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Omnipod failed during the night

Discussion in 'Parents of Children with Type 1' started by Jordansmom, Aug 23, 2008.

  1. Jordansmom

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    Hi All,

    I'm new to the forum. DD 12 years old dx'd Mar08. We just started an Omnipod trial Monday. We are so excited about the tubeless system and all the advantages Omnipod has to offer. But I've done alot of reading on the forums and I'm really worried about the unexplained high bgs with the pod.

    So rather than jump right in, I asked for a trial. DD spent last week on saline with the pod. Everything went great. But that's not much of a test. Her bgs weren't on the line. Monday at pump start the first pod failed during it's self check during priming. I'd rather it did that then after it's stuck to her and inserted. But it's still a little disconcerting. Second pod worked fine. DD loved it. It's the happiest she's been since dx.

    The third pod worked fine for the first 36 hrs. Late last night at bedtime bg, she's up slightly (still below bedtime correction). By 1am she is 250 (that's high for her-still slightly honeymooning). I give her a correction throught the pod. The cannula looks fine. No alarm from the pod. At 2am she's 275. I had to get her up give her a shot and change the pod. DD crying and worrying about whether she should choose Omnipod. GRRR!

    I test her later. A perfect 100. But then I start to worry pod correction and shot correction are both IOB and she's going to crash. Spent the whole night checking to see if her 100 was going to last. It did. She's fine now.

    Unexplained high bgs and DKA are my biggest worry with the pod. I have two questions. Am I being unfair to Omnipod and all pumps/sites have this issue? And to Omnipodders- is this an unusual experience or is this what I have to expect?:(

    I want DD to be happy with her choice, but she has to be safe first. It's getting harder and harder to say yes to Omnipod. I am getting more and more confused (not to mention sleep deprived).
     
  2. alismom

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    My daughter is 13 and has been wearing the pod since Feb. We do not have any problems with unexplained high numbers. She loves the freedom that she has with the omnipod. Most of the time she gets 3 days from a pod with no problem.
     
  3. Adinsmom

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    Well I guess my first question for you is if you were on another pump and the same scenario happened would you be as concerned?

    Only you and your family knows if you made the right choice. In our case I wouldn't have been convinced it was a pod site issue I would have to take into account other factors. There is a lot of variables that have to be fine tuned in the pump: ISF, I:C ratios, etc. It takes a bit to get the kinks worked out. It is exhausting. Pump start had a huge learning curve for me and I obsessively researched and learned everything I could before hand.

    Yes, there will be nights with unexpected highs. At least there is for my son regardless of the pump or MDI. It is the nature of the D beast.

    Good Luck.
     
  4. CC'sMom

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    My daughter has been using the pod for over a year. We just LOVE it. I don't think anyone could take it away from her. The beginning of any pump start can have problems. For us it was adhesive issues mostly. And sleep deprived in the beginning of the pump start is normal too. You have to check - a lot. The only thing I would have done different is to leave the pod on after the shot just to see if it was a pod issue. But it took me months to feel comfortable to do that. It might be something as easy as a basal change. And for my daughter she rarely gets more then 2 days from a pod. We are lucky to get 2 1/2 days. But all in all, there definitely is a learning curve (not exclusive to the OmniPod). If she really likes it, keep trying. It's really worth the effort!
     
  5. linda

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    Hi Welcome!!
    Im sorry for you (& dd) to have to go through this, sorry, we dont use pod, but thinking about it, our COZMO start up sounded similiar to yours. It took some time to learn and make decisions. Our Endo team and Rep helped (also the company very helpful on phone!!!)...hope you get your answers!! Once you get it though, you will see the great benefits like you seem to have ("Its the happiest shes been since dx")
     
  6. selketine

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    I think it is beginner's (bad) luck. When William first started pumping with Animas his very first set failed right around bedtime (we could see blood up the tubing and around the site). We had to do our 2nd set change after only about 8 hours on the first set. Our 2nd failed set was shortly after that (maybe a few weeks later).

    After that - very, very few failed sets and it has been almost 4 years (but it can happen - I think it helps to do at least one middle of the night check IMHO).

