Hi.  I am looking for some information for my daughter (pumper aged 6).  She
has been pumping for almost three years now.  We have been doing great, but
the one problem we have is sites.  We use primarily her abdomen (she won’t
let us put the set anywhere else).  She is very tiny and she does not have a
lot of fatty tissue.

The problem we are now finding is that the skin on her abdomen has become
tough from using the pump (not scarred, the doctor said it is not scar
tissue) and that makes it harder to get the inserter needle into her skin.
This then causes a lot of upset when we need to change the infusion set
(despite the EMLA patch we use).

We are currently using the Minimed Silhouette.  She is on the Minimed 512.
We have been advised that the infusion sets that go in on an angle are
better for small children like my daughter.  My question is this:  Are there
any really good creams or ointments that other people use or have used that
will help keep her skin from getting damaged?   Does anyone with small
children use better infusion sets that are compatible with the Minimed 512?
Has anyone else experienced this and is there a way to try and reverse some
of the damage caused to the skin on her abdomen?   Thanks.

Shanah tovah
From Canada

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Dear Rabbi Meisels,

Thank you for your observation.  However, my Doctors at the Mayo
Clinic (Rochester, MN) as well as my local physicians would strongly
disagree.  I currently take over 100u/day of 70/30 and my BG's are
very close to 300 - not good at all.  When exercising for only a
short time (15 min), my BG's drop from ~275 down to 110 within 2
hours.  My body just isn't happy with insulin... thus the pump
regimen.  We're hoping to be able to regulate BG's with a more
monitored form of exercise, diet, and controlled (fast acting)
insulin.  Management is, what we hope, the key to success.

Thanks again,

Allen

--- In JewishInsulinPumpers@yahoogroups.com, "Rabbi Hirsch Meisels"
<RabbiMeisels@F...> wrote:
> Note, you say you are insulin resistant, from your description you
look to
> be more insulin deficient then insulin resistant.
>
> ----- Original Message -----
> From: "gemmycoins" <coins@c...>
>
>
> > As a matter of fact, shortly
> > after I was first diagnosed, and before it was know I was insulin
> > resistant,

Note, you say you are insulin resistant, from your description you look to
be more insulin deficient then insulin resistant.

----- Original Message -----
From: "gemmycoins" <coins@...>


> As a matter of fact, shortly
> after I was first diagnosed, and before it was know I was insulin
> resistant,

Thank you for the reply, and insight.  Where to keep
the "accoutraments" is now something I also need to give thought to.
Any ideas?  I won't be actively on the pump until Sept 13th.  So I
have a week to figure this out.  Any & All suggestions will be
greatly appreciated.  I prefer to pro-activley deal with these
scenarios vs. reactively.  Planning and prepatation will help me
adapt to a different lifestyle.

With regard to Yehuda's question to my comment - since my body's
blood cells don't absorb glucose without insulin injections, that
means that without medication, my body in theory, is actually fasting
all the time - in it's natural state.  As a matter of fact, shortly
after I was first diagnosed, and before it was know I was insulin
resistant, I remember eating 1 Pint of IceCream, drinking 1 Quart of
Orange Juice, and eating a 16oz steak, and I still was loosing
weight.  It was so bad, that I began seeing ribs, and bones on my
abdomen that I hadn't seen in years. Thus my case in point, and and
explanation as to what/why my Rebbe probably made his comment.

Looking forward to your replies -

Allen

Unomedical's inset infusion set, the first all-in-one infusion
set and inserter, is now available from Animas Corporation.
URL: http://www.childrenwithdiabetes.com/pumps/sets-inset.htm
CRL: http://url.childrenwithdiabetes.com/?u=2061
URL: http://www.animascorp.com/products/pr_infusion.shtml
CRL: http://url.childrenwithdiabetes.com/?u=2062

I keep my phone (Motorola i90c) and my pump (Animas 1200) both on my belt,
one on either side.  Yes, I do need a bigger suit to accommodate :-)
You didn't mention where you keep you glucose tablets, BG meter and
supplies, carb counter...

----- Original Message -----
From: "gemmycoins" <coins@...>
To: <JewishInsulinPumpers@yahoogroups.com>
Sent: Tuesday, August 31, 2004 9:03 AM
Subject: [JewishIP] Questions & Questions +Too Much Stuff to Carry Around?!?


