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Running out of insulin in a day and a half.

Discussion in 'Parents of Children with Type 1' started by Judy&Alli, Apr 18, 2011.

  1. Judy&Alli

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    Is Medtronic the only pump that has a 300 unit cartridge?

    Animas users is there a trick to prime so that you don't lose so much insulin? I fill the cartridge to the max and still only end up with about 180 units.

    Anyone have any luck with switching pump companies before the warranty is up?

    Thanks!
     
  2. Flutterby

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    Judy, we didn't switch companies before a warranty was up, but we did get a new pump. When the revel came out we were able to get it covered through insurance because the smaller basal/bolus were 'medically necessary'.. How much longer do you have on the Animas warranty? Its worth looking into seeing if you can switch to MM because you need a larger reseveroir.

    Kaylee still uses the 180 but we now soon she'll need the larger reseveroir. So we went with the 723 but can still use the smaller reseveroirs (using up our stash as well) until she'll need the larger ones.
     
  3. Judy&Alli

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    We have at the least 11 months, but it could be another 5 years. I am going to start looking into it tomorrow. The animas rep told us that with medicaid it was 8 years.:eek:
     
  4. Flutterby

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    I don't think its 8 years. We have BCBS of MA. The good thing is that it IS only 11months. But thats a long time at the same time. How much over the 180 is she going in three days (well, it really wouldn't be 180, theres always SOME left that doesn't get used, but you know what I mean. ;)). Is it just a bit where you can get 2.5 days out, or are you having to change more than that?

    When we switched MM basically told our insurance company that we were getting a new pump in 3 months (thats how long until warranty was up) so they either pay for it now and it benefits Kaylee or they can pay for it in 3 months. ;) They chose to pay for it now, even though they DID tell MM that it was denied.. I only found out it was covered because I got the EOB showing me they had paid for it, lol.
     
  5. Judy&Alli

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    I am not exactly sure I would have to look at her history on her pump. But for example she changed her site out yesterday morning, around 10 am. Changed it again this evening at dinner. Not because the site was bad but because there was only 9 units of insulin left.
     
  6. Flutterby

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    So, basically every 24 hours she's having to change it.. Is she changing out the complete set, or just new insulin? Poor Alli, thats a LOT of changes! You could always show the insurance the cost that goes into doing a site change everyday. Not sure how your endo is but do you think they'd be willing to write a letter of medical necessity for her?

    When I talked to the guy at MM he did everything for me.. he was great with the insurance company.. I don't remember what section he was in.. it wasn't a regular rep. It was the guy that the CDE would normally talk to.. she gave me his name and number (poor guy, he never knew what hit him, lol).. Maybe you can call the CDE and get their contact at MM.. Its so much easier than going through reps or random people who answer the phone. ;)
     
  7. Judy&Alli

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    Well no, yesterday was her birthday party and she had a lot of extras. So this was probably a bad example. But she is changing it about every day and a half to 2 days.
     
  8. sarahspins

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    There is a trick, however it's absolutely not endorsed by Animas and at most it gets you about 15u more... the pump I have currently will not function with anything less than about 193u so I end up priming out a bit more than I should have to just to stop the "pump not primed" messages when it has anything more than that in it.

    But basically you can pull the plunger out far enough that the first rubber seal is barely "out" of the cartridge, then attach the tubing and insert it into the pump.. that action will "prime" the tubing for you as the plunger is pushed back into the cartridge. Then you can go through the "load" and "prime" processes as normal, except that you don't really "need" to prime the tubing unless the pump is giving you not primed errors.

    I had one pump a while back that was "good to go" at 196u and wouldn't give me errors, but every other one (including new ones) has...and you will notice after "loading" that none of them have 200u even when you "overfill" them. I think the 200u quoted by Animas as somewhat misleading because it's physically impossible to get that much usable insulin into a pump.
     
  9. Flutterby

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    One thought.. could you fill the reseveroir, mannually prime the tubing, disconnect it and get more from the vial the put it in the pump, so there really won't be anything to prime. The reseveroir will be filled to the top and the tubing will be full as well.. it won't give you much more insulin.. maybe another 10u or so, but it would get you a little longer.
     
  10. Jordansmom

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    That's no fun. I'd try to make it as easy on her as possible. I'd only change out the site every other site change. Then I'd prefill a few cartridges for her at a time, so the cartridge change was easy.