    I would not get worried yet.:)
     
  7. Jordansmom

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    No. I'm definitely making the Omnipod prove itself more than a traditional pump.
    I spent most of the night questioning all of those things myself. But I decided if the injected correction put her right back where she belonged it probably was the pod. If the pod was working I would have expected it's correction to send her low from stacking. Thank goodness b/c of honeymoon DD is relatively predictable during the night otherwise.

    But you're right, I am looking with an exceptionally critical eye at Omnipod, and unexplained bg's are part of the territory.

    I feel like this is the hardest decision we've had to make in my life. It's the one aspect of D we really have a choice about.

    Thanks for the reality check.
     
  8. Jordansmom

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    Thanks for the support from everyone. I desparately hold on to every positive experience from other Omnipodders because we really do want it to be the solution for us. There is so little experience out there all the advice I can get is appreciated. And knowing that everyone struggles with traditonal pumping issues from time to time helps ease the frustration as well.

    It's such a hard decision. We are 150% ready to pump. But making a choice and being stuck with it for 5 years is so hard. It's made me super critical of all the choices.

    I have so much to learn!:)
     
  9. Adinsmom

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    I didnt intend to sound critical of you. I apologize if it did.

    I completely understand how unnerving it is to decide on a pump for your child. You only want what is best for your child.

    Can I ask one more question? Why are unexplained bg's part of the Omnipod territory? Or were you commenting on all insulin pumps?
     
  10. caspi

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    We are only a month into this and don't have nearly the experience of others on here that have been on the Pod so much longer. However, in our situation a # in the 200's in the middle of the night wouldn't have concerned me. But YDMV.

    We had two pod issues -- one pod that, out of the blue, decided it didn't want to work anymore while Cam was watching TV. It shut down and we had to change it. Another one wouldn't prime correctly. I called Insulet in both instances and they replaced them without any issue.

    Again your YDMV! But there are a lot of very experienced folks here that are willing to help should you run into any issues. I have asked my fair share of questions in the past few weeks! ;)
     
  11. Jordansmom

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    No I didn't think you were criticising. You were probably dead on that I jumped the gun blaming the pod so quickly. I had just been to the endo and they REALLy drilled into me the exact instructions we followed "remove the pod immediately if first correction doesn't send numbers down".

    I just meant to explain that I think for DD right now my detective work (although incredibly complicated to me) is not as complicated as the rest of you because Honeymoon is helping and unexplained highs aren't common for us. Usually it's a stupid mistake I made that I can quickly identify.

    As to the high bg worries. I have researched Omnipod since dx and the only reason anyone seems to have given up on the Omnipod is b/c of unexplained high bgs. Also I checked the FDA complaint site and the only serious medical scares with omnipod have been the same thing. Reading page after page of kids put into DKA and hospital because their pods unsuspectingly stopped delivering insulin didn't help my confidence and was probably stupid on my part anyway. It's a miniscule number compared to the satisfied podders. It's just easier to find the criticism than the encouragement, happiness and hope that Omnipod provides.
     
  12. Jordansmom

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    When I said unexplained highs are part of the territory I meant part of D in general and that I probably shouldn't have stressed out so quickly about our pump start. It's almost like the first day you bring you DD home and you panic over every little thing and wonder if you're going to survive. Lantus was my security blanket. I knew I was grown up enough to give it up, but the first night I really wanted it back. :)
     
    Last edited: Aug 23, 2008
  13. caspi

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    Again, I am so new to this that I'm learning as well, but I was under the impression that when a pod stopped delivering insulin, it beeped. A LOT. At least that's what happened to us when we had that one pod failure out of the blue. And as for going into DKA, I could be wrong but doesn't that take a number of hours? Wouldn't there be BG checking going on inbetween so that the parent would know if their child was high, and wouldn't that parent be checking for ketones?

    Again, forgive my ignorance as I am so new at this, and so far have had a pretty smooth go at things............. :cwds:
     
  14. hawkeyegirl

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    I think that with any pump, there is a certain amount of mistrust those first few days/weeks. As time goes on, you learn to trust the pump more, and you also know what signs to look for that it is a pump issue, as opposed to other issues that can also cause high BG.

    Hang in there!
     
