Switching of diabetes pump for vacation

[dja14]

Does anyone have experience switching off their pump to lantus for vacation?

16 yr old with type1, uses omnipod. He's 6'4" and changes his pod every day and a half. Would probably be around 50u for lantus. Very carb and insulin sensitive.

Dr asked him about summer plans we mentioned two week trip to Universal. We asked about the rollercoasters. In the past they have been like no big deal but she said recently there had been some questioning and they would want him to switch back to lantus for those weeks.

On the one hand it is great because he will sweat the pods off anyway, so we would use one every day. I don't have to worry about him loosing his pdm. But on the other hand-shots again. And having to carry even more stuff. I am mostly worried about getting it leveled out before the trip. I also want him safe (I think this has to do with the reports of too much insulin being released, you can't just disconnect the omnipod on and off)

We will of course do what they ask, I really trust them. I will question them though if I need to. I would like first hand accounts before our next appointment (we still have 2 before we go, so I have time to work stuff out)

 

[buffettgirl]

I don't know that there really is a great risk of taking the pump on those rides, beyond a few reports that haven't been proven were actually pump issues. What I do know is that WDW alternated with Universal hosts a major T1 convention every year and a huge number of people are using pumps during those two weeks. I've yet to hear any bad report come out. So, that's anecdotal, but it's a lot of people. Just given the sheer numbers of people who are there during those weeks, we'd be hearing a lot of reports - especially on the CWD forums.

That said - it's kind of a pain to go un-pumped on vacation, especially one with a lot of activity. If your son wants to, then I would say maybe switch over a week ahead just so you can get the feel of it again, and then plan on decreasing the basal by at least 75% to start and then increase it back up as your vacation progresses. My son will spend a lot of time unhooked from his pump while in the parks, and water parks, but he'll still bolus through the pump, but unfortunately you can't do that.

Honestly,I think the last thing I'd want to do is lantus during a busy vacation. You just can't take it back once it's there.

 

[gap2368]

there was one time Thought my pump ( medtronic) gave me more insulin then it should have I have since been to disney about 40 times with no problem and I have never disconnected my pump for any rides I do need much less insulin some times I cut my basel down to just 20% and I am still running in the low 80's I have been to CWD the last two years and I have read of no one having problems with there pump or the need to disconnect.

but with that said if you feel like you need to listen to your dr then I think that is what you should do.

 

[nikkislaght]

I dont use a pump ,, so dont really understand all your terminology, but my friend did Disney a few years ago with us using a pump, and he had no issues at all.. and he is a trill ride seeker.. after our Disney trip, he continued through out the US on his own to tour all the amusement parks with the best thrill rides.. all without incident..

 

[dja14]

That said - it's kind of a pain to go un-pumped on vacation, especially one with a lot of activity. If your son wants to, then I would say maybe switch over a week ahead just so you can get the feel of it again, and then plan on decreasing the basal by at least 75% to start and then increase it back up as your vacation progresses. My son will spend a lot of time unhooked from his pump while in the parks, and water parks, but he'll still bolus through the pump, but unfortunately you can't do that.

Honestly,I think the last thing I'd want to do is lantus during a busy vacation. You just can't take it back once it's there.

I am concerned about the lantus. While we've had our problems with the omnipod, the best thing is being able to turn it off when he is low. His lows sometimes come from nowhere and even when we are ready (hiking for example) he tends to go lower than we think and stay low. (It is not unusual for him to sink to 30-40 quickly) At our local water park it was basically off all day, he didn't even need to bolus (and he ate quite a bit) When we first got it I forgot we could turn it off and our zoo trip turned into a whole day of feeding him. There is no way he could do his whole lantus dose with walking and swimming, even if he eats whatever he wants (which, as a teen boy, he really enjoys doing when he can)

I would like to figure out a couple options before we go so we can switch if we need to. I want to prevent an emergency room visit but also I don't want to be up all night testing and feeding him. Our family is not known for smooth sailing although I really try.

