Author Topic: Pumping fun and games!  (Read 409 times)

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Offline Pattidevans

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Pumping fun and games!
« on: 03 December 2016, 09:11:56 PM »
Arghhhh!

I put a Libre sensor on on Thursday morning.   It was less than accurate on Thursday night, saying first of all that I was 2.9 but when I tested with my Combo handset I was actually 8.0 and then later in the night it said 3.6 when I was actually 7.2.  That aside, we got up uncharacteristically early on Friday as we were off on another "adventure" aka a cheap return train fare courtesy of Great Western Railways "over 60's" offer of a £15 return to Exeter and we had booked 2 nights in the Premier Inn St David's.

So walked to the local station (about 10 mins walk, dragging our little cases) after eating toast and OMG... spent the journey fighting down BGs in the teens - toast is not good for me! 
We took a packed lunch and as I said, it wasn't great for BGs but hey ho....  Arrived in Exeter and checked into the hotel opposite the station, then walked 20 minutes mostly uphill into Exeter centre where we did a bit of looking round the shops.  Naturally that induced a hypo.. or two, but was well armed with glucose tabs and got a packet of crisps in the Greene King where we stopped off for a drink about 6pm before going round the Christmas market in Cathedral Close.  Went for an early dinner in Cote in the close, which was nice, but we were really tired, so pleased to just eat and get the bus back to the hotel.  The Libre sensor seemed to kick in and be more or less close to the Combo meter by that time.

Friday we got up and took our time in the room getting ready, and had some snacks we had taken with us in lieu of brekky.  I had to change my cannula and discovered that I had forgotten to pack the applicator, but I did it manually and all seemed fine.  We took the bus into the city centre and did a bit of shopping.  We were in M&S and I was holding all J's outer clothing whilst he tried on some winter jackets when my pump started to alarm.  I had had it in my bra for a day and a half by this time because I had only taken 2 pairs of trousers with me, neither of which had pockets.   Arghhh... anyway, I finally found a quiet corner of the men's department, I thought, OK, the tubing is squished in my bra so that might be the occlusion, got the pump out, primed it through and it seemed OK, so relocated it in my bra and off we went for more shopping.  All was fine until we went to Cafe Rouge for lunch.

Right as I was served with a hot twice baked souffle I tried to bolus.  Yep... got 2u in and ha ha... alarms going off and another occlusion.  This was not so easy since we had a table situated in the centre of the restaurant.  I managed to fish out the pump, silence it and get it to deliver another couple of units before it went off again.  Silenced it, decided that the souffle needed eating and as it was very light and came with salad it didn't need much insulin.  With some trepidation I also ate my main course of mussels & decided to eat some of my frites and correct later.  So afterwards I went to the ladies... unhooked everything and primed it all through, cos I could actually see some bubbles.  I was unsure whether these had formed because of having the insulin get so warm as it was so close to my skin.  Or... in fact if my cannula was to blame.  Things then seemed to be OK and finally after lunch we did quite a long walk to find the restaurant we had chosen for the evening meal.  Walked 20 minutes downhill back to the hotel after that in the late afternoon to drop off our shopping and then caught a bus back to the city centre.

In retrospect I should have put a pen with some Apidra into my bag as I had taken one with me in a Frio, but I honestly thought it had been a bubble and I'd got rid of it.  We stopped off in  the Christmas Market to buy a couple of small things and have a glass of mulled wine, then made our way to the restaurant (about 10 mins walk from the centre).  Now I have to say we ordered an array of truly delicious tapas at Cafe Catalan (couldn't recommend it more) and... oh yea... pumpy was alarming again with an occlusion!  I was thoroughly naffed off at this point and it did spoil what would have been a fantastic and delicious meal for me.  When we finally got back to the hotel I did a full change, cannula, reservoir etc and no probs since... but why does it always have to happen just as we are about to enjoy a beautiful meal?
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 April 2016.


