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Urgent pump advice please

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This thread is now closed. Please contact Anna DUK, Ieva DUK or everydayupsanddowns if you would like it re-opened.
AJLang

AJLang

Well-Known Member
Relationship to Diabetes
Type 1
I had lunch out at 2pm and probably underestimated the carbs a little but did a bolus of 4 units. At 3.45 it has gone up from 8 to 18 - since 3.45 I have done three lots of 1 unit bolus shots plus at 4.30 put my TBR up to 150 per cent. It is now 5.10 and my BG has gone up to 19.9 and I have ketones - and my diabetic nurse has left for the day. I'm going to change the cannual in 15 minutes if it hasn't gone down. What else should I do to avoid DKA but also to avoid it crashing to a hypo? For example how much would you suggest that I bolus after the cannuala change. Should I do a full set change (it was changed on Saturday) if so I won't be able to do this until 6.15 when Mark is home - I still love my pump but I am getting rather worried.
 
AJLang said:
I had lunch out at 2pm and probably underestimated the carbs a little but did a bolus of 4 units. At 3.45 it has gone up from 8 to 18 - since 3.45 I have done three lots of 1 unit bolus shots plus at 4.30 put my TBR up to 150 per cent. It is now 5.10 and my BG has gone up to 19.9 and I have ketones - and my diabetic nurse has left for the day. I'm going to change the cannual in 15 minutes if it hasn't gone down. What else should I do to avoid DKA but also to avoid it crashing to a hypo? For example how much would you suggest that I bolus after the cannuala change. Should I do a full set change (it was changed on Saturday) if so I won't be able to do this until 6.15 when Mark is home - I still love my pump but I am getting rather worried.
Click to expand...

Ok Don't panic....who said that?
1st of all no 1 rule is 1 correction via pump then you use a pen/syringe to correct.
It sounds to me as if things have settled down now and it's time to basal test and sort out your basal patterns. (You will be ready to throw pump out of window at the end of it all)
Have you actually looked at your tubing to see if you have bubbles in it? Just prime the pump to be on safe side.
Also change the set if bubbles not the cause.
 
Thanks Sue - everything was so perfect before this but I can't say that you didn't warn me
 
Sounds like it could be a cannula problem Amanda, change your cannula and give yourself a correction......I'm used to doing this.....cannulas are my biggest problem...my pump is great!
 
Thanks Phil I've now changed the cannula - first cannula change that I've done on my own - amazing what you can do in an emergency
 
AJLang said:
Thanks Sue - everything was so perfect before this but I can't say that you didn't warn me
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You are more than welcome. It is a shock when the bubble bursts :(
Would it help to make a list of do's when you have an unexpected high?
When you have been on the pump for a few months all this will be second nature to you.
There will be light at the end of the tunnel 🙂
 
It would be great to have a list of to do's when BG is high - I will make one based upon what I have learnt so far They never covered that at the pump training, they just said that there was no reason why anyone should go into DKA as long as they looked after themselves....but didn't say hardly anything about what to do if it does go high🙄
 
Hi Amanda,

Something else to bear in mind is whether your set doesnt last for the normal 3 days? Alex can only go 2 days and if we try to go over or forget his levels shoot up even a couple of hours after the deadline!:(Bev


p.s. Alex's levels also increase after a set change so we sometimes set a tbr if levels are already on the high side.
 
bev said:
Hi Amanda,

Something else to bear in mind is whether your set doesnt last for the normal 3 days? Alex can only go 2 days and if we try to go over or forget his levels shoot up even a couple of hours after the deadline!:(Bev


p.s. Alex's levels also increase after a set change so we sometimes set a tbr if levels are already on the high side.
Click to expand...

....I am exactly the same, I often change my cannula every 24 hours usually every 48 hours (steel 10mm) I never leave in for longer than 48 hours as I always have a problem.

Big learning curve Amanda, no doubt you will have to try lots of 'trial and error' ....but all worth it in the end and as Sue says, within a month or so it will be second nature to you!
 
Even though very hypo and square eyed :( surely if a full set change was done on Saturday ie, cannula,cartridge and tubing, at the very latest the cannula should have been changed on Tuesday? This for teflon and Monday for steel cannula)
So if you hadn't done this then def a cannula problem.
Sorry I hadn't picked this up earlier, my bad.

Cannulas unless an emergency change should always be done before a meal so the bolus can flush through the cannula. If this isn't pos then bolus and eat a snack.
Always leave old cannula in for a couple of hours on routine changes, so any insulin left can be absorbed at a normal rate plus you have an emergency working cannula if something goes wrong.
 
Thanks Phil. I've never been so glad for BG to be 15. When we primed the tube we found that there was no insulin coming out for one or two seconds which seemed strange. We've done a complete set change. I feel ready for anything pump wise now, she says hopefully with fingers crossed🙂
 
Thanks Sue for thinking through everything. I did change the cannula yesterday so I'm really not sure what has happened to the cannula today. I really love that you are helping me so much because there are things that I might not have thought of, thank you very much.
 
