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Re: [IPp] Decisions, decisions?

In a message dated 4/29/2002 11:05:10 AM Mountain Daylight Time, 
email @ redacted writes:

> Talked to my new Endo.  Told him I've narrowed our pump choice down to
>  MiniMed's Paradigm or Animas' R-1000.  He says not to be persuaded by the
>  waterproof feature because kids drop their pumps.  What do you experienced
>  pumpers think? 

I'm not sure what he's talking about -- unless he's refering to the problems 
with cracked cases on the Disetronic H-trons that caused the company to 
remove the waterproof guarantee for that pump model .  .  .  Waterproofness 
(is that a word?) was a major factor under consideration when we were 
choosing a pump for our daughter (now 11).  The Animas pump has the highest 
waterproof testing level of any of the pumps available (24 hours at a depth 
of 24 hours).  In contrast, the Paradigm's tested at (I believe) 8 feet for 
30 minutes -- which to me isn't worth much for a pumper like my daughter  
(more about the waterproof issue below).

>  I do like the fact that Animas' basal increment is 0.05 u, 
> but
>  is this something we will not need compared to 0.1 with the Paradigm? What
>  about the Basal profiles - 3 versus 4?  

Though we didn't expect it to matter, the .05 basal increment was very 
helpful for us in fine-tuning my daughters overnight basal rates.  As for the 
number of basal profiles, my opinion is that 3 or 4 is not a significant 
difference and I wouldn't make that a deciding factor on the choice of a pump 
. . . 

We actually use three profiles out of the four the Animas pump has most of 
the time (Regular Days, Weekends -- when sleeping in, and one for Sleepovers 
at other people's houses).  I do use the fourth one when I want to fiddle 
with her Regular basal -- I leave one basal profile set with the regular 
profile we've been using and use the fourth to try out any changes -- that 
was it's easy to just switch back to the old basal profile if the changes we 
try out don't turn out to be right . . . but, as I said, being able to do 
that is a minor convenience and I personally wouldn't care much if I was 
"limited" to only 3 basal profiles -- other features, in my opinion are much 
more important to consider . . .

For example, the limited insulin capacity of the Paradigm pump would be a big 
factor to me if choosing a pump for a boy just heading into adolescence.  I 
don't know what your son's daily insulin use is currently, but since he's 
only 13 you can expect that sometime in the next 4 years (the warranty period 
on the pump -- so you're pretty much stuck with your choice for that long), 
his insulin use is likely to increase substantially for a period of time due 
to insulin resistance from  hormones (it's not unusual for adolescents 
insulin requirements to more than double . . .60-100 units a day or more). 
Unlike most pumps which have a cartridge capacity of about 300 units, the 
Paradigm only holds 175 units which, after you prime your infusion set, 
effectively only leaves you with about 150 units (and that's assuming you 
want to let your child use every last drop of insulin in the cartridge before 
you change it).  A capacity of only about 150 units could mean that at some 
point you would have to be filling and changing cartridges every other day, 
or even daily . . . 

Here is a link to a series of web pages on the Diabetes Mall website that I 
think do a good job of pretty objectively reviewing the various pumps 
currently on the market:   <A 
Diabetes Mall Pump Reviews - Spring 2002</A>   You might want to read through 
these to help you in making your decision.

> What about infusion sets- minimed's
>  quickset vs the paradigm's? (my son who'll be pumping is 13)

You can get the Quick-set (which my daughter uses) in the standard version or 
in the Paradigm-only version.  The only difference is in the connector at the 
pump end of the infusion set.  The Paradigm-only version uses a non-standard  
connector that can only be used on the Paradigm pump.  In my opinion, this is 
another drawback of the Paradigm:  Because of their choice to use a 
non-standard connection, Paradigm users are limited to using only the three 
types of infusion sets for which Minimed (Medtronic) produces a special 
Paradigm version:  the quick-set, the soft-set, and the silhouette.  Granted 
these three sets will meet the needs of most pumpers, but what if your child 
ends up needing to use one of the other sets currently available (or one of 
the new ones that will be coming out over the next year or two)?

