Tuesday, September 06, 2005

Insulin Pump Woes

Just before Joseph left school on Friday, his blood sugar was 118. In the 45 minutes he sat on the bus, and the five minutes it took for him to walk the half block from the stop to our house, his blood sugar dropped 81 points-- to 37.

Of course, we did not discover this fact immediately.

"Mom!" Joseph called out as he walked in the door. "My pump alarm went off twice on the way home from the bus stop. It said ‘Warning, No Prime.’"

"Okay, let's take a look."

"Oh, and mom, I think I might be a little low."

While Joseph washed his hands and prepped the meter, I looked over his pump. According to the history menu, we had primed it the previous night (when we changed his set). Okay then. To be on the safe side, I re-primed. When I turned to give Joseph his pump, a beep sounded from his meter indicating that his sugar had been tested.

"Wow . . . I guess I'm really low."

So, what is it with 37? We've seen this number three times lately (in and among some 40s and 50s). It's like, if he's gonna go way low, it's gonna be a 37.

I don't know.

Anyhow, we treated the low, and Joseph was back up in 15 minutes.

Needless to say, the thought of him walking home alone at 37 was more than a little frightening.

Something else bothered me too. Something that's been needling at me for two weeks. On August 19th, when we'd gone through airport security in Spokane, a security person had actually tried, too late, to prevent Joseph from passing through the security screen. Strangely, he said it was "for his own protection." That's never happened when we've flown before.

Since that day, Joseph has had many precipitous blood sugar drops, despite pulling back his insulin to pre-vacation levels. I had assumed the lows were due to the honeymoon factor-- that his pancreas was simply spitting out higher levels of insulin. But maybe I was wrong.

You see, for one day, our first day back from vacation, the pump recorded Joseph's bolus and basal doses in the previous day's history. In other words, for one day, it experienced an odd malfunction. After I reset the date and time, it worked fine, but still . . .

So, because I was feeling upset, and fearful that his pump might not be functioning properly, I called Animas. After explaining the above to a pump support person, she said, "I can really sympathize with your concerns, but it sounds like the pump experienced what I like to call a 'hiccup.' If it was bumped or dropped, sometimes it loses its prime, and just needs to be re-primed. "

A hiccup. Hmmmm.

"You know I think I'd feel more reassured if we were just talking about a toaster. But we're not. This is my son. And this is his insulin pump."

"Yes, I know. And I understand. But they're really picky about the reasons for sending out a new pump. This really isn't a good enough reason."

"Okay then, " I said curtly, as the anger that had been churning in my stomach finally reached the boiling point, "what is your name?" And then rapidly, "Because I just want to make sure I know with whom I've spoken, in case we need to follow up here. In case there's a problem."

After giving me her name, "um . . . well you know, I was just thinking . . . that um, we might want to do this. Well, it's not something we normally do, but it might be a good idea here. I can send you a loaner pump so that you're not without a backup over the long holiday weekend . . . "

The loaner pump never came.

Fast forward to this morning. I went downstairs to make Joseph his lunch for school, and to go over his overnight sugars with Ryan. As I walked in the kitchen, Ryan was there waiting. And he did not look happy.

"Joseph's pump display is fading," he said, in a defeated tone.

I sat down.

"What?!"

"The left side of the display is gone. I don't know if what's left will make it through the day. He can see enough of the screen to do boluses, but I don't know for how long . . . "

Violently, I grabbed the phone.

Joseph's new insulin pump – his third in seven months – will be here tomorrow.

17 comments:

diabeticfeed said...

A hiccup? I love it. No loaner? Even better. Over the last few weeks, I've heard of 3 separate cases where pumps have stopped working, and the pump companies have been less than responsive to make things right. It incenses me.

I chose a Disetronic pump in 1999, for the simple reason that it came with a back-up pump. I got two pumps for the price of one. Ironically enough, while I've had to send my pump in for warranty service, I've never had to use the back-up.

Unfortunately, Disetronic has become Accu-check, and I have a feeling that they won't send two pumps. I know that I'll have to choose another pump soon, and while there have been many advances since I chose my HTron Plus, I'm not looking forward to it.

