Where do i start?

Hello to everyone in the forum. I'm new here and have found lots of useful info and now I have a question. Hopefully it will make sense and I will get some good feedback.

I was diagnosed with T1 June of last year. I just ordered the Omnipod and I am waiting for a call from the trainer to set up the training, and I have no idea how the whole pumping thing works. Like i said, I have gotten some good information from this site, but what i want to know is what kinds of things should I make sure are covered during the training. I'm sure they will cover the basics like setup, changing basal rate, bolusing, etc. but what kind of day to day things shold I ask about? What kinds of things have you run into that you wished would have been covered during the training. Basically, what questions should I ask?

Thanks again for any input.

Hi. This is a good question and it’s good that you’re thinking about these things. However, I think it’s more of a gradual learning process as you get used to it. You are right to learn everything you can at the beginning. However, there are going to be a lot of things (sometimes very frustrating) that you can only learn through experience. It sounds like you have all the bases covered and I trust that your educator will have all the basics down. You’re right to get as much as you can out of the training experience, but I would supplement that by just expecting that there will be a few bumps along the road and things you’ll have to learn with time - like how your body responds to certain things, what sites work best for you, whether you need different basals for different sites, different times of the day, different days of the week, etc. Hopefully, you have a good diabetes educator who will work with you for some time in the future while you are getting all of these things nailed down. I can’t think of any specific things to ask that I don’t think they’ll cover on their own. I guess if you have any unusual things about your lifestyle that you think might affect the pump - long times in extreme weather, extreme physical contact activities, etc. You might ask about that sort of thing.

Hello man…sorry to hear you’ve joined us, (y’a know…I’m sure your a great person, I mean SORRY TO HEAR YOU’VE JOINED US). The most important thing to ask about is the calculations for sugars vs. bolus, which you must enter into the PDM. This, the basal rate and the time it takes for your insulin “on board” to work itself out…these are basically the most improtant things to put into the PDM…and the trainer will help you with this…you should have an idea before you meet with the rep, however and your endo/diabetes educator can help you out with this as well. Make sure the rep gives you the name of an area “supporter” who can provide emergendy pods, (when needed) etc. Good luck! (this is probably a good time to joing the Omnipod group…given some of the advances they are talking about)(check out some of the other conversations that are taking place here).

Hi tlcayt,

Get Pumping Insulin by Walsh and Roberts. Its our pumpers bible. It’s available in many places, possibly your local library:

That book is so well written that even a dummy like me can understand it. It should help you get 95% of the info you need, and get you ready to ask your educator for the final 5%. ABSOLUTELY A GREAT BOOK!!

It also doesn’t hurt to read through the OmniPod User Manual. It should explain quite a bit of the “quirks” of it, compared to other pump systems.

Cheers and good luck, Mike

My advise for you at this point is to eat only what can verify the carb count on. measure everything. During basal testing I ate a lot of sandwiches, things with package label and I used the measuring cups. You really need to get a feel for what the carbs are doing to you. You may already have been counting carbs and if so that will help. Write down everything and be your own scientist during this time. (had a cold, active day, lazy day, pod in new spot…could be poor absorption…)

This whole process of pumping insulin is a “cause and effect” process.

Also I like Wolperts Book Smart Pumping … I thought it was a bit more intuitive than Walsh’s book, but have both

Who to call and when - insulet vs. trainer.
What constitutes a problem to call about - Should the pod hurt? for example
Develop a plan for what if’s - what if I am away from home and knock the pod off? What if the last 3 pods in my box have priming errors?

My training was very concise, walking through everything on how to work the pod, and my Dr. wanted to set the basals. I should have had my doc tell me a good exercise basal to start with, instead I figured that out on my own, the trial and error way. While the training was very concise, it went along the “ideal” world route, where everything worked. Think of your lifestyle, and problems that may come up, and be prepared with those questions. And, yes! Samples! See if you can get any samples of “just in case” products, skin preps, skin tac. etc…

You’ll probably find that your settings will be conservative at first and that your BG readings may run high until your doctors sneak up on the right settings for you. In the short run, you’d rather have some highs than dangerous lows. If you’re not counting carbs, it is essential that you learn because that’s how you will calculate your boluses. Most people start by placing the pods on their abdomens, as that seems to be the easiest spot for beginners. Keep this forum bookmarked, as you’ll undoubtedly have questions as you get started in this process. The folks here are a wealth of good information and advice.

I think we (the forum) can answer all of these:

