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Need advice - Best pump?

Discussion in 'Parents of Children with Type 1' started by ChazDad, Jun 12, 2013.

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  1. ChazDad

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    DS diagnosed Jan. 2013, 10 yrs. old, and endo now recommending pump. I have 3 choices and have to let them know by the end of this week:

    (1) Medtronic Revel
    (2) Animas One Touch Ping
    (3) Omnipod

    I've read lots on this board and elsewhere about the good/bad of all of them. But I'm still confused. Which do you love/hate? I know this has been answered before, I'm just trying to get some clarity.

    BTW, we cannot get CGM because insurance won't cover it and we can't afford it.

    Also, I'm in the US - would I be better off waiting for the FDA approval of the Animas Vibe?

    Or maybe does anyone think shots are better? I know they are not as accurate, but there are no issues with bad pods / bad pumps, occlusions, disconnects, skin allergies, etc. I know some pumps/pods are waterproof, but with shots, there's no problem with swimming, playing sports (my son plays football), etc. So I'm still undecided if we should even get a pump at all. Am I being naive?

    Thanks for any advice.
     
  2. heypb

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    Why did the endo give you such a short deadline? The best way to know which pump would be best for you and your son is to have a rep from each company show each of them to you. That will take longer than half a week.
     
  3. ChazDad

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    I had 3 weeks but I've been researching them and still haven't decided. Now I have until Saturday.
     
  4. missmakaliasmomma

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    It took me 3 years to decide to put my daughter on a pump (she's 4 now). They wanted me to put her on one very early on, before she was 2. To me, it's a hard decision and only you and your son can make that choice. What made me finally decide was that her lantus was peaking in the middle of the night so I couldn't correct highs of lower than about 220 during the night. I didn't like her being that high. We couldn't go up anymore on her lantus because she was waking up at a good number but I still couldn't stand the highs at night. The dr was explaining to me that being on the pump can fine tune basals at any period of time and boy was she right!

    We still have some highs/ lows just because diabetes is never fully understandable since the body likes to do what it wants sometimes. And because it's never perfect. She's also only about 2 months into it so we're still fine tuning it her pump and all the settings.

    She's on the animas ping. That's what I'd recommend for a child, it's what my dd's endo recommended. It's waterproof, the others are water resistant. I think the waterproof is what sold me. I've heard many issues about the pods, to me they might be better for someone older. It also seems like people could develop allergies to teflon or steel and with the pod, you only have one option, teflon. I didn't even consider the minimed when the reps all came to the endo's office. It's only water resistant.. for me having a child.. we needed waterproof.

    I've had no issues with the pump.. ok I had one with it saying the line was not primed. All i had to do was prime it again and problem solved. The problem to me lies more with finding the right insertion set since everyone's different.

    We are able to get a new pump in 3 years (I know, it's a long time lol) and by that time, my daughter will most likely have a much bigger role in her diabetes care and we will be looking at the tslim because I think she will be old enough for it and to take care of it better. Plus it doesn't like as much like a "pump".

    Sometimes I feel bad when i see the pump on her or when she takes longer using the bathroom because now she has to figure out what to do with her pump and think that injections just would've been easier and no one would even be able to tell! But to have better sugar levels all around, is enough for me to know we made the right decision.

    If shots are working for you, I'd say leave it be. They worked for us for awhile until we hit that lantus road block. I knew she'd be on the pump sooner or later, it was just sooner for us because of that.

    ** I was also told by the animas rep that when they come out with the integrated cgm model of the ping (which I guess is technically the vibe) that we would be upgraded for free.
     
  5. Sarah Maddie's Mom

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    Both the MM and Animas are "waterproof" right out of the box. However, a hairline crack in either will void that and likely kill the pump, either pump. You can narrow the choice down between tubed and non tubed. For now the Pod is the only non-tubed pump on the market in the US. The pod is waterproof, but not the PDM, but it wouldn't need to be.

    If you go for a tubed pump it comes down to cartridge size 300u vs 200u. Your son will have this pump for at least 4 years so TDD may be something to take into account.

    I don't understand why you've been given a fixed date to decide. That's just very odd.
     
