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summer camp was Re: [IPk] Animas and Other pumps



"(3 of these were whilst in the US and resulted in Sarah having to go back 
onto
MDI for 2 weeks whilst at diabetic summer camp)"

Sorry to lift just one sentence from your very detailed reply Karen.  I do 
hope you don't mind me taking you on a tangent for a moment.

My daughter is about to turn 6, and hubby has a plan that next summer (she 
will have just turned 7), we may travel to the US during the long summer 
holiday and enrol Alice in a diabetic summer camp for a week or so. Is this 
what you have experience of? If so, which camp did Sarah attend?

specific concerns surround conversion from mmol to dl etc - did they cope?
was the care good?
did she have lots of fun?
were there any (other) non-US children?
if the opportunity arose, would you do it again?

Thanks
Angie
Mum to Alice 5, dx 02/05, pumping Cozmo 12/07

----- Original Message ----- 
From: "Karen Persov" <email @ redacted>
To: <email @ redacted>
Sent: Thursday, June 12, 2008 7:40 PM
Subject: [IPk] Animas and Other pumps
>
> Woh... I had not intention of starting WWIII.. so I will clarify what I 
> have
> posted. I cetainly had not intented to upset anyone and If I have, I do
> apologise.
>
> My posting about the superiority of the Animas2020 is based on our 
> personal
> experiences of using MM, Cozmo and Animas pumps over 5 years of pumping 
> and
> 10 years of diabetes; it is not meant to be a definitive guide. Whatever
> pump one chooses it is better than MDI and of course one of personal 
> choice.
>
> I like to think of different pumps as you would different cars... with 
> some
> being like a Skoda at one end and others more like a Mercedes or Lexus. If
> you are getting NHS funding for the pump, why not go for the upmarket
> models? After all, all cars will get you from A to B but surely the ease 
> and
> comfort of how they do this is also an issue? (especially if funding is 
> not)
>
> Firstly, I must say that I did not and would not say the Spirit is cr*p.
> Just that its a very basic pump. I do know a few people (adults) who find
> the minimum basal increments to be an issue, including a few who post on
> this list.
>
> About the Minimed.. I am pleased that a few people report good customer
> service experiences, but this does not seem to be the norm. Aftercare and
> service is essential when you consider you are signing up to a 4 year
> contract. (The Cozmo and Animas customer service has been excellent - I
> cannot comment on others from personal experience).
>
> Minimed and Bubbles: You just need to review past postings on this site to
> know that many many people do experience bubble problems with the MM
> cartridge. I was unaware of the Leur adpater until last week when I saw
> someone wearing a 522 with the adapter. I guess it works, but it did look
> quite bulky.. the Animas is a small, neat and inconspicious pump. Although
> many do not experience bubble problems regularly, there have been numerous
> postings on this list on the various methods/tricks used to fill a MM
> cartridge and one person recently reported (on list) ending up in A&E
> because of bubbles and their pump did not alarm.. I personally feel that 
> if
> you are just starting pump therapy, the less nuances the better your 
> chances
> of success. The Animas cartidge has additional o-rings and is made of a 
> much
> sturdier plastic than the MM ones, which if you squeeze the MM cartridge 
> it
> actually opens up the o-rings and lets in air. The Cozmo cartidge is also
> easy to fill and didn't give us problems in this area.
>
> As far this 3 x an hour delivery, I must disagree with Diana. The Minimed
> goes for what it calls "pulse delivery" rather than continous infusion. It
> may well only be relevant for low basal rates and not have an impact on
> higer rates. All other pumps deliver every 3 mins.. hence the Spirit's big
> back page ad on this month's issue of Balance is a knock on MM's delivery!
> I have just spent over an hour looking for this on the MM website and can 
> no
> longer find the details! It was on their website back in February when I 
> was
> trying to convince Sarah to give the MM another go so she could have the
> CMGS. I also called the US customer care back then and was told that the
> pumps delivers in pulses and the pulse method more closely mimics the 
> body's
> natural release of insulin. I have also had my phone on redial to MM
> customer care for the last hour to try to clarify this but after repeated
> mailboxes had a recorded message saying "too busy to take the call". This
> was pressing the button for being a new customer, so I hate to think what
> service existing customers are now getting.
>
> The MM delivers in a minimum 0.05 increments or multiples thereof. So on a
