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Pump Reservoir Revisited.

A few weeks ago, I was out to dinner with Chris and rang in at an excessively high blood sugar after taking part of my meal bolus.  Wondering if my site was conking out, I rummaged through my bag to find my always-on-hand insulin pen.

Well, almost always-on-hand.  This time, I had left it at home. 

Never fear - Old School Syringe is here! 

That experience pretty much encapsulates why I carry a syringe in my meter bag at all times.  Here's how I bolused in a bind:

A blast from the past.

In the side zipper part of my OneTouch Ultra2 meter, I keep an unused syringe, orange cap and all.

Reservoir in the pump.

Wearing my pump is like carrying a teeny little bottle of insulin at all times. 

Reservoir, loose from pump.

I unscrew the reservoir from the main housing of my pump.

Reservoir disconnected from tubing.

Then I disconnect the reservoir from the pump tubing.

Inserting the needle into the reservoir.

Using the syringe, I poke the needle into the spongy access point in the top of the reservoir.

Drawing back a dose.

And as though it were a bottle of insulin, I pull back a few units.  After I inject with the syringe, I reprime the insulin pump to make sure there are no air bubbles stuck in the reservoir or the tubing, and I reconnect to my infusion set.

This little trick has bailed me out a few times and can also be used in a pinch if my insulin pump ever fails on me (or if my brain fails on me and I forget my trusty old insulin pen).

Over the last twenty-one years, I have seen plenty tricks of the trade.  What have you come across?

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Ohhh. I've done this one before. Sucks, but comes in really handy in a tight spot.

Great idea! Happy New Year to all!

Nice idea- I have been stuck a few times (out and at school) in a similar situation...

I actually do this in reverse. There have been times where I have a bottle and syringe, but my reservoir is out - and we're not heading home anytime soon. I fill my syringe with Humalog and then inject it into the reservoir - voila! I prime and don't have to worry about my basals.

I've done this before, a few times. My son has diabetes so I always carry a syringe in my purse. I am always afaid if I get into a car accident and the police have to search my purse they will find the syringe and assume I am a druggie.
It also came in handy once at the beach when my son got sand in his site connection (while untethered) and when I tried to reconnect to bolus for lunch, I couldn't. I ended up using the syringe to pick the sand out of the holes where the clips go. It was a very frustrating and sweaty experience. After about 10 mins of blowing into it and picking at it, all the sand came out and we could reconnect. I would have used the syringe to give him a shot but his bolus was so TINY it was hard to eyeball 1/4 of a unit.

I used to a similar thing with my insulin pen- when the dial was "locked out" (presumably indicating no more insulin could be put out), I would use a syringe to pull out at least another 20-30 units.

Also, (and I'm sure you have noticed this if it happened) is it possible that the pump computer calibration might be off from removing some insulin from the little vial thingy? Like, it thinks there is 20u in there, you take some out, but it still thinks there are 20u in there?

PS I saw you on TV the other day! I was watching d-life (I think that's what it was) and this woman named Kerri came on- you should have seen the look on my wife's face when I said I know you. She gave me a funny look, and I said, no, I know her from that website.
And that's when the eyebrow went up...

Here's my trick, which is a variation on Erica's idea: When I get new insulin bottles, I empty them into my reservoirs (my fiance and I call them bullets). I put all but one in the fridge, and carry one bullet with me at all times. This way, if I run low on insulin while I'm out, I can prime a new bullet.
This trick has saved me from worrying about running low on insulin. Also, emptying my insulin bottles in one sitting also saves a lot of back and forth when it's time to change reservoirs.
Allison raised a great point, which is that you don't want the insulin you carry with you to go bad. To avoid this, I rotate in the bullet in my bag often.

I honestly never would have thought of this! Great idea! Thank you for sharing!

Thanks for the great ideas! I especially like Gayle's idea about the bullets. Plus, when traveling, if you bring along a bunch of bullets instead of the glass bottle of insulin, you don't have to worry about breakage.

Keep in mind, though, if your sugar is really high, you can bring it down much faster taking a shot than you will with a pump bolus. The syringe goes deeper under your skin, so it's absorbed faster. Anytime I get a sugar over 300, I'll just take a shot. (The thing I hate is that if the sugar is because of pump-related issues, like a bent cannula, I won't know that until I go high again. I hate to disconnect and change sites if I don't have to, so I usually actually do wait to see if the problem's going to recur after I've corrected for the high...)

There are probably a trillion MacGyver-ish uses for a syringe. I've used one, for example, to clean crumbs out from under my laptop keys. (It's also fun to scare friends with at parties.) Other useful ideas--there've been several times I've used the beep on my pump to tell people I have another call and have to get off the phone...

I've used this trick quite a few times as well! I also carry an extra, filled reservoir with me when I go out for the night just in case I run out of insulin.

I always have the bottle of insulin that I've been using for cartridges with me, an insulin pen, pen top needles, and syringes. You can't perform this trick with a Cozmo cartridge, there isn't a spongy top to draw from.

Mine is also a pump trick of a similar nature, at least for MiniMed users. I'm not sure how other pump's reservoirs are packaged, but with the MiniMed, you unscrew the plunger and the needle you stick in the insulin vial.

I always keep a pair of these handy because sometimes, you're faced with a string of highs (or a carb binge) that empties your reservoir quickly. If you've only had your infusion set in for a day and a half, it doesn't seem worth pulling the plug entirely.

I disconnect the infusion set at the site, just like you do for a shower or exercise, then follow the usual steps to refill the pump. Do not discard your tubing, just disconnect from the reservoir. Re-attach the filling needle and the plunger to the reservoir, add as much insulin as you think you'll need, then re-attach your tubing, put the whole thing in your pump and prime, being careful to watch for air bubbles.

Once your set is refilled and air-bubble-free, re-attach to your pump site and resume pumping as usual!

yeah, i had that moment that thomas had too! i'm watching my regular sunday d-life and i look up and there's that familiar face! it's kerri! very cool. though my daughter thinks i'm a raving lunatic now for the screaming at my house.

I've used a syringe (a very few times) to give myself an intramuscular shot of insulin when I've had a SUPER high number and wasn't sure my pump site was working any longer.

That trick thanks to a conversation with Scott Hanselman about the super bolus and other alternatives.

That is our favorite trick. When your pump breaks or your site change failed, it can keep you from freaking out and hitting 600.
The first time our pump broke, it was after dinner - a big meal with lots of rice. Our 24-hour pharmacy had ran out of insulin (!?!) and waited 20 grueling minutes to tell us. We changed pharmacies and figured out this trick. The next time that it happened we were much calmer!

Wonderful post. I learned many interesting things. Thank you)

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