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Really hating the pump!

Discussion in 'Parents of Children with Type 1' started by ashley_lynden, Nov 6, 2010.

  1. ashley_lynden

    ashley_lynden Approved members

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    Don't get me wrong, as far as eating what he wants when he wants it's a great thing. Sloan can be an almost normal kid again. The basal mess is driving me crazy though. We've had so many very high highs the past few weeks and tons the past week. We never ever had these on MDI. Last night he got into the 500s. I stayed up another 4 hours trying to bring it down. I got him to the low 300s only for it to spike back up to nearly 400. At that point it was 2 in them morning and I literally could not hold my eyes open any longer. I upped his basal, yet again and went to bed. I slept through my alarm that went off 2 hours later. He woke up at a little over 300 this morning.

    I've been able to hold him off on breakfast. Numerous ups in his temp basal and almost 3 hours later and he's finally down to low 200s.

    I just don't know if I can keep this up. It's getting really old and I'm really tired. :(
     
  2. StillMamamia

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    Ok, your kid is 4. It is normal to have these really big growth spurts and unbelievable basal increase needs. So, after ruling out it's not the site or the insulin, I think you just need an overall basal change, but run it by your endo just in case.

    ETA - also check ketones when you have recurring highs like this.
     
  3. Nancy in VA

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    With that many highs in a row, I would just change the site. Over night, I'm not real worried about identifying the souce of the high - I just want to sleep, so I do a quickie site change and move on.
     
  4. Colleen

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    Sounds like the ISF needs adjusting too. If you are correcting and it is not coming down that is something to maybe tweak.
     
  5. BrendaK

    BrendaK Neonatal Diabetes Registry

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    Sometimes when we see crazy highs, I'll up EVERYTHING by a pretty drastic amount (50% higher). I'll lower meal ratios, lower ISF, and increase basals. Then be very diligent about checking every hour or so. (Unless you have CGMS) When numbers are that high, you are more insulin resistant, so you have to get him down first before you can even test what the new rates might be. Very hard to do. Good luck!
     
  6. kiwiliz

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    Don't give up - it makes a huge improvement to your little ones quality of life. Once you get on top of the basal changes you will be able to get a good nights sleep - it makes the world of difference to how you feel.
     
  7. ecs1516

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    Did he have any ketones during that time? Do you have a Precision Xtra blood ketone meter? If he is that high and ketones I usually suspect the site and change it out.
    Are the cannulas bent or is there blood when you take them out?
     
  8. JackyH

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    This is exactly what I have had to do on the two occasions our numbers went wonky (and we've only been pumping four months). And by wonky I mean highs that didn't come down for three days. The first time was the end of his honeymoon, the second was a growth spurt we didn't know was happening until his trousers lost sight of his ankles! Once the numbers came back under control we saw a marked drop in insulin needs over the next few weeks until we settled back down again. It was only at that point that we could recheck his basals. I don't see what sets you are using. We had lots of trouble with the quicksets - we didn't see any consistency (if there is such a thing with Type 1) until we switched to Sure-Ts.

    I do find pumping extremely hard work compared to MDI but Oscar is so much happier I would never go back. Hang in there - it may take a week or so but it will end and you will get back to "normal".
     
  9. Lee

    Lee Approved members

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    Is he coming out of honeymoon? We saw wild swings like this about 4 months while coming out. We would increase everything by 50% for a few weeks, then lower it back down again, so on and so forth.

    I also want to say, this is not a problem with a pump - this would have happened on MDI as well. And increase in insulin needs has nothing to do with the delivery method!

    Good luck!
     
  10. Jacob'sDad

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    Don't hate the pump. That won't help. It will just make you less willing to learn all the ins and outs of pumping. Just hate diabetes. Diabetes is to blame, not the pump. I'll bet if he was still on MDI you would see the same increase in insulin need. It might seem like a coincidence, but these things happen. We've all seen it. On day things are going along smoothly and the next day, wham, it's like you have a new kid.
     
  11. ecs1516

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    What type of sets are you using?
     
  12. sage68

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    I have been seeing a lot of highs in Elly recently and she has been pumping for a year now. I think a lot of her highs is a growth spurt, and she is also 4. Please give the pump time and work with your diabetes team on adjusting settings. You just haven't found the right one yet. You will definitely love the pump over time.
     
  13. Flutterby

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    Sorry you are having such a difficult time, sometimes the beginning can be very difficult. I know things were much different for us, her insulin needs went way up when we started pumping. It was nice we could put the insulin where it was needed without making her low in other places..

