Wednesday 8 January 2014

New year. New pump.

An insulin pump becomes a part of you when you wear it every day.  It becomes your friend; your partner in crime; your invisible ally; and even your enemy at times. But it is a part of you, come what may. 

As this blog turns four years old on January the 24th, having been started the day before my pump journey began, the time has come for a new pump to be chosen. Pump warranty lasts for four years. And as this has proved such an effective self-care tool for me (with a million pointers from my long-suffering (but well paid) team, and lesser-paid members of the DOC) I have earned the right to keep this tool, according to UK standards.

The way I see it I have three viable options. 

My Paradigm Veo has been my lifeline for the last four years and I could not rate Medtronic, the company behind it, more highly. Their customer service is second-to-none, their technology superb and their customer engagement on the up all the time. But pumps have what the world likes to call,  'Unique Selling Points'. Much like a car, phone or long-desired gadget you may still be delighting in after Christmas, there will be something about each pump that best suits your life and your needs. 

When I started the Veo I still didn't fully understand the mechanics of Continous Glucose Monitoring (CGM), but I knew that Medtronic were the only company offering this in the UK, which is why I so wanted one; just to have that option. Patient choice.  The pump teamed with CGM has a low glucose suspend feature which, if you suffer from unexpected hypos - particularly overnight - is a godsend. 

But, travel a few years forward and having tried the Enlite CGM and come to learn about the Dexcom system which people seemed to so rave about, I fell in love with the Dexcom way of doing things. And this was the system I ultimately chose. Given that fact, perhaps the USP of the Veo isn't quite so relevant to me anymore? 

My second option was to go tubing free. You know those people who say the tubing is no big deal? Well, I. Am. Not. One. Tubing is the bain of my life and for me, the one part of pumping which pisses me off. Anyone with cats will understand  the kitty playground you become during set changes. Anyone with doorknobs in their houses beware, should even an inch of tubing escape from your waist area, be prepared to learn what 'involuntary tubing-induced reverse' feels like. 

The Omnipod is the only tubing-free patch pump system available in the UK, and since the upgrade to a newer, smaller pod, is freakin' tiny! It's about a third the size of normal pumps and can be place anywhere on the body you can inject, being controlled with a wireless remote-control. Sex. Ee. 

My experience with Omnipod all those years ago when they first landed on our shores was not good. I won't go into it again but they seem to have turned a corner. This time my demo pod arrived only days after my enquiry with a bright, bubbly letter. Their communication has been good and word on the street is their popularity is growing all the time. 

But I keep a close eye on their Facebook group, because I'm a nosey PWD who likes to know what's going on, and the frequent complaints about pod failures, some people claiming up to 10 month (seriously?!) is something I can't overlook. You see, the next pump I wear will, I hope, bring me through at least one safe pregnancy. I have been using steel cannulas for a year now because Teflon ones kink like a bitch, and switching to steel ones means I've removed that risk factor all together.  Omnipod don't have steel cannulas, a USP I have come to rely on. 

Perhaps that's why, despite its attraction and apparent popularity with Omnipod converts, I haven't even taken it out of the box. It still sits neatly in my (rapidly growing) diabetes drawer under the bed, still resting in its case. (By the way, anyone else's bedroom/kitchen/living room drawers being taken over by diabetes paraphernalia?!).

So I have one last option: the Vibe. The Animas Vibe is a tethered (meh) pump, but it has several features which - for me, for now, for my life -  make this one a major contender. Firstly, the Dexcom I so treasure can now be integrated onto the screen of the pump in exactly the same way that the Veo's could all those years ago. Granted, I have a (very expensive) handheld receiver that I prefer to use (easier during exercise/work meetings/dates/driving) but like those steel cannulas, I have come to rely on my Dex so much, and plan to make it a huge part of my diabetes management during pregnancy, that if anything were to happen to my handheld receiver I would be screwed. We can't afford another one, end of story. So as with the Veo all those years ago, if the worst were to happen and it broke/got stolen/ran away to Rio, I would have the back-up option of my pump which can act as a receiver and display the information to me. 

