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Starting OmniPod. Any "I wish I had known this when starting" advice?

Discussion in 'Parents of Children with Type 1' started by DavidN, Dec 18, 2012.

  1. DavidN

    DavidN Approved members

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    We meet with the OmniPod rep in a couple days. I'm sure she'll be very helpful. But the real nuggets of wisdom come from those who have been through the drill. For example, on the phone she said the pods will last 3 days. From this site I've learned that that's not necessarily the case so I pushed back. She said, "yes, you're correct, I'd estimate 50% of our customers' pods last 3 days and 50% 2 days". Well that's good to know but she wasn't going to offer that up. Are there any other "I wish I had known that when we started" tips out there? Thanks!
     
  2. caspi

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    Post pod change highs. Not everyone experiences this, but we did and it drove me crazy! What we now do is bolus a unit after the pod change and do a temp basal of 80% for 4 hours. We haven't had a high since we started doing this. :)

    My son has been on the Omnipod for 4 years (with a short break in between). He loves it! Good luck on your pod start and feel free to post any and all questions you might have. We're here to help! :cwds:
     
  3. mmgirls

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    We dont pod but I hear that the new smaller pods are coming out in feb/march with a new and improved PDM.

    I would ask what the differences will be between the two so that you have it in the back of your mind. i hear that they will be changing the way IOB is calculated.
     
  4. maciasfamily

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    Get the dr to write the rx for changing the pod every 2 days. We almost always get 3 days out of them, but always better to have more than enough than not enough, especially if it costs the same through insurance.

    We don't experience the pod highs's as others do, but we're new at podding. I have heard what the previous poster mentioned is the key though.

    You may want to test the PDM meter against another meter to gauge the BG amount and change the code from 16 to 17. You'll understand this more when you get it. I realized on code 16 it showed my son was lower than what he really was and changed the code strip to 17. I think it helped to avoid ending up with a lot of highs when it wasn't a true low.

    Personally, we have to tape down every pod. It's too top heavy (as I call it) and the pod will come off the pod tape. If we run a piece of Hypafix tape across the whole top, it helps to secure it. This will change when the smaller pods come out next year.
     
  5. dqmomof3

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    We almost never get the full three days out of a pod. Prescription is written for every two days, and even then we run out about a week before the next three month shipment is due! DD is a soccer player, and she is forever pulling one out or off. Her skin tends to get irritated as well. Our best buy? Duct tape! She puts it underneath the pod and we've had great skin results ever since.

    Enjoy Podding...we are former MM pumpers, and my daughter says she'll never go back now :).
     
  6. Melissata

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    Our trainer didn't know about the additional 8 hours beyond the 72, thought I was crazy. I wish that I had known to tape it down, because the pod can rip away from the adhesive, and they won't replace them for that reason. I also wish that I had known that she was going to have a problem with the adhesive after a month or so. She has had it for 3 1/2 years now and I really can't see her going back to a tubed pump unless there is no choice.
     
  7. Megnyc

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    Several things:

    Skin-tac. I wipe the wipe against the adhesive on the back of the pod making sure to get the edges. Then I wait about 90 seconds and then put it on. This keeps the edges from peeling up.

    Prescriptions. Get your endo to write your prescription for the max number of pods covered by your insurance. Mine covers 20 for example for every 30 days. After the first few months you will probably be able to get away with 15 for 30 days but you don't want to run out in the beginning. You will be testing a ton for the first few weeks. Have your endo up your prescription for test strips if you don't already get 10-12 a day.

    Vet-wrap. I use this for running, skiing, anything that my arm will be swinging around. I also use it if I am swimming and feeling self conscious. I have found amazon to be the cheapest place to get it. Let me know if you can't figure out how to put it on and I will post a pic.

    I think that is all for now. Good luck! I bet your son will love.
     
  8. virgo39

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    I wish I had known:

    How basal is delivered (in pulses of .05 u evenly spaced over the hour, counting from the end of the hour. E.g. A basal rate of .05 u/hour is delivered in one pulse at the end of the hour).

    That DD would have post pod change highs that did not seem to appear until after a 2 hour check ( which in our experience was not meaningful-- at that point we were seeing the basal from the prior pod). We now do a "priming" extended bolus after a pod change.

    That the pod continues to deliver basal and bolus insulin until 8 hours after it expires.

    That one can remove insulin from a pod (not recommended by Insulet).

    That it would be useful to keep track of which site was used.

    That for safety reasons, the PDM rounds down, so that if you were doing a correction and a bolus, each could be rounded down in a way that you might not expect with general math rounding principals and that that can lead to some under bolusing at times (less of an issue now, but DD was initially more " carb sensitive").

    That it can be much more convenient and less wasteful to fill pods from pen fill cartridges rather than vials.

    FWIW-our pods almost always last three days. DD swims and has had no issues with pods coming off.

    Good luck!
     
  9. 3kidlets

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    Hana's Pods always last 3 days. She swims 5 days a week and we've never had a pod come off.
    Post pod change highs are vicious! If we don't do a 3 unit bolus right away with the pod change, she will end up in the 3 or 400s!
    For us, the freestyle strips read much lower than one touch. So we continue to use one touch and manually enter the blood sugar. With one touch, she can get a reading of 180 but Pdm will read 140. The other night she was 300 on one touch but 209 on PDM. Just saw above about changing code though. I will try that and compare.
    Hana loves the pod and says she will never go tubed.
     