© 2015 Patti Evans

Offline Liam

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Re: Pumping fun and games!
« Reply #1 on: 03 December 2016, 10:17:20 PM »
I've so rarely gotten occlusions I've always wondered if my pump doesn't report them as accurately as others might. I had a couple near the start of using a pump and had a night a bit like your day. It keep going off all night until I got up and did a full change. Sorry to hear how it ruined a lovely meal. I guess we need to think of all the days of great service we get and how the better control over weights these little blips. Easy to say when it isn't your pump alarming :)

The whole carrying other methods of getting insulin is an interesting one. I don't unless I'm really sure I can't get home quickly (so really only on holiday) But there are times I've not had any when getting home would have wasted a day out. I carry a spare set with me if I'm leaving my home town (basically have ones that live in jackets mostly) That is more about it getting pulled out somehow in my mind than anything. That doesn't happen much now but I lost loads when I first started.
DX Type I 1994.    Novorapid Animas Vibe pump
HbA1c 3/10 10.2%, 7/10 8.1%, 12/10 7.5%.
2/11 7.8%, 8/11 8.6% 9/11 8.3%.
3/12 62 (7.8%). 10/12 67 (8.3%)
4/13 63 (7.9%) 6/13 59 (7.5%)
1/14 71 (8.6%) 7/14 59 (7.5%) 11/14 (6.7%)
3/15 56 (7.3%) 12/15 49 (6.6%)
Ramipril: 10mg Quetiapine: 550mg Metformin: 2000mg

Offline himtoo

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Re: Pumping fun and games!
« Reply #2 on: 04 December 2016, 03:13:57 PM »
Patti -- I think it might be that you are always having nice meals in one shape or another -- it is a big part of your lifestyle ( and a very nice one I might add )

interestingly -- I always carry my fast acting pen anytime I am out of the house for more than a half hour.
it even seems a bit OTT to me -- but it has come in handy 1 day when my pod was giving out the distinct smell of insulin mid bolus in a restaurant -- so I pen bloused instead -- and changed the pod after lunch back in the car !!
T1 Dia Aug 1972 -pumping omnipod since 29/09/15  Losartan 100mg , simvastatin 40mg,Furosemide 40mg, Omeprazole 80mg , Doxazosin 8mg
Hba1c - 06/2013 6.1 02/2014 43(6.1) 07/14 42(6.0) 08/14 40( 5.8 ) 12/14 39 (5.7) 08/15 41 ( 5.9) 10/15 44 ( 6.2 ) 03/16 49 (6.6)
cholesterol --nov 2011 4.3 june 2012 4.4 June 2013 4.1 Feb 2014 4.1 dec 14 4.5 oct 15 4.4
Dafne grad. necrobiosis lipoidica on legs
laser treatment on both eyes 2002 and 2012, injections left eye 3 , wearing Noctura mask since oct 2014

Offline everydayupsanddowns

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Re: Pumping fun and games!
« Reply #3 on: 05 December 2016, 10:09:36 AM »
How frustrating for you Patti! I have been mercifully spared occlusion alarms since I moved to angled sets. Having said that I only had one or two in my first year-ish of pumping on 90-degrees sets and those were where the cannula had bent at right angles after insertion (when the inserter needle had been removed) and the flow was blocked. I'm not sure I would expect an occlusion from a bubble - the problem I'd anticipate is the bubble getting to the end of tubing and it being delivered instead of x hours/minutes of basal.

Perhaps Roche's pressure sensitivity is more twitchy than Medtronic? There's a little gaget in the Medtronic box that allows you to crimp the tubing and induce an occlusion alarm with a bolus if I wanted to check that the sensor was still working, but it seems to take approx 1-2u or more (can't remember!) of completely blocked tubing for enough pressure to build up on a Veo - I haven't tested the MM640G.
Mike

Type 1 since: 1991 Last HBA1c: 45 (6.3%)  Total Chol 5.0 (1.9HDL / 2.8LDL / Trigs 0.7)
Pumping NovoRapid in a MiniMed 640G
Blogging at: www.everydayupsanddowns.co.uk

Offline sedge

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Re: Pumping fun and games!
« Reply #4 on: 05 December 2016, 02:35:06 PM »
Patti literally gets shedloads of Occlusions - I have had two ever since I started pumping - once was a complete air gap along half the length of the tubing and the second I had managed to REALLY trap the tubing somewhere - untrapped it, unattached it and re-primed in both cases and all was fine.