Secondly, my husband Jamie and I hooked up because of a surfing holiday to Cornwall. It was one of the fondest times of my life and for three years we went back every year to the same place, and beach, where we became a couple whose futures were intertwined. Problem was, with an insulin pump that was barely splash-proof, I had to go without insulin for the 4 or 5 hours we would be at the beach, and sure enough each time I would have angry tell-tale high BG readings for hours afterwards, making it an increasingly miserable experience. The Vibe, you see, is waterproof. Problem solved. We could surf again. I could Kayak without trying to squeeze my pump into waterproof cases that barely work and worry the whole time that splashes of water may render my pump useless. The Vibe, solves that problem. 

It also has steel cannulas. And a customizable food database ready for (*squeezes eyes shut and prays to a god she doesn't believe in*) a pregnancy. 

Have you lost count of the USPs yet? Yeah, me too.

The choice was obvious to me, too. 

I've been hooked up to my cutesy, pink, pumpette now for 48 hours. Unlike my initial learning curve of 'ohmhgodIpressedthewrongbuttonamIgoingtobreakit' when I first plugged in the Veo,  I have learned that the way a pump functions is pretty much the same from one pump to another. A bolus is a bolus; a temp basal is a temp basal. There are, I guess, some features that seem awkward to me because the vibe does them differently to the Veo. Mechanics are louder on the vibe but the screen is easier on the eye. Some menus are more complicated, some things are much easier to find. I know that familiarity will come with time. In a matter of weeks, maybe days, I will forget the 'old' pump and simply remember the new. 

So here she is, the still-nameless-but-rather-beautiful, bath-tubbing, Animas Vibe. 

And so the next leg of the journey begins. 

The mandatory Animas water action shot


  1. Oooo excited - this is the combo I am hoping for too when I finally get there :) Good luck with it all - I managed 2 healthy kids on MDI so you will do great with it all and a pump and CGM - a great tool set to have onboard. Enjoy the surfing and thanks for blogging about it all too, it's great to hear someone's experiences.

  2. Thanks Katherine :) when are you due to renew?

    You have no idea how reassuring it is to hear from people who've done well during pregnancy. As someone whose controlled went AWOL for many years, I struggle to feel calm about pregnancy. Heading 'it'll be OK' is priceless. Thank you.

  3. I'm in exactly the same boat - I started pumping January 19th four years ago :) I've gone for an upgrade on my animas, for pretty much the same reasons you have - I want the dexcom cgm, especially for pregnancy. I had a little bit of a fight with my clinic because they're more comfortable with medtronic during pregnancy, but I know it's been ordered, so I'm just waiting for it to arrive :) And now it's all about setting up the self-funding side of the cgm, since there's no way in hell I'm getting NHS funding! If you're thinking about pregnancy, have you been to your clinic for pre-conception stuff?

    1. Hey Angie,

      I'm so pleased for you! The Vibe's obviously really hot stuff at the moment! Di you have the 2020?

      I've been to my clinic for pre-pregnancy counselling, which was basically an opportunity to ask questions and reassure us. Is that the sort of thing you've been to? I think we're a little while away from it yet as we've not even had our honeymoon yet, and we'd planned to travel for a couple of months, but hopefully that will be happening later this year!

      I'm self funding CGM too, but you know Animas are the cheapest ones to buy them from? And often sensors last 3 weeks easy (mine's on day 19 and help down with a bunch of tape but still going strong data wise! :)

    2. Yeah, I had the 2020 before, and I really liked it - I did some research on the other pumps and talked to some reps, but nothing gave me all the options I wanted like the Vibe does. I've spoken to our local rep about the CGM, and he's suggesting that I arrange a meeting with him and a DSN a couple of weeks after I start on the new pump, and going from there. I've found blogs like yours really useful for information about CGM and costs etc! :)

      We've had similar pre-pregnancy counseling - I dragged hubby along to the appointment so he could see how these things work! I've also been referred to the pre-pregnancy clinic, which is run by DSNs and midwives, as apparently in my clinic they like you to start going there if you're planning on trying within the next year! We wanted to get everything sorted, so that we could make the decision ourselves as to when we actually wanted to start, and they've said they're happy for us to start trying whenever we like, as I've been on folic acid for three months, which is a little bit terrifying as the ball is now in our court!

