Why Is She 430?

[BRANDYB]

:eek:OMG...I just checked Haley and she is 430!!! We did a site change about 30 minutes before and it looks good. How can tell if her site is bad? She has been low for days and this is her first high. The doctor changed her basil rate again this am to 0.75. What is going on? When I change her site do I leave the old site in or what? The pump was totally off for about 5 minutes. She has no ketones. We did a bolus correction when she checked. We are using the minimed so please if anyone has info please tell me. OH I do not know if I am going to like the pump!! How do I know that insulin is going through to her? I primed her tubing but when I do a fixed prime,should the pump have been connected to her. HELP ME!!!!:eek:

[Heather(CA)]

:eek:OMG...I just checked Haley and she is 430!!! We did a site change about 30 minutes before and it looks good. How can tell if her site is bad? She has been low for days and this is her first high. The doctor changed her basil rate again this am to 0.75. What is going on? When I change her site do I leave the old site in or what? The pump was totally off for about 5 minutes. She has no ketones. We did a bolus correction when she checked. We are using the minimed so please if anyone has info please tell me. OH I do not know if I am going to like the pump!! How do I know that insulin is going through to her? I primed her tubing but when I do a fixed prime,should the pump have been connected to her. HELP ME!!!!:eek:

Probably a stupid Q, but are you sure her hands were clean? I don't know much about pumping, but maybe after confirming with a re test, give her correction with a syringe? Then if she comes down but goes high again, you will know it was the pump??? It will be ok, you will figure it out.

[Charmed7]

I'm a new pumper, but I was told you prime the tube when its not connected. You could even do an extra amount to watch the end for a bubble of insulin. Then you connect and have to prime the cannula (sp)

As far as being high...there are so many factors. If you rule everything else out, then do a site change. don't freak out too much, it sounds like you're doing the right thing. Keep checking her urine and keep an eye on her until she comes down. If you put a correction bolus in the pump and it doesn't go down, then do the site change. I'm not sure how long you would have to wait, that you might want to ask the doctor. For my son, I would wait about 1/2 an hour.

Good luck,

Charmed

[Kaylee's Mommy]

yes, when you do a fixed prime the pump should be connected to her.. what set are you using? the fixed prime is only to fill the cannula.. when you are priming the tubings you do NOT want it connected to her.. you'll see the insulin come out the end of the tubing.. Ifeeling is that if you only did a site change 1/2hr before this number its NOT the site.. it would take longer than that half hour.. did you check her BEFORE the site change? I would correct her and wait an hour, if she's not coming down, correct again (although our protocal is 2 highs and you change the site..but you don't know what she was doing, if she was still going high, or what.. so I do two corrections) or if she has ketones at the next check then change out the site.. the pump will alarm if NO insulin is getting through, but it takes a few units before it recongnizes that.. we hardly ever get that alarm because kaylee does use enough insulin.. if her blood sugar stays high but she has no ketones, she's getting insulin, so I correct again.. if the third time shes high I'd change it out..

the first few weeks of pumping are HARD.. getting everything figured out is crazy, but trust me, it gets SOOOOO much better!

[Carrie]

First of all, I wouldn't panic over 430 with no ketones.

I probably would of corrected through the pump and re-checked in an hour. Our daughter used to shoot high after site changes because they were so traumatic to her (stress).:( When first pumping, we forgot about the fixed prime and that too would send her high.

What I usually do is do the site change and then do a fixed prime right away so I don't forget.:rolleyes: The purpose of the fixed prime is to fill up the cannula that you just inserted. We used to do about 0.5. We now do 0.6. If you press ACT and go down to Prime, the option to do a FIXED PRIME is in there. An amount has been pre-programmed and should be blinking. Press ACT to fill the cannula.

I then disconnect her pump. (I usually put in enough insulin to last through a couple of site changes.) If you do need more insulin, throw away the old tubing and get out a new reservior and fill with insulin. On your pump, go down to PRIME and pick the option to rewind. Walk through those steps. Insert the new reservior and prime the pump. Priming (sp?) is where you are getting the insulin into the tubing and maybe pushing out some air bubbles that might be in there. You don't want to prime with it attached to your daughter because you don't know how much insulin is coming out of the tubing.

If the old site is still working, I usually leave that one there for a couple of hours just to make sure that the new site is okay. If not, I can re-attach to the old site while the numbing cream is working on a new spot.

Sorry to ramble! We've all been where you are at so we can say it will get easier! :) It is a pain at first and quite a bit scarey! Good thing is you've got lots of people to turn to!

[Mama2H]

If you are using the Sure-T's I was taught to prime while disconnected and then insert. I was told NEVER to do a fixed prime with the sure-t's.

[Treysmom]

If you are using the Sure-T's I was taught to prime while disconnected and then insert. I was told NEVER to do a fixed prime with the sure-t's.


We were basically told the same thing, but when there are bubble he disconnects and I do a fixed prime till all are removed.

[Sarah Maddie's Mom]

You need to remember that with pumps kids can go high very fast due to not using any long acting insulin. It's the price we pumper pay for being able to correct without a shot. So... take a breath. You won't realistically know if the site is good for atleast 90 min after doing the change. And, if her old site wasn't working to full efficiency when you changed it, and her numbers were on the rise for a bit before the site change you may have a persistant high that will take a little more insulin to get down.
Stay calm, keep checking bg and try not to alarm her. If you are convinced after an 2 hours that the site is not good ( very rare in our experince) then change it and cover with a correction via injection, but don't double correct via pump. And, ofcourse, check again in 60,90 and 120 min.

[BRANDYB]

Thanks for all the advise. I checked her about an hour later and she is 150. I do not know why she went high out of the blue like that. I will keep checking her throughout the night. I love you guys!!:cwds: