Insulin Nation

The Great Pump Switch

“If it ain’t broke, don’t fix it.”

I’m not superstitious, but that expression kept replaying in my head as my husband and I contemplated switching our 7-year-old daughter from the Minimed Revel insulin pump to the OmniPod system.

Was it my subconscious fear of change talking? No, Lela’s old pump was not broken, but the 4-year warranty was going to expire in the spring. It was time to think about upgrading to a new model, regardless.

Oh, but she liked her pink pump. She had even become…ahem…attached to it. Her adorable handmade Too Sweet pump pouch, the omnipresent bulge under her shirt, it all had become part of her identity. Everything was going so well …

In a way, we were circling around to the beginning of our original pump decision. When we were ready to put Lela on an insulin pump for the first time in the spring of 2010, a year after her diagnosis, the OmniPod’s tubing-free design had intrigued us even then. Lela had just turned 4 and she loved to play dress-up. She would change from a tutu into a princess dress into a lion costume and back within half an hour. Surely, she would no longer be able to do that with tubing attached to her?

That concern, we now know, was nonsense. She found a way. She always does. But at the time, we ultimately decided there simply wasn’t enough real estate on our little girl’s tiny body to place the sizably larger first-generation pods and find fresh sites. So, since May of 2010, Lela had been a happy Minimed pumper.

But with the warranty expiring and a small crack discovered in the pump casing (see, it was broken…just a little), we had to decide whether to upgrade to the new Minimed model that’s coming out in early 2014 or to consider a more drastic change and try an entirely new insulin pump.

Our daughter is now in second grade and has become a super-sporty girl who loves rock climbing, karate, dancing, skiing. The Minimed’s tubing has never bothered her in her adventures, but would the tubing interfere with her freedom of movement as she advanced in her activities? Would she eventually become self-conscious about the characteristic bump under her clothing?

At the Riding on Insulin ski and snowboard camp for T1 kids in Breckenridge, Colorado last April, founder Sean Busby, a professional backcountry snowboarder with Type 1, told the kids he loved his next-generation OmniPod, which had become about ⅓ smaller and ¼ lighter than the original model. If the OmniPod gives that guy the freedom to do what he does, we figured it had to be Lela-proof.

Still we mulled. Then, at a T1 event in the summer, I watched a father manage his daughter’s dinner with the handheld PDM (Personal Diabetes Manager) that’s part of the OmniPod system. The little girl, maybe 5 years old, sat at the kiddy table, chatting and munching, uninterrupted, while her dad occasionally peered at her plate before pointing the device in his hand at the girl, wirelessly giving her another bolus through the pod on the back of her arm. Lela, on the other hand, had to stop the fun and lift her dress for me every time she reached for another piece of watermelon. That impression stayed with me.

Throughout the fall, we spoke with Lela’s endocrinologist, asked other T1 parents and diligently researched the OmniPod’s pros and cons online. The one warning that gave us pause was that the pod’s adhesive patch doesn’t seem to stand up to extensive time in the water. That could put a crimp in our summer style. Long summer afternoons at the pool had been a challenge for us on the Minimed, too, but for different reasons. The prospect of being able to leave the pod on during hours of swimming and playing in the water whilst getting basal insulin had been a feature that drew us to the OmniPod. Was the stickiness issue in water also its biggest drawback?

We had heard about solutions and things we could do to alleviate adhesion problems, but the proof would be in the water. In the end, we knew every system had its drawbacks, and we decided it was a risk we were willing to take.

Perhaps most importantly, Lela, uninhibited by her mom’s fretful “ifs” and “buts”, was over the moon about trying something new. We sensed now was the time to switch.

So far, the transition to the OmniPod has been smooth. One of the biggest, and possibly least expected, improvements has been the ease of site changes. Prepping, inserting and activating a new pod takes mere minutes, compared with the almost hour each site change took on the Minimed, which included cream to numb the skin for the new site.

I’m slowly letting out my breath. Sometimes, change is good in its own right, even if there is nothing to fix.

The opinions expressed in this column are the author’s alone. Insulin Nation does not endorse one product over another, nor did the writer receive compensation from any diabetes product manufacturer for this article. Always consult a professional health care provider before making any decision to change a diabetes care regimen.

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