Thursday, February 23, 2006

The Color of Progress

About two months, ago I received a call from an Animas Pump Support Rep. He was wondering if we could return our back-up insulin pump.

Typically, "loaners" are provided if the user will be traveling out of the country.

Or, if someone's mother is at the end of her rope because her son is on his third pump in seven months.

"Could we just hang on to it for one more month?" I asked him, "This may sound superstitious, but if we could get past that four-month mark... the time when we always seem to have trouble, I'd feel a whole lot better."

Well, this rep-- understanding the concept of good customer service-- granted my request. In fact, he said we could hang on to the loaner for two more months, if that would make us feel more confident.

Good thing, too.

Joseph's numbers were pretty funky all day yesterday. He had a persistent low at school-- the kind that adamantly resists treatment. It took almost 40 minutes and a whole lot of glucose tabs to bring him up from 60 to 82.

He was high the rest of the afternoon, despite corrections.

Last night, Joseph was due for an infusion set change-- I had hoped this might help alleviate some of these wild fluctuations...

But all it would yield was more trouble.

You see, when I came to the "prime tubing" step of this set change, each time I held down the "prime" button, the pump stalled.

On the third attempt the pump froze completely, displaying an error code and a message that read "Call For Service."

This might be a good time to mention the phone message I'd received earlier in the day from my friendly Pump Support Rep. It seems our two-month extension was up and it was time to send back that loaner pump.

Uh huh.

So last night, while holding the ceased-up pump in my hands, in a state of near shock at the realization that this was our THIRD pump malfunction-- I called for Service.

After I recited the error code on the pump's display, a very calm Service Rep explained that "because the pump is always doing self-checks, it occasionally needs to be re-booted. Just take out the battery, put it back in, and do a full rewind."

"But what about the stalled primes? And we've had some funky blood sugars today. Should I be concerned that the pump might not be working properly?"

I asked these questions, hoping for some serious reassurances.

And in a very serious tone, the Service Rep responded.

"Don't put the pump back on him. Sandra, we'd rather be safe here. We'll send out a new pump right away."

Pump Number Four is en route.

We completed the set change using the silver loaner pump (all three of Joseph's pumps have been black, so this was quite the novelty for him).

"Mom, this pump looks so new," he said as he turned it over in his hands, "And I like the silver... it looks just like a cell phone."

At about 10:30 pm, Joseph's blood sugar was 143, and he was finally off to bed.

By 12:30 he was 241.

Two hours and one correction later, he was 289.

Two-and-a-half hours and a second more aggressive correction later, Joseph's blood sugar was 324.

No. Way.

Ryan, who'd been doing these overnight checks, wisely gave Joseph a MUCH more aggressive correction via syringe.

Within two hours Joseph's sugar dropped to 187. Less than 30 minutes after that (at breakfast) he was 138.

The very first thing I did this morning was change his infusion set.

As he pulled out the old set, we all noticed that the cannula was bent completely to one side. In fact, the cannula looked as if it had never even entered his skin.

Another horrifying realization... from 10pm until 5am, my son had likely received no insulin.

Thus it was no surprise that just before leaving for the bus stop he said, "mom, I'm feelin' a little nauseous."

A left hook, right to the gut.

"Honey, do you think you could pee real quick before you go... just so we can check for ketones?"

He's had ketones only once before, and they were trace; he'd never even had them at diagnosis.

But he had them today.

Almost immediately after dipping that ketone stick, it turned a deep shade of pink.

Small ketones.

"Let's have you drink a large glass of water before you go, and I'm gonna kick up your basal rate for a couple of hours." (We'd been conservative with his breakfast bolus because he was coming down so fast... )

After he left, I called the school nurse to give her the heads up on what was going on. To make sure that at the slightest sign of trouble, they would check for ketones... and call me.

So far so good. His sugars were in the low 130s at snack and right before lunch.

And he sounds good.

But man...

In the meantime, I keep thinking back to something Joseph said this morning, right after breakfast:

"Mom, Dad, I want to upgrade soon to the 1250, and this time I want a silver pump. "

He paused a moment, looking thoughtfully at the loaner pump in his hands.

"Because, you know... " he said, looking up at us with an absolutely earnest expression.

"Silver is the color of progress."

17 comments:

Shannon said...

"Silver is the color of progress". I love it.

Have you considered switching pump brands altogether? Brendon has been on the Cozmo for 2 years and we've never had a malfunction.

Caro said...

I guess, all in all, everyone has done a great job. The rep letting you have the loaner, Animas are sending you a new pump right away, you and Ryan navigated the high sugars and now the the ketone issue and Joseph is well... great!