 

[gap2368]

I would like to figure out a couple options before we go so we can switch if we need to. I want to prevent an emergency room visit but also I don't want to be up all night testing and feeding him. Our family is not known for smooth sailing although I really try.

well if you ever need medical help on vacation Disney world is the place for it they are great there ( free transportation to and from the hospital or urgent care sadly I know for exsprince) celebration hospital is good ( stay away from orange county) bit yes some times you can do every thing right and still not be good

 

[buffettgirl]

I am concerned about the lantus. While we've had our problems with the omnipod, the best thing is being able to turn it off when he is low. His lows sometimes come from nowhere and even when we are ready (hiking for example) he tends to go lower than we think and stay low. (It is not unusual for him to sink to 30-40 quickly) At our local water park it was basically off all day, he didn't even need to bolus (and he ate quite a bit) When we first got it I forgot we could turn it off and our zoo trip turned into a whole day of feeding him. There is no way he could do his whole lantus dose with walking and swimming, even if he eats whatever he wants (which, as a teen boy, he really enjoys doing when he can)

I would like to figure out a couple options before we go so we can switch if we need to. I want to prevent an emergency room visit but also I don't want to be up all night testing and feeding him. Our family is not known for smooth sailing although I really try.

I think I'd just keep it on him then. There is no real proof that insulin delivery can happen on rides, and you have a lot of proof that there are times when he needs it suspended. Maybe just suspend it while he's on a rollercoaster, without removing it? So that all delivery is stopped? (can you do that on the pod without it deactivating?)

The only other option would be to use your quick acting insulin as basal and give a shot every hour or so...literally (and figuratively) a pain.

 

[Selket]

I'd post this question over at the Children With Diabetes forums. We go to the CWD conference down there in July every year and I've never heard of anyone having an issue in the past - but I don't know if Ominpod could have changed something recently. I sure wouldn't want to have my teen switch to shots and figure that out. We did last year on spring break because his pump broke (nothing to do with amusement park rides - lol!) and it wasn't that easy to get things right.

I can see the concern as the Omnipod you can't really disconnect from the insulin - CWD folks may have additional insight. Good luck!

 

[dja14]

Thanks everyone! I am going to investigate this further. We have a few months so we have time. We already do a lot of nighttime testing and I really don't want it worse then.

My husband and I discussed just leaving the pump off during the day on park days and doing shots for basal and bolus. We have done that before when we were camping and he sweat his pods off. It is a pain but maybe would be the best of both worlds, no pump and no lantus. If his basal needs to go as low as I think it will it would be just like turning it off anyway.

 

[buffettgirl]

What about using something intermediate like Regular(R) as a basal? It peaks, so you'd have to worry about timing food, but it's only lasts about 6 -8 or so hours, so it wouldn't be as hard as using lantus.

It's also really great for handling high fat restaurant food. So it might be a win... not sure how long you've all been at this, and I probably wouldn't suggest it to a newly dx family, but if you've got a good handle on insulin action and duration, then it might be something to consider. You'd have to also cut out some of the novolog (or humalog or whatever you use for short acting) . Though, your endo probably would look at you like you've got 6 heads.

 

[dja14]

Our regular dr put him on an extended type insulin when he was first diagnosed (before we saw the endo and he was tested for antibodies) He (We ) did not have a good experience with it. We didn't know anything back then (a shot in the office and sent home (way over 400) with 1 page of what not to eat) and he had a very strong honeymoon period, we were pretty much feeding the insulin. It was a mess, I am not sure I am up for that again. It is one reason why I trust our endo office so much (in our regular dr's defense he was new (First emergency appt)to us and probably saved son's life-old dr never even tested his blood sugar and he had textbook symptoms, bad ones. He just doesn't work with type 1 kids)

We are not brand new to type 1, about 4 years. I know how to change things and have made adjustments in between appts. He is not the most responsible 16 year old though and still often feels it is unfair he has diabetes (and he has autism and ocd and motor tics as well, so he does deal with a lot) Even though we are not new this will be our first big vacation since he was diagnosed and I feel a little uneasy and overwhelmed. We have had so many health things with the kids over the last few years we have cancelled anything longer than a short week or weekend.

I think I am leaning toward keeping things the same as much as possible. He even said yesterday he just wouldn't ride rollercoasters (which he loves) because he would rather have his pod (and eat more-I think was his thought) I am still going to call omnipod and ask on the CWD forums but from everything else my husband and I found online it really looks like a thing where everyone is covering themselves.

 

[buffettgirl]

Yeah, just keep it on. He'll have a better vacation. You'll have a better vacation. You'll do great!!