    Keep up the basal testing, test ISF too.. if thats off it can be such a headach! Also, check the duration of active insulin too.. It DOES get better, I promise!
     
  14. Heather(CA)

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    Did you test for ketones?
     
  15. ashley_lynden

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    To answer everyone's question...

    Yes, I check ketones and he is always negative at 0.0 on the Precision meter.

    He is using Mios. There is no blood and it is not bent. Something I have noticed though is that there is a hard spot where the canula was. It's like a little scar or something and they are sticking around forever.

    Right now his ISF is set at 200. That is what the CDE had me set it at at pump start. I don't know anything about ISF to even attempt to change that. (I really need to order that Pumping Insulin book!)

    His correction was set at greater than 250. I dropped it to 200 today and have noticed a bit better numbers.

    I've also had him on a increased temp basal most of the day. Anytime he wasn't increased his BG went higher almost immediately.

    I'm going to get groceries tommorow. He's liking string cheese now, I think he would eat some jello. He likes beef sticks and peanut butter by the spoonful, too. What are some other no carb things I could pick up to do basal testing? And can you guys help me out if I do it? He won't be home in the mornings until Friday, unless his BG goes sky high again and I hve to keep him home from school, but hopefully I can do it then.
     
  16. Flutterby

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    Pumping insulin is a really great book to have on hand.. I'm a bit confused, you said his ISF is at 200, and you wouldn't begin to know how to change it, but then said his correction factor was 250 and you moved it to 200 today. ISF and correction factory are the same thing.. in the pump its written as the Insulin sensitivity factor (ISF).. so I'm wondering what you changed today from 250 to 200.

    To check ISF, when the bg is high, give 1u correction and check each hour.. you can also check insulin duration with this as well, but you need to make sure basals are set right before checking duration. So, when I checked Kaylee's ISF she was above 300, needed a 1u correction, I checked at 2, 3, and 4 hours past.. her insulin duration is 3 hours, so I used that number (and she didn't change from 3-4hrs past.) By the 'books' her ISF should be near 125, but when I did this test it was 280 (its always been way higher than the 'books').. Her ISF before that was 250, but she was dropping to low after corrections.

    When one thing is off, it can make a mess of everything else.. its easiest to know your basals are right before you try anything else.. also, when you change basals, you'll most likely have to adjust ratios and the other way around.

    Good basal testing foods are veggies, lunch meets, cheeses, sugar free jello, some nuts may be OK. I find dinner the hardest time to basal test because you need to make sure there is no active insulin before going into it..
     
  17. ashley_lynden

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    I don't know! All I know is on the pump the ISF (maybe it was called something else, he's alseep so I don't want to go messing with his pump right now) is set at 200. Then his range was at 80-250 so he didn't get a correction until he got above 250. I changed that 250 to 200 today.

    And I've got Pumping Insulin in my Amazon cart right now. I'm just trying to find soemthing else to bump my price up to $25 so I can get free shipping. :)
     
  18. Flutterby

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    Ahh, ok, his ISF is 200, thats his correction factor.. you changed his target from 250, to 200.. that will help.. That is a LARGE target area, what will happen is if he's over 200 he will be correct to 200, if he's under 80, he'll be corrected to 80.. I know you are just starting out, but sometimes its easier to have ONE target, rather than a range. It leaves a large area for everything in between. I know he's little too, so you have that wider range, but he won't get ANY type of correction until he's over 200.. with a pump if you had his top range at 175, he'd get a small correction earlier. It'll give corrections down to .025, which makes it easier for his top range to be lower. When K was on MDI her ISF was over 400!! We had to wait until she was well over 400 before we could give her .25u otherwise she'd crash way to low.. but with the pump (also the revel) you can give that .025.. its so nice to be able to give that little bit, to help him from going to high.
     
  19. rebesser

    rebesser Approved members

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    Dear Ashley

    if things are all over the place it might be worth going through the basics again with your diabetes team - its easy to forget the basics (as I did - even though I am a paediatrician with type 1!) - for example, how to draw up, remembering to take the insulin out of the fridge for an hour before priming so you don't get too many bubbles etc I have been on a pump for 10 years but after the first few months I realised that I had not been doing one of the early basic steps correctly, and this helped smooth things out enormously when I sorted this out.

    hang in there

    best wishes,

    Rachel
     
  20. StillMamamia

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    I thought of you recently. Was wondering where you were.:)

    And I do agree that sometimes going back to basics is needed. Maybe not the very very basics, but a simplified version of what we're currently doing, then working our way up. But to each his/her own.
     

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