Friday, May 15, 2009

6 month review of the insulin pump

Greetings friends!

It's been 6 months (+ 5 days - but who's counting?!) since my life drastically changed due to the insulin pump. I've learned a lot about the medtronic paradigm system, and I wanted to share my review with you here.

The 'honeymoon' phase of feeling invincible wore off after a few weeks, but in general I cannot compare now to 6+ months ago. A few general observations:

-I sleep much better. I used to always wake up tired and lethargic, no matter how many hours of rest I got. Now I pop out of bed promptly at 5:15 AM daily whistling "It's a wonderful life!" Well, that may be a slight exaggeration, but really I wake up feeling refreshed, and that has everything to do with the blood sugar averages thanks solely to the pump.

-I'm less moody. Again, operative word: less! All kidding aside, my overall attitude, motivation, and energy level are much higher. Irritation levels have decreased [ note: that's my irritation level of how I feel, not how much I irritate others - :) ] Why do I hear a booming, "A-MEN" coming from my wife and kids??!

-I like testing my blood sugar. 20+ years of ka-ka-me-me readings makes you a little jaded towards testing. But when you see those normal readings on a consistent basis, you start to think, "hmmm, when can I test again?!"

On to the review:

1. "Low resevoir" means I should change my set soon.
I know, I know - thanks a lot Captain Obvious! But for some reason I think of insulin as liquid gold, and treat it as such. A while back I learned that there's about 10 units of insulin in the primed tubing, so even when the pump reads "0 units left" you still have around 10. Again, I should know better. I had to learn the hard way...I ran out of of insulin (bone dry) in the middle of the night, and awoke at 511 mg/dl. Yes, I said 511. Even when my average was high 511 felt horrible - but when your average is normal, 511 feels like your worst nightmare. Lesson learned.

2. De' ja' flu
I was worried about getting sick and being on the pump. I normally get the flu every few years. Well, I got the flu this year (despite the flu shot), and it was really no biggie (see a previous post). But then, I got it again. Not quite as easy the second time around, but being really sick stresses out the body, and after a day or so I recovered fine. Having the pump actually makes it easier to control the blood sugars while sick, so that's a bonus.

3. The meter & the pump talk.
So you test your blood sugar, and moments later, "voila" your reading is displayed on the pump. Magical (actually, RFID, but still impressive). They say it works up to about 8 feet or so, but the other day I had my pump off (shower) and tested my blood in the kitchen. My pump was in the bathroom - around the corner, down the hall, in the room, take a left, through 3 doors and 2 walls. Suddenly I hear the familiar 'bzzzzz bzzzzz' and I think, "whaaat now?" I look at the pump and there it is, "113." You've got to be joking me...nope, that's how cool this stuff is.

This communication makes taking your insulin easy. And who really remembers to test 2 hours after you last ate...exactly after 2 hours? The pump and meter combo make it a cinch.

4. Dress up.
Medtronic calls them 'skins,' and it's an adhesive you can put on your pump to personalize it. Being baseball season, I now sport the Milwaukee Brewers pump. Ironically, ever since the pump and the brewers got paired, the brewers have hardly lost. Who knew the team needed the paradigm insulin pump?

5. Painless.
I can't remember the last time inserting the infusion set actually hurt. Usually it's totally pain-free, as in I cannot feel it at all. Once in a blue moon it's slightly uncomfortable, but no where near the 'muscle shot' pain. And to think you only have to change it once every 4 days (I mean, 2-3 as they recommend - lol), again: awesome!

6. Care link.
It's a usb dongle that plugs in to your computer (pc only - I've logged plenty of complaints!) that reads EVERYTHING from your pump. Every setting, blood sugar reading, insulin dose, time, carbohydrate value, correction amount, basal, and bolus. As if that weren't cool enough, you can customize a variety of charts and graphs to visually see everything that's happening with your diabetes management. You can go from a daily report up to SIX MONTHS! This tool has been invaluable to me, and helps you identify trends that you might otherwise miss. I can't endorse it more highly.

Fancy acronym for "continuous glucose monitoring system" which in English means a sensor that you wear that remotely sends your blood sugar to your pump every 5 minutes, 24 hours a day! (that's 288 blood sugars a day!!)

I tried the sensor twice before and we didn't get along well. So many stinking error messages, it caused more anxiety than anything. Now I know how to get around all the drama, and realize it's just the sensor and transmitter courting (who doesn't have a few minor issues while courting?!), it has nothing to do with the pump.

I gave it another try and absolutely love it. Well, mostly love it. See below for what I don't like, but I would definitely endorse it and think it's another great way to get tight control.

Here's my current screen...oh the bliss of the straight line (means blood sugars are steady)..

Notice the 'skin'? Brewer time. Also I have no clue what that is under the ACT button. My guess? Some Reese's Peanut Butter cup derivative...(I love having ratios that work!!)