>
> Hi everyone, I'm new to this forum, so please excuse any repetitious
> questions I may post here.
>
> Firstly, I'm a Frum professional who carries a cell-phone, briefcase,
> and as of today an Animus Insulin Pump.  Where does everyone put
> their phone & pump?  Are they both on the belt?  What if you're not
> wearing a belt?  I generally just put my phone into the pocket of my
> pants that don't have my car keys.  There just aren't enough pockets
> to do this with a pump too.  What do you do?
>
> Also, sleeping is going to be a challenge.  I roll from side to side,
> as I'm a very restless sleeper.  Where do the men attach/secure their
> pump?
>
> Lastly, so far, my Rebbe told me not to fast for any reason what so
> ever, since I'm diabetic.  He said that being diabetic means that I'm
> fasting all the time.  However, now that I have a Pump, what is
> generally accepted for Yom Kippur?
>
> Thanks,
>
> Allen
>
>
>
>
>
>
>
> Yahoo! Groups Links
>
>
>
>
>
>
>

There are many on this list who will tell you how they carry or clip their
pump. I would suggest that you contact your Animas rep and ask the same
question. My son uses the Cozmo pump and his rep  has a beeper, two cell
phones and his pump besides his wallet and keys. Watching him maneuver
everything while talking to us was quite an eye opener.

Sleeping - my son is also a restless sleeper and he keeps it clipped to his
pajama bottoms. He has never complained that he woke up because of the pump.

Now the harder question.
You wrote:

(snip) Lastly, so far, my Rebbe told me not to fast for any reason what so
ever, since I'm diabetic.  He said that being diabetic means that I'm
fasting all the time.  However, now that I have a Pump, what is
generally accepted for Yom Kippur? (end snip)

I am not sure what you mean by "fasting all the time"?

For more information on fasting with the pump see our Tishrei 5764 issue of
Going ForWarD.
http://www.friendswithdiabetes.org/files/Tishrei%205764%201.pdf

Both the pump and better long acting insulin (Lantus) have made an impact on
the issue of fasting. You may want to review the issues mentioned in that
article with your Rav and medical team and see what they think about you
fasting.

Yehuda Y. Scheff, Supervising Special Auditor Investigator
NYS AG MFCU
120 Broadway. 13th Floor
New York, New York 10271
Voice: (212) 417-5658
Fax: (212) 417-5410
E-mail address: yehuda.scheff@...

Hi everyone, I'm new to this forum, so please excuse any repetitious
questions I may post here.

Firstly, I'm a Frum professional who carries a cell-phone, briefcase,
and as of today an Animus Insulin Pump.  Where does everyone put
their phone & pump?  Are they both on the belt?  What if you're not
wearing a belt?  I generally just put my phone into the pocket of my
pants that don't have my car keys.  There just aren't enough pockets
to do this with a pump too.  What do you do?

Also, sleeping is going to be a challenge.  I roll from side to side,
as I'm a very restless sleeper.  Where do the men attach/secure their
pump?

Lastly, so far, my Rebbe told me not to fast for any reason what so
ever, since I'm diabetic.  He said that being diabetic means that I'm
fasting all the time.  However, now that I have a Pump, what is
generally accepted for Yom Kippur?

Thanks,

Allen

WASHINGTON (Reuters) - The U.S. distributor of a wearable insulin pump
has received a warning from regulators for failing to promptly report
that its devices may have contributed to serious injuries in some
diabetics.

The Food and Drug Administration (news - web sites) wrote to DANA
Diabecare USA last month, saying its procedures for reporting adverse
events associated with the DANA Diabecare II pump were inadequate.
DANA Diabecare Chief Executive Officer Susanne Jernigan said the New
Orleans-based company had adjusted its reporting procedures to address
the FDA (news - web sites)'s concerns but disputed any serious injuries
were linked to the insulin pump.
"Our device is not dangerous, it is not causing problems," Jernigan told
Reuters on Tuesday. "We have never had a death from our pump."
The FDA in its letter dated July 23 and posted on its Web site on
Tuesday, said: "Your firm received complaints regarding these pumps,
which represent events that should have been reported as serious
injuries ..."
Jernigan said the reporting of possible adverse events began immediately
under new procedures without waiting for weekly staff meetings or any
gatekeeping by senior executives.
The DANA Diabecare II insulin infusion pump is made by Sooil Development
Co. Ltd of Seoul, South Korea (news - web sites).

My first answer is to quote the home page : "Please consult your physician
for medical questions, and your Rav (Rabbi) for halachic (Jewish law)
decisions."