  10. DavidN

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    Thank you for all of the great advice! We're a tad anxious but these nuggets of wisdom will definitely help with the transition.

    David
     
  11. danismom79

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    Am I reading this wrong, or are you saying that if the rate is 0.05/hr, nothing is delivered for a whole hour??? What happens after a pod change?
     
  12. virgo39

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    I am saying that, because the smallest unit the pod can deliver is .05, that amount is delivered at the end of the hour. If the basal rate were .10, it would be delivered at the half hour and at the end of the hour. But remember that the basal rate for the prior hour is delivered in the same way.

    After a pod change, the basal continues as programmed. It is my understanding that you would miss the basal pulse if there were no pod active when the basal was due to be delivered. In the example above of a .05/ hour rate, you might miss the basal if you were changing a pod at the end of the hour. I have not confirmed all of this with Insulet (except for how basal is delivered).
     
    Last edited: Dec 19, 2012
  13. virgo39

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    One more thing, I wish I had known:

    When changing a pod, one can fill the new pod before deactivating the old one. It will then beep periodically until it is activated, but we find that filling the new pod first makes pod changes quicker.
     
  14. DavidN

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    Do you guys change pods at night or morning? I'll ask the rep but wanted to know your thoughts/experiences. Evening seems like a convenient time but if we experience post pod change highs, I'd have a tough time bolusing going into a nights sleep, even with 2 am checks. Thanks.
     
  15. swellman

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    You can set the alarm to only alarm on expiration an hour before the 72 and like others have said have 8 more hours after that.
     
  16. MyHandsAreFulll

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    We too have post pod change highs. I give her an extra bolus of .15 (she only weighs 38lbs) and I try to change the pod right before a meal so the meal bolus goes through the new pod. Seems to help. Our pods normally last 3 full days, even in summer with daily swimming. If I am concerned about a pod getting knocked off I use Kinesio tape, a 2 inch wide strip across the pod. We have only had a few "defective" pods, normally didn't prime and we do draw the insulin out to put in a new pod. I also carry an empty syringe in her D bag incase a pod comes off while we are out, I can draw the insulin out to bolus her (never had to do this yet, just prepared) We have been very happy with the pod.
     
  17. maciasfamily

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    We usually always change at night before dinner. This gives us time to get things ready. Doing it in the morning is just too rushed.

    We also use DeSolvIt to remove the old pods. It's literally slides right off while the new pod is priming.

    And I thought the basal is delivered at the beginning of the hour, not the end of the hour.
     
  18. virgo39

    virgo39 Approved members

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    I don't know how to link to another thread-- but one called "Omnipod basal delivery question" has a quote from email info that I received from Omnipod.

    Here is the link to the thread. http://forums.childrenwithdiabetes.com/showthread.php?t=56807&highlight=omnipod+basal+delivery
     
    Last edited: Dec 20, 2012
  19. DavidN

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    After our first night on the omni-pod, I can now offer my own "I wish I had known this when starting" advice. So far my list applies to any new pumper.

    - Make sure you get a ketone meter. I'm a tad annoyed my Dr. didn't suggest this.

    - I read in the archives last night about a poster whose Dr. made them submit a four day diet of low fat foods. I think this is a terrific idea and one we didn't implement.

    So far that's it.

    Quick summary of last night.

    2:00 pm - Pod attached.
    2:20 pm - First bolus, tangerine. Son savored the moment as no needle came out.
    6:30 pm - BG 104. Ate ham sandwich (regular french roll - 40 carbs store clerk got from bag) from Honey Baked Ham store with some chips. Bolused for 55 carbs. Big smile from son who gave himself the bolus with parent oversight.

    6:40 pm - Son still hungry, wants to split sandwich with me. He orders turkey sandwich, which unbeknownst to us came on a croissant. They didn't have a carb amount for the croissant so wife and I guessed at 15 for half a sandwich. Son boluses again with big smile on face.

    8:50 pm - BG 275. Check ketones with stick. None. I'm nervous as my first thought bad pod or bad site. I would never call Dr. under these circumstances but given my uncertainty with pump, I called. She said to do a correction bolus. I said it hasn't been 4 hours. She said it doesn't matter. I said I'll wait. She said as you wish.

    10:30 pm - BG 261. .9 unit correction using pump calculation. I did not check for ketones because he was barely above 250 and I didn't want to wake him to pee on stick. Surely he would hate the pump if he associated it with being pulled out of a deep sleep to pee.

    1:33 a.m. - BG 126.

    2:30 a.m. - BG 109

    3:30 a.m. - BG 99 (Gave son 6 carbs of choc milk). I read in archives last night that treating at this level is not advisable but he's honeymooning, it's our first night on pump, and I'm nervous (and want sleep).

    8:00 a.m. - BG 123

    All-in-all I'd say night one was a pretty big success. Thanks for all the input!

    David
     
  20. JNBryant

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    Seeing the results of your son's first day on the pump really eased my mind. My son will be starting on the pod very soon, so it's nice to see that not only does it make things a lot easier (not having to measure a 'hair' over or under a unit with a syringe), but that your son has taken to it very well. Congratulations!
     

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