What I don't like:

1. No back light on the meter.
An obvious design oversight. My one touch ultra smart has one, my one touch ultra has one, the one touch ping pump meter has one...the one touch ultra link does NOT. I've logged my frustration with Life Scan (one touch maker), but they have no plan to resolve the issue. When you test at night, or when out to dinner, or when driving at night, or at the get the point....YOU CAN'T READ THE SCREEN! So I use my cell phone as a light. Lame.

2. No back light on the pump buttons (halo lights).
Again, I don't know how this went unnoticed. Although the screen lights up beautifully, the buttons themselves do not. Having back lit buttons would ensure the proper buttons are being pressed. This would be an easy fix, and I'm going to photoshop a pic of what it could look like in the future.

3. Insulin delivery is slow.
You wouldn't think it would matter, but if you bolus (take your insulin) before a shower, you may have to wait a bit until you disconnect. If the delivery was faster (ala animas ping), you'd be ready quicker. Not a huge deal, just a minor preference issue.

4. Tubing options limited.
The tubing is what connects the pump and insulin reservoir to your body. The current options are 23" & 41." I use the 23" as I stay around the abdomen for infusion sites. But I could use a 6 or 9" as the pump and site are often just inches away from one another.

5. Care link log book
Although I sang the praises of care link above, the log book feature is useless. I called and made many suggestions for changes, none of which were incorporated. You need to be able to enter blood sugars and notes outside of the defined times, and you can't now. It's not very intuitive or user friendly, and I bypass it altogether.

Yes, we're happy together now. But I have to admit, it is somewhat finicky and high-maintenance. The thought of the CGMS can be better than the reality of it at times (the CGMS is generally about 20 minutes behind your actual blood sugar). However, through proper calibration and updating, you can get the numbers to be fairly uniform. The errors and hassle therein can be a drawback, but if you simply insert the sensor and connect the transmitter WITHOUT TURNING IT ON on your pump...and leave it in for at least 2 hours before turning on (doing it before bed works best), then when you turn it on, within 15 minutes or so you calibrate and you're off and running (thanks Kevin for that great tip!)

My biggest frustration is keeping it on. The sensor uses adhesive, but the transmitter does not. I've yet to find adhesive that works well for me, and I prefer none at all (although that's risky and I've learned the hard way that the sensor can become dislodged this way rendering it useless).

7. Low blood sugar symptoms
I am much less sensitive to low b/s symptoms than before the pump, because my average is so much healthier now. I still have them, just not as pronounced. Not really something to complain about, more an observation than anything. This is where the CGMS comes in handy!

One final thought....I've noticed many diabetes suppliers and manufacturers believe we hate testing our blood sugar because it hurts. Further, many pump companies think we despise taking shots. My contention is that we don't like testing when control is difficult as more a psychological issue than a physical (pain) issue. Additionally, I never thought needles were a big deal. I mean, sheesh, they're so small and narrow you can hardly feel them at all. Again, a mind (mental) issue.

For me, being on the pump isn't great because of no shots. Before the pump I thought, "I'd rather take 10 shots/day rather than be hooked up to that pump." What you can never imagine until you experience it is how it will affect your...everything.

I'm a better husband, better father, better son, better friend, better man, better child of God, better employee.....

I'm just plain better -

Because of the pump.

So get better, and get pumpin....


Karen said...

What a great post!! I've been on the pump for just over a year (and diabetic for almost 30) - and most of what you said applies to me too. I wouldn't trade my pump in for anything, and I no longer put off testing my blood because I don't want to see the reading. :) I'm trying your CGM tips today too - not turning it on in my pump until I test before dinner.

beckybj said...

Congrats on 6 months!

Wendy said...

I don't have diabetes but I came by because you visited me... and I'm glad I did. I got a whole different perspective on something I don't know anything about. I don't know anyone with diabetes, but my father in law is having to test his blood periodically now because they are worried he might be going that way. Thanks for the insights. I'm really happy there is something that makes your life better!

Steve said...

I have had such bad experiences with Medtronic that I will not consider using anything they manufacture. My first pump was a Minimed and was noisy and unreliable. When I lived in La Jolla, I ordered a Medtronic replacement because of assurances that the Medtronic pump was superior to the Minimed pump.

It was far worse.

It failed in differing ways on 13 of the first 14 days I had it. The Medtronic phone people blamed me for throwing or dropping the pump, living in an area with too much static electricity, not tightening the battery cap, not inserting the infusion set (into my own body), inserting battery backwards, using the wrong size battery, and finally - "not telling the truth".

I called the office of the CEO in Minneapolis and told his administrative assistant that I would return the pump to him personally the next time we met for golf. She seemed composed and assured me that various heads of Medtronic would contact me ASAP "to put the matter right". I told her again that I would return to the CEO at our next golf outing, thanked her for her concern, and disconnected the call.

Within 30 minutes, I had received 3 calls from nervous managers at Medtronic, and I dismissed them all. Two days later, a FREE Medtronic pump was delivered to me, but I refused it and sent it back to Medtronic with a short note

Medtronic has been harassing Smiths Medical with so many frivolous lawsuits that Smiths, the makers of the Deltec Cozmo insulin pump, have withdrawn from the market to avoid the needless expense of constant lawsuits.