  1. Yes, the pods are waterproof. The “official” answer is 30 minutes, but I’ve been in the water longer than that and I’ve read similar stories from others. I think the biggest problem is loosening of the adhesive the longer it stays wet.
  2. The pod can only be worn for a maximum of 3 days + 8 hours. After that, it will shut down. Your doctor will have written your prescription for either 2-day or 3-day duration. Personally, I like changing my pod at the same time of the day each change; I’ve figured out that my 3-day usage of insulin is right around 120 units, so I only fill pods with about 130-140, to minimize waste.
  3. Insulet will replace malfunctioning pods, but be aware that occlusions are not considered a malfunction (just bad luck). It never hurts to ask, of course; other than a bad spell of a couple of months last year, however, my experience says that very few pods malfunction.
  4. I’m no doctor, but I don’t see any reason why OmniPod would not work well during pregnancy. Like any pump, it’s easy to adjust basal, IC ratio, and other settings to accommodate daily fluctuations in insulin requirements. There are no other sized pods available; the max a pod can hold is 200 units of insulin.
  5. Make sure your insulin is room temperature; remove as many air bubbles as possible from the filling syringe; keep the pod resting in its plastic case for the priming (supposedly to avoid any shaking or shifting during the priming).
  6. Some people have adhesive problems, others don’t. Thankfully, I’m in the latter group. I’d say that if you don’t generally have adhesive problems, then exercise won’t cause pods to suddenly start just falling off. Having said that, I do recommend using a self-adhesive wrap that you can buy at any pharmacy (Walgreens, CVS, etc) or WalMart for $3-$4. One name brand is Coban, but the generic ones are a lot cheaper. I recommend the 3-inch or 4-inch sizes to cover the entire width of a pod Here’s one for example: http://tinyurl.com/yzsn759
    I use these when the pod is on my arm and I’m going to do anything like softball or racquetball that I know will jostle it a lot. But for just “working out” or doing yard work, etc. I don’t even bother with the wrap. You’ll just have to see for yourself what your own needs are.

Hope this helps,
Eric

Thanks for the welcome and the info. I wish I wasn’t part of the group, but glad to have you guys here since I am. My training is scheduled for the 31st, looks like I have some homework to do ahead of time. I will check out the books you guys mentioned. I’ve been counting carbs since July, i’m not an expert yet but i think i’m getting it. I’ve seen from different postings on here that the Calorie King website/book is a good reference for helping with carb counting, are there any other good resources?

Make sure the trainer enables the BG Reminders feature; it offers to set up a reminder to test BG after every bolus (you have the option of how many hours to wait). This feature is integral to learning how your body is reacting to the pump and also makes you better at carb-counting, as you will see how each meal affects your BG and how good your guesses are.
I consider this feature one of the most important of all; it made all the difference in the world for my control to know what was happening in the hours right after meals and boluses.
You can always enable/disable the feature yourself, but make sure to have the trainer turn it on initially and show you where to control it.

Two other books that I would recommend to everyone if you do not have them are The Diabetes Carbohydrate and Fat Gram Guide by Lee Ann Holzmeister. She is a registered dietician, and the book has the American Dietetic Association and the American Diabetes Association’s stamp of approval. Mine is in paperback, and I purchased it at Barnes and Noble.

The other book is What to Eat When You’re Eating Out by Hope S. Warshaw. This book, too, contains carbs, fats, fiber, etc. for most of the popular food chain restaurants in the US. Both are invaluable if you do not have access to a computer (on the road especially) and you want to know how many carbs that Hardee’s regular roast beef sandwich and 1/2 an order of regular fries equates to. Answer: 54! I have mine tabbed with post-it stickers for the restaurants that I frequent the most so I can find their listing easily.

Another hint: If you generally go to the same five or six restaurants when you eat out, type out a list of the foods you generally eat and their carb totals. I have my “favorites” in two 8-point type lists that I have put back-to-back and “laminated” with packaging tape. I keep the list in my wallet, and that way if I am at a restaurant, I can quickly take the list out of my wallet, figure the carbs, and take the bolus with no guess work. I keep the same list in a “notes” app on my iTouch, but I do not always have my iTouch with me.

Counting carbs will become second nature to you, and having lists of favorites certainly helps me keep on track.

Good luck to you!

Thanks for the heads up about this. I currently test 3 times a day. I’ve talked to my trainer and she says until we know how I’m reacting to the pump and have all the settings correct i will need to test at least 8 times a day. having a reminder for those extra tests will be very helpful.

I don’t have any questions for you to ask - just wanted to tell you what our experience was - my daughter started on the pod back in November - it took us one month to get the basal rates set up correctly - I was ready to give up! We were getting up every three hours all night long during that time. We had some problems with the sites and she did get sick during that time. Once we got the basal rates set up correctly and were using the lower back almost exclusively it got so much easier. It was much more difficult than I expected and I never would have chosen to do it around the holidays if I had known that. That being said - I love that I can correct her quickly whenever she is high (even if she is just a little high), we don’t have to plan our meals around her schedule anymore and I don’t have to force her to eat if she is not hungry. Some of our issues had to do with her being a two year old but I wanted you to know it might take a few weeks to iron everything out - don’t give up - you will have so much more control (and flexibility) when you are done. Good Luck!!

You should start testing more times a day now. By testing before eating, and 2 hours after eating, it lets you know if your meal insulin dose is the right amount. Then, by testing again before your next meal, it gives a good indicator if your lantus is the correct dose. Knowing this information will help get you started on the correct bolus/basal to begin with on the pod.

A lot of insurance companies like to see logs with 6-8 times a day testing when you get a pump…
As an aside… PLEASE try testing three hours (perhaps on the same day, or during a different week (one week 2 hours, the next 3) as well as two hours after a meal… Seriously if i bolus based on my 2 hour post meal glucose i almost always will STACK insulin… Not a good thing… you may find your insulin is still working 2 hours after and hasnt lowered the BG significently yet!.. Also try to get a 2am/3am BG for a few days or longer… even if your still on MDI/Lantus/Levemir… you might find your unknowingly crashing at night…

The extra bg testing will pay off, and youll start to make a habit out of it…
And when you print out the reports from your meter (your meter does have software)… youll start getting a flood of usable information for the pump start…