At last! DSN called re: new pump!

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Pattidevans said:
@trophywench something she told me was that I should have been changing my Combo pump every 3 days, rather than what I swear I was told 8 years ago, that was to change the cannula every 3 days and the pump every 6. Anyhoo been doing it that way for 8 years and for the remaining time I shall continue. Thought! If that is the case then why supply cannulas without tubing?
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You are correct, she was wrong. Cannulas however often you need em (me 2, yourself 3 days) Reservoirs and tubing, every 6 days.
 
Pattidevans said:
@trophywench something she told me was that I should have been changing my Combo pump every 3 days, rather than what I swear I was told 8 years ago, that was to change the cannula every 3 days and the pump every 6. Anyhoo been doing it that way for 8 years and for the remaining time I shall continue. Thought! If that is the case then why supply cannulas without tubing?
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trophywench said:
You are correct, she was wrong. Cannulas however often you need em (me 2, yourself 3 days) Reservoirs and tubing, every 6 days.
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Perhaps she is more familiar with Medtronic where the whole kaboodle gets changed every 3 days?

Most pumps seem to work that way tbh, I‘ve never used a Combo, but reading your experiences often made me rather suspect I would frequently forget what I was supposed to be changing on which day with the 6 day / 3 day thing. Though I would have much appreciated the reduction in waste and wasted insulin with all those extra tubing fills and the dribs and drabs left in the extra reservoirs.
 
Ahhh.. you could well be right Mike. She’s probably never been responsible for starting someone on a Combo. I think I was probably the last person to get one from my clinic and it was at the time Animas stopped doing pumps, so there was only the Medtronic on offer. At the time me being offered another Combo was a one off and there was a different pump nurse at the clinic. I obviously didn’t need to be instructed in it and just set it up myself.

I know what you mean about confusion though. I frequently ask Julian “do you remember what day I changed my pump” as he usually gets the insulin out of the fridge when he makes the morning tea.
 
I've been saying exactly that to Pete, practically for ever now and there's no escape for him for the next 4 and a half years......
 
I have a medtronic pump and only replace the res when empty which is 6 - 8 days cannula is changed every 2 or 3 days depending if I'm sore.
 
The DSN was saying that the insulin degrades when transferred from the glass vials into the plastic reservoirs. However @Pumper_Sue I have to say that like you, mine sometimes goes 7 days rather than the recommended 6, although I only usually fill it to 150u not the recommended 315u. I find if I leave the cannulas in more than 3 days I sometimes get a small sore lump, so I try to remember to change every 3 days.
 
Pattidevans said:
The DSN was saying that the insulin degrades when transferred from the glass vials into the plastic reservoirs. However @Pumper_Sue I have to say that like you, mine sometimes goes 7 days rather than the recommended 6, although I only usually fill it to 150u not the recommended 315u. I find if I leave the cannulas in more than 3 days I sometimes get a small sore lump, so I try to remember to change every 3 days.
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There's a lubricant in the reservoirs which is why they think it degrades. I use the 180unit reservoirs so six days is the norm for me at the moment. I've been pumping for 14 or 15 years now and have never had insulin go off in all that time, so will carry on as I am as against my religion to waste money even if it's not mine.
 
Pattidevans said:
Had my appointment yesterday. I was offered the Medtronic 640G (no mention of the 780). To be honest it felt like half a brick in comparison to my Combo, both larger and heavier, or alternatively I could have the Omnipod Dash. The DSN talked through the pros and cons of each pump and answered my questions. Julian had come with me so I asked if he could come into the appointment and I was glad this was allowed as he brought up a couple of queries that I wouldn't have thought of e.g. regarding the insurance of whichever pump for which I would be responsible. Plus at the mention of holidays the DSN told me that Omnipod would lend me a handset to take with me, which was an advantage as far as I was concerned as my Combo handset had malfunctioned on a holiday earlier this year. Though I did have the handset from my old pump with me - along with the old pump. I was able to pair the old handset with the current pump. However, I'd not have that back-up next year.

I thought the set up and application of the cannulas on the Medtronic somewhat clunky and unecessarily complicated plus an awful lot of plastic waste was generated. Whereas Omnipod have a system where you send used pods back for recycling (part of which process fuels their manufacturing needs for electricity).

I'd noted from another thread on this forum that it was possible to change your mind within the first 90 days if you didn't like the Omnipod. However, the DSN cautioned that it was necessary to read the small print on this matter as in fact it isn't really possible to "back out" unless you return all the gubbins within 30 days and she explained that in reality I would have just 5 days to make that decision, given the processes the hospital would have to go through to return things within the 30 days.