  4. Exciting times! I think with having the handheld Dexcom receiver and the Animas combined pump you have the best of both worlds. My Dexcom has turned up today (it feels like Christmas has finally arrived!!!) Only downside is having to wait five hours for the receiver to charge up and with it being the time it is now I think I'm going to wait until tomorrow to get hooked up. In some ways I wish I'd gone for the Animas too rather than the Accu Chek Combo, purely from the Dexcom cost side of things, however I do like the fact that I can have the pump tucked away and just use the remote feature of the Combo. Am really looking forward to using the Dexcom! Will keep you posted. Jonathan H

    1. Hey Jonathan - I'm so sorry, I wasn't able to reply immediately the other day and then completely dropped the ball!

      I'm so glad your Dexcom has arrived, I'm sure you will love it. Like you said in your last comment, the not knowing makes it so much more stressful. The Dexcom just removes that completely. Granted there is the odd spurious reading here or there, although most of the time if I get a strange reading I do another blood test and low and behold, it suggests the CGM was the correct reading anyway!

      I do like the idea of the remote control and it's the only thing the Animas is missing. For me I don't mind it too much, but it is such a great tool hopefully they will develop even a basic remote control for it.

      let me know how you get on. If you need a good step-by-step insertion guide (I found the one in the book a little confusing) then I find this video a good guide

      Mainly because the sensors are so costly you don't want to slip up! :)

  5. Thanks Anna, appreciated, I will indeed. Just been watching the tutorial and as you say it's not the best. I think the various YouTube videos are more useful! Just hoping I get the same success with sensor longevity!

  6. :-) My husband has been following your blog for a while now, and I've finally caught up! Just to reassure you, I've had diabetes for 24 years now, and have had 3 perfectly healthy, beautiful babies (now 6, 4 and nearly 2). I would have really struggled with the rollercoaster of blood sugars that pregnancy brings without a pump!

    I'm also a little envious of the fact that you (and seemingly a fair few other people, judging by other comments) have so much choice over your pump. The PCT I am under is incredibly prescriptive and basically is very, very reluctant to hand out any pump which is not made by Roche. I find this SO infuriating (a few years ago I fought an appeal against their decision to give me yet another Roche pump, arguing on medical grounds that other pumps would be more suitable to me as an individual. Sadly it made no difference, and their justification is that it is cheaper for them to use Roche for all of their patients, regardless of individual need). I will be due my next "upgrade" in summer 2015, but am hoping that having changed to a different hospital and consultant (bizarrely enough, still within the same PCT, but seemingly more open-minded), I may be allowed a little say in the matter this time round.

    I hope you are gradually getting used to your new pump! I look forward to following your blog regularly now, rather than reading it over my husband's shoulder! P.S. If you think the combination of a cat and pump tubing is bad, I won't even begin to tell you about the mixture of a baby/toddler and pump tubing! :-p

    1. Hi Bella,

      I completely understand your frustration! My experience working with INPUT showed me how many gaps and variations there can be from clinic to clinic. But you do have a right to choose the right pump for you, and even though a clinic may be uncomfortable with it, you should - within reason
      - be encouraged to explore the best option for you.

      Your approach of moving hospitals is spot on for improving your chances of getting a pump you would prefer, but INPUT may also be able to give you some advice if you'd prefer not to move hospital (for ease or convenience, although it sound like you may be looking forward to the change). Their link if you wanted some advice or to see what your options *should* be, is

      And thanks for the reassurance about babies. The more I hear stories of success the more I feel it's something I could handle. Thank you! (And for the toddler-tubing combination warning!) :)

  7. Hi,
    I've been following your blog for a while now as I feel we have been going through many of the same situations. I've recently upgraded from a Paradigm pump with the old Sof-Sensors (go harpoons!) then Enlite to a Veo with Enlite, hoping the accuracy of the Enlite would improve with the new pump. Up to now, I've been disappointment with the results... I'll soon have the option of switching to a Vibe with Dexcom, but I'm a little apprehensive about the switch. I'd like your opinion on a couple of things as a recent switcher.

    - Do you miss the ability to scroll back on your CGM graph to see actual values?
    - Are the Vibe menus as bad as I heard compared to the Veo?
    - How does downloading work with Diasend? Are the reports comparable to the Carelink ones?
    - I had the chance to play around with a Ping and was surprised (worried?) about the speed at which the bolus is delivered. Do you feel a difference? I would also be worried about the fact I wouldn't have a chance to catch a mistake choosing my bolus since it delivers it in 1U/sec. With the speed at which I go through the process, mistakes tend to happen from time to time.
    - Do you really see a difference between Dexcom and Enlite? I can't seem to make my Enlites last longer than about 4-5 days before values become erratic.

    Thanks and best of luck with your transition.