 

[bfamily5]

Hubby removes his pump the evening before we fly and takes lantus. Then each meal his fast acting and boluses sometimes in between as well depending on blood sugar levels. He feels its a break and likes the spontaneity ( water rides, pools) we haven't had any issues. A few lows but no more or less than with his pump

 

[dja14]

Hubby removes his pump the evening before we fly and takes lantus. Then each meal his fast acting and boluses sometimes in between as well depending on blood sugar levels. He feels its a break and likes the spontaneity ( water rides, pools) we haven't had any issues. A few lows but no more or less than with his pump

Does he take less lantus or the regular amount (for him I mean), if you don't mind sharing? Does he test for highs more (and then bolus)? Does he have any trouble switching back?

Thank you.

 

[mamattorney]

My daughter just took a pump break over winter break from school. Admittedly there were no roller coasters during her break, but it was a lot easier than I thought it would be. We literally just swapped her basal for roughly an equal amount of Lantus (a little less) and went from there.

She enjoyed the break for a bit, but went back to her pump after about 10 days. One of the things that she noticed was that her boluses sometimes hurt quite a bit. When she went on her pump, she was 10 and taking only 20 units of insulin a day. When she took this break a couple of months ago at 13, she's taking around 80 units a day - for high carb meals her boluses can be 15 units alone. That much insulin taken so quickly hurt (her pump - t:slim is known for its slow delivery of insulin)!

 

[dja14]

She enjoyed the break for a bit, but went back to her pump after about 10 days. One of the things that she noticed was that her boluses sometimes hurt quite a bit. When she went on her pump, she was 10 and taking only 20 units of insulin a day. When she took this break a couple of months ago at 13, she's taking around 80 units a day - for high carb meals her boluses can be 15 units alone. That much insulin taken so quickly hurt (her pump - t:slim is known for its slow delivery of insulin)!

I hadn't thought about that. He does use a lot of insulin, about 200U every day and a half (that's why he changes his pod so often) His basal alone is 60 per day and he is a 6'4" teen boy, so he is always hungry. I am thinking he would need much less basal with all the walking.

I am still conflicted with this. I wish kids came with a manual. As of right now, he suggests just turning his pod off. I am going to call Omnipod but I don't think that will be enough IF the magnets and g forces are a problem. Husband has suggested using a dual approach, no pod during the day, putting it on at night. I feel that is wasteful really and also I am thinking I will feel insecure and still be up testing him at night. (I really don't want to do that)

I really appreciate everyones comments. No matter what we decide I feel better talking it through

 

[buffettgirl]

Husband has suggested using a dual approach, no pod during the day, putting it on at night.

the biggest issue with this is that you're going to have to do some sort of basal, like lantus, during the day, unless you just do a shot every hour of quick acting. But, if you do lantus, when you put the pump back on at night you'll be overlapping your lantus with pump basal, and if you just turn down the basal on the pump then it gets you no where. Might as well leave it off in that case.

 

[dja14]

the biggest issue with this is that you're going to have to do some sort of basal, like lantus, during the day, unless you just do a shot every hour of quick acting. But, if you do lantus, when you put the pump back on at night you'll be overlapping your lantus with pump basal, and if you just turn down the basal on the pump then it gets you no where. Might as well leave it off in that case.

I do realize this. If we go the pump off during the day then we will just do the shots. We have had to do that before when he was sweating so much the pod would not stay on. We did shots and testing every two hours. That was a stop gap, emergency type thing though.

 

[BethCPTSD]

By the way, have you heard of Diabetes Service Dogs? This may not be of interest to you or your family AT ALL, but if your son is on a pump, I've read many, many times, that the dogs that alert to highs and lows are often much more sensitive and accurate than the pumps can be. Just wanted to plant that little bug in your ear, in case! Best of luck to you guys and I hope you have a great time at Disney!

 

[gap2368]

By the way, have you heard of Diabetes Service Dogs? This may not be of interest to you or your family AT ALL, but if your son is on a pump, I've read many, many times, that the dogs that alert to highs and lows are often much more sensitive and accurate than the pumps can be. Just wanted to plant that little bug in your ear, in case! Best of luck to you guys and I hope you have a great time at Disney!

Just an FYI a pump dose not tell you if you are high or low