Starting the process for a pump

Diabetes Technology Insulin Pumps
#1

Okay my Endo recommended starting pump therapy at the last visit and i thought long and hard for 2 months about if I was going to tansition or stay on MDI. I have decided to go with the pump. Then comes the next step evaluating and choosing a pump. (What a process.) I eventually landed on the Medtronic MiniMed 530G as recommended by my Endo. I went to my Endo appointment and advised him that I will be beginning the process for getting a pump. He seemed thrilled. He advised me that as soon as I got set up with the pump to call and schedule an appointment with him to go over dosing and all that good stuff. I called my insurance company (BCBSFL) who recommended me to call the DME provider Carecentrix who handles all DME request. BCBSFL will provide the pump at $0 cost share so i am pretty thrilled about that. I called Carecentrix and started the process. They took all of my information and asked for all of my Endo's info to contact him and get started on the paperwork. So i guess the waiting game begins now. Heard it can take anywere from a couple of weeks to a few months. Any input on the waiting time? Carecentrix told me that the longest part would be waiting for my Endo to get them all of the requested records. They said after that they will place a call to Medtronic and have the pump sent out within a few days. Hopefully all goes well and I can get this done pretty quick.

Thanks for any and all input guys.

What are peoples oppinions on the pump?
#2

It took me like a month, or maybe 5 weeks. I had to submit a month of records and then things fell into place quickly. My perception is that the Medtronic SalesNurses are anxious to get you on track with them so they can sell you stuff. Which is OK with me because I loe my Medtronic pump!! I've been pumping since 2008 and it made my life much easier and more rewarding! I hope you like yours as much!!

#3

Have you compared any of the other pumps available in the market with the Medtronic 530G? There are several other pumps out there. Since your insurance pays for your pump you will not be able to replace it with a new one until at least four years, maybe longer.

I know it might be hard to know which features will be important to you but I recommend at least considering a few of the other models.The ideal situation would be if you could actually try a few of the other pumps before you commit to purchase.

If I were you I would do some research on the Animas Ping, Asante Snap, Tandem T:Slim, Insulet Omnipod, and Accu-Chek Combo.

It looks like you're following your doctor's lead on this and Medtronic may be the best model for you. But your doctor is not going to live with this piece of hardware attached to him 24/7/365. I would investigate some of the other offerings and "kick a few tires" so to speak. There are also TuD groups for every major brand of pump. Read through a few of the old posts. We're not a shy community about voicing our complaints about this kind of stuff.

Good luck. I've been pumping insulin continuously since 1987. This technology has served me well and it is getting better every year.

#4

http://www.blogtalkradio.com/diabetessocmed/2014/04/22/dsmalive-rents-pumping-pumps-and-parenting

I called into an internet radio chat with some folks about pumps and encountered TuD member, former Admin, etc. Melissa who has tried, uh practically every pump in the universe. The roundtable seems like it might be useful to compare the brands but I have kicked some serious butt w/ Medtronic. Melisa blogs at sweetlyoiced and has tons of info about trying various pumps and pros and cons. I had a similar "we use Medtronic" experience w/ my doc and went with it and have been very happy with it but, part of me wonders "what about the T-Slim" etc.

#5

I was kinda forced into the medtronic 530g, so far no enlite sensors as I'm really iffy on those and I feel like they'll be really bad on my anxiety, but I do like the pump. It only took me like 2 weeks to get mine once I had my pre-pump appointment which was basically okay we'll start you on the pump, let's play with one and familiarize you with it. It did take a month for me to get to pump class, which was on Monday. That seemed to go well but my first infusion set did kink on the cannula :( . Mine was also covered pretty much, like 90% and I feel like the supplies aren't all that expensive and they sent me plenty for a long time (like 3~ ish months, I'm likely gonna exchange some infusion sets, explaining that in a bit) . The 530g is super easy to use in my experience, though I do not have personal experience with any other pumps, though a lot of them don't look this simple. It is like stuck in the 90's so you don't get the luxury of a color screen, but the backlight is nice and easy to read with . I'm super sensitive to insulin so it's been nice to do tiny doses that do the job , and I believe my basal rate is right now and I like it where it's at and I've had pretty good numbers even with some infusion set struggles.

THe only other thing I will tell you is , not to scare you, but the quickset infusion sets are pretty prone to cannula kinking and it's been the only negative thing about pumping so far and I've had 2 bad ones 1 good one and I'm unsure about the one I'm wearing right now but hoping it's good because I don't need that crap. I've got mio and sure t samples coming in the mail. Forunately, they're sending me these for free so I can try them and I'm pretty sure the ones I ordered before that weren't overnighted are gonna be full boxes but just getting 2 mios tomorrow. The quickset is like the default what they send you first, you might have luck with it but do not stick with them if you have kinked ones. Fortunately the 530g seems sensitive and accurate to occlusions and I always get alarmed if it's not a good set (usually half way through a bolus it'll stop with a NO DELIVERY alarm) ,and medtronic seems to have pretty good customer service and wants to help me at all times. The 24 hour helpline has been a godsend. I really hope if you get the quicksets only and not a bunch of samples that they're good for you, as they're legit the only thing that is making me feel any negativity towards my pump.

#6

I've had excellent results from the Medtronic Silhouette sets, they go in at an angle and I pinch some skin and stick them in manually, instead of using the inserter. I've can't recall any ever kinking or any set problems. If I get up and forgot my pump is on my lap or something, they are sticky enough to "catch" the pump so it doesn't get yanked out.