  6. ChazDad

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    I have a fixed date to reply because the hospital has to order to pump before the class we are required to take and has to make sure they have ample time to receive it before the class. They will give it to us at the class and show us how to use it. We were told the Insurance process and ordering time takes about 3-4 weeks so they are trying to get us in their July class on time.
     
  7. missmakaliasmomma

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    According to Animas' website, the minimed is splash resistant only and the omnipod is watertight in 25ft of water for an hour. Animas is 24 hours in 12 ft. Maybe this is old and the revel is now waterproof, but I think if that were the case, they'd update it.

    http://www.animas.com/animas-insulin-pumps/onetouch-ping/compare-insulin-pumps

    They did lie about how long the battery last on the ping though IMO. It only lasts about 3 weeks for us.
     
  8. Beach bum

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    First, I'm curious as to why you have to have a decision this week. It's not a choice to make lightly and you also want to be able to talk to a rep and try them out and also find out about insurance coverage.

    That being said, we have had Animas products for 7 years now and are very happy. We love the fact that there is a remote (especially handy for nighttime corrections) but hate the fact the cartridge only holds 200u. I like that you can have several different basal, carb, sensitivity profiles. I wish that you could reduce basal from the remote.

    Basically all pumps do the same thing. Deliver insulin. Some have more bells and whistles than others. Here is a chart that shows all available pumps worldwide. http://www.diabeteswellbeing.com/insulin-pumps.html
    Another to consider is the T-Slim. Keep in mind, that you will most likely have this pump for 4 years before you can change again, so definitely do your research.
     
  9. SandiT

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    Hi ChazDad,

    Right now, we're in the process of getting our 6 year old a pump. We've decided on the ping, and I'll tell you some of the reasons why... and maybe give you some things to consider as you go forward with your own choice. However, keep in mind that we're in the same place, I'm not speaking from experience with any of the pumps.

    My choice came down to between the ping and the omnipod.

    I decided right away against the medtronic, because their lock is proprietary. If for some reason, Kira has issues with their insertion sets, you're still rather locked into them anyway. With what's called a "leur lock", you can make the ultimate decision to try other insertion set types, styles, or brands. With MM, that's not going to be possible.



    Now, I eliminated omnipod for a couple of reasons, but they were minor reasons except for the final one which was the clincher for me... you HAVE to use the remote to program the pump. Without the remote, you aren't going to be giving a quick bit of insulin for an unexpected treat. If we go on a trip to grammy's house and realize we forgot the remote (and I'm not going to lie, for OUR family, this is a very real possibility), we have to turn around and go straight home for another 1.5 hour trip.

    But that being said, if it weren't a concern, then I think we would have gone omnipod. The cordless potential and the ability to more easily wear it on the arms seems like a great idea. Additionally, being able to wear it all the time seems positive, as well.

    Additionally, you get a whole new one every few days. That seems to have its merits, too.

    On the other hand, again, since the pump IS the insertion set, if there are problems with reactions or the like... it seems tougher to deal with from what I've read around about the forums and other places.




    All of that being said, a huge strong favorable thing for the ping is its ability to deliver very tiny doses. With as little insulin as Kira requires due to honeymooning, tiny dose delivery is a big plus for me. Additionally, the cartridge size for Ping and Omnipod are the same... and Kira never goes nearly through a whole bottle of insulin in a month as of now.

    I also like that you can use different battery types for the ping. So if we're out and about and 'oh yay, batteries are going out', we can toss in a couple alkalines until we can do better later.

    And you know, being pretty new to the whole thing, I'd be lying if I said the "integrated calorie king" in the meter-remote didn't play in at all. :D I also like the double-and triple-check factor on the ping. I can see how for people much less accident and error prone than I am, it would get very annoying, very quickly. And it probably will for me, too... yet at the same time, it gives me a sense of relief and security, as well.




    Because of the difference in your child's age versus my child's age, you may consider the 4 year warranty... you will have this pump until your son is 14, most likely. So you want to look ahead 4 years and consider... is the cartridge size going to end up being something major that you regret (the ping's is smaller than the MM's, but equal to the omnipod)? Will you wish to god that you had considered cartridge size over ability to deliver minimal doses or over ability to switch out insertion sites?