By the way, my father thanks you. I had been reading your blog for a while before you found the diabeticfeed podcast, and read a post that really hit home. I called my dad and thanked him for being there for me. (And of course, I thank you as well, for baring your heart. It's not in vain.)

Cheers,
Christel
www.diabeticfeed.com
diabeticfeed@gmail.com

Kathleen Weaver said...

This REALLY bugs me, because I have an Animas pump too.

I will say that they have always replaced my pump when I thought they should -- with my IR1000, I chipped the battery cover. And with the IR1250 they shipped a replacement a day early because I wasn't comfortable with what was going on with the pump.

I will give you that they were planning on shipping then anyway -- mine was one of the recalled ones.

Very weird.

At the same time though, they never did anything when I complained that the siren on my IR1000 wasn't loud enough.

Shannon said...

Consider getting Cozmo. I've never had a problem with their service. They've been nothing but accomodating.

Sandra Miller said...

You know Shannon, Joseph did a saline trial with the Cozmo, and really didn't like the pump. We also were not terribly impressed with the local support for the Cozmo.

Now, I loved the Cozmo software (see my "Parents of Prospective Pumpers" post), but preferred the Animas hardware, and local reps (that's why this incident was so upsetting-- we've always gotten terrific support in the past).

Ultimately, though, we wanted to let Joseph make the final choice.

Laura said...

i have never had a problem with my pump until this past weekend. Saturday I changed the batteries and then later in the day it kept saying the battries are almost dead .

Then when I would bolus it shuts down and restarts. Monday i called Minimed and they said they would send me a pump out it would be here today but it never came although the ups guy came and picked up my broken pump so now I been on injections since yesterday morning.

im trying to take humalog every couple hours till then

Gina said...

I have had so many new pumps in the four years I've been pumping, Minimed paradigm 515 just got the upgrade and i totally love it! the old minimed i had i hated it was broken like every couple of months but I have always received a new pump the next day at 9am, they are very accomodating i think! lol

Sandra, thanks for the post on my site!

Jamie said...

Sandra - how annoying! That's scary how quickly his blood sugar levels dropped in such a short period of time - it definately is NOT something you want to play around with. I'm glad they are sending you a new pump, but man - this is the 3rd one in seven months!?! Crazy. I do like hearing about people's take on different pumps though, as someday we will most likely be getting one for Danielle - the more I know, the better :) Hope the new pump doesn't give Joseph any grief!

Shannon said...

I should've added one more thing about Cozmo. Brendon will be on the pump for two years in Oct and he has never had a problem with his pump. With all of the knocking around it gets, it's never malfunctioned.

Shannon said...

I didn't see your comment back to me. Don't think I was disregarding what you said to me :)

Darrin Decker said...

Sandra

I am a firefighter/paramedic and have been wearing my pump for almost a year now. I have the paradigm 515 and it has been durable to say the least. I routinely carry equipment on my waist, radio, cell phone, fire pager and pump. I look pathetic, but it goes with the job and diabetes. Anyway, I am constantly banging them on doorways, counter tops, getting in and out of the car and on the ground when they fall off my belt. I have never had any problem with my pump. You mentioned the airport security incident, and I would suspect this may have had something to do with the pump failure. I received several warnings about high magnetic and radio energy whith my pump. However, three in seven months is terrible. I read a lot of information about the pumps, customer service departments, accessories, company history and anything else I could have gotten my hands on prior to picking a pump. I just recently had the chance to put the customer service to the same test as the pump. After missing a shipment of infusion sets twice, I called to check on the shipment status. After finding out that the shipment was waiting for authorization from the insurance company I informed the agent that I was nearly out of sets. The agent informed me that they would send out some free sets to hold me over till the shipment arrived. After agreeing to the free supplies I was told there would be a costly fee for the FedEx. After a short discussion about Medtronic’s history with my insurance company in an attempt to waive the shipping fee I asked to cancel my order and told the agent that I would just go back to my routine of injections. I thought my wife was going to pass out. She gives me that "you must be crazy" look. However, the agent was obviously giving me the same look. After brief pause, the agent informed me the fee would be waived and the shipment would arrive the next day. There is no perfect company out there, and definitely no perfect pump. Sometimes you just have to persuade them to help you. I have put both to about as rigorous test as I can get by with without the insurance company and medtronic telling me to take a hike and they both passed. I know it is hard to change pumps, we all resist change. If you don't see better results from your pump company you will most likely see more guys like me taking care of Joseph.

