A Tandem Vacation

Is it back to the future or forward to the past? 

I’m not quite sure.

What I do know is that this month is my two-year anniversary using a Tandem insulin pump and I just went back to using my Animas Vibe. I am hoping that an older, simpler pump will ease my navigation through the current dark clouds of my Type 1 diabetes. I wrote a blogpost in late November about my diabetes life as a country music ballad and things haven’t changed much. My elderly dog is recovering well from pneumonia but struggling to move around due to arthritis and an injured foot. The cold and cloudiness of late fall continue to trap me in gloom and icy streets prevent neighborhood walks. I have been in an extended funk where my diabetes doesn’t follow the expectations of “If I do A, then B will happen.” A lot of time I do A and seemingly nothing happens. Is it the pump? Is it the insulin? Is it my behavior? Is it one of Diatribe’s 42 factors that can impact blood sugar? I am burdened by diabetes technology that doesn’t give me sufficient control over intrusive beeps and sirens.

Many of you know that when I get frustrated with my D-Life, I try new tools with the conviction that there is a solution to BG frustrations. I have added Lantus as an adjunct to pump therapy with the Untethered Regimen. I have adopted low carb diets and reset my life with a month of Whole 30. I have changed types of insulin and models of infusion sets. Wil DuBois of Diabetes Mine wrote an article this week titled “To Pump or Not to Pump with Diabetes?” and shared his feelings about the benefits of changing up your D-regimen: 

“I find that any time I change from one tool to another, I do better. If I changed every two months, I’d probably stay in control. I think it’s because change makes you focus. That, or diabetes is an intelligent alien parasite that can be caught off-guard only for a short time.”

But back to the subject of this post. I am using my Animas Vibe in place of my Tandem t:slim X2. I have always relied on the Vibe as a backup pump so it is not a bad idea to road test it after two years in the closet. I figured that I would quickly miss the X2 but have instead discovered that I really like this old pump.

I was concerned that going back to scrolling for carb and BG numbers would be horrible but in many ways it is easier than using a touchscreen and navigating through multiple “Are you sure?” screens. I really appreciate the immediate bolus delivery of the Vibe. With Animas, I program the bolus, it whirrs, and delivers insulin before I can get the pump back in my pocket. With Tandem, I program the bolus, it delays for a while, micro-boluses, and eventually finishes with a confirmatory vibrate a minute or two or three later. The Animas clip is a delight with its easy attachment and actually holds the pump securely on my waistband. Temporary basals are simple to enter and a temp basal of zero does not result in an annoying warning alert several minutes later. The Combo Bolus function remembers my last setting rather than requiring a recreation of the split and duration each time. My arthritic hands are having an easier time with the Vibe buttons than with the increasingly stiff T-button on my X2.

There are lots of wonderful things about Tandem pumps but I have been one of the unlucky people who gets occlusion alarms. Most users don’t get them. The vast majority of the alarms are false. I just hit “Resume Insulin” and go on my way. Lately I have had a couple of alarms that actually required replacement of the infusion set and/or cartridge. I have done extensive troubleshooting with Tandem over the years and am on my 4th pump. Only one of those pumps did not give me occlusion alarms and it unfortunately had a defective T-button. I never had occlusions in 12 years of pumping with Medtronic and Animas.

I am tired of troubleshooting. I sometimes experience one or two occlusion alarms a week and then go a while without them. But after two years of alarms, I think about occlusions almost every time I bolus. I average 8-9 boluses per day and that is a lot of thinking about occlusions. I am tired of holding the pump with the tubing extended post-bolus to prevent occlusions. I am tired of feeling guilty for stubbornly refusing to use the Tandem case and for not changing my cartridge every 3 days. I have a low TDD of insulin and an every 3-day cartridge change results in wasting as much insulin as I use. I do replace my infusion set every 2 days.

Longterm I know that I will eventually be back to Tandem. I am probably just being a pouty and whiny problem child. Despite fewer alarms and intrusions into my life, the Vibe has not cured my diabetes but I am doing better. I am committed to Dexcom and thus don’t envision switching back to Medtronic. I am super excited about getting access to the Dexcom G6 and Basal IQ; as someone on Medicare, that should happen in the spring. Hopefully the benefits of Basal IQ and eventually Control IQ will outweigh the insulin delivery problems. An Animas pump is not a longterm option. Johnson & Johnson abandoned the pump market and there is no customer support for my out-of-warranty Vibe. If it quits working or the case breaks, I am done. Fortunately I have a lot of supplies and was recently given enough reservoirs to last for several years. I can use Tandem infusion sets by substituting the t:lock tubing with luer lock tubing.

