On the Fence About Pumping

I started using my Ping on June 28th.  The first few days were great and I really loved it but then I started having a lot of site problems. My sites were breaking down fast and after a couple weeks, I started getting hives – I apparently have a Teflon allergy.  I stopped using the pump and let the hives clear up and when I started the pump again, they came back so I knew for sure it was the sites and not something else.  I switched to steel sets and that problem went away.

I have also had some insulin issues.  Apidra breaks down fast for me and when it is warm out, I have to change my cartridge out every day and a half. In December I started having problems with my insulin fizzling out about 10 days after I open a new vial.   If I don’t change my cartridge out early or throw a vial of insulin away after 10 days, my blood sugar skyrockets.  I feel like I am wasting both cartridges and insulin by having to do that.  I like Apidra better than any other insulin I have used, but Apidra and the pump don’t seem to be a good mix for me.

In December, I started having problems with big gaps of air in the tubing.  I did not call Animas right away but posted the problem in the Animas group on TuDiabetes. I had some great suggestions of things to try there and the problem went away. In January, I started having problems again.  I worked with Animas to try some different things but pretty much was ripping the pump off every day.

On Friday, January 14th, I had a doctor’s appointment in Pittsburgh so the Animas rep for the Pittsburgh area was kind enough to meet me at my doctor’s office (I live in another rep’s territory but since I was going to be in Pittsburgh, she agreed to help out).  She watched me fill the cartridge and agreed I was doing everything right.  That pump was always noisy but it seemed even noisier when I started having problems.  She also agreed that it did not sound right and she even pulled her pump out so I could hear what that sounded like compared to mine.  About an hour after I got home from Pittsburgh, I had a phone call from Animas that they were going to replace the pump.   My new one came the next morning and I was very anxious to get the pump back on.

Everything was going along great until I did a site change around dinner time on Saturday.  I noticed when I did a load cartridge, the pump sounded louder than it did before.  About 3:30 that morning, I woke up to find that my BS was very high.  I looked at the tubing and there were big gaps of air.  I did a full prime to get rid of the air.  I was afraid to do a full correction bolus because I was not sure if that was a one time problem and I wanted to make sure I got all the insulin that I intended to take.  I figured I should just take a little bit until I could get everything changed out.  I went downstairs to take some insulin with a syringe and got my stuff out to change the cartridge again.

I decided to call Animas and because the motor sounded louder than normal, she said that she would replace the pump.  She asked if I had a backup plan, which I did. She recommended not putting the pump back on, but I decided to try it with another new cartridge – it did not take very long to get the big gaps of air in the tubing.  I went back to MDI early Sunday morning and I am sitting here waiting for the big brown truck to show up with my replacement pump.

I am not sure I want to put it back on when it comes.  I have really lost my confidence in the pump.  There are good things that I really like about the pump. I have DP and can set my overnight basals to account for that. I don’t have to worry about my BS starting to go up at 5 AM.  I was on Levemir prior to going on the pump and that is what I am using for my backup.  I really like Levemir, but it only lasts about 7 hours for me.  I took the Levemir every 8 hours and filled in the gaps with Apidra.  That meant if I wanted to go to bed early, my alarm had to wake me up at 11 so I could take insulin. If I wanted to sleep in, my alarms were waking me up early to take insulin.  Although most days I am up early, it was nice not hearing all those alarm clocks!

I really like using TAG.  I kind of did a non-official version of it on MDI, but the pump makes doing that much more precise.  I eat 2 grams of carbs for lunch and the rest of my bolus is for protein and fat. I use the combo bolus and take 2.9 units of insulin spread over 4.5 hours. I can’t do that on MDI.

Because of gastroparesis, I was taking on average 3 shots of Apidra insulin per meal on MDI plus the 3 shots of Levemir.  I did not mind doing that because I had very good results doing that but it is nice to be able to set the pump to do that for me without my having to constantly think about taking insulin or hearing those reminder alarms.

I have now had 2 pumps break in about 8 months (if you subtract the time I did not use the pump).  The second pump only lasted a few days past the two month mark.   I feel like something that my insurance company paid over $6k for should last longer than that.  One thing that I was not aware of until my pump broke in January is that Animas has the option of replacing the pump with a reconditioned pump.   I know other people don’t have issues with that but I do. If a brand new pump doesn’t last more than a few months, I am certainly not going to put my confidence in a used pump holding out.

There was also a problem that I was not aware was even a problem until after I got my new pump.  I am waiting until I hear back from Animas what they found wrong with the first pump before I talk about that, but it is something that really concerns me.

I have to change cartridges out every day and a half or my insulin goes bad.  I can’t use a vial of insulin in 10 days but if I go longer than that, my BS goes up.  I feel like there is a lot of waste with the pump.  I feel like my control has actually gotten worse because of all the problems I have had.   I am actually waiting to get results of my last A1c and I would not be afraid to bet Monopoly money that it went up.  I need to call my doctor’s  office to get the results and this is the first time in the last 4 years that I am actually afraid to  do that because I know it went up and I broke my record of being in the 5s. Not because of anything that I did, but because of pump problems.