  8. Hi Steph,

    Firstly, thanks for reading! :) I think us PWDs go through a lot of the same things at the same times but before we had blogs we really didn't know it! So I'm glad some of this resonates with you.

    With regards to your questions:

    1) The first thing I noticed about the Dex was that you couldn't scroll back and frankly, I was disappointed. However, that seems to have been a bit of a 'grass is greener' complex as since I noticed it, I have never once thought 'if only I could see the number'. Because it shows trends so clearly the specific number isn't as important for me as it still shows me being around 5 or 17, which is still very valuable data. Also because the accuracy feels so much better I have confidence that the Dex is right, whereas I didn't always have that confidence with the Enlites.
    2) I've only ever heard one person say they didn't like the Vibe menus and had they not said anything to, me, I don't think I would have noticed the difference. There are little annoyances, for example, if you want a 24 hr temp basal on the Veo you can just press 'down' once and it is immediately selected. On the Vibe you have to go all the way 'up' through the hours up to 24 rather than being able to land straight on 24 hours, making it more time-consuming. Also on the Veo the 'up' button acts as 'back' in some menus whereas the 'up' button on the vibe doesn't do the same, so if you go into a menu by accient you have to scroll right the way down to 'main menu'. That said, I am being EXTREMELY fussy because I want to be as critical as possible for the sake of being as detailed as possible. The realistic difference is an added second or two here or there. I certainly haven't got lost in any menus and don't find it frustrating. And I am a very fast-mover (like you, by the sounds of it.)
    What I might do if you like is a direct comparison of the two systems delivering a bolus and working through some menus?
    3) Diasend/Carelink - I haven't actually done this yet so jury is still out. That said, I was diabolical at doing the carelink. I mean I literally did it twice in 4 years! So I might try and find a fellow blogger who could give you a much better idea if you like? I think Grumpy Pumper and Understudy Pancreas both utlise that.
    4) I too was worried about the bolus speed. In fact the first Mio set I had in felt a little awkward and the bolus 'stung' at dinner time as I was delivering 9 units in under 20 seconds. But again, with my latest set I haven't noticed that at all and have delivered equally as large amounts. I have mine set to slow which also means there is a pause in between the units so if you did make a mistake that you knew immediately, you would be able to catch it after the first unit (also the Vibe is equipped with an 'any button bolus halt' feature, so you can press any button and it will immediately stop. The Veo you need to do the full 'suspend' process to stop it). Again I will do a video if this will help choose the right pump for you.

    1. 5) With regards to the Dexcom/Enlite I have absolutely no reservations that the Dexcom is a better perfomer on accuracy. I am just about to restart my sensor (which will be day 22) and my test this morning was 0.7mmol away difference between Dex and BG meter. Taking into account the 10-20 minute time-lag I consider that superb. The Enlites were so vastly better than the Sofsensor that I thought they were great, at first. However, something still didn't make them 'worth it' for me to pay out for it, whereas by day 3 on Dexcom I was sat their looking at our budget with my husband (who was equally as impressed) finding ways to afford it. And due to the length of wear you can get out of a Dex, it costs £50-75 a month for my CGM (wearing it full time) whereas the Enlites I never got more than 8 days, meaning full time cost would have been in the £150-200 mark. FYI which part of the country do you like in? If we lived close enough I'd be more than happy to meet so you can have a proper nosey at the system.

      There are still the odd strange result on the CGM (mainly if I haven't calibrated for 12 hours) but that;s why they have around a 90% accuracy. They even recognise that there can be an odd result, hence action should always be backed up with a BG reading. That said, on a number of occasions I've done a 2nd blood test as the reading disagrees so much, and what do you know? The second BG reading totally agrees with the CGM, making you wonder if the blood results are as accurate as they are supposed to be.

    2. I hope you wanted a 4000 word essay reply :)

    3. Anna,

      I appreciate the detailed answer. I think it will help with the decision when I get to that fork in the road.

      To me, it's a choice between a very decent pump I know, with low glucose suspend and a good customer service (95% of the time) but an inferior sensor (which kind of offsets the appeal of the LGS) or a new pump, waterproof, better sensor integration but with a few quirks (bolus injection speed being one of the for me).

      BTW, thanks for the invite for a demo, but I'm in Canada, so it would be a little hard to pass by ;)

      Keep us updated with your transition to the Vibe, I know I'd like to know more about it.

      Best regards,