If out all day, I just carry a syringe on the basis I can get the cartridge completely out of the pump if it's so bad this is called for - and used it to syringe bolus.  However DSN has given me a thing to have one Novorapid and one Levemir Flexpen to my 'repeat' as you can now get them in ones and she reckons I ought at least to take these on holiday so if the pump decides to really go base over apex, and it might take a couple of days to get a new one to me (not always anywhere with a phone signal let alone a postal address LOL - on a site this weekend, just outside Stratford (on Avon) without a signal on any phone (or therefore any internet between 24 of us)  except someone with an I-phone, so there you go but who cares, since it's only about 23 miles from our house anyway LOL - and Stratford itself is quite civilised anyway these days too !
Jenny

T1 DX 1972, pumping Novorapid 24/05/11

HbA1c - 7/07 8.7, 1/08 7.8, 9/08 8.4, 3/09 7.3, 7/09 7.2, 12/09 7.3, 11/10 8.1, 2/11 8.6, 9/11 6.5 2/12 6.4  5/12 50/6.7  11/12 52/6.9  01/13 46/6.4  06/16 46/6.4  12/16 45/6.4

Offline Liam

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Re: Pumping fun and games!
« Reply #5 on: 05 December 2016, 02:41:13 PM »
Oh I have insulin in the fridge for pump failure / holidays. I just don't carry it around with me unless I'll be unable to get home. I need to get more Levemir for Malta in January. It has been taken off my repeat because I haven't ordered in in over a year. The old system I could just add it on and write a note why and the GP has always accepted that and prescribed it. The new ordering system I can't do that, I asked at reception and they said just to call when I needed it and they'd pass the message on.
DX Type I 1994.    Novorapid Animas Vibe pump
HbA1c 3/10 10.2%, 7/10 8.1%, 12/10 7.5%.
2/11 7.8%, 8/11 8.6% 9/11 8.3%.
3/12 62 (7.8%). 10/12 67 (8.3%)
4/13 63 (7.9%) 6/13 59 (7.5%)
1/14 71 (8.6%) 7/14 59 (7.5%) 11/14 (6.7%)
3/15 56 (7.3%) 12/15 49 (6.6%)
Ramipril: 10mg Quetiapine: 550mg Metformin: 2000mg

Offline Pattidevans

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Re: Pumping fun and games!
« Reply #6 on: 05 December 2016, 02:43:21 PM »
Mike

The Roche pump is very sensitive.  I never let it get below 20u in the reservoir as I know I will get multiple occlusion alarms if I do (though apparently that didn't happen to Sedge when she used the Combo), because there is ALWAYS a bubble (and usually a large one) by the time it's been on 6 days.  I don't know why this is, but I do know that a lot of people in the Roche FB group have the same problem of bubbles appearing where there were none.  ISTR you once made a very good analogy of standing a glass of water on a sunny windowsill and how it will develop bubbles.

To be honest, in the end I do not really know what was causing the occlusions, whether it was a bubble or whether the cannula had got kinked so it only let in drips which was fine as basal (because BGs were fine prior to the meals) but ask it to deliver a bolus and it was too much.  Not had any problems since I did a full change.

Paul

Yes, we do rather like nice food!  Either at home or in a good restaurant.  Like Liam I carry pens and cartridges when we go away, just in case of pump malfunction, but never think to put em in my handbag "in case", they are usually safely stowed either in a fridge or in a Frio in the hotel room!
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 April 2016.


© 2015 Patti Evans