It is like pulling teeth trying to get supplies for the pump. I have had a few bumps over the years with syringes but the short time on the pump has been 100% times worse than 27 years on MDI as far as supplies goes.

As I wait for the big brown truck to pull up, I need to decide if I really want to try this again.  They say 3rd time is a charm but I am not so sure about that!

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4 thoughts on “On the Fence About Pumping

  1. Yeah – saw this post before I’d seen your other latest blog (thanks for linking to Stephen Krueger post I wrote a few years ago).

    I’m about to call up Animas Canada to inquire about the refurbished pump. I always wondered about the loaners that I get for holidays – if they were perhaps not “new”. I know when I had the problems with my 1st pump during holidays – that Animas Canada originally had said to send back the loaner pump – and that they would send a replacement (whether ir was refurbished or not is the big question again). I told them if it was okay to keep the loaner pump – and they said normally they don’t do that (and perhaps like you say – our rules are different here in Canada compared to USA). I was told to keep it – and it’s been going well without any glitches for over 1 year now (previous pump lasted 2 years – and again – it didn’t really “die” – I think my problem was battery cap wasn’t checked for tightness – which I now do check when I remember – e.g. like NOW).

    Thanks for the explanation of the difference between Apidra / Humalog – I think that is what Dr. Bernstein was saying as well.

    Off I go to make that call to Animas Canada – this FatCat needs to know the truth – the whole truth – and nothing but the truth. Investigator cap being slapped on my head! \\^,,^//

    • I am sure alot of people would not know who Stephen was and you explained stuff so … I have also learned when I know what site something is on, the easiest way is to use Google and then put the site in (in your article’s case, I used Diabetes1.com). It is easier to find what I am looking for!

      When the first one went, I did rule out the caps – I always worry about that because one day I was having some problems & Animas had me check the caps. I thought they were OK but after I took it off & put it back on, the problem went away.

      Good luck with your call!

  2. Kelly – so sorry to hear that your pumping experience is giving you probs. You’ve had a lot happen over such a short period of time – which for me – occurred after 2 years of using my Animas 2020 (like your Ping – without the remote). BTW, I didn’t realise that when they replace a pump that’s gone “bad” that it’s a reconditioned pump. So far, the replacement pump I had from Animas is working fine (it actually was a loaner pump I’d had at the time for a holiday). My original pump was taking in water in the batter ycompartment. The pump still worked BUT rather then risk it going wonky – we Animas/myself decided to replace it.

    BTW, you say your insulin in your cartridge only lasts 1 1/2 days. Are you saying that you fill up the WHOLE cartridge and keep it going until it runs dry? Reason I ask is that I only fill up my cartridge with enough insulin to see me thru’ 2 days – in my mind – it’s fresher that way. I also refill my cartridge on average about 5 times before chucking it out. Many pump users do this to save money – but for myself – I just don’t like adding more waste to the dump site. I always check to make sure the plunger goes back/forth smoothly and check for any bubbles that maybe seen in the rubber component of the plunger which if you see those, means the plunger may not work properly. I’ve never had bubbles in my cartridge yet tho’.

    BTW, I did ask my endo about switching to Apidra for my pump. He said that there is really not much difference beween what I use now (NovoRapid) – they are just both fast acting insulins that are made by different manufacturers. I’m reading Dr. Bernstein’s book right now (what a fascinating man) – and he says there is a difference between lispro (http://www.nlm.nih.gov/medlineplus/druginfo/meds/a697021.html) and aspart (http://www.nlm.nih.gov/medlineplus/druginfo/meds/a605013.html) . If memory is right – I think he said the lispro was the better choice.

    Anyway, hope the big brown truck arrives soon – and that the next pump goes alright for you.

    • Anna, I am glad that I am not the only one that did not realize they would replace a pump with a reconditioned one! Everyone seems to think I should know that – I am not psychic and never would have thought that even possible. Since you are in Canada, you might have different laws regarding replacement pumps, but the warranty is on the US site & states they have that option. I always seem to learn stuff the hard way!

      I only fill the cartridge up partially. When I first started the pump, I did fill the cartridge up because I had no idea what to expect. I actually had a little spreadsheet going to know how much I was using & how much I was throwing away. I usually had a little extra in because you never knew what was going to happen, but if I found myself starting to throw too much away, I would cut back. Because of the insulin going bad so much, the only time I really would let it run down to zero was if I had a bad day and used more insulin than normal.

      For me, there was a big difference between Apidra and Humalog. I had a lot of days that Humalog was like injecting water. I didn’t have as many of those days with Apidra, but unfortunately, they seem to be having a lot of problems with bad insulin these days. Apidra was a lot more consistent for me. Humalog stuck around in my body for about 4 hours & Apidra was out in 2 ½. Because of gastroparesis, I need to stack my insulin and that was a lot easier to do on Apidra since it was out of my body faster.

      I am guessing you read this one before you saw that the big brown pump came and unless he comes back with a new pump, I am done pumping!

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