By the way, I picked medtronic because while sitting in the Endocrinologist office for a pump consult, I read an article in a business magazine about the top companies with best benefits and happy employees. That right, medtronic was right there.

Good luck with everything. I will bookmark your site and try to visit once in a while.

Darrin Decker
deckermd@alltel.net
Newark Ohio

Sandra Miller said...

Darrin,

Thank you so much for taking the time to share your insulin pump experience.

Like you, I did a lot of research before choosing Joseph's pump. About all three we considered, I found that there were both wonderful (e.g., we met a mountaineer who wore the Animas; almost every Type-1 child we came across wore a Minimed and loved it; our endo highly recommended the Deltec) and not-so-great stories (e.g., repeated no-primes on the Animas that prompted pump replacement; the Minimed pump did not alarm when a friend's child's cannula was kinked-- she ended up hospitalized in serious DKA; the front cover peeling off the Deltec). In addition, I looked through incident reports in the FDA's Medical Device Reporting Database (in order to get less anecdotal, and more broad information on problems with the pumps) I found that the only serious issues reported on the Animas involved exposing the pump to MRIs. That's not to say that other things weren't happening that simply weren't getting reported...

Further, I subscribed to the Insulin Pumpers newsgroup. There, I learned a lot about both the pumps, and the customer service provided by all three companies.

After all of this, in the end, I felt enough confidence in all three pumps that I decided to let Joseph make the final choice. After all, he'd be the one wearing the thing 24/7. And you know, after doing saline trials on all three, he had a clear preference for the Animas.

Now, so far, things are going well with Joseph's new pump. And we do have a back-up loaner pump in hand. Animas has really bent over backwards to make up for the serious gaff made by that first rep.

Frankly, I think we may be with the Animas at least until our insurance will cover a new pump. At that time, however, we will definitely re-evaluate...

Thanks again for your thoughts on this.

Sandra

BTW, I find it interesting that you agree with my suspicions about the airport security screen being the cause of the pump failure... hmmmm.

Anonymous said...

Hi,

I am glad to see your blog, I am looking for a new pump at the moment, and dying to find out about customer service. I am shocked about your experience with Animas, I know they had a hard time transitioning as far as customer service goes, from being a privately held company to being a Johnson and Johnson company, but I have never had an issue with them not sending me a new pump. I noticed when I first got the Animas pumps that I was "going through them" every couple of months, but recently, I have had the last one for over a year maybe two with no problems, so I think they may have updated their technology and worked out some kinks.

That said what I would like to know from anyone out there is about customer service from the different companies:
How are they negotiating with your insurance?
How are they with sending a travel loaner (cost, paperwork, hassle, etc.)?
How are they when you break your pump, or it just dies (getting one to you quickly, not charging you for sending it quickly, or for you returning it, tech support not making you feel like an idiot, tech support understanding when you've already "done all that" and moving on, etc.)?
When you call in to order supplies not treating you like a number, giving you a reliable cost estimate, shipping the stuff to you in a timely manner, emailing you to remind you that you need to order, hours of availability, website ordering service, etc.)? thank you for your help,
Katie

insulin pump problems said...

Hello, I also have an animas pump. I received a certified letter the other day from them telling me that they had sent me a replacement pump back on 3-08-05 and that i never sent back the one that was being replaced. I did indeed send everyone back! I have no record of it for they send their own pre-paid envelopes to send back their things. I went to the shipping place i dropped the envelope (containing the pump) and asked them if they could check for me, they of cource do not have any receipts from that far back, suggested i call DHL which i did, they told me they only could go six months back and that a man had called with the same problem. Is anyone else getting these crazy letters? I do not know what will happen, I wrote an e-mail to them telling them that i did indeed send every pump back to them, and that i would like this cleared up. will they charge me for this? I do not know what to do, i also called and left them many messages about it stating that i have returned them all! the same thing happend to me with the mini med company when medtronic took them over they said i owed them 250.00 (although the pump is going to be way more that this!) and that if i did not pay i would be turned over to a collection agency. I had paid them for everything! this was also from years before. How can these companys get away with this. I suggest to everyone to copy everything for your records. I never dreamed of making a copy of the return envelope but i will from now on. I would love to hear of anyone else with this problem and what they are going to do, for we do not have thousands of dollars to just give to them for nothing!

best regards,
Lori

Chadd said...