My second answer is to excerpt the third post on the Jewish Insulin Pumpers
group archive which was written by Rabbi Meisels (dated September 2003):

*******start excerpt*********
When I started pumping (apprx. four years ago) I asked my rav and I was told
that I should everything in the usual way. (snip)

Again, my rav told me that I can change batteries or cartridges or sets
whenever needed. L'maise I have a routine with changing batteries, so I
don't wait until it tells me the 'low battery alarm', so having to change on
shabbos is very rare for me. (snip)

********end excerpt*********

We have a list specifically related to pump questions; to join please go to
our main page at www.friendswithdiabetes.org and click on the Jewish Insulin
Pumpers link.

"Ah guten Shabbos !

Yehuda Y. Scheff, Supervising Special Auditor Investigator
NYS AG - MFCU
120 Broadway, 13th Floor
New York, NY 10271-0007
Tel: (212) 417-5658
Fax: (212) 417-5410
E-mail: yehuda.scheff@...
NYS AG WEBSITE www.oag.state.ny.us

My wife has the new Cordless Minimed Insulin pump and I was wondering
if anyone is familiar with the Surprise Bolus Feature and how to use
it?

A Randomized, Prospective Trial Comparing the Efficacy of
Continuous Subcutaneous Insulin Infusion With Multiple Daily Injections
Using Insulin Glargine.
URL: http://care.diabetesjournals.org/cgi/content/abstract/27/7/1554

Children With Diabetes is running a survey about infusion set disconnect
devices.
http://www.childrenwithdiabetes.com/survey/infusionsetdisconnect200406.htm

Diabetes Health - 25 June 20048 Tips For Making Infusion Sets Stick Better

Do infusion sets refuse to stick to your skin?

Do they come off when you sweat?

Does body hair affect how well they stay on?

Or does your tubing get caught on doorknobs or other objects and get
disconnected?

If you are familiar with these problems, the following tips for making
infusion sets stick better can help.

These tips are for everyone.

Start with clean skin. Try to change sets after you shower so the skin is
free of oils. Avoid soaps containing skin softeners, because they leave
behind oily residues that can make it harder for the infusion set to adhere
to the skin.
Apply a clear, unscented antiperspirant to the area where the set will be
placed to prevent any perspiration under the infusion set.
Swab the skin with a skin preparation product, such as Skin Prep or IV Prep,
to remove bacteria and make the skin sticky. Let the skin dry before
continuing.
Try using a dressing such as Tegaderm or IV 3000. Place the dressing
directly on the skin and insert the infusion set through the dressing. Or
you can apply the dressing on top of the infusion set to help hold it in
place. You might also use both methods for extra security. If you place the
dressing on top of the set, first cut a hole in it so the set can be
disconnected. To cut a hole in the dressing easily, fold the dressing into
quarters and then snip off the folded corner.
Sometimes body hair is a problem, because the infusion set tends to stick
better to the hair than to the skin. You can shave the area where the
infusion set will be placed. If shaving irritates the skin, simply trim the
hair down to stubble.
Using medical tape is also helpful. You can buy rolls of Hypafix or
Transpore from your local pharmacy. Place the tape around the edges of the
infusion set to help anchor it in place. You can also apply the tape later
should the infusion set tape start to peel back at the corners.
Michael Robinton, of Insulin-Pumpers.org, recommends using "gorilla snot" to
help hold infusion sets in place. Gorilla snot is an old military term for a
very sticky liquid. Use tincture of benzoin, Mastisol, or Skin Bond to help
hold sets in place. These liquid adhesives are applied to the skin before
the tape or infusion set, and work like glue to hold it on the skin. Let the
product dry until it is tacky to the touch before placing the tape or
infusion set. If it is still a runny liquid, the set will just slide right
off the skin. You may need to use an adhesive remover when it¡¯s time to
remove the infusion set.
If your tubing is always getting caught on objects and getting disconnected,
consider using a safety loop. This is a small section of tubing that is
taped to the skin beside the infusion set in a circle or loop. When you
catch the tubing on something, it allows an extra inch or two of tubing to
unroll before it yanks out the set.
For more discussions on topics like this one, visit www.insulin-pumpers.org
and join the insulin pumper e-mail forum.
-John Hughes

Now, What About That 'Goo?'
Now that your infusion set is sticking securely, you have another problem:
How do you get it off?

And how do you remove that "goo" from your skin?

