Happy Pumpers

| Oct 1, 1998

My Observations of People and Pumps

For the past five years I have spent several days each summer as a medical staff member for our local diabetes camp. This is my third summer wearing an insulin pump at camp. We typically have one or two campers who pump as well.

This year has been different from previous years, and has proven to be a learning experience as well. Including myself, we had two nurses, a dietitian, a social worker, three counselors, and six campers who wore insulin pumps! I also started another camper on an insulin pump, which made a total of 14 insulin pumps among 150 people. One nurse was also waiting to go on the pump.

I made several observations concerning pumps and pump users during the week. I would like to share my observations to answer pump users' questions, and to help those considering pump therapy.

Observation One: Beating the Heat

The nation was dealing with unusual heat indices. Being from Oklahoma, we expect warm summers. Average daily temperatures of 105 degrees, however, were a very difficult thing to manage. The experience taught me a few things.

Eleven out of 14 pump users agreed that spray antiperspirant, when worn under a layer of IV Prep, made a significant difference in the length of time they were able to keep an infusion set from falling out. Another problem solver was Tegrederm adhesive dressing, which added significant strength and protection.

Observation Two: Informal Education Works

Doing a pump initiation at diabetes camp seemed odd but turned out to be very successful and a whole bunch of fun. After an initial standard teaching format, informal teaching occurred throughout the day. I think it is unfortunate that educators are not given the time or financial resources to do pump initiations over several days in real-life situations.

We had a dynamic dietitian (who also wore a pump), who could spend a few minutes teaching us each day at meal times. Along with her, I taught our young students the reality of carbohydrate counting and pump management. In the camp dining hall, food is served family style. Campers are expected to take appropriate amounts of food for their insulin needs. Being so similar to daily life, the dining hall was a perfect classroom.

Observation Three: Older Does Not Mean Wiser

Living with other pump wearers for over a week gave me the opportunity to view daily routines and practices. When blood glucose levels rise quickly and illness, diet and infection are ruled out, it is usually related to an infusion set problem. Such problems may be a leak in the tubing, a cannula that is bent or kinked or simply an infusion set that has been in place too long. Most educators would probably agree that if all else fails, change the infusion set.

When blood glucose levels are suddenly high, educators recommend acting without delay. Actions include giving a bolus with a syringe to receive insulin immediately, rather than waiting to replace the infusion set.

After being on the pump for a significant amount of time, people seem to leave out important steps of changing an infusion set. People get into a hurry, and basic step-by-step precision becomes a thing of the past. When changing an infusion set, it's important to remember the following steps that people tend to overlook:

  • Make sure the connection between the infusion set and reservoir is tight, and always check for any possible leaks in the infusion set.
  • Program the pump to deliver, and watch to see if a drop of insulin comes out the end of the needle before inserting the infusion set.
  • Use aseptic techniques established by your health care provider.
  • After removing the needle, prime the cannula according to manufacturer's recommendations:
  • Sof-set: 0.5 units
  • Silhouette: 1.0 units

The age of the pump wearer seems to make little difference. Our pump group ranged from age 9 to over 30. Those who had been wearing the pump for four months or less had sharper skills than those who had been wearing it for a longer period. The only exception was a fellow educator who had worked with pump patients, and frequently reviewed the basic procedures.

Lessons From Summer School

A pump basics review course, offered quarterly, yearly or biannually, would benefit many people. I believe, however, it would be difficult to convince long-time pump users to enroll in such a class. I spoke with pump users at camp, and none had initially reported any need or desire for review training. They quickly discovered through our camp classes, however, that an occasional review might not be such a bad thing.

If you have been on the pump for a long time, and your control is not what you would like it to be, contact your educator to review proper procedures, some of which you may have forgotten.

As with general diabetes management, insulin pump therapy does not lead to success without a few snags along the way. Learning to effectively problem solve is crucial.

Like countless others, I believe strongly in the benefits of pump therapy, and I am proud of the accomplishments I have made with my own diabetes management by using an insulin pump.

After camp, each pump user had learned a valuable lesson, including me. I hope that my observations will help you as you climb the ladder of successful pump therapy and diabetes management.

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Categories: Blood Glucose, Diabetes, Food, Insulin, Insulin Pumps, Syringes

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