Re the anxiety with the CGM, it's sort of had the opposite effect on me, I do much less work than "meter only" management. I still test a lot because I like being confident the CGM is reading correctly but have had very good results with both the old SofSensors (which not that many people were fond of...) and now the Enlites, which I prefer as they seem to be a bit more reliable.

#7

+1 on using Silhouttes. In 17 months of pumping, I've only had 1 problem with a Sil and it was my error (I pinched too much skin when inserting and when I let go, somehow the cannula bent side-ways.)

#8

I'm gonna try those next if I don't like the Mio or Sure T. I feel like the inserter problem though is what causes the kinks for me where the mio might eliminate the problem that comes from putting it into the insterter wrong. We'll see. If not, I'm also trying the Sure T , but regardless I'm trying everything and saving any kinked infusion sets to send to Medtronic in a canister.

#9

Thank you for all the info you guys have shared. I will probably call and check on the status after about a week if I don't hear anything. Terry I did research on the Animas Ping and T-Slim as well as the Medtronic before I made my decision. I feel very comfortable with the Medtronic and the rep was very helpful. As far as the infusion sets thanks for all the advice. One of my worries was kinking, and I will probably ask for the Silhouettes as I've only read and heard good things about them.

#10

I used Medtronic MiniMed pumps for over 20 years. They’re dependable, durable, and always gave me great customer service.

You’ve done your homework! Good luck with your pump start. Soon it will feel like second nature to you.

#11

I've been a loyal Silhouette user for years - highly recommend - full disclosure I used to work for Medtronic so I may have slight bias (albeit unintended...I am still plenty critical!) Just wanted to add that I think you are picking the right time to get a pump - as someone stated above the "every four years" policy of insurance can be a real bummer if you hit the timing wrong and new technology comes out (for instance, I can't get the latest pump and CGM technology covered for another two years --- despite the new CGM being a huge enhancement in accuracy, and me having a new, different insurance policy). Welcome to pumping!

#12

Sensorium, I LOVE my Sure-T's, I wouldnt give them away for anything, so make sure to try these out, I haven't had any site problems with them for over 8 years now. :)
Good luck with your pump.

#13

If one of your worries is kinking, Vinnie, you might consider using metal sets. I had lots of problems with kinking, and had been avoiding the metal sets as I thought they'd be harder to put in. They are actually easier to put in (especially for uncoordinated people like me!) and of course there is nothing to kink. I've had a couple times where I didn't push the plunger up or something and there was a space between the insulin and the top of the cartridge. But other than that I know longer have set problems. So if I am unexpectedly high I no longer have to consider the set as a likely variable. Also if it hurts so I know something is wrong I just pull it back out, pop it into another space, tape it down and I'm good to go. No muss, no fuss and no waste! I use the contact detach by Animas. I don't know the equivalent names in other brands.

#14

The Contact detach is like the sure t in medtronic pumps.

Also good to let me know and I hope I'm not hijacking the topic but I need to get tape now as this is a genius idea if I have problems with it I can just tape it down if it's not on right.

#15

Congrats Vinnie! Can't wait to welcome you to the pumping world! I've been using the Medtronic Revel 723 for just over a year and I absolutely LOVE it! I've never had a problem with it. I use quick sets and haven't had a single issue with those or the Mios I use either. :-) I test drove the Medtronic CGM for a week and didn't care for it much. I now use the Dexcom and am floored by its accurancy, durability, and comfort. I was only on MDI for about 6 months after diagnosis. However, I wish I could have started pumping the day of diagnosis. I have so much more freedom now. Changing sets every three to four days ia a breeze. The pump has helped me get my A1C down to 6.5! Also, I have Dawn Phenomenon that kicks in for me around 4:30 and we have been able to adjust my basal settings to nip that in the bud!! Congrats! I hope things will move quickly for you! Keep us posted. I think waiting is the worst!

#16

I spoke to a rep from Carecentrix today who told me that they spoke with my doctor and are just waiting for him to fax over the appropriate prescriptions for all of the supplies. Looks like it is going pretty quick. Will update as the process continues. Thanks again for all the advice and sharing.

#17

For the Silhouettes I would recommend that you try inserting them by hand. The spring-loaded inserter is prone to kinking them. Also if you are thin or of average build, I would try the 13mm length - they are less prone to kinking.

Manual insertion may seem a bit of a scary prospect at first, but it's actually really easy. There are plenty of youtube videos showing you how to do it.

#18

I encourage you to try out a few different style infusion sets. What you start out with may not be the best for you long-term. It's OK to switch.

I order all my D supplies in 90-day quantities. It took me a long time to realize that I could "mix and match" the 90-day infusion set order so that I could try out different styles of infusion sets. Changing the model of infusion sets I used two years ago helped restore good control with a major reduction of impaired infusion site absorption.

#19

Okay well the process kind of hit a few snags. Carecentrix couldn't get through to my doctor so they ended up just canceling everything on their end. I called the Medtronic Rep who handled everything and it took 2 weeks to get approval from BCBSFL. I am proud to say about a month after starting the process my new pump has arrived and i can't wait to start using it. Have to wait to schedule training though, but I am stoked.

#20

That's great Vinnie. I think you will find that pumping will change your life. Now comes the fun part, waiting for training.....AARGH