advertisement

pump questions

Discussion in 'Parents of Children with Type 1' started by shannong, May 30, 2013.

  1. shannong

    shannong Approved members

    Joined:
    Sep 15, 2012
    Messages:
    568
    My son just got hooked up to his pump on Tuesday. So excited! He is just on saline now, but gets switched to insulin next Tuesday. I will probably have a million questions...but here are some I already have:

    1) The trainer said we do NOT have to alcohol swab the site area. Is that true? Seems to me that it would be important to do so.

    2) When we detach (we have the Animas ping) for going in water, do we have to cover the pump site? Does water get in or do I not need to worry about this?

    3) The trainer is calculating his basal rate by taking his TDD and dividing it by 24, less 20%, then assuming he will get 50/50 basal/bolus. However, reading Think Like a Pancreas, he suggests taking their Levemir dose and dividing that by 24, less 20%. I get two very different numbers that way. What are others experience with how they calculated basal rates and did it work or not?

    4) When your child started on the pump, did you keep him home from school for a few days or send him right away? I'm worried that the insulin doses may be totally off because it's pretty much a guess what he will need, so worried about sending him to school right after he starts on the insulin.
     
  2. mocha

    mocha Approved members

    Joined:
    Feb 27, 2011
    Messages:
    430
    I believe as long as there is some type of disinfecting going on, you should be okay, but rubbing alcohol seems to be the easiest way.

    The infusion site (the part that's stuck to him) keeps water out while you're detached. The clips that come with the infusion sites are more to keep sand out at the beach. If you're going in to a pond or lake or ocean, I'd put the clip on just to keep the grit in the water out. It makes it hard to reconnect if there's stuff in the clippy part.

    Oh, goodness, that was ages ago for me. I believe my endo did the TDD when he calculated stuff and tweaked stuff (along with my parents) over the following few weeks.

    I started on a Friday, but went back to school the following Monday. You might want to keep your child home the following day, just because there still might be some long acting still working (at least, that's the reasoning my parents gave me for why I couldn't go to a sleep over that Friday :p) and you'll both probably be really tired after a long night of checking every hour or so to see how he's doing.
     
  3. Beach bum

    Beach bum Approved members

    Joined:
    Nov 17, 2005
    Messages:
    11,315
    My son just got hooked up to his pump on Tuesday. So excited! He is just on saline now, but gets switched to insulin next Tuesday. I will probably have a million questions...but here are some I already have:

    1) The trainer said we do NOT have to alcohol swab the site area. Is that true? Seems to me that it would be important to do so.

    We use SkinTac which has an alcohol base. If we did not use that, we would use alcohol. IMO, it takes 2 seconds to wipe it on and it takes any germs out of the mix.

    2) When we detach (we have the Animas ping) for going in water, do we have to cover the pump site? Does water get in or do I not need to worry about this?
    We use insets and in the box is a cap. Unplug the pump, slip in the cap. We do this only for fresh/salt water.

    3) The trainer is calculating his basal rate by taking his TDD and dividing it by 24, less 20%, then assuming he will get 50/50 basal/bolus. However, reading Think Like a Pancreas, he suggests taking their Levemir dose and dividing that by 24, less 20%. I get two very different numbers that way. What are others experience with how they calculated basal rates and did it work or not?
    Can't help you here, our doc gave written orders to trainer to follow.

    4) When your child started on the pump, did you keep him home from school for a few days or send him right away? I'm worried that the insulin doses may be totally off because it's pretty much a guess what he will need, so worried about sending him to school right after he starts on the insulin.
    My daughter was only in pre-school, but we still sent her and I checked in for all snacks and lunch. We had to call in daily to our endo in the first week, so it was a constant state of change.
     
  4. KatieSue

    KatieSue Approved members

    Joined:
    Oct 5, 2010
    Messages:
    921
    We're on omnipod so I can only address a couple of the items. Our pump nurses gave us the settings to use. Then we uploaded the data every couple of days for the first few weeks and they helped us with tweaks.

    I think we started on a Friday so we had the weekend then she went to school on Monday.
     
  5. nanhsot

    nanhsot Approved members

    Joined:
    Feb 20, 2010
    Messages:
    2,626
    My son uses IV Prep pads before he puts his sites in. I do think you need some type of skin preparation.

    The thing with basal is no matter how you do it, major tweaks will be necessary, so just go with one of the plans you mentioned. They took his lantus dose and divided it into 24 but that wasn't even close, his basal needs via pump were MUCH higher than they were on shots, it was weird. He needed a lot more overnight too, so the level split wasn't good for him. Thing is that no matter what you do, you'll have to change it again, and probably again and again until you find the sweet spot (which will of course change anyway!!)