> basal of 0.1units an hour this will deliver just 2 pulses an hour vs the
> Animas which delivers every 3 mins even at low rates. Even on a 0.5/hr 
> basal
> it would give 10 pulses.. so doesn't get parity of delivery to every 3
> minutes below this basal rate. The issues arise where for example basal is
> say 0.15/hr. Since the pulse starts on the hour.. you'd get 2 pulses of 
> 0.05
> in the first half hour but only 1 in the second half hour. This can be an
> issue for disconnecting and basal segment changes. So if you had basal set
> on 0.15/hr, for an half hour segment, you would actually get 0.1 delivered
> not 0.75. A greater issue is when using temporary basal rates.. so if you
> are reducing say for sports and lower accurate delivery is important the 
> MM
> can still only deliver in 0.05 increments. Please note I am talking about
> the actual insulin delivery rather than what you set and think the pump is
> doing!
>
> As far as pump choice, my understanding from the NICE guidelines is that 
> you
> should be allowed to choose the pump which suits you best..Yes certain
> hospitals do have contracts with Minimed (as Minimed is known to fund the
> nurses) but that does not mean you shouldn't push for the pump of your
> choice..after all you're then stuck with it --literally --for 4 years.
>
> The issue of waterproofness is to us quite important. Sarah must bolus her
> breakfast insulin 20 minutes before eating or she will have a high
> mid-morning spike. She boluses, then showers, then eats breakfast.. it is
> not a good idea to bolus then immediately disconnect. Similarly, in the
> evening, she may want a bath after dinner and before bed, so again,
> disconnecting is not practicle. Having said that, there are waterproof
> pouches you could put the MM in, but why add another hassle?
>
> With reference to the MM CMGS, my experience is of the older versons, but
> technically, its time-lag is quite significant. It doesn't cope well with
> sharp drops or rapid rises, but having said that any CMGS is better than
> none. The Dexcom will be in the UK by the end of the year and our personal
> experiences of it are fantastic.. their Customer care is also brilliant.
> Sarah managed to flush her first one down the loo and we were sent a free
> replacement immediately.
>
> I did not say anything against the Cozmo. We did pump with it for 4 years
> and customer service is good. However, in the first 3 months of this year 
> we
> went through about 6 pumps. Two were for over-delivery issues... the pump
> alerted for "non-delivery", the pump showed cartridges had around 40units
> remaining yet were completely empty! Others such showed error messages,
> buttons failed or screens went blank.
> Cozmo policy is to send refurbished pumps as replacements... we have
> received 5  replacement pumps in 4 years that failed to start up at all! 
> (3
> of these were whilst in the US and resulted in Sarah having to go back 
> onto
> MDI for 2 weeks whilst at diabetic summer camp). Cozmo recalled over 1000
> pumps in February this year because of over-delivery probelms, but
> interestingly only recalled US pumps and none in Europe. The Cozmo is a 
> good
> product but they have been having problems.. I am happy to hear these
> haven't affected kids on the CWD website.. but accuracy and durability 
> must
> surely be an issue when considering what pump to choose.
>
> With reference to Di's comments about having IOB calculations, carb 
> counters
> and bolus wizards.. these are handy time saving functions which are useful
> but not essential. Given the postings a few weeks back about people having
> difficulties with maths, surely these features  for them would then be
> invaluable. Sarah can calculate her IOB in her head and similarly 
> calculate
> food and adjustment ratios and boluses. However, as said, when starting on 
> a
> pump there is so much to learn and to take into account, having these
> functions does simplify matters. The IOB calculation on the Cozmo is based
> on straight line usage so is not accurate. I cannot comment on the IOB
> calculation of the newer MM's as I do not have experience of them.
>
> Interestingly, I dont know of anyone on an Animas who has then switched to
> another brand. Again, I do apologise if I have upset anyone on the list 
> and
> certainly have not intended to partake in "pump bashing". I have purely
> given our personal experiences of the various models. I'd still say that 
> the
> Animas is the Lexus/Mercedes of pumps and once integrated with the Dexcom
> will be the Rolls Royce.
>
> Karen Persov
> Mum to Sarah age 11.5 - diabetic since 18months old, also Hypothyroid.
> Pumping Animas2020 and Dexcom, HbA1c 6.6% (during puberty)
> .
.
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