Nervous about changing to a pump - advice

[Chorleybeck]

Hi
I have been T1 diabetic for longer than I care to admit as it makes me feel v old! having used a pen for most of that time, I have been asked to consider pump therapy but whilst the control and reduced hypo benefits are irrefutable, I am "stuck" on the impact on lifestyle - particularly the practicality of actually wearing the device. The things that may appear completely frivolous but are real sticking points for me are below. Any experience or advice welcomed!

• if I get a tethered pump where do I put it when I am wearing a dress not something with a waistband/pocket?
• If i get a patch pump how "lumpy" is it going to be and will I knock it off?
• How much do you have to consider your clothing choices to avoid a "clash with waistband" scenario?

Thanks in advance
K

 

[helli]

HI @Chorleybeck and welcome to the forum.

I think I went through all those questions before I started pumping and confess my first experience was a love-hate one - I loved the extra control and less hypos but hated that my diabetes was on display all the time. Things have improved since then but that does not mean your concerns are not worth considering.
I have used both a tethered and a patch pump.

if I get a tethered pump where do I put it when I am wearing a dress not something with a waistband/pocket?

I had a pump belt that I would wrap around my upper thigh when wearing a dress. This kept it out of the way and was not visible (unless I was wearing a very tight dress). The only downside was if I needed to get it out for a bolus, I had to fumble under my dress. Some tethered (and patch) pumps now have a "remote control".
Other women put their pump in their bra. I am too "slight" so would have looked very lopsided although I purchased a "chicken fillet" and larger bra but found it all too much faff and I still had the problem of fumbling around in my underwear to make a bolus dose.

If i get a patch pump how "lumpy" is it going to be and will I knock it off?

I now have a patch pump. My Medtrum Nano is tiny - you have to look very hard to see it even when, like today, I am wearing skinny jeans. the previous generation of Medtrum was bigger .. probably a similar size to the OmniPod. Again, it was not something anyone else would see unless they were really looking.
And I have never knocked it off despite being very active with cycling, climbing, gym, ...
Both OmniPod and Medtrum provide dummy pumps if you want to give them a go with regards to comfort and knock-off-ability

How much do you have to consider your clothing choices to avoid a "clash with waistband" scenario?

With a tethered pump, you can always move the pump on its tether and place it wherever you want.
This is not possible with a patch pump - it is in the same position for 3 days.
The only "clash with waistband" scenario I can think of is to ensure that the cannula is not immediately under your waistband. I guess this will depend upon the height of your waistband but it should not be too much of a problem to avoid, for example, your very high waisted trousers for 3 days if it clashes with your cannula position.

After pumping for 8 years, I would definitely recommend it.
After using a tethered and a patch pump, if you are concerned about your appearance and having your diabetes on display, I would recommend a patch pump. But there are limitations such as no choice of cannula and the pump being in the same place for 3 days.

 

[Chorleybeck]

HI @Chorleybeck and welcome to the forum.

I think I went through all those questions before I started pumping and confess my first experience was a love-hate one - I loved the extra control and less hypos but hated that my diabetes was on display all the time. Things have improved since then but that does not mean your concerns are not worth considering.
I have used both a tethered and a patch pump.

I had a pump belt that I would wrap around my upper thigh when wearing a dress. This kept it out of the way and was not visible (unless I was wearing a very tight dress). The only downside was if I needed to get it out for a bolus, I had to fumble under my dress. Some tethered (and patch) pumps now have a "remote control".
Other women put their pump in their bra. I am too "slight" so would have looked very lopsided although I purchased a "chicken fillet" and larger bra but found it all too much faff and I still had the problem of fumbling around in my underwear to make a bolus dose.

I now have a patch pump. My Medtrum Nano is tiny - you have to look very hard to see it even when, like today, I am wearing skinny jeans. the previous generation of Medtrum was bigger .. probably a similar size to the OmniPod. Again, it was not something anyone else would see unless they were really looking.
And I have never knocked it off despite being very active with cycling, climbing, gym, ...
Both OmniPod and Medtrum provide dummy pumps if you want to give them a go with regards to comfort and knock-off-ability

With a tethered pump, you can always move the pump on its tether and place it wherever you want.
This is not possible with a patch pump - it is in the same position for 3 days.
The only "class with waistband" scenario I can think of is to ensure that the cannula is not immediately under your waistband. I guess this will depend upon the height of your waistband but it should not be too much of a problem to avoid, for example, your very high waisted trousers for 3 days if it clashes with your cannula position.