Thank you Bev I guess it is trial and error about how long cannulas last. Thank you about the TBR suggestion for set changes
 
AJLang said:
Thanks Phil. I've never been so glad for BG to be 15. When we primed the tube we found that there was no insulin coming out for one or two seconds which seemed strange. We've done a complete set change. I feel ready for anything pump wise now, she says hopefully with fingers crossed🙂
Click to expand...

Hi Amanada, Always check your tubing at least twice a day to make sure there are no bubbles in the tubing.
It sounds as if you have air seeping into your cartridge thus you have bubbles forming in your cartridge. Make sure your tubing is connected tightly to the cartridge.
 
AJLang said:
Thanks Sue for thinking through everything. I did change the cannula yesterday so I'm really not sure what has happened to the cannula today. I really love that you are helping me so much because there are things that I might not have thought of, thank you very much.
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I suspect nothing has happened to the cannula, esp after you said you primed the pump and no insulin came out for a few secs.
That would equal a lot of insulin that wasn't being delivered :( hence your very high blood sugars.
 
Hi Amanda,

Also dont forget you can get bent canulas - it isnt common - but it does happen and can mean your still getting insulin but its restricted due to the bend. We use 'mio's' and *touch wood* we rarely get a kink in one - not sure about others though.🙂Bev
 
hi from another pump user

Hi there. I have only just joined forum today and saw your post. Hope you have sorted things by now? I used a pump for 2 years and came off it because I had a few episodes that nearly drove me into insanity when my BS would rise very quickly. It is scary and please don;t think you are the only one or that your fear is irrational. I have gone back on my pump as only when you are faced with hypos, being told you cannot drive and ending up putting 2 stone in weight from having to eat to keep up with Lantus do you realise that whilst not perfect a pump is your best option! Always remember your pump is a machine and as such is never full proof - this is the biggest lesson you have to learn and then come to terms with. I wanted full proof, and to be honest I read pump forums and thought I would have a pancreas albiet attached outside my body. The way I look at it now is the pump works on most days and we all have Bad hair days so why shouldn't my little friend my pump?! I now just take a pen with me when I go out and about and if all else fails I would just have an injection and sort the pump out when I got home. I have also had to accept that when I get a bad infection I have to have some lantus to help the pump out for a day or so. Overall, the pump isn't the miracle that perhaps I thought (or read about) but it has improved my control, outlook and quality of life. You will be fine and you will find out what works for you and what is theory. We are all different and the pump will do different things for us but we all benefit overall. Good luck and if you need to ask anything else just give us a shout. 🙂
 
I've never had a Roche one kink yet - no that's a lie. Early on it was, changed cannula and it stung a bit when I primed it - and then I stood up. Instant pain like someone was digging a spike in and blood dripping all round the cannula. I literally ripped it out BY the tubing - and had a gusher!

Jeez. You should have heard me screech - what with the pain from the cannula and the sticky having pulled my hair out and my skin off by the roots.

Lovely bruise!

Anyway, that one was folded in half at right angles. God knows what's in my belly that it hit!

Never happened since Amanda! LOL
 
liam said:
Hi there. I have only just joined forum today and saw your post. Hope you have sorted things by now? I used a pump for 2 years and came off it because I had a few episodes that nearly drove me into insanity when my BS would rise very quickly. It is scary and please don;t think you are the only one or that your fear is irrational. I have gone back on my pump as only when you are faced with hypos, being told you cannot drive and ending up putting 2 stone in weight from having to eat to keep up with Lantus do you realise that whilst not perfect a pump is your best option! Always remember your pump is a machine and as such is never full proof - this is the biggest lesson you have to learn and then come to terms with. I wanted full proof, and to be honest I read pump forums and thought I would have a pancreas albiet attached outside my body. The way I look at it now is the pump works on most days and we all have Bad hair days so why shouldn't my little friend my pump?! I now just take a pen with me when I go out and about and if all else fails I would just have an injection and sort the pump out when I got home. I have also had to accept that when I get a bad infection I have to have some lantus to help the pump out for a day or so. Overall, the pump isn't the miracle that perhaps I thought (or read about) but it has improved my control, outlook and quality of life. You will be fine and you will find out what works for you and what is theory. We are all different and the pump will do different things for us but we all benefit overall. Good luck and if you need to ask anything else just give us a shout. 🙂
Click to expand...

Hi Liam,


It sounds like you have had a rough time using your pump.😱 I am just wondering what help your team have given you with the issues you have faced? I am surprised that you have had to return to Lantus. What is the reason for doing so? Which pump do you use as most nowadays have different patterns that you can set for illness.

Pumps are not ' a miracle' - they are only as good as thier user. They are harder work than injections but the health benefits outweigh it in my view. I do know a couple of teenagers who have come off their pumps - mostly due to image or lack of training in how to use them.🙂Bev
 
Status
This thread is now closed. Please contact Anna DUK, Ieva DUK or everydayupsanddowns if you would like it re-opened.
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