I have a silver IR1200, and for me, Silver was most certainly the colour of progress, after three years of headaches, multiple malfunctions and associated unnecessary highs. (Not with Animas!)

Funnily enough, I also had three IR1200s in seven months. The first one went belly up at three months. It absolutely refused to complete a prime cycle and the screen went wonky at the same time. It seems it may have allowed water to leak in.

The second pump lasted three months, but for a different reason: I finally got the approval to actually buy my own. Yes, it took six months of letters, sweat and tears to get the NHS pay for the upgrade my consultant requested, but the company that supplies Animas here patienty kept me pumping on a loaner, and with free supplies, for all that time! Awesome.

My current IR1200 has been going for three months, so I'm keeping my fingers crossed!

Kassie said...

I say keep that loaner indefinately.

That silver is kind of snazzy ;)

Penny said...

What is it about silver? Riley's pump is blue. But, at the training today they had a silver one that he played with. When we left, Riley decided he would now like a silver pump. He liked it better. All I could say was "Too late now kid." I hope the problems are not associated with the 1200 and not the 1250. The 1250 is what Riley has. It does seem that Animas has been somewhat accomodating though.

Tyler Wolf said...

For me, the scariest thing about being on an insulin pump is being disconnected and not realizing it. There have been times when I unintentionally disconnected the pump from my body while changing clothing and I consequently slept all night without insulin. Sadly, my pump does not let me know when I’m not connected. It just continues pumping. I’ve woken up with some very high blood sugars and nausea as a result.

Kerri. said...

Have I ever told you the story about the dinner at Olive Garden two years ago, with a pitcher of Sangria and a severely kinked cannula? The one about bloodsugars clocking in close to 500 mg/dl for three hours, moderate ketones, and a state of True Panic? The one where I called my mom?

Silver may be the color of progress, but dark pink is definitely the color of chaos.

:) I'm glad you guys all recovered from that ping ponging. Best of luck with the new (progressive) pump!

Sandra Miller said...

Shannon -

Switching pumps at this point would be really tough-- as our insurance won't cover a new pump until this one falls out of warranty...

But in three years, yeah we'll give the Cozmo another look.

Caro -

You're right. I think given the situation, we all did pretty well-- pump company included.

By the way, after I called my "Friendly Pump Support Rep" and told him about what had happened, we spent over half an hour on the phone troubleshooting the malfunction. Then, he called back later in the afternoon "to make sure Joseph was okay."

Kassie -

Yes, I agree-- that silver pump looks quite snazzy. I am definitely gonna see if he can keep that one.

Penny -

Joseph still uses the IR 1200, so it is possible that the issues we've come across are specific to that model... But as I say above, Animas has been tremendously responsive during all of this.

Tyler -

The fact that Joseph had been without insulin for so many hours was definitely more frightening to me than our third pump failure.

And Kerri -

Thanks for the perspective :-)

We're having a much calmer night this evening... hopefully things will stay that way.

Shannon said...

Aw that sucks that you have to wait. Hang in there.

Ellen said...

Kudos to Animas for the great customer service and even greater kudos to you for trusting your instincts and holding on to a back up pump! Whe Z first started pumping, we bought the Disetronic because it gave you 2 pumps instead of one. I wish that existed today.

We have a Precision Xtra meter only for ketone testing. Urine ketone testing shows hours old information. The research is clear that testing blood ketones is far more accurate and timely.

Nicole P said...

Yikes. Disconnected without knowing it... The worst.

I've had a day like the Olive Garden Day. Superbowl Sunday, Patriots v Panthers (I don't remember what year), eating and having a few drinks, testing at "High --" you know you've got a problem when your monitor registers your sugar with a word instead of numbers -- oh and then there were the large ketones. Feeling as sick from the sheer terror as from the high glucose level, as I pulled back the tape from my site and realized all I could smell was the insulin that I hadn't been getting... That smell.

Two injections, a changed infusion site, enough water to satisfy a large zoo animal for a day or two and four excruciating hours later, the Pats had one the Superbowl and my bloodsugar was finally under 200.

Grrrr...

Now, you'll see me, at least three or four times a day -- usually more -- reaching to my hip or thigh or abdomen, just to be sure that that cannula is right where it's supposed to be...

Nicole P said...

PS "Silver is the color or progress" is now running across my computer screen... You've got an amazing kid there, Sandra.

Allison said...

Ah HAHAHA!

Aw man.

Can I take Joseph home with me? He's so cute...

Next time someone asks me their opinion on what color they should get, I will absolutely say, "Silver is the color of progress." Brilliant.