After pumping for 8 years, I would definitely recommend it.
After using a tethered and a patch pump, if you are concerned about your appearance and having your diabetes on display, I would recommend a patch pump. But there are limitations such as no choice of cannula and the pump being in the same place for 3 days.

Thank you so much for your replies - really helpful and also reassuring that I am not alone in my wonderings!

 

[Inka]

I resisted a pump for ages @Chorleybeck I thought it would be like being tied down and make my diabetes always there. In actual fact, it gave me my freedom back and within a few days I felt more myself than I’d ever felt on injections.

Dresses are simple: I wear them most days to work. I use a Hid in soft belt round my waist and use my phone to control my pump (I have a Dana i pump). When I’m going out and wearing a tighter dress, I just slip the pump into a Tubigrip round my thigh. The pump is tiny and I honestly forget it’s there.

I don’t consider my clothing choices much at all. I’ve found the Hid-in very helpful as it can be worn with most things and can go round you in a variety of ways. I also have a bra bag thing that hangs under my arm. I prefer a tubed pump because I can put the pump where I want whereas a patch one is fixed for those days. Also, I’m quite clumsy and would knock a patch pump off but the cannula of my tubed pump is small and I’ve never knocked it off yet in 20 years of pumping. I wear dresses, skirts, trousers, leotards, tight clothing, etc and have always been able to stash my little pump somewhere with no problem.

 

[helli]

Also, I’m quite clumsy and would knock a patch pump off

I keep seeing this mentioned ... by people who have never tried a patch pump.
I too am clumsy - you should have seen my half way up a climbing wall with a tethered pump dangling from my waist - but I have never knocked off a patch pump. I appreciate we are all different but I tried to give my opinions based on experience - a patch pump is secured fast: faster than a CGM.

 

[SB2015]

Welcome to the forum @Chorleybeck

I still remember going round in circles before deciding whether to switch to a pump. When they first refused I was almost relieved, but then the frustrations of MDI reared their ugly heads and I asked again after gathering data to address the issues that they had raised previously. I also remember the day I started on the pump and how nervous I was.

I have only ever used a tethered pump, and do not fancy having a patch pump. Each to their own.

If wearing a dress I put my pump in the centre front of my bra, or slip it into the sleeve hole on a sleeveless dress. Where the dress has pockets I make a buttonhole inside the pocket, have the pump in the pocket and the tubing through the hole and connected to the cannula. Where I have skirts or trousers I hang my pump from a pouch that is hooked onto the side of my bra.

As @helli said the waistband issue is to ensure the cannula is not sat on the waistband that you are wearing. I put on the clothes I will be wearing for the day, and then put the cannula above or below the waistband.

I wear my sensor on the back of my upper arm, and find that it is out of the way from compressions when lying on my side. My pump roams free at night without any problems.

I hope that that is useful. Come back with any more questions

 

[Inka]

I keep seeing this mentioned ... by people who have never tried a patch pump.
I too am clumsy - you should have seen my half way up a climbing wall with a tethered pump dangling from my waist - but I have never knocked off a patch pump. I appreciate we are all different but I tried to give my opinions based on experience - a patch pump is secured fast: faster than a CGM.

I’ve tried a dummy Omnipod @helli It stuck up too far for me and felt prominent. I would definitely have knocked it off at some point and did catch it. I didn’t like having something so important so vulnerable. I appreciate it depends on the individual.

 

[Chorleybeck]

Welcome to the forum @Chorleybeck

I still remember going round in circles before deciding whether to switch to a pump. When they first refused I was almost relieved, but then the frustrations of MDI reared their ugly heads and I asked again after gathering data to address the issues that they had raised previously. I also remember the day I started on the pump and how nervous I was.

I have only ever used a tethered pump, and do not fancy having a patch pump. Each to their own.

If wearing a dress I put my pump in the centre front of my bra, or slip it into the sleeve hole on a sleeveless dress. Where the dress has pockets I make a buttonhole inside the pocket, have the pump in the pocket and the tubing through the hole and connected to the cannula. Where I have skirts or trousers I hang my pump from a pouch that is hooked onto the side of my bra.

As @helli said the waistband issue is to ensure the cannula is not sat on the waistband that you are wearing. I put on the clothes I will be wearing for the day, and then put the cannula above or below the waistband.

I wear my sensor on the back of my upper arm, and find that it is out of the way from compressions when lying on my side. My pump roams free at night without any problems.

