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A Canadian Butterfly
Tips And Tricks

Things You Learn From Experience, Your's Or Someone Else's .

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Here is a link to a 'Tip' page at the Minimed site.



The following are tips and tricks we have learned ourselves, tried upon the advice of others, or have read about and thought they were a good idea. Many thanks to the Insulin Pumpers for all their help! Individuals are, well, INDIVIDUAL! What works for Erica might not work for you or your child. The key is to keep learning and determine what is the best for you or your pumper.

Any changes you might be thinking of making should be discussed with your medical team first. They are key to your pumping success. These Tips & Tricks are based on our use of a Minimed 507C Insulin Infusion Pump, and a Silhouette Infusion set. The Silhouette is also known as the Tender, and the Comfort. They are the same thing.

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1. Setting good basal rates is THE MOST IMPORTANT THING YOU WILL DO! Correct bolus ratios are a close second! KEEP A WRITTEN RECORD OF YOUR BASAL RATES IN THE EVENT YOU HAVE A PUMP ERROR THAT ERASES YOUR BASAL INFORMATION. I consider FASTING BASAL checks to be the most accurate means of determining basal requirements. There is a lot of information about this on the Insulin Pumpers Website. Check my links page.

2. The Silhouette (Comfort/Tender) SEEMS to be the best choice of infusion set for most people. Many people have made the switch to Silhouettes when they found their infusion sets were not staying on, were crimping, or were just plain uncomfortable. I wore a Silhouette for 2 days prior to Erica's pumping startup and really didn't feel it. However, I also know people who love their Softsets, so again it is a matter of personal preference. Try and learn.

3. In our experience, the Silhouette can be applied in almost any direction left to right, right to
left or angled up or down. The sites we use are the tummy, back, and upper butt. The most
consistent and comfortable one for Erica is the upper butt.

4. EMLA is a help if you need some comfort when you start pumping. It numbs the skin at the
infusion site and can be purchased OTC at a drugstore. A lot of people use ice, put on the 'site to be' for a few minutes to numb it. In the beginning we used Emla, now we seldom do. It depends where the site is going to be.

5. Always have spare batteries on hand.

6. If your syringe runs dry and you are not near home, you can actually load the syringe with a
little air and use that to push the remaining insulin out of the tubing. This requires a little
practise and should only be used in an emergency. You'll have to e'mail me for specifics on this
one :)

7. The pump has taken many bangs, and has been immersed in mud and water with no adverse
effects whatsoever. Take out the batteries and syringe, rinse it out, air dry it, and get pumping
again. Call Minimed for guidance here.

8. If you have problems with your sites lasting as long as they should 2-3 days, a mixture of
regular insulin and Humalog often helps. We use a ratio of 5H:1R and it works like a charm.
Erica's sites consistently last 3 days. Again, something to discuss with your medical
professionals.

9. We find the mixed insulin stays stable in the syringe for 8-9 days which is the amount of time
it takes Erica to empty one.

10. The higher a blood sugar is, the more insulin required to bring it down to acceptable levels.

11. Get Those Bubbles Out! It will mean more consistent blood sugars. Check out the Insulin
Pumpers link for more on this :)

12. Leaving the old site in place for up to 2 hours after a site change seems to help keep the
sugars stable.

13. A neat little thing to put the pump in at bedtime is a sock. Just put it into a baby sock and pin
the sock to the inside of your pyjamas or nightgown.

14. Wearing it in a pants pocket without the tubing showing is easy. Just put a small hole in the
upper part of the pocket lining, and thread the tubing through it.

15. Always be prepared with a backup glucometer. Especially when you travel.

16. Carb counting booklets are invaluable for those fast food places

17. Stand up when inserting your sils to prevent the tape from bunching up :)

18. We haven't done the following, but plan to!
a) Confirm that a notation 'insulin pumper' is on
Erica's record at the Children's Hospital.
and then . . .
b) Affix a sticker to the pump which says something
like - "MEDICAL DEVICE! DO NOT remove
without parental approval, or authorization from
the CIU, IWK Hospital, (555)555-5555"

19. If you wear the leather case over the pump, you are less likely to have an error caused by
static electricity.

20. If you wear your pump upside down, by clipping it to a belt from the bottom, it will help keep
bubbles in the pump syringe and out of the tubing.

