Thursday, March 14, 2013

Already Gone

I started pumping on the Tandem t:slim in October 2012, less than six months ago. Let me begin this post by saying that I consider myself extremely fortunate to have access to expensive medical devices like touchscreen insulin pumps. Not everyone is so lucky and not everyone has good insurance.

My endo reminded me today with a smile at my quarterly checkup that I had begged her to let me try this pump. I had high hopes. So it is with frustration, embarrassment, and a heavy heart that I put this pump back on the shelf.

I loved the innovation. Loved the employees with whom I have interfaced. Loved their responsive customer service. I won't tell you not to get this pump. I hope your experience is incredible.

It was not the right choice for me.

I've blogged here regarding the fact that Apidra insulin cannot be used in the t:slim. Cannot. Be. Used.

When I last blogged, I stated that I would be trying Apidra on a 48-hour rotation to see if I could have a functioning pump for that short of a cartridge lifespan. By hour 30, my blood sugar had skyrocketed. By hour 37, my insulin was spoiled. Cloudy. Gray.

Before that last attempt with Apidra, I had tried Humalog from early December through mid-February. My highs were 300-400s. My lows seem to hang on for hours. I felt like I bounced from one end of the glucocoaster to the other.
Posted this image on FB in January. Felt so lost.
Did not believe pump at fault. Took full responsibility.
There was a 3-day period on a Humalog cartridge though where my blood sugar never seemed to skip below 200.
Feb 17. I was now suspicious. This isn't right.
There was a time when I tried to prime nearly 100units of Apidra from a new cartridge and watched as there was not enough pressure to dislodge the air bubble in the tubing connection (at the luer lock). No insulin drop ever appeared at the needle.

There was that time the whole luer lock fell off.
January 3
There was the fact that this was my second t:slim in five months because the first screen would time-out mid-button press. (I kept blaming myself - am I triple tapping the screen? Am I that ham-fisted?)

There was the fact that I had taken to charging it only when it didn't have an insulin cartridge so that it didn't risk overheating (if indeed that was the culprit). Inconvenient, to say the least.

There was the night I slept on it on my hip and it felt warm to the touch when I woke up with a high blood sugar in the middle of the night and my Apidra was spoiled.

So many highs in the night when my basal insulin should have kept me relatively flat, whichever insulin I used.

I love the touchscreen. I love the input features like color coded information, carb calculators, the basal profiles that show all your ratios alongside your basal!

I didn't particularly like the clunky packaging on supplies, the 3min+ it took to slowly fill the (short) tubing every three days, the fact that the bolus calculator didn't adjust your insulin dosage down (reverse correction) until you were below 70. All of that was in my initial review. Not dealbreakers.

Pumps have their pros and cons. After 13 years on these devices, I know that you take the good with the bad.

But what I hated...what I can't allow the feeling that I have to babysit my own life support. Like I can't trust it. Like I'm putting my life on the line for a flashy new toy. And that's where I find myself now.

I've told myself it's user error. I've told myself it's all in my head. I've told myself I'll lose face. I've told myself that no pump is perfect. Some of the people in a rather "love it or leave it" t:slim group on Facebook have asked me to stop posting about my issues and I've left the group.
All in my head?
This is how I woke after a night on my old Cozmo pump, pumping Apidra, March 10th.
Leaving an expensive product you placed a lot of faith in and that you're still not sure it's not all your fault you can't make work is hard. There were times when the t:slim was a dream to use.

But I can't hear simultaneously that I've reached the crossroads of "you have a family now" and "your eyes are bleeding" and make the call to stay the course with this device.

I have too much on the line.


  1. Time for Sanofi-Avantis to improve the pidra formula. Ti have such delicacy in an insulin is pretty perilous. *I* tried Apridra in a MM pump when it first came out, and within hour 40, it was shot. I had to leave work to go home and change out. (I'd grown to trust the pump and my sites to not have extras with me.) I came back to work, filled with Humalog and haven't gone back since.

  2. Mel,

    Thanks for posting your experiences, this device would drive me insane not to mention I am just not willing to give up my Apidra... MM for me


  3. I think you've given your pump/insulin combo every last chance and benefit of the doubt before reaching your decision. It's a shame it didn't work out, especially considering the money paid for the pump -- I hope there's a way to get a pump (in current manufacture) that you want and can use... a trade perhaps?

  4. I am so glad you've taken a stand on what you need to do for yourself. You've done very well in giving it your best shot. I'm still contemplating what I want to do with mine. I like it.. and I absolutely love most of the features. The one I can't get past though is the reverse-correction part. It's too risky for me. I'm still fighting in my head of whether just to ignore it and push through or to go back to my Ping or Omnipod system. I keep asking myself that if it were E who were diabetic and on the pump, what would I do? The answer in my mind is without a doubt to switch off of it and go back. But since it's not, I'm just in a debate about the whole thing in my head.
    Thank you for sharing your honest views, Melissa. I heart you for it. :-)

  5. Your photo of the broken-off Luer lock made me think of a photo on Wil Dubois' lifeafterdx.blogspot. Look at the January 30 post. Is this the same problem? Don't know any stats on the frequency of this occurence (if, in fact, they're the same), but I hope t:slim is collecting them. For the record, I am interested in the t:slim, but the time isn't right.

  6. Your experience has been helpful and, in at least one specific case, nothing short of cathartic for me! Sound like we were very similar in that we both caught a case of T:slim Fever before it had even hit the shelves. As I've struggled with major disappointments in the pump I've spent much time trying to sort out legitimate complaints from the over-inflated expectations I came into this relationship with. I'd made it at least 95% of the way towards DEFINITELY deciding to return it but, somehow, reading your line, "the first screen would time-out mid-button press" assured me that the problems I was seeing were NOT all in my head (nor fingers) and delivered about a 60% decision-making confidence boost, bolting me far beyond that final 5% I needed to pull the trigger! (Yes, I have repeatedly experienced the massive frustration of having the screen time-out seemingly in response to my touching a virtual button. Grrrrr ......) Sounds like the worst of your problems relate to using Apidra, which is not an issue for me as a Humalog user, but there are enough performance quirks and simple software design choices I disagree with to go back to something more familiar. The ultimate lesson I'll try to take away from this experience comes from a subject I've been schooled in many times but can't seem to get through my thick skull and locked into long-term memory: regardless of how exciting and promising a new technology appears to be, it's ALWAYS a good idea to hold out for at least the second generation while some other poor suckers endure the growing pains of the de-facto beta trials that are the destiny of new tech's first gen.

  7. I too am excited by the TSlim...but the negative insulin factor doesn't seem to be that big of a deal. I would never even consider a bolus if my BG was 70 or even less than 100. I just wait until my BG comes up to 120 or so and then bolus. I have had type 1 for 43 years and enjoy very good health and good control. I have own a pump for some 20 years, had MM, Animas,and Omnipod, I am currently looking at a another new pump called "Snap" by Asante. I hate them all! but this looks promising to me. I try to keep you informed of my findings. It needs to be small, easy to read and while I have a degree in computer science I would like to not have to need it to get my pump primed and ready to go!