6 weeks on the pump

I am beginning my 6th week using my insulin pump and things have been going well. I have been surprised at how easily the transition has been but I’m still getting comfortable with everything.

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Startup

Under direct supervision of my trusted associate Zorra (seen above) getting up and running was very easy. Prior to beginning I met with a Tandem Diabetes representative to calculate estimated basal rates, correction ratios, carbohydrate ratios, and a target glucose value. This was all confirmed with my physician and I was up and running.

Changing out cartridges and switching sites every three days is fast and easy  but I hate wasting any remaining insulin in the cartridge. With previous insurance plans insulin was a commodity not to be wasted so I always try to get the most out of my supply.

Past Struggles

When I first moved to Iowa I cycled between two jobs every 6 months. At that time I had 6 month waiting periods before preexisting conditions would have coverage. This meant I had no prescription benefits for insulin (~$750/month for Novolog and ~$750/month for Lantus) or test strips (~$120/box of 100) every month. This is following coverage that cost me $60/month for the Novolog ($25), Lantus ($25), and test strips ($10/200 strips). I still remember standing shocked at the pharmacy counter in downtown Des Moines telling the pharmacist I couldn’t pay for it all. She was very generous and being a type 1 diabetic herself offered me all the test strips she had in her purse at the time. I thanked her but insisted I would be fine and ultimately purchased the Novolog alone. Being young and not fully aware of options and complications, I only took short acting insulin for the next several months and conserved test strips as best I could. At that time you could purchase a new glucometer for $10-20 and get 10 strips with each new meter. I also received numerous samples from the generous endocrinologist’s office. Ultimately my glucose control was compromised and my A1C suffered. Being frustrated by all of this I decided I would purchase my own private insurance policy but I was denied immediately due to my previous diagnosis of Diabetes. Eventually the Affordable Care Act provisions were enacted and my coverage was able to begin on day one of the policy. Regardless of the totality of Obamacare’s success or failure, the provision prohibiting insurance companies from excluding preexisting conditions was a huge step for type 1 diabetics and I am grateful. Now off my soapbox…

Tethered

One of my concerns about using a pump was being attached to something and I can say that was both good and bad in my short time using it so far. When doing hospital rounds and moving through clinics on busy days it has been great to check my current status and take insulin with a just a couple buttons pushed. No need to get out my glucometer and insulin kit, place a needle on the insulin pen, select the correct dose with clicks, expose a spot on my abdomen, inject, remove the needle, and place everything back into my kit. With the pump’s preset target glucose value I can manually enter my current blood glucose value and it will calculate the exact dose necessary to get back down to the target range. Using an insulin pen you can only work with whole units of insulin (1, 2, 3, etc.). On the Tandem pump I can administer partial units of insulin down to the hundredths place. (1.11, 1.12, 1.13, etc). Because the pump knows where I want to stop, it makes the necessary calculation. Unfortunately at this time even though the pump knows my current blood sugar value, the current number must be manually entered prior to calculating. Dosing on the run has never been faster for me which is amazing.

Mishap

I had one mishap relating to the tubing which reminded me it’s still not a perfect set up. Normally I tuck the excess tubing between the infusion set and the pump into my waist band. One night after changing sites I left the tubing out. I had no shirt on and was walking into the hall on my way to put the supply boxes away. The tubing caught on the door handle and  before I knew it, BOOM! The entire infusion set was pulled out of my skin. Adhesives used on the infusion sets are pretty good and removing each set is usually not uncomfortable after wearing it for three days. When the adhesive is only 2 minutes old its less fun. Honestly I was more upset about losing the insulin in the tubing when I had to switch it out.

Pro Tip

Anytime something like this happens, call the manufacturer (not your distributor). I called Tandem Customer Service, explained what happened, and after a short call the rep reassured me he was sending a replacement. I had another infusion set with me but at the end of the month I was going to be short and insurance does not typically waver on dates for refilling. The bonus for me was that the rep sent a box of 10 infusion sets rather than a single one as he explained its not uncommon for this to happen so now I was covered if it happens again. I have had similar experiences with Dexcom Customer Service and while they only send a single sensor for a mishap, it is typically by expedited shipping.

 

Overall I have been happy with my transition to an insulin pump but I want to hear from you.

Do you have any stories about mishaps? Share below!

 

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