    I don't have an answer to that, because again they're at different ages, but perhaps others can advise on it. But it's something that was definitely on my mind... this pump must do well for her now... and then. And I must consider when she's 8 or 9, not just when she's 6.




    Also, keep in mind that omnipod has a program called 'cut the cord' or some such (someone will correct me, I'm certain :) ), that allows you to get the omnipods for use during the summer. So you can feasibly have two different pump types. Summer is a few months of the year, so you do have choices that can be made with the 'cordless by omnipod' or whatever program in mind.


    I know that this is a big decision (boy do I know), because we're facing it right now. And there seem to be pros and cons all over the place.

    I don't have really anything else to offer, just the reasons we chose and things that I think you may see differently. Perhaps seeing another person's choosing process will jog some ideas for your own. If not, sorry for the book-length essay if it didn't help, lol.
     
  10. MomofSweetOne

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    I would take the time to trial the pumps. You'll be living with it and its quirks for the next four years.

    We got Medtronic and now we've Cut-the-Cord for the summer. I can honestly say there are things I love about Medtronic and hate on the OmniPod (Insulin-on-Board calculations and 24-hour temp basals) and things on the OmniPod that I often had wished were on the Medtronic (My records - that include records of temp basals without uploading data to the computer an being able to see the basal profile on one screen without scrolling).

    We've had bad sites with both. They happen on all systems. Once you're used to them, set changes are similiar in process and length of time. I prefer the 300 unit Medtronic reservoir and changing it out when it's low rather than estimating insulin for 3 days with the variance in puberty.

    We did the Omnipod Cut-The-Cord because an Aquapack didn't work well for water activities for us and reconnecting every hour at waterparks or kayaking isn't making diabetes merge easily into a teen's life. We also had a pump failure with the Medtronic and ended up doing shots, so having a back-up pump for pump failures was an added perk, as well as being able to wear dresses easily.

    My daughter says she's wearing the Pod for the summer and then switching back to the Medtronic.

    If you're not sure, you might want to consider buying a tubed pump and then cutting-the-cord as well. My daughter says she'd want a main pump and then to cut-the-cord if we were doing it all over again as well.

    Don't wait for the Vibe. It takes ages for things to get through the FDA. It might be out in time for your next pump purchase.
     
  11. Traci

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    OP, you need to make an appointment with a rep from each pump company and touch, feel, hold, play with, program, look at, etc. each of your choices. I would never decide on a pump based on any other information. Your family will have individual needs and preferences that might not apply to others. When we first started pump shopping, I had already decided which one we were going with...only to eventually choose our #3 on my list based on actually USING each of them! I realize you have some time crunch, but this is your child, your money, and your decision. Don't let someone make it for you. Schedule an appointment and tell your dr that you'll have a decision once you've met with the reps. You are in charge here.

    We chose Cozmo the first time around and are now on Omnipod. To me, Cozmo was just far more user friendly and intuitive than the other pumps back then. We went with Omnipod this time because we spend a ton of time at the lake and in the pool and disconnecting, plugging the site, covering the site, uncovering the site, reconnecting, bolusing, applying sticky stuff, disconnecting, etc ad nauseum made me crazy--absolutely crazy. Going with Omnipod made summers much more enjoyable for us! (See, that's one of those things that's important o ME, but probably not so much to someone else!)
     
  12. SandiT

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    I think this is why hearing other people's decision-making process can be truly invaluable. Sometimes knowing what annoyed other people can be something where you go, "that would annoy me, too" or it could be something where you say, "actually, I think I'd be more worried the other direction". I'm glad you shared that, because it speaks to the more day-to-day issue of tube vrs. tubeless.
     
