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Subject: [IP] Pump questions

<<First off.  Infusion sets.  Do they really NEED to be changed every 2-3
days, or is this a marketing thing >>

They really have to be changed every 2-3 days - some can push it to 4-5
days, but rarely any longer.  They make a hole in the skin, and holes in the
skin tend to get infected.  So, you need to change the site of the hole to
prevent infection.  Also, the tissues get "tired" of absorbing insulin after
a few days, and refuse to do it any more.  So, you have to give some fresh
meat a chance to do the absorbing.

<<Are there any other sources for supplies for the pump (or are the
supplies from the 'other' pump mfg. any cheaper)?  >>

Price it out.  This is a limited market.  ALL the Silouettes /Tenders /
Comfort sets are made by 1 manufacturer, so there's no competition.  Most
people who've had to buy them through medical supply houses have not found
them much cheaper than the pump companies.  But, shop around.

<<and WHY does the damned pump cost $5000 for a NEW one, but only $450 for
a "refurbished" one?  (but you can't buy a refurb FIRST!)>>

Profit, my dear, profit.  This is, after all, a capitalistic society.  Yeah,
there are R&D costs that have to be recouped, tech support, pump
representatives.  Again, the market is limited, not everyone wants one of
these things, so they have to make their money where they can.  Neither
company is in the Fortune 500, so one can assume that they're not getting
terribly rich with insulin pumps.  And, be glad there are "refurbished"
pumps, so you don't have to shell  out the $5000 again if you bust one up.

<<Second question.  My Doc recommended the MiniMed
pump.  One of the reasons I kind of wanted to try the MM is the computer
interface.  NOW I come to find
out the interface isn't even available yet.  WHY do companies advertise
stuff they don't offer for sale?>>

No answer to this one.  But it's probably coming.

<<What's the story on MiniMeds wearable BG
monitoring device?  Is this ALSO vaporware?  No one at the company would
confirm or deny>>

They're available in limited release.  Only physicians can get them right
now, they don't have a continuous readout, but rather gather data for 3
days, then you take it back to the doctor and get a print out.  So, not
helpful to the real world yet, but at least there's an approved prototype,
just to know it's not JUST vaporware.

<<Fourth.  Needle or softset?  I ordered the softsets, thinking they will
be more comfortable, but have NO IDEA.  Should I even bother trying the
needles? >>

There are people who favor each kind of set.  Most people who've tried more
than one seem to like the Silouette/Tender/Comfort set the best - sticks
better, less coming out at unexpected times, more comfortable,  detachable,
etc.  But there are a lot of folks who like the soft-sets just fine, mostly
because they're easier to put in, but getting them to stick seems to be a
recurrent theme on the list.   A few diehards  still use the original bent
needle, but most people have moved on from there.  Try all of them.  They
will send you samples of each.

<<Getting past the salesman/company bull, what kind of things should I
be aware or/watch out for?  Any kind of known problem
areas/defects/issues I should keep an eye out for?>>

You know what the greatest part of this is?  Both pumps work REALLY WELL.
As with any electronic equipment, there are times that they break.  Minimed
users seem to report skipping screens the most.  Disetronic users hate that
the batteries are special, and you either have to get them from D, or go
through a really elaborate process to use ones available at a drug store.
But, most of the problems with the pumps are getting you basal rates / bolus
ratios/ etc set correctly, and adjusting for the ever - changing variables
that the diabetic body throws at you.  But the pump hardware will be the
least of your problems.

<<Last.  TRAVEL.  I travel extensively, including overseas and into
underdeveloped areas.  (although usually stay in developed or good
hotels/homes)  Also into places where it is HOT all the time (up to
115-120F).  Any suggestions for use, awareness issues,
backups/spares/redundants, etc.?>>

Since you're getting a Minimed, backup pumps aren't really easy to do.  Make
sure you take regular syringes and insulin with you, and the FedEx number
for where ever you are - Minimed will get you a loaner pump as fast as FedEx
can get it there.  Take 50% more supplies of everything than you think
you'll need.  Supplies are not easy to come by other than ordering them.
Most people haven't had problems with airport security (my daughter's been
through the metal detectors a number of times without setting it off), but a
letter from your doctor explaining what it is, and its medical necessity
never hurts if you're trying to get out of a jam.  Probably your biggest
challenge will be getting the sites to stay in if you're hot and sweaty.
There are a zillion threads on how to get sites to stick better.  Go back
into the archives of this group, and read up on those.  They range from
putting deodorant on the site before insertion, a number of different
"sticky preparations", such as IV prep, skin prep, Carrillon (sp?) cream,
Tincture of Benzoin, different tapes and "sandwich" techniques using
Polyskin/Tegaderm/Opsite/IV 3000.  You'll just have to see what works for

<<Thanks for any answers/opinions in advance.  Groups like this make me
thankful for computers and the internet, without which we'd all be back
in the dark.>>

The biggest thing is that the learning curve for pumping is steep and real.
Be prepared that things will take a while to work out. Don't schedule your
pump start up at a time when you can ill afford to have some whacky blood
sugars for a while.  Read Pumping Insulin by John Walsh, including the
Humalog supplement, until you can recite it by heart.  And take your laptop,
so you can post the questions that will undoubtedly arise to the experts of
this group.

Nancy Morgan

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