ALL the other pumps on the market (including the Minimed 508) use the 
industry standard leur-lock connection.  As a result, you can use ANY 
infusion set made by any company on ANY pump made by any of the manufacturers 
(EXCEPT the Paradigm) . . .  The benefit here is that you are not limited in 
your options.  So, for example, my daughter is currently able to use the 
Minimed Quick-set infusion set that she prefers (and which works well for her 
in terms of BG levels) on her Animas pump.  And if some other new type of set 
comes out that would better serve her needs, she'll be able to use that set 
on her Animas pump too . . .

Below my sig line, I've appended a write up I posted in response to other 
peoples inquiries about the Animas pump and why we chose it for our daughter. 
 I hope you;ll find that useful .  .  .  In the end the choice of a pump 
should be an individual decision based on the needs and preferences of the 
pumper.  They are all "good" pumps in the sense that they can get the basic 
job done -- the trick is figuring out which set of features are going to help 
your son be the most successful pumper he can be .  .  .

Pumpmama to Katie (11, email @ redacted) happily pumping with her Animas pump "Elvis" 
since 6-1-01
Here's the "reprint" on my previous post on why we ended up choosing the 
Animas pump:

When we were pump shopping (a little over a year ago) , we did a lot of 
research and really looked at things carefully.  In the end, the reality is 
that they are ALL "good" pumps (couldn't get FDA approval if they weren't) 
and that selecting a pump should be an individual choice based on the needs 
and preferences of the pumper (and the parents, in the case of a child). 

In the end, my husband, daughter, and I ended up choosing the Animas R-1000 
pump as the "BEST" pump for her.  She's been pumping for almost 10 months now 
and with that experience under our belts, I'm happy to say that we are 
extremely happy with our choice.  We love the pump and have been very happy 
with Animas as a company.  Not only has the service been first rate, but 
every person we've dealt with has been just plain nice.  

Here are some of the things we like about Animas pump:

Animas has the highest waterproof rating (Tested at 12 ft for 24 hours).  I 
paid attention to that one because my daughter is half fish . . . Although 
she *can* disconnect, she virtually never does except to hook up a new set 
every three days.  And, by staying connected (1) you get to take full 
advantage of those finely-tuned basals you work so hard to get, and (2) if 
you wear your pump all the time, it's easier to ignore tha fact that you've 
got this thing connected to you (kind of like how you don't feel your wedding 
ring on your finger).

In the shower, she just clips her Animas pump to the shampoo rack.  In the 
tub, she just sets it on the ledge next to the tub (so as not to cook the 
insulin).  In the pool, she just clips it to he bikini bottoms.  

Last summer, we spent three weeks in Hawai`i.  In the ocean or in a murky 
lake, I ask her to put it in a neoprene sports belt just because I didn't 
want to have her $5,500 pump get knocked off during some horseplay and end up 
in Davy Jones locker!.  She wore her pump in the ocean at least once a day 
while we were there. She also wore it kayaking and snorkeling.  This summer 
she plans to try surfing . . .

The thing I like about her staying connected is that she has her pump (with 
insulin!) with her at all times if she needs to bolus (like if we kayak out 
to the little island in the bay with a picnic) or if she's just not playing 
hard enough in the water to make up for all her normal basal 
requirements(then she just has to punch a couple buttons to do a bolus that 
will give her the insulin she needs). 
Plus, then we don't have to worry about finding a safe place at the pool or 
beach to store the pump where the insulin won't get roasted, or the pump 
won't get lost, damaged, or stolen (as happened to one poor fellow on the IP 
this past summer who stashed his pump in a little cooler which someone ran 
off with while he was swimming in the local pool).

I know some pumpers prefer to disconnect when swimming, and some don't have 
an option because their pump isn't waterproof, but for us, her having a 
waterproof pump 
has been great.