I regret the loss of the Deltec pump from the few available to diabetics. My Deltec pump has been accurate, easy, non-proprietary, and 100% reliable and dependable in the five years that I have owned it. Customer support for the Deltec Cozmo has been exemplary, with them providing near-instant solutions instead of endless blame-shifting and avoidance of responsibility.

The time to purchase a replacement pump has arrived, and I will buy an Accu-Chek Spirit, in spite of the fact that Medtronic sent me the largest, splashiest, most colorful brochure of all.

Missing from the Medtronic brochure was the assurance that their pumps have the largest insulin cartridge available. Also missing was any information that Medtronic does not use proprietary infusion sets. Also missing was any reference to the disproportionately high number incidence of pump inaccuracies and failures. Also missing was any reference to the VERY slow rate at which Medtronic pumps pump insulin.

Given the foregoing, no prospective pump shopper should put their health, bodies, and life into the fumbling hands of Medtronic.

If you can get Medtronic to mail you an insulin pump brochure, see if you can figure out how anyone could function on a daily basis with the pump as shown, clipped on the top of the model's jeans, just inches away from the infusion site - if she sits, twists, bends over, of just walks, the pump is going to fall off, or she will pull the infusion set out of the site. This illustration further demonstrates to me, the ignorance of the people of Medtronic when it comes to being a "real live" person with diabetes.

NO to Medtronic.......again!

Pink said...

I am going over reviews for pumps and found this one to be very good...just wanted to say thank you for writing this.

FfiFfi said...

So glad I've just seen this blogg, stumbled accross it earlier this evening, and have been glued to the screen ever since.

I'm going into the hospital on Monday, to start the process of getting a pump (whatever the process is) and to say that I'm scared is definatley an understatement.

Thankfully you've pointed out all the positives, rather than the negatives I seem to be getting off others (especially the staff from the hospital, for some reason)

So, thanx for making me feel a little be reassured!!

I'm sure to be keeping regular checks on your blogg!

Carl said...

I'm comparing pumps and reading reviews. Thank you for such a complete and well composed review. It helps that you're a real user and that you wrote this review after 6 months of use!

Anonymous said...

I had a minmed for 4.5 years, before the CGM. It was a decent pump, but the problem for me is limits. I need (at times during the day) a basal of 5 units an hour, mini does not go above 3-4 units (can't remember exact) and I need 27-36 units bolus, the pump maxed out at 25 units, so then I would have to set an alarm to remind me to bolos again 30-1 hour later.... I switched to Cosmo 4 months before they announced they are discontinuing. So now I am looking for a new pump. And am considering the mini with CGM. because my main problem with taking blood sugars is carring all the extra gear, then say you eat at 7am, you get to work and are in a meeting at 9am, you really can't just say "stop i need to go check... or again eat at noon and 2pm....

Anonymous said...

Thank you for posting this. My 10 yr is getting the pump and we are all excited. He had a problem with the infusion site. He said he was hurting him. So we pulled it out and placed it on his rump. He seems to like it better. Once again thank you

Ruthie said...

I've been really happy with my Medtronic Minimed Paradigm for at least 3-5 years (and had another Minimed before this one). I've only had one time that there was a real issue and Medtronic took care of it immediately with GREAT customer service.
I'm now trying to decide whether or not to get a CGMS, as we're planning on getting pregnant soon and I want to be in complete control.
Thanks for your post & tips

Tony J Diaz said...

Can you help me by publishing this article or commentary on it to help the Animas Company see their inefficiencies and correctly manage the needs of diabetics like me?

By Thoughtful Diabetic on:

The Animas Corporation, a part of the Johnson and Johnson Corporation

The Animas Corporation is the most inefficient and irresponsible. I have been dependent on their pump for about a year and two months. The company sells a pump, which uses a weak plastic that was cracked after the first ten months of my regular usage.
We depend on supplies like catheters, which are the needle for the pump, and cartridges which hold the insulin we need to live. The Animas does not work with our needs and in many cases either refuses to handle our needs or just looks the other way as we run out of supplies, and have to return to injecting ourselves multiple times a day.
In my case after three separate calls to Animas by myself and two by a secretary they came up with elaborate excuses each time. The worst of which was that they had received the incorrect phone number, for a company who repeats numerous times, “most of our representatives are diabetics or have close relations to diabetics so they will understand us” this is a blatant lie and disregard for us as customers, and medical dependents.
It is not bad enough that this company has disregarded us diabetics individually, now the government is looking to giving a grant to them for advancing diabetic research. Do we really want to give the monetary funds for our disease’s cure to a company that can’t even handle public relations or shipping logistics.
I am just one of many who have been wronged by this corporation, join me in asking them to stop hurting our diabetics, friends, and families.

Antonio J Diaz

Rawya said...

I was searching for reviews cause I am in aprocess to have the medtronics one for my 5 years old son,I like your information so much and made me feel very good to have it "little bit worried"thanks alot .