Im not sure if our pump is working well for my daughter, think of going to shots for a bit

I dont know what is going on,but lately I dont think her pump is working right. I don't know if we need to try a different infusion set, or what. Day one with a new site goes well enough and then by day 2- 2 1/2- day 4 her numbers start to creep up and stay up past 160. we only seem to stay in range for late over night to early morning, maybe throw in a low here and there. (if the pump wasn't working, I would think she wouldn't be having lows)

So maybe we just need to increase insulin or make changes to our dosages. I'm sure that they will make some changes at her next appt on the 3rd. But, if you could see her numbers, I do think that for some reason the pump in not working right. I can't explain why. I almost feel like it the pump is saying that it is being delivered, but it not actually going in, or at the very least, being absorbed well.

There have been a few times recently that she has been in the high 200s to 300s and I have given her a shot with the same dosage (or as close to as I can) she would be getting with the pump and she then Bottoms out. I have waited at least two hours to make sure that she wasn't coming down before giving her the shot. Her bottoming out does not make sense to me. Confirming my suspicions that something isnt right with the pump or infusion set.

Anyone have a similar experience. If I am not explaining it well, please ask questions because I will be talking with her team really soon and I want to be to explain myself well enough to make a positive change.

She is on the medtronic 523 with mios.

 

Do you rotate sites well so she is not getting too much tissue build up in one spot?

 

My son is 7 and has also uses the medtronic pump with mios.

How long have you been pumping?
How old is your child?

I wanted to give a few suggestions, but you should also talk with your endo team. How often do you change pump sites? My husband (age 44) can wear sites for 3-4 days, but my son can only wear them for 2 - 2 1/2 days. After that point, his blood sugars do rise. You mentioned in your post that at 2 1/2 - 4 days your child's blood sugar seems to go up. I would suggest doing site changes every 2 days and see if that helps. After the 2 days the insulin just doesn't absorb as well.

Once site problems have been ruled out, you need to do some basal testing. As the children grow, you have to adjust and increase and at times decrease their basal rates. If is a constant monitor and adjust. Adults don't have this problem, but definitely kids do. I have periods where my son's blood sugars begin to run high and I have to add more insulin to his basal.

Try these - I don't know how long you have been pumping, but don't throw in the towel yet. It is so much easier to use a pump to address high blood sugars by pushing extra insulin with the push of a few butons.

Let us know how things go.

 

How long are you leaving her sites in? Many people only get 2 days out of sites, and 3 days is probably the limit. It's not unusual that you'd see BGs increasing on day 3 or 4.

 

Are you new to pumping or have you been using it for a while?

Changing sites more often is a good suggestion. Trying a different set is also a good idea. You are already talking with your health care team, so that's good.


Another idea might be to talk to your pump rep or call Medtronic. They can help you test the pump and rule that out as a possibility. Since it is working on day 1, it sounds like the mechanism is working properly, and that a different set, or different site location on the body (try using a spot you have never used before) might resolve your issues.

Depending on age/independence level do your dd, going back to shots for awhile might be a good option. Perhaps a few months of healing might be what will resolve this.

Good luck!

 

According to past posts your child is 7 1/2, dx two years on a pump and G4. With that tool kit it should be pretty clear to your endo if 1. her sites are staying in too long, 2. her basal rates are off 3. her carb ratio is wrong or if she's just seeing a loss of honeymoon.

The first think I'd try is changing the site every 72 hrs.

Good luck.

 

I think the pump malfunctioning is the least likely root of your problem here. Here is how I would troubleshoot, probably in order:

1. Change sites every 2.5 days.

2. Change where you are placing the sites on her body.

3. Change the kind of site you use.

4. Change the insulin that you use.

5. Adjust basal rates.

Good luck!

 

I have to agree with everyone here on changing the site in 2 days, 3 tops. We have found that third day of insulin just does not work well.

 

Thanks. I will change it every two days and see how things from there. I have been able to get more than two days before, but that might be a thing in the past from now on. We do rotate it all over arms, stomach and butt. She doesn't enjoy changing it but it has to be better than going back to shots.

 

So it feels like forever since we pumped but one idea I had was that if it is really hot where you are maybe the insulin (near her body and all) is going bad because of the heat. Just a thought.

 

piggy backing to this, you could try changing insulin sooner and see if that helps at all.

you could also change insulin's and see if there is any difference. Humalog just stopped working for us, we would remove a site on day three and the cannula would look all cloudy and gunck'ed up, we switched to Novolog and it was a 360 in just a day, had to back down her insulin to not have lows. For some reason she was fighting the insulin at the site and clogging it up, the insulin switch was absolutely the easiest to try first. Just got a sample bottle from the endo and filled the cartridge

 

Thanks, ill be sure to inquire about this.

 

I had the same thing where it said insulin was being delivered but I thought in no way was it actually coming out. There was a lot of trial and error- switching insulin, switching from flexible cannula to steel, raising basal more than I was comfortable doing.

At one point I bolused a large amount through the tube- not in her- and it clogged and then squirted out with force. So I definitely think it was getting clogged. I got a new pump after that problem but all the other things I tried were after we got the new pump.

She was getting 4 days out of a site until it started getting warmer out. Now I have to change it in 3.

 

I did remove the tubing once and gave it a blouse and it did SHOOT out. I figured it was because it boloused it like 4.7 units. Not like when you fill the tubing for the first time for a new site where it drips out. After, that I filled the cannula when I hook her up and it would get stuck and say no delivery. But then I rewound it and it worked.
So, I have changing it every two days, it goes ok so far. Ill see what they tell me at my appointment.

 

Quick easy stuff to try. Switch sets. First try the super short steel set then try switching insulin types then try changeing sites every two days. I actually had major pump issues for years that were a combination of bent Teflon sets, clogged sets and needing to change more often. I first switched to steel sets, big help, then to Novolog from Humolog another big help and then for me swapping sets out every two and a half days. 99 percent of my issues disappeared. I once again was only dealing with exercise food and hormonal issues:tongue: