Insulin Pump Crisis

The timing for this could not be more terrible. But yet nor could it be more opportune.

My six year old out-of-warranty insulin pump went wrong on Saturday morning. I’ve experienced pumps going wrong at least half a dozen times in the last 10 years, but the sinking feeling you get when you realise there is a problem is always the same. Except this time it felt worse. Because the one time you really, really don’t want your pump to go wrong is when you’re pregnant and not only your health, but the health of your baby depends upon your ability to keep your blood sugars in tight control.

To be honest, I should have seen it coming. I got the Animas IR1200 back in 2005, but only used it for a little over a year, until I switched to the Medtronic Paradigm 522 with integrated CGM. The CGM was the only reason for the move. The Animas pump remained my favourite pump, but it languished in a box at the back of my wardrobe until last year when escalating frustrations with the Medtronic system led to me buying a DexCom CGM which left me free to switch back to the Animas pump. With only just over a year of use on the clock, it should have been good to last. However, it was out of warranty. Animas eventually agreed that I could continue to use it until such a time as funding for a new pump was possible (at that time not due until late next year). But I knew that without the warranty, any problems could be…. Well, a bit of a problem.

Which is why I’ve been turning a blind eye to the crack that recently opened up along the edge of the battery compartment. With an in-warranty pump it would have been a simple phone call and a new pump would be on the way, but I had no choice but to keep using it. I knew this rendered the pump not waterproof, but since I wasn’t planning on swimming, bathing or showering with it, I figured that I could get by.

What I didn’t count on was all the low blood sugars that would crop up in pregnancy. Two nights ago saw me waking startled, stuck to my pillow, drenched and sticky with sweat, mind fogged in confusion and limbs as heavy as lead. The low was quickly treated and I turned over to return to slumber, almost certainly lying across my pump. A hot, damp body and a pump with a crack in it don’t, as it turns out, make good bedfellows. The only explanation for what happened next is that the moisture from my sweaty low somehow condensated inside the pump, due to the crack in the side.

When I awoke for real, some three hours later, I looked at the screen of the pump. Two thirds of the display was missing. It was completely unreadable and therefore rendered useless. Amid growing panic, I tried the usual tricks – giving it a bit of a tap, pressing around the edges of the screen to sort out loose connections. I even removed the battery to see if this might kick start it in to life.

That, it turned out, was my biggest mistake. Because once the battery has been removed, the Animas pumps require a full rewind and re-prime. And the sequence simply wouldn’t run.

So here I am: pregnant, striving for the best control of my life and relying upon the piece of technology which has just fatally malfunctioned to help me achieve it.

I couldn’t have felt much worse, at that moment.

A long call to customer support, forwarded to the US, and then a wait for a call back later, and the only advice they could offer was to switch back to injections. My pump, after all, was out of warranty.

Switch back to injections? That makes it sound as though it were something I’d done recently. And nevermind the fact that everything is so different now that I’m pregnant. I’ll hold my hands up and admit that I sat on the bed and cried. I felt absolutely lost. It’s just a small box. A tool to help me deliver the insulin that my body lacks. But it’s a tool that I understand, know how to work with and depend upon entirely. I can manage diabetes with nothing more than insulin, a syringe and a blood glucose meter, if I have to. But I can’t control  it to the same extent I can with a pump. And control has never been more vital.

Fortunately, given twenty minutes to dry out, I managed to run the prime sequence and get the pump back on for basal rates. I can’t use use the bolus wizard or insulin on board features. In fact, I’m bolusing with a syringe at present. And I’m currently unable to make any basal edits as I can’t see the screen properly, which makes it imperative that I get something sorted out before insulin resistance starts to step up. So I’m awaiting the UK office opening tomorrow, who promised they’d help me with any problems despite the pump being out of warranty.

There’s a flip side though: Once the immediate crisis had eased, I realised just how opportune this could be. This week I received confirmation of funding for CGM from the NHS . I’ve now got a pretty good (!) case for funding a new pump. And the new Animas Vibe – insulin pump and integrated CGM – is due to be released within the month. With some luck that’s what I’ll be transitioning to.

So long as they don’t think I damaged the pump on purpose for precisely that reason!

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