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DKA and Pump Failure

Discussion in 'Parents of Children with Type 1' started by KarenLynn, Jun 5, 2013.

  1. KarenLynn

    KarenLynn Approved members

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    Hi...It seems like forever since I've visited. 11 year old Daughter went into DKA on Sunday. Vomiting, listless, high ketones, etc. She's fine now, home, back to school. Pretty sure it was caused by pump failure. She is on the Minimed, no CGMS. We had an issue with a Minimed pump in the past as well. So I'm wondering....anyone else have pump failure issues? They are electronic and electronics fail. I just don't know if I can do this again. I'm also wondering if we should switch pumps. I have heard that the Animas have occlusion issues. Just not sure what to do. Also, we are not "ready" insurance-wise for a switch, but could I possibly fight insurance due to the pump failure and risk to her life? Thanks for your thoughts.
     
  2. Amy C.

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    There are lots of reasons a pump could fail to deliver insulin. Testing every few hours and taking action when out of range is the strategy most on a pump use.

    You didn't specify the details of what happened. Did she go for a long period without testing her blood sugar?
     
  3. Sarah Maddie's Mom

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    That's a shame. Was she in the hospital long?

    I know that our mm is prone to "no delivery" but it yells at us so we catch it and it's always caused by dd inserting her new site in her favorite old spot. ;-) Did it happen overnight? And what have you learned from the pump history?
     
  4. KarenLynn

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    Well, we were having some high numbers for a couple days, but not consistently high. Lots of fluctuation. I had been sick with a virus earlier in the week so I thought perhaps she was fighting it as well. Or that growth hormones were kicking in high gear. She didn't spill ketones until Sunday, which is when she started throwing up. And at first I still thought it was viral. But then she complained about excessive thirst and her arms hurting and she would take a few sips of water then vomit an unusually large amount of liquid (considering what she had consumed). When she finally cooperated with the ketone testing, it was high. I tested her BS as we were pulling out of the driveway on the way to the hospital, watched the pump count up the insulin for correction, then gave her another temporary bolus. When we arrived at ER, they asked how much insulin I had given her. When I checked the pump, there was no record of any correction. Only the temporary basal. That's why I KNOW the pump malfunctioned. I WATCHED it count the correction. I'm very frustrated as I sit here, trying to get back to normal (we just came home last night), and fuming over another pump failure.....
     
  5. Meredithsmom

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    That had to be so scary. I'm glad she's feeling better, but I know it would take me a long time to get over it. We've not had a pump failure (knock on something resembling wood) so I cannot offer anything about that. Take care of you.
     
  6. Mish

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    Obviously, any pump can malfunction. What did MM say when you reported it? They're going to send you a new one, right?

    One thing to note though - it doesn't sound like you have blood ketone strips. Even if you don't routinely want to use them they're invaluable during times like these when urine strips just aren't working. I don't want to imply that you did anything wrong especially when the pump was malfunctioning, but usually you can catch a problem by early ketone testing any times numbers are over 250 and especially if you suspect an illness.

    I think that with some general changes to management during periods of weird highs , more BG checks, and with more frequent ketone testing you will alleviate some of your fears of another pump malfunction. Many of us have had it happen before, they are just electronics, but it's what happens surrounding that event that will make the difference next time it does.
     
  7. KarenLynn

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    She was in the hospital from Sunday until Tuesday. She was fine Sunday morning, got ready for church, then said she didn't feel too well and went to bed. I was taking a nap because my son had been mugged at 2:00 in the morning and my hubby and I were at the ER with him until 5:30. Hubby decided to go to church while I was sleeping and left Gracie at home in bed. I was surprised to see her when I woke up. But she declined rapidly from noon to 2:00, when I called the DR. She is my hero. And so is my son, who is mending and doing fine. Apparently, the suspect is in worse shape than my son! Turns out the guy who attempted to rob him was apprehended and wanted for several bank robberies and will be charged with armed robbery (thankfully, the gun was filled with co2 and not real bullets). It was a crazy day.
     
  8. Beach bum

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    I am so sorry you guys had to go through that and am relieved she is doing better now.

    We are on Animas and have only had 3 occlusions in 7 years. The occlusions are not from the pump, but it's within the set. For example, the last two we had were in a few days of each other. Turns out it was something I was doing when applying the infusion set (inset) that caused the cannula to kink slightly, enough to sound the alarm (phew). Luckily, the alarm went off almost immediately.

    Again, glad she is doing OK now!
     
  9. KarenLynn

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    They overnighted a new pump, but since it was Sunday, we didn't receive it until Tuesday. She is having normal BS now.
     
  10. SarahKelly

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    I am so sorry you guys have had to go through this.
    I am not sure if I have the answers, but I can share a few frustrating moments recently.
    Isaac has been using the revel and it's been fine until about 6 months ago, then I noticed I could hear it when it would give a large bolus (more than a unit). I called MM and they said that's fine. Then I started noticing higher numbers and started checking his ketones (blood ketone strips), trace, so I did a new site and corrected with a pen. His bg came down, but again I could hear the motor. i took the pump off at the detach site on him and did a large prime to see what was coming out, very little, while doing this a motor error occurred and I called MM. They overnighted a pump. It was a PITA to wait as we had it occur on a weekend, too!
    Then about 3 wks ago we had the exact same thing happen. New pump. I am now VERY cautious about any number over 300. Anytime I see a BG keep going up at that high I check ketones. Or if he has two over 300 I check ketones. I am quick to use a syringe to correct due to worries of DKA as Isaac seems to be one that develops ketones very quickly.
    Now I feel that whenever we can't get a BG down (and has ketones) with just his pump for more than 24hrs it is more than likely a pump issue. In the past when he's ill his ketones don't develop very quickly or will go away quickly with a lot of fluid, but not with a pump issue.
    Anyhow, just our experience. I hope this is your only experience with pump failure it is very frustrating and scary.
     

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