Lori, I have to agree with you that you need to make a copy of records in case something happens to prove that you have gotten something. I had learned this from my parents and once from myself. There is a person in the same city with the same First, Middle and Last name as I, along with 1 digit off on my Social Security Number. I can't tell you how many times, my electricity, phone, car payments, and the police coming knocking on my door and coming to my employment to serve a warrent, and to arrest me, cause of this other person not paying bills, committing crimes. I have gone to the point of having my name changed by different spelling, having my social security number changed. With documenting, I scan every bill, letter into the computer, creating it in a PDF format so it is easy to print, or even e-mail and post on my website, if needing for agencies to get access to it quickly (with password & login access of course) When I make a call, I always get their first name, what we had discussed. I keep all the log info in Microsoft Office Outlook, where I have everything organized. When I do the scanning, I create a hard copy, that gets printed and filed away in the file cabinet, and a copy get filed (archived) on my home server. Sounds like alot of work, I guess - but it has saved me countless of times in problems with companies who don't write down what was discussed over the phone. I have gone down to the point of actually recording the coversation and archiving the conversation on the server. Due to I have a home business on the side, I have this set up at home on my servers. I had worked for a collection company & at a Help Desk, and learned that DOCUMENTATION IS EVERYTHING!!!! But was told at the collection company, not to document certain things cause what isn't written down, isn't legal binding. Due to what collection companies & help desks, their software is written that you can't go back and edit the info. It gets time stamped, and if it gets audited or called into court, its a legal document. So as a consumer myself, I document and record conversations cause of the problems I have had in the past.

I have just started on my first insulin pump. I have gone with MiniMed 722 and love it. I have done alot of research on all the pumps. I think I pretty much have driven my Diabetic Educator up the wall by doing comparision, wieght, consumer reports, reports from others who have had problems with them. I pretty much did alot or research on these.

Sorry for the log ran out log....

James said...

My daughter has been on a Cozmo pump for 2 and half years now.

I used to tell people that it was infallible, then a couple of months ago, an alarm went off (a kind of siren actually) and it said 'depleted battery' or something like that. We changed the battery - no improvement. We called Smiths Medical (who own Cosmo) and they said they could replace the pump, but that it'd take three days to arrive. Meanwhile Phoebe's blood sugar was rocketing, and we were totally de-railed. My wife asked if there way any way to get the replacement sooner ... they said it could be expedited, provided we paid for the delivery ... $300 ... we paid, and 12 hours later a replacement pump arrived, flown in from Minneapolis (to NY). Awesome, but expensive.

That was a couple of months ago. And I'm sorry to say, the same thing has just happened again. Just as we were putting the kids to bed, that freakishly annoying alarm went off - same thing! We have spoken to Cosmo again, and they are sending a replacement pump, again.

May be time to start looking at alternatives ... but then again, my research tonight seems to indicate that all the pump brands have problems like this.

God I miss the days when we believed the Cosmo was infallible.

Anonymous said...

Hello,
I currently have a "Loaner" MiniMed 515, as my Paradigm quit while I was on vacation. When I do get a new pump, it will be my 3rd one (all MiniMed Paradigms) in 6 years. MiniMed has been very good to me, but I thought that I would look at other companies (Animas & Smith's CoziMore), hoping to find a more durable pump with some longevity. Any suggestions?
Thanks,
2scotts (wohlin1@yahoo.com)

Mom said...

My daugher (12 years old now) has been using the COZMO for 5 years now and has never had a problem. Even though the warranty ran out a year ago she's still using her original pump. The service we get from Deltec is awesome! Every time I've called for a new battery cap or glucometer, it's been shipped the very next day. And they always send her birthday and christmas presents. Now how thoughtful is that for a child.
The reason I went on this blog is because I'm thinking of upgrading her pump and wanted to hear what others are saying. She really wnats to try the Omni Pod but it's soo new I'm hesistant. Is anyone using the Omni Pod? What can you say about your experience with it?