Our daughter just proposed a pump break. My husband and I agreed that she is entitled to a break after 7 years of constant wear, but we’ve asked her to please wait until after the Girl Scout camping trip she and I are going on tomorrow. We’ve gone to shots in the past for a couple days at a time while waiting for a replacement pump when hers died, so I’m sure it will be fine. I just really don’t want to deal with middle-of-the-night corrections with syringes at a campsite, climbing into a tent full of girls. So much easier to just use the remote for her pump!
So, she’ll be starting her break on Sunday or Monday. We plan to use the pump to calculate boluses. Any other tips or comments on taking a pump break? This will be the first time we’ve gone back to shots for more than a couple days.
My son has been taking a pump break for the last few weeks. If your daughter does a good number of corrections a day ie sugar surfs don’t forget to buy a good number of syringes. Also pen cartridges are a super easy way to carry insulin rather than vials. Plus you don’t have to inject air.
Good idea on the pens. She have an endo appointment next week, so I’ll ask about a prescription for those.
Yes, syringes are a thing of the past. Get re-usable pens that dose in half units instead of the disposable pens that can only dose minimum 1 unit - either the NovoPen Echo for Novolog or the HumaPen HD (or whatever it’s called, I’ve only used Novo pens) for Humalog. Treat the pens like a pump and inject as many times as necessary. Try to use a more modern basal than Lantus - either Levemir which can be taken every 12 hours and adjusted, or Tresiba. You can use Regular insulin which can be purchased cheaply over the counter at Wal-Mart to simulate square wave/extended boluses.
Actually I think syringes have place. In addition to doing things with them that you can’t easily do with a pen, they are much more compact. When my son wants to go somewhere without his bag, he can fit the meter/strips/syringes, and a pen cartridge in one pocket. 1/2 unit reusable insulin pens are very convenient when size isn’t an issue.
Fair enough, I don’t have much, if any, experience with syringes but never had a problem fitting a pen in my pocket. What can they do that a half-unit pen can’t though?
You can pre-load the syringe with a fixed dose. So if you want to give a shot while moving (cyclying, running, rockclimbing) then a syringe is nice. I think @eric is pretty much the only one who does this
I only use a syringe as an emergency backup to draw insulin out of my pump or to draw insulin out of a pen if I have a pen failure. Never had to do either but I keep them around.
For camping MDI I would do Fiasp/Levemir and pretty much do everything like a pump. I did MDI with pens for years before going on the pump. The only thing you loose with MDI is ability to play with temp basals. With MDI I kept track of IOB with xdrip+ and I just bolus calculator in my head or with a cell phone calculator.
As @Scotteric says, with levemir 2 times a day you have some basal adjustment. When I went hiking using levemir, I would cut my morning levemir by 50% or more and that would usually be enough to stop me from eating too much hiking candy.
@sahmcolorado - Has your daughter tried the Omnipod? I use one and I do not even notice it. It may be easier than dealing with tubes for some people. (Actually I just searched for where my pod was and discovered I was earing 2 of them to be fair one was on my back by my spine and the other was on the back of my arm.)
It is easy to carry syringes with different sized needles for IM or other uses. Mostly, the benefit is just size, although you can also easily mix different things in a syringe as well. These aren’t “common” things, but all have a purpose.
My son, when pumping, always carries a couple of syringes and a pen cartridge of insulin in case he needs to make a quick IM correction.
Good to know, I’ve never done an IM shot or mixed insulins, so didn’t think of that.
I do IM into my calf muscle with a pen. I just have a little bit of skin there and no fat so I can reliably hit the muscle when I flex it.
Harder to do when using a pump
@sahmcolorado Don’t forget you can use xDrip+ as a fairly accurate dose calculator, IOB calculator, and low predictor. Just go to settings>xDrip+ prediction settings and input your C:I ratio, DIA, and other information. Then just be sure to enter carbs and insulin dosages in xDrip+ (just tap the eyedropper icon).
I don’t use a pump, don’t want a pump. Been MDI with various insulin for 48 years. XDrip+ makes it very easy.
Thank you to everyone for your thoughts and info on this. I’ll be interested to see how this goes. She doesn’t want to pay attention and stop what she’s doing to give herself a bolus on the pump. I can’t imagine that she will want to bother with either a syringe or insulin pen every time she wants to eat something. But this is interesting… she said that she thinks she’ll remember better because it is something different. Like that a break in the routine will help her pay attention. I think that may be true.
That makes my leg hurt just reading that.
My son says it doesn’t hurt much, and the insulin hits him much faster than traditional injections
Her basal rate changes so much during the day and night. What do you know about how this will look with long acting insulin?
Probably Levemir would be your best basal bet.
There is no perfect basal insulin. They all have pluses and minuses. But, if you have a difference between night and day - depending on her dose amount - Levemir might be your best option.
The duration of Levemir is dose-dependent by units per kilogram of weight.
If you don’t mind sharing her total basal amount per day and her weight, I can point you to some idea of how long Levemir would last. It’s super easy when it’s 12 hours, because this would let you split it into 2 doses per day. That’s the ideal duration for people with a difference between day and night (for example - one amount in your shot at 8am or 9am, and a different amount in your shot at 8pm or 9pm, works great).
But it depends on how much she needs. If it lasts like 16-18 hours, it becomes a bit more tricky. And Lantus unfortunately falls into this range for a lot of people.
What I meant to say is that she has a lot of variation throughout a 24 hr period. The duration of each basal rate is far less than 12 hrs.
Depending on how much she takes, Levemir can last anywhere from 6 hours to almost 24.
The nice thing about Levemir is that the duration is very predictable.
If she is in the 6 hour range, that can give you some flexibility, but it won’t get her completely through the night. You can use both Levemir and Lantus to cover higher amounts at certain times. Or small amounts of NPH at night to also cover higher needs during the night.
Here are Levemir durations based on units per kilogram of body weight:
|Dosage amount (units / kilogram)
Make sure you convert body weight to kilograms.
If you want to share her basal amounts per hour, I can help you come up with a plan.
I’ll post her basal rates when I get a chance.