I think highly of Tandem and have always had good customer service. Until starting to use the t:slim X2, I was never a problem child with diabetes tech and continue to believe that there is something wrong with an insulin pump that frequently quits delivering insulin. Is it the design of the pump? Is it my low insulin use? Is it random bad luck? Am I at fault? I don’t know and am at a point as Gone with the Wind’s Rhett Butler would say: “Frankly, my dear, I don’t give a damn.”

12 thoughts on “A Tandem Vacation

  1. Laddie –
    “I am super excited about getting access to the Dexcom G6 and Basal IQ; as someone on Medicare, that should happen in the spring.” Do you know this for sure or is this a guess or hope?

    I am due for a new pump in the Fall and I am hoping this is true!
    Best Regards,

  2. I use my old Medtronic 530G as my backup. In the last 32 hours I have had to use it because of the steroid use associated whit the RA infusion. Each time i get it out I am so excited I no longer have to use it. Sure it comes back to me in a few minutes of use, but I woudl be happier to leave it on the shelf.

    That bigness said, if I had occulaiton issues this current pump woudl no last a week. So I certainly understand what you are doing.

    • Are you using the 530 in addition to your 670G? Steroids are evil but I know that your infusion makes a huge difference in your RA life.

  3. Sorry to read your continuing woes, Laddie. You WILL prevail, I’m sure. One minor/major change you might consider is to try using the newer steel cannulas rather than the plastic ones. I can imagine you & many of your fair readers thinking “EWWW!! NO way!!” Decades ago now, when I began pumping, all we had were horse-needle sized steel cannulas and I swear I could visualize them slicing up my innards. However, today’s cannulas are a much finer gauge than the insertion needles for a plastic cannula.

    PLUS, when I occasionally insert into an “OWWCH!” site and want to change it out, it’s SIMPLE because it’s steel, so I waste no time and no $$ in lost supplies and insulin. I just add a bit more “glue” to the white part and cover the inserted part (not the quick disconnect) with tegaderm or the like. And, rarely do I get an occlusion since in the steel vs soft tissue, steel wins where plastic loses.

    I went from having to change sites every 1-2 days and fearing I’d run out of good landscape on my T1D body, to being a relatively happy camper. I began using steel cannulas with my prior pump – my beloved Deltec Cozmo and have never looked back these 8+ years. Holler if you’d like sample 🙂

    And no, this is not a PAID endorsement, but T1Divas here in ABQ know I sing the praises of my short! steel cannulas to anyone who’ll listen.

    • Laurie-You will be pleased or disappointed to know that I use steel sets about 50% of the time and get occlusion alarms with them at the same rate as with the angled VariSoft sets. TruSteel sets have solved the occlusion problems for some users, but not me. Thanks though for taking the time to endorse the steel sets. Laddie

  4. Sorry to hear of your ongoing frustrations – that’s a long time without a real solution! I just received my t:slim x2 today, and I’m excited about it largely because of the basal IQ. I hope it’s a smooth adjustment from the Omnipod…

    However, I realized after playing around with all the screens and buttons, that no matter how much it saves me from dealing with lows, etc, it’s still a device that I have to wear on my body 24 hours a day to stay alive. Along with the good, there’s still just the day to day-ness of it all.

    I hope you find your Animas-time to make your life more relaxed and easier, and the sun shines and you can walk your dog again soon!

    • I hope that Basal IQ goes well for you, Lucia, and your switch to Tandem goes smoothly. Thanks for wishes of sunshine and amazingly that always makes a huge difference in my spirits.

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  6. I recently met with my Tandem rep and they told me there is an update in the works for 2019 that will decrease the sensitivity for Tandem’s occlusion alarms, making them far less common. I’m very much looking forward to this.

    • Cory, I hope that is true. Before I purchased my X2 in 2016, I questioned my local rep and was assured that insulin delivery with Tandem pumps was no longer a problem. Well, not exactly true for me…. At the same time I would purchase a Tandem pump again because I want a pump that integrates with Dexcom.

  7. I’m sorry to read about your occlusion alert fatigue with the X2, Laddie. Your posts have often been a help to me. I too, get bogus (and occasionally true) occlusion alerts with the Tandem X2 on an all too regular basis. I never got them with medtronic. In fact, I’ve recently sparked up an ancient medtronic 522 and then a 722 to use Loop. Same sites, never an occlusion. (I super recommend Loop if you can find an old medtronic pump) Tandem never helped me and told me the problem was my sites themselves. FWIW, I did find that I got fewer false occlusions when my reservoir was full than when it was nearly empty. Unfortunately I don’t think i’ll Renew my X2 when I’m up for a new pump unless I read that they’ve officially recognized and solved this issue. Here’s hoping they do. We are with you, Laddie.

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