I am very partial to the insulin pump, I must admit. I can not think of any reason I would not want to be on it. Even though I am telling you how wonderful the pump is, it is not for everyone. It is worn all the times, though taken off for showering or swimming. Other than that, its worn 24/7 for the most part. The cannula, or small piece of tubing, is in you at all times unless you decide to take it out for some reason. But once it is out the insulin isn't being delivered so it isn't that smart to take it out for long period of time. Having the pump means frequent testing. When you want to eat, it is best to test to see how much insulin you should cover. Your doctor will help you establish and insulin to carbohydrate ratio. For example, at breakfast, for every 10 grams of carb. I eat, I will do 1 unit of Novolog. But hey think of it this way, would you rather do a finger stick or a shot every time you want to eat? I for one, would much rather a quick prick. Wearing the pump all the time can be a little bit of a pain but that is not a big deal. It isn't heavy, and is about the size of a pager, a little bigger. I wear it hooked to the pocket of my jeans/pants or the waist is there are no pockets to hook it to. I personally don't mine if people see it and ask questions about it, though I do try to make it not too obvious. Many people glancing at it mistake it for a pager. There are three main companies that make it-- Deltec, Minimed and Disetronic. I am not familiar with the Disetronic at all so anything I may say about the pump is about the Minimed and Deltec though all the pumps probably are quite similar. Like I mentioned, it can be taken off for showering and swimming or if one needs to take it off for some reason, but
remember when you do, you are missing your basal rate. A basal rate is equivalent to a long acting insulin only it can be fine tuned to your needs better than NPH. It can be adjusted in .1 (in some pumps .05) increments, and set for different rates all through out the day (in units per hour delivery) A bolus is the dose given when eating (breakfast, lunch, dinner, snack doses). Those are the two basic terms for pumping really. I use Minimed's Quik-Sets. I insert the set with a special inserter...it is a needle with a small cannula or tubing around it and then remove the needle so only the cannula remains. It's pretty painless, really. There is a line of tubing connected to the site and the pump that insulin goes through when it's delivered. The come in two different lengths. I prefer the longer ones. The pump only uses one type of insulin. I use Novolog, and another option though is Humalog or a buffered regular called Velosolin. A thing that concerns doctors/patients about using Humalog or Novolog in the pump is if there was a pump problem by chance, your blood sugar would go up quicker, since they aren't with you as long as say, Regular insulin. The pump user must be responsible and willing to check his/her blood sugar more often than on shots, since whenever eating, insulin will need to be done if not low. The pump site needs to be changed every 2-3 days, or as directed by doctor otherwise the wearer may develop hypertrophy, or a buildup under the skin, since insulin is a growth hormone. As a teenager, I appreciate the flexibility the pump offers in my life. I do not have to follow a strict schedule of meals and snacks. Insulin is always conveniently on me. Going out with friends and eating isn't a problem. Nor is having to worry about only eating sugar free things. As long as I count the carbohydrates in what I eat and do the appropriate amount of insulin to cover it, I am able to eat basically whatever I want, within reason of course.
In February 2003 I started on a new pump called the Deltec Cozmo. I fell in love with it immediately. It is a little bit smaller, comes in 3 colors and has a lot of useful features. For example, you program in your insulin to carb ratio as well as correction factor into the pump. Then you have the option to program in how many carbohydrates you ate and what your blood sugar is and it will suggest doses for you based on your ratios/factors. It makes life even easier with diabetes by doing all the math for you. Under the "history" section of the pump it tells you how much insulin you took for basals, correction factors, and food each day and does averages for multiple days. It has a "touch bolus" so you dont have to look at the pump and it will beep or vibrate so you know how much you are doing without looking. It uses one AAA battery. The Deltec is extremely easy to load and change the site. Definitely something to check out-- Their webpage is www.delteccozmo.com.
Best of luck with your decision to go on the pump if you're interested. If I can be of any help, don't hesitate to email me!
PUMP TIPS
Getting the air bubbles out of the syringe... tap the syringe against the table (not too hard of course) so that all the bubbles rise to the top and are easier to get out. I've had great success with getting them out that way. Or tapping the syringe with a pen works pretty well too.
Avoiding hypertrophy... Be sure to rotate so that you don't get any "bumps" from injecting your pump site in the same spot. Try using your lower hip. It doesn't sound comfortable to some, but I found it is the same as my stomach.
If you find that you run out of insulin before it is time to change your site frequently there is a piece you can take out inside the pump to enable more insulin to fit into the pump. The neck of the syringe will stick out but it sure beats changing your site before you really need to.
Where to wear the pump for sleeping... I hook it to the waist of my pajama bottoms, on the front since I don't sleep on my stomach. It doesn't move around, and therefore I don't notice it is there while sleeping at all.
Having a tough time inserting your site? Some days it just seems so much more "stressful" changing your site, even though you know you can do it. I sometimes find I have to walk away for a few minutes to just forget about it so I wont tense up. If you tense up, it'll just hurt more and cause stress...lol
Tape problems? I find the tapes Minimed puts with their sof-sets don't work for me. One of them doesn't stick to me and the other gives me a little rash, so I found that Tegaderm (and IV tape) sticks well for me, even through swimming all day.
Going to be at the beach? Keep the pump out of the sun in a cooler (but not right on top of ice). If you don't want people to see the pump site (wearing a 2 piece, or boys) try your lower hip as in insertion site. Be sure if you take off the pump to cover the basal rate you're missing.
If going to be active for a while... Set a temporary basal rate to avoid unnecessary eating if planning on wearing the pump through strenuous exercise. Set it a little before you start exercising though so that you wont go low early on.