That said, my Minimed pump is purple. But that's only because purple is my absolute favoritest color in the entire world.

But silver would be a nice second-choice. All high-tech and snazzy.

Sandra Miller said...

Ellen-

Thanks for the tip. I'd read about the Precision Xtra a while back on Wil's blog... even asked our CDE about getting one through their office, but she said the urine sticks should be just fine... hmmm.

Anyhow, went on ebay this morning and snapped up a Precision Xtra for a song... now I'm on the hunt for some blood ketone sticks.

Nicole -

Oh yes, that smell... like a Band Aid...

Makes that Super Bowl all the more memorable, doesn't it?

And hey, I showed Joseph your comment-- the boy was smiling ear-to-ear when he read of your new screen saver.

Allison -

No, I'm afraid you cannot have him :-) At the rate this kid is going, I'm gonna be beating them off with a stick by the time he hits his teens-- probably before.

And yes, I thought his comment was brilliant, too.

Tommy said...

Jenny says:

Sandra,
Those ketone days to come scare the heck out of me. I just recently acquired a precision xtra also. Today I picked up 8 sticks at Shopko for $31. So expensive, and for some reason not covered by our insurance. I will have to call our insurance and ask why. People have told me that you get them on-line for 8/$24.

I hope you and Joseph are feeling back to "normal" soon!

Wil said...

Hmmmmm....that's a pretty high failure rate. Makes me glad I went with the Cozmo, not the Animas.


But, it doesn't come in silver. Such a pitty.

Anonymous said...

Reading your documentation of the Animas pump use will be very helpful to future pump users. When I researched which pump to buy, everyone assured me that all the pump companies were great, all the pumps were equally good. I checked the FDA website before purchase and found one comment regarding Calorie King database problems, which Animas had corrected. We purchased Animas 1250. Two months after purchase -- and NUMEROUS documented problems, they updated the FDA MAUDE database. WELL, WELL, I got the shock of my life! A warning letter -- 5 pages, I believe -- from the FDA to Animas documenting numerous problems and threatening to shut down their plant if they didn't fix them. Among the many FDA complaints was the fact that Animas fixed problems with new product but did not FIX THE PUMPS ALREADY IN STOCK, as required by FDA regulations. Also that they recirculated malfunctioning pumps. The list goes on and on. Many of these pumps go on children. We noticed problems two to three weeks after pump start. Once we ascertained in was definitely the pump and not our site change technique (her mother is an RN and this kid was getting 4 site changes a week), we requested a new pump. So-called "new" pump, after a month failed in school. Whereupon we discovered they did not send us a "new" pump, despite the fact that our pump was 3 weeks old. They sent us a "refurbished" pump from their stock -- from the same stock they do not correct existing noted problems. We complained. I am using the word "complained" lightly. I had to raise holy hell to get a new pump out of them. They finally agreed to send us a new pump. When it arrived it was very old and dusty looking. They admitted it was another "refurbished" pump. Sent us another "new" pump but in an old box. We are really taking their word for it that it is, in fact, "new." At one point, we had 4 pumps in our possession! This latest "new pump" (we've had it about two months), started vibrating and refused to deliver insulin one morning at breakfast. We got the same explanation you did and reprimed the pump. On the whole, it has been working well. I shudder to think of how it will work a year from now. Animas has the best Customer Reps in the business, I believe. And they need them, because their PRODUCT is, in my opinion, definitely SUBPAR. Great pump, great ease of use, but pump does not seem to hold up over time. If I have any more problems with the Animas pump, I am going DIRECTLY to the FDA. Needless to say, I will not stop there. Although I am sure Johnson & Johnson does not fear me, I am equally sure that Johnson & Johnson has the money to stand by their product and the warranty that they give to consumers. Since when do you buy a new product with a warranty, the warranty is not up yet, product malfunctions after a month, and they ROUTINELY send you a "refurbished" replacement? No, this is not a toaster. It is a device put on children to keep them alive. Animas should remember that and treat it as such.

Anonymous said...

i would just like to forwarn all of you fellow diabetics about my experience with minimed. i am 26 years old, type 1 since i was 13 months old. ive been through lots of diabetic supplies and dealt with many companies but am apalled at minimed. apparently they will replace a malfunctioning pump quickly, but if you have any negative feedback or need to speak with a higher up over a supervisor... good luck. ive been trying to get them to take back my 722 and "real time" system for a number of reasons. i havent heard back from anyone for 3 months now, and thats after 7 emails and apx 23 phone calls. if you want a pleasant experience stay away from minimed.