So, to cut a long story short I decided on the Omnipod - to be truthful I was already leaning in that direction even before the appointment and I didn't hear anything during the appointment that put me off, whereas I could see disadvantages to taking the older Medtronic model.

I should get the new pump early on after Xmas and then I will have a long video conference with the DSN plus a rep from the manufacturers in order to set the pump up and get me running with it.

@trophywench something she told me was that I should have been changing my Combo pump every 3 days, rather than what I swear I was told 8 years ago, that was to change the cannula every 3 days and the pump every 6. Anyhoo been doing it that way for 8 years and for the remaining time I shall continue. Thought! If that is the case then why supply cannulas without tubing?
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how is the Omnipod going???
 
Hi @alisonmf not got it yet. I pick it up next Monday from the clinic and will have a 3 way training online session with the pump nurse and the Omnipod rep on Wednesday 19th.

After a conversation with the pump nurse when she phoned me to tell me it had arrived I am a little concerned as she said to me "I know you have probably 24 different basal rates set on your pump at the moment, but we like to start you with time blocks of so many hours at a time on the same basal rate". I came off the phone rather taken aback. Yes, I do have more or less 24 different settings, but time in range is 92% with only 1% below 3.9. So if it's not broke why fix it? I know I will struggle with what she's suggesting and it kept me awake for a while until I thought "just do what they want and when you get off the phone set it back up how you have your current pump".
 
Pattidevans said:
So if it's not broke why fix it?
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I think just because simpler is better. So if the time blocks works OK, that'll be simpler than your current setup.

Configurations of lots of things get more and more complicated over time, and there's sometimes benefit in a general resetting of it all because sometimes some of those turn out not to be helpful (even if maybe they were for a period).

(It's also conceivable that the nurse doesn't fancy configuring all those detailed rates then writing them all down for your notes.)
 
Bruce Stephens said:
I think just because simpler is better. So if the time blocks works OK, that'll be simpler than your current setup.

Configurations of lots of things get more and more complicated over time, and there's sometimes benefit in a general resetting of it all because sometimes some of those turn out not to be helpful (even if maybe they were for a period).

(It's also conceivable that the nurse doesn't fancy configuring all those detailed rates then writing them all down for your notes.)
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It's taken a lot of effort to get where I am though Bruce. I keep a very close eye on my basals and tweak as necessary. I've been more or less left alone to get on with it for the last few years and yes, I admit, I don't want someone else fiddling with it! Mostly anyone I have seen in the way of HCPs during that time has been very surprised at my tight control. I suspect your last sentence in brackets is more like the truth!
 
Hello @Pattidevans
I think Bruce's "conceivable point" is probably correct as that's what they did for me in the first instance with my DSN stepping up the time blocks to a total of 9 now in a 24 hour period. Some consecutive time blocks are the same value but are noted as 1 time block. But............ you can have 24 individual time blocks in any 1 day and that makes up 1 basal programme. You can have 7 more different Basal programmes to cover differing settings for say exercise or holidays or gardening etc.
Of course you can make correction changes to your Bolus dose to cover Hi's or for Lo's suspend your Basal programme.

For simplicity i am happy with the 9 time blocks and only have the one programme for every day but make corrections for Hi's or Lo's by Bolus correction or eat some carbs.
I'll think you will probably find that your T1 time blocks will be quite happy with the same Basal rate thus reducing the individual number of time blocks required over the 24 Hr period.

Best
 
Pattidevans said:
Yes, I do have more or less 24 different settings, but time in range is 92% with only 1% below 3.9. So if it's not broke why fix it?
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I used to have that attitude as well, then I ended up with the Animas pump so had no choice but to work things in a different way as only 12 blocks I could use I think not to sure on the number as over 2 years using the medtronic.

No idea what your DSN's problem is though because all you have to do is transfer the data over.
When I collected my new pump I had already written down my basal rates, correction factor, carb ratios and the cats mothers name and it took less than 10 mins to sort it out and I was off and gone out of the door.
 
mark king said:
Hello @Pattidevans
I think Bruce's "conceivable point" is probably correct as that's what they did for me in the first instance with my DSN stepping up the time blocks to a total of 9 now in a 24 hour period. Some consecutive time blocks are the same value but are noted as 1 time block. But............ you can have 24 individual time blocks in any 1 day and that makes up 1 basal programme. You can have 7 more different Basal programmes to cover differing settings for say exercise or holidays or gardening etc.
Of course you can make correction changes to your Bolus dose to cover Hi's or for Lo's suspend your Basal programme.

