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Re: [IP] Re: Almost a week with this pump

<<<I have a trainer and I realize that this thing takes time. I even had a 
better experience tonight by eating a Southwestern Chicken Salad at Jack In 
the Box and programming 45 units in my thing(that salad could not have been 
worth more than 30!) I got a 275 reading, then I corrected it, went over to 
my friends house for two hours, came back and got a 310 reading...something 
has to be wrong with this piece of crap. $6,000 should provide for a quality 
product that adds some form
of satisfaction to one's life. I hate minimed, I'd rather risk going low, 
then not being able to eat a salad with this horrific high.   Honestly, I 
don't want to go low, in fact, the ultimate decision maker for me was having 
the paramedics called on me by my father, two months ago...that had never 
happened in the 9 years of having this. I don't want to go low, but my 
diabetes is so messed up now, I guess some person was saying that I 
shouldn't blame the pump, but this thing is mine, and I have a right to 
express my dissatisfaction with this thing. My trainer keeps saying this 
will correct
itself within time of writing down stuff and calculating. If you were in my 
position, I think you would feel the same, I don't think I'm overreacting 
here...I mean, I don't want renal failure, limb amputations, loss of 
erectile function when I'm 40, or any of that stuff.   Thank You for your 
thoughts though.>>>

I know you're frustrated, but it will certainly take more than a week to 
sort through what the problem is.  It may not be fun, but once you've 
figured it out, it really does make life SOOOOO much easier.  I started 
pumping when I was 21 during my senior year of college (during finals no 
less!)  It was very rough at first, and the very first time I went out to 
eat at a restaurant with it, I ended up spending the entire night throwing 
up from lack of insulin.  These things happen to almost everyone when they 
start, but after 6 months (or less), almost everyone feels that the pump 
would need to be pried out of their cold, dead hands before they'd give it 
up.  The pump is really an amazing piece of equipment and it can do things 
that you couldn't even dream of doing with injections.

I do have a few suggestions with what could be going wrong.  It definitely 
sounds like you might not be getting the insulin delivered appropriately 
from the pump (if similar amounts of insulin from a shot worked to bring 
down your BG).  However, this is most likely not an issue with the pump at 
all, but with an infusion set that just doesn't work for you.  They make 
several different types/styles of infusion sets because not everyone is the 
same.  MM most likely started you off with the Quick-sets because they're 
pretty simple to use and they are the most commonly used sets by adults 
using their pumps--but that doesn't mean they work for everyone.  A lot of 
other people have nothing but trouble with them.  They can kink or fold when 
inserted, and in addition, the disconnect can become disconnected on its own 
and cause insulin to not be delivered properly.  If you are inserting them 
with the Serter, try to insert them manually once or twice, or try with the 
serter if you have been inserting manually.

Also, before you give up pumping all together, contact MM and ask them to 
send you samples of all of their sets in all of the lengths that they come 
in.  I would suggest at first trying the Silhouettes and the Quick-Sets in 
both the short and long lengths.  If those don't work, then you can try the 
Sof-Sets, the Sure-T straight in metal sets or the Polyfin angled metal 
sets.  Just by trying those out, you may find a world of difference in what 
your BG does when you give a bolus.  You should also try inserting sets in 
different places on your body.  The stomach, the upper butt, the 
love-handles, etc are all good places to try, but they are also not the only 
places.  You may find that you need to give a certain part of your body a 
rest or even that a certain part of your body just doesn't work with a 
certain set (I can't use Silhouettes in my stomach because they don't stay 
in very well, and I can't use Quick-Sets in my hips because they kink).

Personally, I have tried all of the longer length sets except for the 
polyfin angled metal set, and I prefer the Silhouette the best.  The Sof-Set 
doesn't work super well for me (I got lots of no-delivery alarms) and the 
Sure-T is too short to stay in my body except for two spots (it only comes 
in the short lenght and it just falls out of me on its own).  I used the 
Sof-Set for years because I thought it was my only option because I was told 
that the Silhouettes were only for very skinny people (before the Quick-Sets 
came out).  Years later I found out this was not true at all, because I am 
not skinny, and the Silhouettes work great for me.

It's very difficult to nail down what the problem is when you've only been 
pumping for a week, because as everyone else has said, there are so many 
things that need to be set up properly for everything else to work.  If the 
infusion set you are using just doesn't work for your body, you're never 
going to be able to see if your basals and boluses are correct.  That 
doesn't mean there is anything at all wrong with the pump.

The other thing I would recommend is trying to eat meals that are very 
straightforward and easy to calculate while you are getting everything set 
up.  The meals that you have mentioned could very well be part of the 
problem.  I find that restaurant food is notorious for having "hidden" carbs 
all over the place and if you run high after a meal, you never know if it 
was a problem with your settings, or a problem with the meal.  This will not 
last forever (maybe a few weeks), but restaurant food is so bad for 
guestimating carb counts, especially early on.  The biggest reason for this 
I think is that it is exceptionally high in both fat and protein, which can 
both affect BG when consumed in large amounts.  Even now (I've been pumping 
for over 6 years), when I go out to eat, after I calculate the carb count I 
often double the recommended bolus.  Many times I still go high after that.  
But the pump makes eating out so much easier because I can check my BG 2 
hours after a meal like that and know if I did OK or not, and can fix it 
very quickly if I messed up.  I couldn't do that very easily while on shots, 
and I certainly couldn't program a square wave bolus for meals that take a 
while to digest (steak and pizza are two meals that I just couldn't eat 
before I started pumping for that very reason).  Therefore, for the first 
couple of weeks, go boring with your diet and eat lots of home-cooked or 
pre-packaged simple meals that are very easy to calculate the carb count of 
(avoid pasta, pizza, and very high fat/protein meals at first at all 
costs!).  Once you get everything stabilized, then you can experiment with 
these new foods and after a few months, you should be very experienced with 
what you need to do to eat these foods.  It's not an overnight thing, but 
it's well worth the time you invest in it.

Best of Luck!

Sarah, dx'92, pumping'00
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