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Re: [IP] Getting an infusion set to last three days-Yes!



Hi, Maryle - I am to hear of your success in mixing insulins and especially
using R. I have never tried it.  If I had to do it, I would go back to
using R in pumps.  I have hear people do it successfully.  I love my
Accu-chek Ultraflex
infusions, especially since I use them with two different pumps.  My
question to you is...you said you use the infusions in your arms.  Doesn't
the tubing interfere with your arm movement?  Thanks for posting your
experience.

On Tue, Mar 29, 2016 at 4:59 PM, Maryle Ashley <
email @ redacted> wrote:

> From the great conversation and the tips you shared, I made a list of
> things
> to try and have been working through it. I have used Humalog since Sept
> 1996.B  I remember trying Apidra once and checking and checking again to
> see
> if I had forgotten to bolus - the startup time was so slow.B  So I stayed
> with
> Humalog.
> Here are the things I have worked through - I'll tell you in advance there
> is
> a "miracle happens" moment.
> 1. I changed to Comforts.B  After some experience, including operator error
> and remembering how painful insertion can be, I went back to my Accu-chek
> Ultraflex 8mm set on the day I was off to an all-day meeting and had no
> time
> to deal with a faulty insertion.B  I found the Ultraflex worked as well as
> the
> Comforts.
>
> 2. I also pumped only basal trying to minimize what the set had to handle.B
> The best I could do with the Comforts was getting a third day by pumping
> 160%
> or more to keep it going.B  The Ultraflex did that, too, so I returned to
> Ultraflex.
> 3.B  I tried new territory, upper arms, with no difference.B  I still have
> raised bumps where the sets went in and it's been a month.
> 4.B  I finally turned to a mix of Humalog and Regular 5:1 on March 1st.B
> Had
> some learning curve on getting a 5:1 cartridge but was not too far offB
> When
> I had an empty bottle for better mixing, it was easier.B  Continued 5:1
> through March 20.
>
> I thought there was some improvement but I did never got three days without
> increasing the basal.B  I was pretty confident on getting 2 days, though.
> And
> was using 130% basal to get the third day.B  I did make 4 days once with
> 160%
> basal so I got some confidence I could meet the Medicare three days/set
> mandate one way or the other.
> 5.B  Then on March 19th I had an all-day meeting; it was day 2 on the
> infusion
> set so I thought I would be fine.B  Driving home that evening my Dexcom
> went
> up a little to 106 but in traffic here there is no pulling over and I was
> ok
> with that number.B  When I got home Dexcom read 116. But when I checked my
> BG
> it was 175.
> I believe when I do not have enough basal on board, my liver gives me a
> push
> just as in the 3am Dawn Phenomenon.B  And when that happens Dexcom does not
> pick up on this rising BG like it does for a BG rise coming from eating
> something. You don't have to agree here.B  This is my YMMV experience.B  I
> only mention this because it added frustration that led to my subsequent
> decision.B
>
> Apparently this set stopped working at 48 hours, even using 5:1.
> 6.B  Now the miracle occurs.B  I changed the set that evening when I got
> home.B  The next morning when I was making up a new cartridge, I decided to
> try a cartridge of only Regular. I did not have meetings for a few days
> and I
> would be home and able to watch this.B  Here's what happened.
> I left my basals as they were rather than try to think back to how R
> should be
> programmed earlier than Humalog since it comes on slower.B  To my
> amazement my
> basals worked very well.B  I felt like I had a little more basal in fact.
> (That's very subjective but I am sensitive to having a every three minute
> basal delivery.) Something felt different and good.
> I got three days out of that set, and never raised the basal percentage.B B
> On the next set I ran for 4 days and again did not have to raise the basal
> percentage. Running at 100% only.B  What a surprise!
>
> I used Humalog by injection for meal boluses so I would not have to rethink
> that part.
>
> Overnight I run a little lower than I'd like (60-80) but the pattern is
> pretty
> level.B  No drops.B  (My overnight basals can be a crap shoot so this is
> different.)
>
> 7. The other miracle is how well Dexcom works since I switched to R.B  I
> had
> changed to the G5 when I lost my G4 transmitter in Feb 2016.B  I found the
> G5
> very slow to sync up.B  Was usually 20 points off, could be either up or
> down,
> too.B  I talked with Dexcom and they said it had to be in the sensor.B  I
> told
> them my G5 didn't work any better than the Dex 7.B  Did not sync up well
> until
> the 6th day.B  Usually the G4 worked well from day 1.B  But I had converted
> the receiver to G5 so I was stuck.
> I am on day 11 of the Dexcom sensor today - began a new one the day before
> I
> started using R - and it continues to track well.B  Often spot on. This is
> a
> change.
>
> 8.B  My conclusion is I do have an allergy to Humalog.B  There is no overt
> reaction like a red bump or itching so I'll call it a mild allergy.B  But I
> was not getting all the basal delivered.B  Which may be bringing my liver
> into
> play.B  Which in turn affects my Dexcom readings.
>
>  With only R basals I am more stable, sets last three days, Dexcom works
> great.B  I am truly amazed.
>
> To take this a little further, I have been bolusing R with the pump, too,
> for
> the last two days.B  Again I am surprised that my usual bolus is working
> quite
> well.B  Not sure if there is a little more tail on it, but it is mild if
> so.
> I don't see my endo until late May so I am building up data until then.B
> She
> will likely give me a prescription for Novolog, but she may not believe
> me.B
> Once again, I am glad to have IP to learn from.B  A very big learning for
> me
> this time. Couldn't have done it without you!B  Thank you all.
>
> MaryleDexcom - Spirit
> .
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.
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