makes sense and MDI more often. We’ll see.

How well informed are you about all the pumps currently on the market? If you were to bump into someone who was having problems with a … pick a pump at random other than the one you currently use … could you confidently step up to assist them with it? Would you be familiar enough with the specifics of how it works?

I certainly would not. Maybe if the problem was general enough I might take a guess, but otherwise, no. Yet people seem to assume that their doctors staff will be able to do this.

For a large organization like Joslin, perhaps that should only be expected. But if a practice is small enough and has a diverse enough group of patients I can certainly understand the staff not wanting to take time away from other demands on their time to invest in being a master of all available pumps.

In other words, it may look to you as though a doctor is dictating to people what to do. To the doctor it more likely feels like an attempt to prioritize and best use scarce resources. I don’t prefer that approach and would rather that all practices could support all devices. But I can certainly understand how that might not happen.

Perhaps it would be nice if doctors could do a “Take a diabetic to work” day. I think the experience of trying to keep up with a doctor while they go through their patient list for a typical day could be eye opening (and probably exhausting).

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It’s a valid point. I live in Boston with perhaps the highest density of med schools, teaching hospitals and specialist clinics in the world. I’m frequently reminded how unusual that is on the TUD forums when people weigh in from places where the nearest endocrinologist may be a day’s drive away and their PCP only has the most basic knowledge of D, and that usually confined to T2. Well said.

The Asante Snap was my first pump, but hadn’t been my first choice – as it went thru pharmacy, it was the only one that could get thru my insurance at the time. Ironically, it did become my favorite pump; however, I didn’t really know that until I was orphaned from it. As it turned out, Asante has STILL helped me, as the trade-in deals gave me a change to try the Omnipod (about which I have mixed feelings) and the Animas Vibe (which I am using now).

@irrational_John If you’re happy with “one size fits all,” that’s great, but it’s pretty clear from the discussions here that one size most definitely does not fit all. Everyone is different, and I expect my physicians to recognize that and be well-versed enough to try to find the best fit for each individual that they treat. There’s quite enough of being dictated to by the medical community as it is. Providers who care work with their patients and should care enough to familiarize themselves with several options, not just one. Many of the complaints that I see on this forum have to do with providers who seem to care more about their own convenience than their patients’ optimum experience. We are talking life-saving devices here. Is it really too much to ask that more than one be on the menu?

Yeah, that was exactly the point I was trying to make. People should not be given choices and just do as they are told. That’s the entirety of my world view in a nutshell. Thanks for picking up on that. :smirk:

I’ve been tubed pumping since 2001. I switched to OmniPod for a few months but it just didn’t work, so those are not an option for me. I love pumping, but I get social stigma from it - I guess it makes it look like there is something is wrong with me. Whatever the deal is, my friends seems embarrassed when I use it. I want to lose 60 lbs and get disciplined enough to do MDI, but I do know it’s a lot of work. In the last 14 years of pumping, I have tried MDI a few times, only to switch back eagerly to the pump. My nephew’s Taekwondo instructor does MDI. His Minimed pumped 50 units into him in his sleep by mechanical error and he was like that’s it. I guess everyone has a reason for whatever choice they make. In the end, whatever you chose would inevitably be the right choice for you.

The same for me too. In the Bay Area we’ve got UCSF, Stanford, and a few other big medical care systems like Kaiser, Alta Bates, and Sutter Health. I stick with university-affiliated medical centers because they’re at the top of their game when it comes to medical research. I think it would be heresy for an endo at a place like that to limit patient choice. This is definitely true for both UCSF and Stanford. I get a big reality check when chatting with others that have doctors that are hours away.

It’s a different experience for those in different regions. I don’t think that’s a good thing though. However, I can appreciate that resources are less for those not in major metro areas.

Thanks for your comment, Cocheze. I think the key to weight loss is less food so we’re taking less insulin. I don’t think how the insulin gets into our blood stream matters.

However, if my friends had issues with me pumping, I’d get new friends. I’ve never tolerated ignorance from other when it comes to my diabetes. I don’t run away to give myself a shot. I let folks know I’m diabetic, and I’m about to check my blood sugar and give myself insulin (whether that’s via a pod or an injection). If they’re squeamish they’re welcome to turn away or take a 5 minute walk. I don’t take shots in nasty public restrooms either.

I’m not missing wearing the pod, so definitely going to extend this vacation for awhile. I just got a box of new pods so I have to decide whether to send those back or not. In fact, let me call Omnipod right now to see if I can send these back and have them take me off of autoship.

Have you ever used a tubed pump? What would be some of your reasons for not using a tubed pump?

I wrote when I started the thread that before the pods I wore Medtronic pumps, so the answer is yes. I’ve worn pumps since about 2006. Started with a Minimed 508 or whatever it was and the one before the pods was a Paradigm.

Why don’t you try going back to a tubed pump?

I’ve thought about it a lot because you would never have the occlusion problems i have had on MDI. However, being unable to turn off the delivery of long acting insulin…well, that is the issue with MDI. Btw, Roche has a very nice meter (like their combo pump meter) that calculates things out like a pump. If I did do the injections, I would go for the meter. I think it is through doctor’s office only…

You are talking about the Accu-Chek Aviva Expert meter.

You program in your I:C ratio, ISF, DIA, etc and it will then recommend insulin dosage, show IOB based on a straight-line calculation (not really ideal, IMO), plus it will give you reports on how you’re doing.