  13. hawkeyegirl

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    The Medtronic is waterproof right out of the box too. (We have this conversation all the time on here.) They no longer advertise it as waterproof, because once you drop any pump and it gets a hairline crack, water will fry it, and they were tired of replacing pumps for water damage. People seem to fry their Animas pumps with water just as often as they do their MM pumps. I would not let my child swim with either pump on, so I personally would not consider this a factor at all. But, the current MM device is the EXACT same pump that had the EXACT same waterproof rating as the Animas pump does currently. They no longer seek to have it given that rating, because again, they can only guarantee its watertightness new in box.

    This is not a logical reason to eliminate the MM pump. The exact same sites are available for all of the tubed pumps. They're made by the same company (Unomedical). The only difference is the tubing connector. You have just as many (and the EXACT SAME) choices on MM for sites as you do on the other tubed pumps.

    To the OP, given that your child is 10, I would put a lot of thought into getting a 300 unit reservoir. The only available pumps with a 300 unit reservoir are the Medtronic 7 series and the Tandem tslim. We just switched from Medtronic (after 5 years on it) to the tslim. I'm of the opinion that it's the nicest pump out there in terms of interface and features. Is there a reason that it's not on your list to consider? Plus, just look at it: http://www.tandemdiabetes.com/Products/tslim-Insulin-Pump/ Oooooh. Pretty. ;)

    But seriously, in terms of operating the pump, the menus on the tslim blow everyone else out of the water. We've used the Medtronic and the Omnipod, and I've played with the Animas. There is no comparison, really, with any of them. I really, really, really would recommend getting your hands on the pumps and letting your son play with them before making a decision. It's worth delaying pump start a bit to make sure you love the one that you choose.
     
    Last edited: Jun 12, 2013
  14. ecs1516

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    We have been on Minimed 508(starting 2001), Cozmo(out of business ), and right now Animas Ping.
    No reason for you to wait on the Animas Vibe because it has the Dexcom integration which you said you can not use. The remote on the Ping is nice for nighttime boluses. We do use The Animas Ping for Kayaking and White water rafting. Never for swimming at pool or beach. We disconnect for that.
    We loved the Cozmo , it had site change reminder which is now on the new Tandem T:Slim. Not sure why the T:Slim is not on your list. I would definitely consider it before making your decision. We will be looking at the T:Slim soon.
    Also, T:Slim plans integration with Dexcom too.
     
  15. ChazDad

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    These are really helpful replies, thanks for taking the time, we truly appreciate it.

    It seems my replies are taking about 30 minutes or so to post, probably because I'm a new registered user here, so if I don't reply right away it probably means that I already did, but the sysop is reviewing my posts first before putting them online.

    I've been reading posts on these forums here for several months but never registered until today. Dunno why, guess I thought I'd leave the posting to the experts as we are still learning here. The whole diagnosis was a shock to us - we have no history of D in the family at all - so to hear our little boy had T1 was (and still is) overwhelming.

    Having said that, we try to follow what our endo and diabetes team tell us to do for the most part. Since they recommended the pump, we started to research. We put together the pros and cons of each, and we called all 3 companies. 2 of the 3 companies offered to have a rep visit, but we said no because we didn't want to feel obligated. Based on your responses, I guess that was a bad decision on our part.

    Just like everything else we buy, different models have different features and it makes it all very confusing. Our little guy plays flag football and at first said he wanted the Omnipod since there are no tubes. We thought that sounded good. But after a little research, we found lots complaints about them falling off, failing, leaving skin rashes and such, having large occlusion rates, etc. we started to second guess our initial choice. Then we started leaning towards Animas because it is waterproof and he could disconnect when he played ball, and also we like the Calorie King built in because we are not so great at remembering carbs of everything he eats. But then we heard about the lack of IOB, plus (what we already knew) the fact that he'd have to sleep with the unit attached worries us, and that the tube could kink or get pulled out. And we weren't aware that you can't reduce the basal from the remote, which we just learned from BeachBum's post. As far as the Medtronic, that was the last one on our list because it wasn't waterproof and it had the tube, and there's no carb menu, but the surprisingly, we see so many people on these boards that love that one. As far as the T-Slim and others, we were not offered those so we did not research them. I guess we'll have to ask the Insurance if they'd be covered or not. We were given just the three brochures and told to choose.