Using the pump (to do a bolus, set up a basal profile, change the clock when 
it's daylight savings time, etc. etc.) is a snap because this pump is all 
menu driven.  If you can read English (or whatever language you request for 
your pump) you can run the pump.  You don't have to memorize anything, just 
read the screen.  It's like using an ATM machine. Go try it for yourself on 
the "Virtual Pump" on the Animas web site (www.animascorp.com).  

My daughter mastered it in minutes and we weren't far behind.  There's a 24 
hour customer service line if you ever have any questions or problems, but we 
haven't opened the manual since pump start let alone needed to call customer 
service about how to do something on the pump.

All the "mechanical" stuff is easy -- even if you're NOT mechnically inclined 
. . . Filling Cartridges (with insulin) is like drawing up a syringe (and 
takes about that long).  Then you just drop in in the chamber, close the 
little door, twist on the infusion set of your choice (unlike the Paradigm, 
Animas uses the industry standard Luer lock connection) and you ready to 
roll.  Changing batteries is that simple too -- plus they use a standard 
"357" battery that you can pick up at Walmart, Target, or a pharmacy if you 
ever need to (though the ones from Animas are cheaper and seem to last 
longer) -- but a least you're not stuck if you forget to pack extra pump 
batteries when you go on vacation . . . some pumps require special batteries 
that you can only get from the pump maker.

How the pump looked was very important to my daughter.  The Animas pump is 
small and thin and (most importantly to her) looked like a pager.  She also 
really liked all the snap-on covers you can get in something like 20 
different colors including metallics and irridescents.  They also have 
re-usable pump cover stickers in various sports and holiday themes.  You can 
"try on" a few of the pump cover colors on the "virtual pump"  and the pump 
cover stickers are in the "autumn" newsletter on page 4 (also on the web 

Animas has the lowest hourly basal rate increment (.05 uph), a feature that 
we didn't think would matter to us -- but we later found that being able to 
adjust our hourly  basals in increments of five hundredths of a unit per hour 
(instead of one tenth of a unit increments like other pumps) did actuallly 
make a difference when fine tuning Katie's overnight basals.

The Animas pump allows you to set up up to  four basal profiles (basal 
programs) to deal with different types of situations that affect you basal 
insulin needs.  We weren't sure how much we would use this feature, but it 
too has come in handy.  We've played around with several different profiles, 
and right now we have set up three profiles: School Days, Weekends, and 
Sleepovers.  It's so handy to have these already set up.  It's very easy to 
just switch from one to the other.

We also use the temporary basal feature which gives you lots of options to 
raise or lower your basal rate by percentages for periods ranging from a half 
hour up to 12 hours.  We use this feature a lot to prevent lows related to 
exercise.  Katie likes not having to eat right before/during exercise just to 
keep from going low.

The Animas R-1000 performs 1,000 safety checks per minute (hence it's name).  
It also has powerful motor to overcome potential occlusions coupled with the 
most sensitive occlusion detection system of any pump on the market.  I also 
like how I can set maximum limits on basals and boluses to help keep my 
daughter from accidentally doing a bolus of 14 units when she really meant to 
do a 1.4 unit bolus (and then change those limits based on what we need them 
to be).  

As I said, these are some of the main things we like about the Animas pump.  
You may find some of them aren't of interest to you, or that other features 
of the pump are of more interest.  

The thing you need to do is to review each pump's features and figure out 
what the benefit of that feature would be to a pumper, whether that benefit 
even applies to you, and how important it is to you.  

An example I can give you is audio boluses.  Now I think that all the pumps 
currently available offer this feature, however, if one didn't, but offered 
other features we wanted the lack of the audio bolus wouldn't matter us 
because that's a feature we never use -- I want my daughter to visually 
verify the bolus amount before she activates the pump to actually deliver the 
bolus of insulin (therefore we have that feature turned "off" on her Animas 
pump even though it has the capability).
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