"Failure to Launch"

This post has nothing to do with the movie, except that I was watching Failure to Launch yesterday and thinking about how the title encompassed my day Thursday.

I woke up with a bg of 400, waaaay higher than I ever am. I actually had gotten breakfast at the campus dining hall (I'm a freshman at college, finished my 3rd week now), then tested and got the 400. Yikes. Did a correction bolus and dumped the food in the trash can.

After my 8 am class I went straight back to my dorm room and changed the site. When I pulled out the old one, the cannula was bent about halfway its length at a 90-degree angle! This is the first time it ever happened to me.

The rest of the day was rough; in the 300s all day and 2 sites later finally came down into range by bedtime.

My question is, (and I asked the guy I spoke on the phone with from Medtronic too), why doesn't the pump alarm when the cannula is so far bent?

With all the technological advances it seems to me that this should be a given-- the pump should be able to detect a failed site. However I did not receive any alarm whatsoever to warn me of a bg in the 400s!

Since I'm 400 miles away from my home, my mom (who has always helped me before), and my CDE, it was a rough day. Thank goodness for long distance phone calls.

Kudos to all of you who can keep calm during a day like this one. I hope I'll eventually reach that point too.

sorry about the bad site.  it happens more when you are away or anytime it can be really inconvenient.

all pumps have a miniature pressure sensor, it's used for detecting a clogged infusion set/site.  It's sensitive enough, but can't be too sensitive so it becomes a nuisance (alarms for no reason).  during basal delivery, the sensor is far too insensitive to alarm before you hit bs-60000, and that's the main reason the pump manufacturers tell you to test often.

during a bolus the sensor can be hit-or-miss (may or may not alarm on a bolus).  The newest revel and ping pumps have better sensors and software, and even though the basal alarm isn't going to save you, I read that they both have improved occluded site detection.  I can't see the POD having anything close to this, becaus the pump sensor is (relatively)  very expensive and the pod's sensor would have to be throw-away.

calm is a decision.  when I have a really  high number and I suspect the site, a bolus with a syringe (pen whatever)  fixes it in about 2 hours.

sorry again and hope you have a nice long string of good lucks.  =)

Hi Amanda,

I've had T1 for 17 years, and on the MM pump for 10 yrs.  Im happy that I am able to share some words of wisdom at least in one area of life!  When your pump was not working correctly overnight, you most likely had been high for a while.  The longer the sugar is high, the longer it takes to come down.  Now, I have found that in these situations that a correction bolus with an injection works better.  Then I change sites, like u did, and do an additional square wave bolus of an amount appropriate to the blood sugar and overall situation.  The minimed has been very reliable as far as these things go.  On very rare occasions do kinked cannulas happen; but the pump only will alarm I found if there is absolutly no insulin delievered, and u must have been getting a small amount.  The way u find out is like u did, by being abnormaly high.  And I stay well hydrated when that happens too.  This is just what I do in that situation. 

Good advice Caterina. The injection correction is all too often forgotten when you struggle to determine what is happening. The Injection can pretty quickly ID the site as the problem and what action is needed.

Joe- thanks for the info about the alerts/alarms. Didn't know all that, but it helps to know how the alarms work.

Caterina- I'll try that next time! I have only been on the MM for 3 years and it's the first pump I was ever on (4.5 yrs since dxd) so this is really helpful. I think the second site I used (the one to first replace the bent cannula one) would have worked; I made a bad decision to put it in my butt too, so that didn't help the whole get-the-bg-down-quickly idea. I should have done an injection. I will remember that for next time. I was drinking a lot of water, and I think that may be what helped keep my ketones negative the whole day. If I had had ketones, I would have been freaking out.

I've learned a bunch from this experience, which I guess is a good thing. Thanks to you guys for your advice & encouragement.

I get bent cannulas all the time. They are actually really common if you put the site in somewhere where you have a lot of muscle. I always put my sites in my stomach because of issues of not having enough fat anywhere else. And because my stomach is mostly muscle the cannula tends to bend. It's also going to bend if you're putting the site in the same place all the time. Scar tissue will build up, which is another one of my problems, and causes the cannula to bend during insertion.

I was actually wondering if any of you guys put anything on your skin after you take your old site out to reduce scaring and/or soften that skin?

Cocoa butter is a great product to reduce scars, and soften skin; I always use Palmers brand.

I actually got another failed site in my stomach yesterday, so guess what-- I put one in my leg! For the first time ever! It was hard but it's working so so what!! :)