    There's always the option of covering some basal with a lantus shot. But it would be a cold day in he** before my DD would agree to that.

    We change sites and cartridge every two days because of site problems anyway. It sucked at first, but you do adjust.

    Make sure to get your scripts changed to cover all the extra insulin and supplies.

    Good luck getting the minimed regardless.
     
  11. NomadIvy

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    Don't know how the Animas pump works... but if K's pump is running low on insulin and it's not yet time for site change, I just change the reservoir. I disconnect, take out old reservoir, rewind, put in newly filled reservoir, prime - but only to get the piston up to the reservoir - no need to prime tubing because I use the same tubing I just took out.
     
  12. Connie(BC)Type 1

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    With the Aveo, I only prime about 4 units between full set changes, it's air locked so seldom get bubbles, I use the same tubing about 5 times before I switch infusion tubing, juct changing sites, that way I don't waste as much insulin
     
  13. kimmcannally

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    You don't need to change sites when she runs out of insulin. Just put in a new reservoir (or refill the old one- I use each one twice) and prime the old tubing.

    Here is what we do: J's pump gets down to 20 units and he tends to get air bubbles and start going high. So I prime the last of the insulin into the tubing to make sure there is no air in it. I usually see a squirt of insulin, then a big air bubble, then insulin again. I re-fill the cartridge with new insulin as full as I can get it, using the needle and "handle" from a new cartridge. I also fill that new cartridge with insulin, put the cap on it, and put it back in the fridge in an empty novolog box to protect it from light. That way the next time he needs a cartridge change, I just pop in the new cartridge.

    I've never had a problem with using the cartridges twice - on the initial fill, I don't cycle the cartridge, just press the air that comes in it into the novolog vial, then pull up insulin. Then when I refill it, I don't pull air into it, I just suck insulin into it from the vial. That way the o-ring inside has only been the full length of the cartridge 5 times total by the time I throw it away. No leaks yet :)

    I change J's cartridge about every two days and we are just starting to try changing his site twice a week - he has no problems going 4 days between site changes, so I'm going to try changing him on Sundays and Wednesdays. It will be easier to remember :)

    We do site changes totally independent of cartridge refills. We also re-use the tubing one time. I have a bunch of insets with the long 45" tubing, which he hates, but I'm not wasting them. So I alternate those with the 23" tubing and re-use the shorter tubing one time with those longer tubed insets. I just throw the longer tubing away.
     
  14. mom2Hanna

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    I have done something similiar, there was a point where Hanna was needed a change every day and a half. I have gotten as much as 193, never more then that. I also try to never prime more then 10u. I found that when her basals are very good, her TDD goes down and we get 3days again.
     
  15. hawkeyegirl

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    Honestly, it wouldn't be worth it to me to try to "trick" the pump into another 10 units. What would that get you in this situation? Another 3-4 hours?

    To answer your original question, yes. MM is the only pump with a 300 unit reservoir now that Cozmo is out of business. Your best bet to get one is to have your endo write a letter of medical necessity, as Kim mentioned. :)
     
  16. sarahspins

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    Well, no, for me that's more like 10 hours, which makes the difference between changing a site at night, or waiting until morning. I don't like changing sites at night.. in fact when I find myself having to do this, I just refill/reprime and connect to the old site, then start a new site in the morning.

    Because of the luer connection it's not really possible to just refill/replace the reservoir without having to prime the tubing like it is on MM pumps.. that is the one feature I miss the most... in addition to the "time to empty" calculation. It's not hard to do the math in my head, but it was nice to just see a number.
     
  17. hawkeyegirl

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    Gotcha. My 3-4 hours was actually aimed at the OP. If she could get 10 hours out of another 10 units, I assume that she wouldn't be having to change the reservoir every 1.5 days. ;)
     
  18. Judy&Alli

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    I left a message for the local Medtronic rep to see if we can't figure something out. In the meantime thanks for all the tricks that were posted:)
     
  19. Abby-Dabby-Doo

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    I wonder if your insurance wouldn't agree to it because you'd be using less supplies (switching everything at 1.5 days instead of 3 days). Or maybe they would call that a medical necessity issued by your doctor to the insurance company. I'm sure the MM pump rep will have some ideas for you.
    Good luck!
     
  20. Judy&Alli

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    Can I just say that I am so happy you are back???:D:D:D:D Welcome home;)

    Talked to the rep, that is the angle we are going to try. I hope it works.
     

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