    My son rarely puts that little plug thing in. It's probably a good idea though, particularly in lake water type environments.

    We homeschool so can't help you with the school question.

    Good luck! Pump start is exciting.
     
  6. obtainedmist

    obtainedmist Approved members

    Joined:
    Aug 3, 2010
    Messages:
    1,537
    Molly uses Skin Prep.

    She never plugs up when in the water.

    We divided the Lantus units by 24 minus 10%. She went a bit low the first night and we freaked out...but keep in mind that the first few days, there might be some residual Lantus/Levemir still working. We lowered all the rates and then had to up them again in a few days. You will find that a flat rate won't work well. You might need more in the am and less in the late afternoon depending on insulin sensitivity. You'll be testing frequently at night to get it right for a while. Molly started out at .45 and now is anywhere between .5 and .65. Just think "TRIAL & ADJUSTMENT" and you'll be fine! :)
     
  7. cm4kelly

    cm4kelly Approved members

    Joined:
    Apr 28, 2011
    Messages:
    547
    Congratulations!

    Congratulati0ns! We love our pump. My 6 year old has been pumping for almost three years now with minimed revel.
    At the beginning I always cleaned sites with alcohol swabs, but rarely do now. Just need to make sure it is completely dry before inserting so the tape will stick.

    We do not plug in unless at the beach. As a matter of fact, we went in the pool today - just unhooked the pump and got in. No plug. It does keep sand out at the beach though - a necessity there.

    I really don't exactly remember our basal/bolus - but our doctor started conservatively. We can high for some time while we made adjustments. So just be patient. It can take a little while to get the right settings. We have gone anywhere from 35%basal to 45%basal. My son tends to have lows if we go higher in basal. But every child is different.

    I was fortunate enough to be a teacher and start pumping in the summer. I was able to keep my son home for about 6 weeks before school started. Many people here though - go right back to school within a few days.

    Be patient with this adjustment period - but it will be great!
     
  8. cdninct

    cdninct Approved members

    Joined:
    Jul 29, 2011
    Messages:
    888
    1) The trainer said we do NOT have to alcohol swab the site area. Is that true? Seems to me that it would be important to do so.

    We do site changes after bath time, and we have never used alcohol--it dries his skin out too much and causes irritation. I think as long as the skin is clean and he is not prone to infections, there should be no need.

    2) When we detach (we have the Animas ping) for going in water, do we have to cover the pump site? Does water get in or do I not need to worry about this?

    We cover only at the beach when sand is in play. The rest of the time we leave the site as is.

    3) The trainer is calculating his basal rate by taking his TDD and dividing it by 24, less 20%, then assuming he will get 50/50 basal/bolus. However, reading Think Like a Pancreas, he suggests taking their Levemir dose and dividing that by 24, less 20%. I get two very different numbers that way. What are others experience with how they calculated basal rates and did it work or not?

    Honestly, I don't think it will make much of a difference in the long run. Neither will give you perfect results as rates and ratios will likely change a lot in the first few weeks. In either case, it is just a starting place, and as others have mentioned, endos tend to start conservatively. In general, though, I like the TLAP formula better because the 50/50 assumption is often not accurate.

    4) When your child started on the pump, did you keep him home from school for a few days or send him right away? I'm worried that the insulin doses may be totally off because it's pretty much a guess what he will need, so worried about sending him to school right after he starts on the insulin.

    We had our pump start (straight to insulin) on a Saturday, and sent him to daycare on Monday morning. I think I did a brief training session with the staff member in charge of his care on that day. They had a child on a pump a couple of years earlier, and they were comfortable with the technology. All of his rates and ratios were set conservatively, as I mentioned before, so we were comfortable that he was not going to go low in the time he was away from us.
     
  9. Ott8965

    Ott8965 Approved members

    Joined:
    Jan 17, 2013
    Messages:
    18
    Congratulations on pumping! We were diagnosed in August as well and started pumping in January. Others have more experience than me but wanted to chime in and say good luck! We don't always use alcohol pads, try to most of time but don't sweat it if not. I just asked question number 2 at our last visit and was told yes, but, honestly, I don't see that happening all summer long. For what its worth, my little guy is no where near the 50/50 rule on basal/bolus. He is way over on his bolus. We love having multiple basal settings and have been able to really tweak his insulin needs. Finally, we did send him to school the very next day. The school was aware of the change and they watch him very closely anyway and are always in contact with me when needed. In fact, I think I went up at lunch for a few days to help demonstrate using the pump and make sure we were all on the same page.

    Wishing you the best!
     

Share This Page

advertisement

  1. This site uses cookies to help personalise content, tailor your experience and to keep you logged in if you register.
    By continuing to use this site, you are consenting to our use of cookies.
    Dismiss Notice