For simplicity i am happy with the 9 time blocks and only have the one programme for every day but make corrections for Hi's or Lo's by Bolus correction or eat some carbs.
I'll think you will probably find that your T1 time blocks will be quite happy with the same Basal rate thus reducing the individual number of time blocks required over the 24 Hr period.

Best
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Hi @mark king I do know that on the Omnipod I can have 24 different basal settings, one for each hour. It was one of the stipulations I had for a new pump (not that I was given much choice in reality). My current pump has only 5 different basal programmes, but since I only really use one I wasn't too bothered about that. When you are retired most days are more or less the same! 😉 i.e. no work days.

Because I have the different basal rates set i.e. ramping up from midnight (00:00 - 01:00) when it's set at 0.26u per hour, to 08:00 when it has risen by teeny increments to 0.55u most nights I have a nice flat line. If it's not a flat line I normally know why. It goes on increasing, again by very small increments, until 12:00 when it has risen to 0.98u and then gradually drops to 17:00 when I am on only 0.10u per hour until 20:00 when it starts to increase again. I'm happy with this and it does mean I'm not constantly stuffing my face, or putting in corrections.

I've been left alone to get on with it for years. Now there is a new pump nurse who has only met me once to explain about the pumps on offer (a meeting where I hardly got a word in) she doesn't know me, hasn't seen my Libre records and wants to change my basals. Basically I don't want to come across as cocky or know-it-all but the idea of being forced to do something which goes so much against the grain is causing me a lot of anxiety. I'm not normally a nervous or anxious person and I take most things in my stride. Even when I was initially diagnosed my attitude was that I was going to beat this thing, learn all I could about it and make it fit into my life... which I have.

I atttach a couple of screenshots of my logbook for yesterday which is typical. The 3.8 in the evening was due to bolussing for dinner and then dinner being delayed as I was trying out a new recipe and decided it needed longer in the oven than the recipe suggested.
 

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Pumper_Sue said:
I used to have that attitude as well, then I ended up with the Animas pump so had no choice but to work things in a different way as only 12 blocks I could use I think not to sure on the number as over 2 years using the medtronic.

No idea what your DSN's problem is though because all you have to do is transfer the data over.
When I collected my new pump I had already written down my basal rates, correction factor, carb ratios and the cats mothers name and it took less than 10 mins to sort it out and I was off and gone out of the door.
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Hi Sue

Did the Animas only have 12 blocks? Goodness - I was offered that as a first pump and tempted as it was waterproof, but in the end decided on the Combo.

I've filled in a form I was sent with all the details that you've mentioned (basal rates, correction factor, carb ratios etc) and sent it to both her and the Omnipod rep. To be honest there are a couple of blips where the basals have gone up and then down again the next hour, but I can sort that easily by averaging the two for 2 hours. Still, what I am doing is working. I think she's used to starting new people on the pump and wants to control it to start with, I'm just not prepared to spend a week or so with crap numbers whilst letting her experiment. I must stop getting myself worked up about it!
 
Pattidevans said:
Hi Sue

Did the Animas only have 12 blocks? Goodness - I was offered that as a first pump and tempted as it was waterproof, but in the end decided on the Combo.

I've filled in a form I was sent with all the details that you've mentioned (basal rates, correction factor, carb ratios etc) and sent it to both her and the Omnipod rep. To be honest there are a couple of blips where the basals have gone up and then down again the next hour, but I can sort that easily by averaging the two for 2 hours. Still, what I am doing is working. I think she's used to starting new people on the pump and wants to control it to start with, I'm just not prepared to spend a week or so with crap numbers whilst letting her experiment. I must stop getting myself worked up about it!
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When I started on my latest pump, I did all the setting up - the DSN and pump rep walked me through how to do it rather than giving me a preconfigured pump. If they show you how to do it, you can set up a new basal pattern with what you need when they have finished in the comfort of your own home.

BTW I remember my Animas having 24 blocks. My current pump has 48 (one block for every 30 minutes) and I use 10 of them.
 
helli said:
BTW I remember my Animas having 24 blocks. My current pump has 48 (one block for every 30 minutes) and I use 10 of them.
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I had the the Animas Vibe and it def had 12 blocks. I have just checked the manual (page25) 🙂
 
helli said:
When I started on my latest pump, I did all the setting up - the DSN and pump rep walked me through how to do it rather than giving me a preconfigured pump. If they show you how to do it, you can set up a new basal pattern with what you need when they have finished in the comfort of your own home.
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I'm picking up an unconfigured pump and then all the stuff is to be done via video conference. I set my current pump up, exactly how the previous one was set up.... it's probably had a fair few tweaks since then. My plan is exactly as you said, let them instruct me in how they want it and then alter it after the conference!
 
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