I hope that that is useful. Come back with any more questions

Thanks for this - you say you move the canula to avoid waist band of your clothes - so can you move the canula when you want? I had thought they were attached for a few days at a time? And what do you mean by "roams free" at night? [I have a CGM sensor already so have the placement of that sorted!]

 

[SB2015]

Thanks for this - you say you move the canula to avoid waist band of your clothes - so can you move the canula when you want? I had thought they were attached for a few days at a time? And what do you mean by "roams free" at night? [I have a CGM sensor already so have the placement of that sorted!]

My cannulas are in for two days. I position on day 1 to suit what I am wearing that day, and choose what to wear on Day 2 to suit the cannula. If for any reason the cannula is uncomfortableI can change just the cannula without changing the insulin cartridge.

My pump is just in bed with me, attached through the cannula , but otherwise just there. I don’t like wearing belts etc. My tubing is 60 cm long so it gives me space to roll, turn as I want and does not get caught up. I sometimes have to move it to the same side as my sensor and they are chatting to each other throughout the night and making adjustments to my insulin (closed loop system - another step)

 

[PhoebeC]

Hi
I have been T1 diabetic for longer than I care to admit as it makes me feel v old! having used a pen for most of that time, I have been asked to consider pump therapy but whilst the control and reduced hypo benefits are irrefutable, I am "stuck" on the impact on lifestyle - particularly the practicality of actually wearing the device. The things that may appear completely frivolous but are real sticking points for me are below. Any experience or advice welcomed!

• if I get a tethered pump where do I put it when I am wearing a dress not something with a waistband/pocket?
• If i get a patch pump how "lumpy" is it going to be and will I knock it off?
• How much do you have to consider your clothing choices to avoid a "clash with waistband" scenario?

Thanks in advance
K

The pump for me since March 2023 has been life changing for me.

Some weeks I have zero hypos, before my pump it was hypos most days. I sleep better. I have better TIR. My quality of life is hugely improved. I think everyone should have the access to pumps based on how amazing I have found it. Nothing is 100% perfect and it is still an effort, its not a cure, but much less effort than before.

I use the pump patch, omnipod and I play full contact rugby, a few times a week, with matches every 2 weeks, and I have never had one knocked off. During rugby or any other time. And yes it has had some knocks.
I have had one that didn't stick but it came off immediately so I knew.

I was the same about a wearable device pre the libre, but the libre changed my life so I love it on display actually, it raises awareness and starts conversations that I will gladly have.

It doesn't really get in the way much. On the training session with omnipod they said plan the sites around what you are doing and wearing (the DSN laughed at the wearing part, and said she would never advise based on outfits), as an example I have my pump on my bottom for matches. It would get knocked on my arms or legs. But for work and female clothing I find my arms or legs are best. Sometimes I can't wear certain tight skirts or clothing with it on my stomach so I do think about if I am in the office (dressing smart) or at home (in my casuals), and then what else I have going on, where the libre is / will be.

You can order the tester to stick on. I suggest doing this. Some of the other none patch can send samples too. Worth looking at.

Also I am the clumsiest person, I do knock it but as I said above it won't budge. Zero knocked off in 11 months. A few weeks ago I was due to put a new one, the sticker was peeling off (very fair) and I had an hour in the mud playing full contact rugby and it still stayed on. I have tested the life of the sticking

 

[Mumpie_olgran]

The pump for me since March 2023 has been life changing for me

Great post @PhoebeC thank you! I'm weighing up heading to a pump and the pod is v appealing. I'm also considering the Tslim for different reasons

Do you have to use the reader with it or can you use a phone? I like the idea of having it all in one place

 

[PhoebeC]

Great post @PhoebeC thank you! I'm weighing up heading to a pump and the pod is v appealing. I'm also considering the Tslim for different reasons

Do you have to use the reader with it or can you use a phone? I like the idea of having it all in one place

No it’s a separate device, so phone and pump device everywhere.
Would be better in the same place but the pump device is smaller than my iPhone so it’s not blucky.

 

[icowden]

The new Omnipod 5 (if you can get it) does away with a separate pump device in favour of just using your smartphone.
My daughter uses Omnipod dash which is the same size. It's very rare for them to come off - usually it's either extreme conditions (water park, hot tub etc) or because the skin hasn't been completely dry / free of creams etc before applying.

It doesn't have to be on your stomach - quite a few sporty types wear on their leg instead.

 

[Inka]

My Dana i pump can be controlled by my phone. No separate device is needed. I find it very convenient. and can easily and discreetly bolus or change basal rates when out. The Dana pump is the most popular pump at my clinic. This is the second Dana I’ve had 🙂