21. Hormones play havoc with blood sugars.

22. Some people use a rubber band round the pump to ensure the door doesn't open.

23. If you like to bolus through your clothes without looking at the pump, this was a tip passed
along to me from a posting on the IP (Insulin Pumpers). Go to a hardware store and buy the
smallest round plastic bumpers, or feet (approx 3/8 in dia and half that in height) They are self
stick and can be applied to the audio bolus button, and the ACT button. The buttons can then be
felt through almost anything and the sticky glue doesn't seem to harm the pump.

24. Are you sure that pop (soda for our American friends) you ordered while at the restaurant is really diet? We have been caught by this before. Even when they swear that it is diet pop, they have been known to have the pop hooked up to the wrong switch. Take a Keto-Diastix (the ones which have a glucose band on them) and cut it in half lengthwise, that will give you two testing sticks. Put a few in with your glucometer and if in doubt, dip the ketostix into your pop. If it is not sugar-free, the test area for sugar in the urine will turn brown after about 15 seconds. So, if it goes brown, put it down, if green stays bright, its alright. We never use all the Stix before they expire so we always have lots of extras on hand.

25. Skin So Soft is an excellent product to remove adhesive from your skin. You smell nice too!

26. Is your pump in 'the shop'? Is your syringe running low and you want to save the insulin for basal while using a regular syringe for bolusing until you can reload? Are you going to be disconnected for a long time and want to inject regular insulin instead of trying to cover the time with Humalog from the pump? All these scenarios can be covered by injecting insulin through your infusion site with a regular syringe. Make sure that you are dead in the center of the QR, you can see the needle on the other side to make sure. I have been told it works with both the Silhouette (Comfort/Tender), or Softset, although we haven't done it ourselves yet. Another nice thing to know though!

27. If you notice a large air bubble in the tubing and want to get rid of it, just keep an eye on it and when it gets close to the Infusion set, you can disconnect and bolus it out.

28. Some people, Erica included, checks her daily totals before having a long leisurely shower. We leave the pump running and when she gets out of the shower, she primes in the amount of insulin she missed.

29. Even though it is not suggested to do so, a lot of people prime their pump until a drop of insulin comes out the end of the tubing if they have been disconnected. Erica does, as it gives us a little more confidence knowing it is right there at the end.

30. Another tip I received, is to hit suspend if you have nothing on you to treat a hypo and you feel one coming on.

31. Have you had a 'gusher' lately? Need some tips to remove blood from your clothes <g> These were passed along to me.
Removing Blood Stains
a) It seems that saliva works wonders on your own blood. You apply a little
and rub it in, whamo - the blood starts to dissolve and washed out easily.
You can't get anyone else's blood out - just your own. Something to do with
enzymes, I imagine. And you have to do it before you try anything else.
b)Take a wet paper towel, wring a few drops of water onto the stain and then
sprinkle salt directly onto it. It will cause the stain to completely
disappear (Hemolysis) and nothing will be evident after it dried. It works
on fresh stains.
c)When rinsing or washing blood out of fabric (or off of anything else, for
that matter) NEVER use hot water. Hot water SETS the stain and you will
likely NEVER get it out (or off). The water doesn't need to be ice cold,
just NOT HOT!. Alcohol does NOT remove blood stains.
d)Be careful using peroxide on fabric. It is an oxidizing agent and will
easily bleach many dyes out of fabric and may actually damage some natural
fabrics. If you plan to use it on an unknown fabric, test a bit on an areathat can't be seen first.
e) Also useful is cold seltzer water, mmmmm seltzer and blood. Stops the stain from setting and lifts out the spot.

32. Spare Glucometers. I have not paid for a glucometer for years and always have 2-3 available to me. One for school, one for home, and one as backup. I find the companies who manufacture these are very forthcoming with free meters, especially when you tell them you have a pumper and require frequent blood testing. Don't buy, ask!

33. HOT TUBS. Some people have to avoid them due to going low, or they have another medical reason to do so. We found with Erica, that we cannot do a site change soon after she gets out of a hot tub. The hot tub stimulates her circulatory system and when the introducer needle is inserted it fills up with blood. We wait for her to cool off, then it is okay. This is not a problem for most people we have talked to, but we did want to share the fact it could happen.

34. Losing Time on your Minimed pump? Yep, we do too, a few minutes a month, but according to Minimed it is not something to be concerned about.

35. Do you have any tips or tricks to share? Please e-mail me if you do!

**REMEMBER EVERYONE IS DIFFERENT!! We personally have not tried all the tips and tricks above, although we have used most of them. We thank everyone who has sent us tips and tricks to add to our list. It is very important to share any changes you wish to make with your medical team, at least until you are a pro yourself :)
Happy pumping!!