  15. Darryl

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    We've used 180+ pods over 18 months and have had one or two fail. However, if a pod fails,
    you will virtually always see one of the following things happen:

    1) The pod will alarm - beep continuously
    2) The PDM will show an error code and require a new pod
    3) If it's a site problem, it is usually clearly visible through the pod's window. The site will
    look red or bruised, or the site will be unusually painful.

    If none of the above happened, then you most likely encountered a night (or several hours)
    where increased basal was needed.

    That being said, if BG increases to unsafe levels and pod insulin corrections don't at least
    hold BG steady, giving a supplemental insulin injection is always a good idea to be safe,
    and buys you some time to determine if the pod is really the problem before replacing it.
     
  16. Seans Mom

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    I think you did the right thing. It is what we were told to do also, if the first correction doesn't work, change the site. I've had to do that once in the middle of the night. His site seemed fine, but once asleep he started climbing so I corrected and he didn't go higher but didn't go down either. So I gave him a correction by injection and changed his site (luckily for me, he mostly slept through it) and he came down nicely. I'm not sure with the Omnipod if you can check the tip of the cannula like you can with traditional pump sets, but the site I took out had a slight bend in the cannula. It wasn't cutting off all insulin but wasn't giving it all either. Omnipod isn't more prone to that than the other sets w/ a teflon cannulas.
     
  17. Jordansmom

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    It can happen alot faster than I previously thought if you believe the pump is delivering basal and it isn't. We got a long lecture about this from our endo yesterday. That's probably why I overreacted.

    I am extremely new to this and no expert on anything D.

    My experience doesn't feel smooth. But I know we really have it easy in comparison.

    The pod is supposed to alarm but it doesn't always as evidenced by the FDA complaints. And our CDE made a big point of training on that. That's why you're instructed to visually inspect the cannula frequently and be extra vigilant about bg monitoring. Even then it occasionally has unidentified and undetected problems. But I think you are right that if you are doing the bg checks you shouldn't have to concern yourself with serious problems.

    Later when I looked at the other pumps on the FDA website there were hundreds of pages of issues there as well. Pumping isn't foolproof obviously, but we are definitely committed to working out the bugs and learning as much as we can, because we're sure the advantages outweigh the negatives.
     
    Last edited: Aug 23, 2008
  18. Jordansmom

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    The reality check and encouragment from each of you is so exciting for me. I have felt for the last 6 months I was running in circles making decisions and then second guessing myself. I can make myself nuts.

    Intellectually you know there are others out there experiencing the same things, but until someone expresses that directly to you, some days (or nights) you still feel like you're all alone. Thanks so much for taking the time to respond.
     
  19. Abby-Dabby-Doo

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    I wanted to say welcome to the forums. I'm glad you found us. You'll find a wealth of information here, parent's that truly care, and we all "get it".
    We are not Pod users, but I wanted to point out a few things to you.

    Starting any kind of pump, whether it's the Pod or the other brands that are out there, it's a learning curve. Remember that Lantus or any other long lasting background insulin isn't there. So starting the pump/pod with basals can be a learning curve, or in plain english just down right frustrating to get set just right. You throw in there the correction factor, sites, and carb ratios, it can be overwhelming in the beginning.

    Stress, dreams/nightmare, growth hormones, activity, and food just to name a few can also be factors in high or low numbers. It really comes down to trusting the pump, and that can take time. If you aren't already I would suggest logging numbers, so you can catch patterns for changes that need to be made.

    Again welcome to the forums. No question here is ever stupid, so ask away!!!
     
  20. Darryl

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    I also wanted to mention... if you ever remove a pod with the suspicion that
    it may be bad, you can confirm this in a few ways:

    1) Remove the pod but do not "deactivate" it.
    2) As soon as it's off, inspect the cannula for a kink
    3) Send the pod a bolus command and see if it works

    In the two pods (out of 180+) that we've had fail due to a site problem, in both
    cases the cannula looked fine when we removed the pod, and we confirmed that
    the pod was bolusing properly after we removed it.

    In other words, we've never actually had a pod fail without alarming, or with a
    site that was obviously and visibly bad.

    On the other hand, we've had many nights when BG shoots up due to growth
    episodes after bedtime, when significantly more basal was needed until around
    2 or 3 AM. These have nothing to do with the pod.
     

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