    I think we are in a similar position as SandiT - thanks for your post - it was very helpful. Our DS is still honeymooning, he is currently 4 1/2 Lantus per night and 1/40 CHO ratio. Most of what you listed were our primary deciding points, but I never even thought about the need for a larger reservoir until you and others on here mentioned it!

    For laughs and giggles, here's what we'd like (though we know it doesn't exist):

    - Tubeless, easy injection, flat and hidden, with no skin rashes or occlusions
    - touch screen pad
    - 100% waterproof
    - built in carb meter for every food known to humankind, and for every variation (i.e. Big Mac versus Small Cheeseburger at White Castle)
    - 500 unit reservoir
    - idiot proof (for me, not my son) and unbreakable (for my son)
    - 100% free replacement program for any reason, and free upgrade if within 5 years of purchase when newer models are FDA approved
    - Integrated CGM that works perfect with accurate readings and with no need to re-calibrate EVER (free coverage would be nice, too)
    - all the alarms, charts, tech features (like downloads), remote capabilities from my home via cell phone (so I don't have to run to the school every day to fix something because the nurse isn't allowed to do it), and all the other bells and whistles
    - painless to attach, take off, etc. Truly painless, that is.
    - most of all - dependable and accurate

    OK, we're never going to get all that. And I forgot to list half the stuff we'd really like. But that just gives you an idea of all the stuff we've been reading about these things.

    Animas and MM users really seem to like their pumps for the most part, and it reminds me of Windows vs. Mac, or Xbox vs. Playstation, or Mercedes vs. BMW. Both Animas and MM must be good. And I like the idea MomofSweetOne said about getting the pump and cutting the cord in the summers with the Omnipod, so this post has been really helpful. We welcome any more tips / complaints / recommendations / things to consider / etc. We will continue our quest to make the "perfect" choice, hopefully. Thanks again, and sorry for the length of this reply.
     
  16. DavidN

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  17. MomofSweetOne

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    LOL. The local diabetes camp won't allow either pump brand in the pool because of failures!
     
  18. hawkeyegirl

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    FYI, my son played two seasons of tackle football wearing his MM pump, and it came through completely unscathed. I would not worry at all about your son playing flag football wearing a tubed pump.
     
  19. hdm42

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    First of all, to pump or not to pump is your decision, not your endo's. if shots are working well for you and your child and you are comfortable with it, that's great.

    My son very recently started pumping, after nearly 6 years on MDI. We made the move because puberty and his other health issues were making things tough on shots.

    I agree with the earlier advice to call the pump reps and have them show you the pumps. That way you can really see how they work and run through the menus. This was immensely helpful for us in making the decision.
    Take your time, it's a big decision.

    We chose the t:slim, and we've been very happy with it. It's super easy to operate, and my teen son loves the sleek look and the touch screen.
     
  20. hawkeyegirl

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    I wanted to address your worries about your son sleeping with the pump attached and the fear that the tubing would kink or pull out. First of all, it is virtually impossible to INTENTIONALLY kink tubing in a manner that would interrupt insulin delivery. Seriously. Do not worry about kinked tubing. Second, we very rarely lose sites, and never in my son's sleep. I think he might have pulled off a handful of sites during his 5+ years on the pump, and most of them have been while swimming. Third, sleeping with the pump is really a non-issue for most kids. You either clip it to their pants or they wear it in a pouch around their waist.

    I'm not sure what you mean by lack of IOB on the Animas, but Animas does track IOB, just like MM and Omnipod do. They all calculate it a bit differently, but I wouldn't choose one over the other based on that.

    You'll find a few people that use the food database on the Omnipod and Animas, but I think if you ask most people on those pumps, they'll say that it's a feature that they don't use at all, or very rarely. With smartphones these days, it's much easier to just look up carbs on there, IMO.

    I will say that we Podded for a week, and in addition to other many and varied issues we had with it, my son knocked those pods off constantly. Just could not keep them on. If Omnipod is still doing their cut the cord program, I definitely would not have insurance pay for a pod. We paid $199 out of pocket for our Omnipod system, and we let insurance pay the $7000 for our tubed pump.
     
    Last edited: Jun 12, 2013
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