Use a medical adhesive remover such as Detachol or Unisolve to remove the
set and the tape.
Fingernail polish remover or makeup remover can also be used.
Baby oil will work, but it's messy.
Alcohol wipes will often do the job but require more rubbing on the skin.
Citrus-based cleaning products such as Goo Gone will remove the sticky stuff
Leave it to time. After a number of showers, the residue will disappear on
its own.
An Infusion-Set Company by Any Other Name
Maersk Medical has a new identity.
The Danish company, which specializes in the development and production of
infusion sets for insulin pump treatment, is now known as Unomedical
Infusion Devices.
Since launching its first infusion sets in 1986, Unomedical has become the
world's leading supplier of infusion sets for insulin pump treatment.
Unomedical manufactures the Comfort, Silhouette and the Tender, which was
the first soft-cannula infusion set with an at-site disconnection feature.
They also produce the 90-degree Quick-Set.
To learn more about Unomedical, log on to www.infusion-set.com.
Source: Unomedical Press Release, December 2003
-D. Trecroci

Some time ago sarah levi <sarahlevi2002@...> wrote:
> Can any experienced pump users advise me on how to
> (easily?) completely remove all remnants of tape from
> skin around insertion site after changing sites?
> Thanks,
> Sarah
>
I'm almost certain that all of us have (unfortunately) discovered that the
far easiest way to remove a catheter and all connected tape is to have it
done when least wanting it.

If I could ONLY figure out HOW to get my tubing caught on a handle, twisted
or otherwise immobile, thus causing the not only painless but unknown
complete dislocation of the catheter, I would publish my results.

[no one even congratulated me on  23+ years of pumping last week!]

Yerachmiel

Any teenagers who wonder 'Can it be done' I've got 42+ out of 44+ years of
diabetes and I'm still walking around with my own feet, legs, kidneys, eyes
and everything else they've thought would not behave this long.

#1 suggestion for long term health: Follow HaShem.
The stricter one follows hilchos kashruth the better one's control will be!

[wouldn't say it if I hadn't SEEN it]

I use simple ethyl alcohol, which may be bought at any liquor store. The acetone
and its mixtures are OK for nails while are harmful penetrating into body
through the skin!


  sarah levi <sarahlevi2002@...> wrote:
Can any experienced pump users advise me on how to
(easily?) completely remove all remnants of tape from
skin around insertion site after changing sites?
Thanks,
Sarah



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[Non-text portions of this message have been removed]

We use a product called uni-solve made by Smith &
Nephew

joel
--- sarah levi <sarahlevi2002@...> wrote:
> Can any experienced pump users advise me on how to
> (easily?) completely remove all remnants of tape
> from
> skin around insertion site after changing sites?
> Thanks,
> Sarah
>
>
>
> __________________________________
> Do you Yahoo!?
> Yahoo! Mail - Helps protect you from nasty viruses.
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Nail polish remover (with Acetone) works well.

[Non-text portions of this message have been removed]

I found in a school supply store a glue remover, I give one little squirt on
the set, and it falls off and leaves no residuals.

----- Original Message -----
From: "sarah levi" <sarahlevi2002@...>


> Can any experienced pump users advise me on how to
> (easily?) completely remove all remnants of tape from
> skin around insertion site after changing sites?
> Thanks,
> Sarah

From the "MEDSCAPE" website
URL:  http://www.medscape.com/viewarticle/480642
<http://www.medscape.com/viewarticle/480642>  (you may have to register)
Insulin Lispro Injection (Humalog) for Use in External Insulin Pumps
On June 2, the FDA approved the use of insulin lispro (rDNA origin)
injection (Humalog, made by Eli Lilly) in several external insulin pumps.
Insulin lispro should not be diluted or mixed with any other insulin when
used in a pump.
Pumps included in the approval include MiniMed Models 506, 507, and 508
using MiniMed Polyfin infusion sets, the Disertronic H-TRONplus V100 insulin
pump (with plastic 3.15 mL insulin reservoir), and the Disertronic D-TRON
and D-TRONplus insulin pumps (with lispro 3 mL cartridges) using Disertronic
Rapid Infusion sets.


Yehuda Y. Scheff, Supervising Special Auditor Investigator
NYS AG - MFCU
120 Broadway, 13th Floor
New York, NY 10271-0007
Tel: (212) 417-5658
Fax: (212) 417-5410
E-mail: yehuda.scheff@...
NYS AG WEBSITE www.oag.state.ny.us




[Non-text portions of this message have been removed]

(snip) Which of pumps are approved exactly? Or give the link please! (snip)

I checked the Diabetes in Control website and they have posted exactly what
Rabbi Meisels wrote in his post. There were no links to any other site. I
have tried to locate the information on the FDA website without success.
Stay tuned as we try to find out more information. I am suprised as my son has
been on the pump since May 2003 and has only used Humalog in his pump.

Yehuda Y. Scheff, Supervising Special Auditor Investigator
NYS AG - MFCU
120 Broadway, 13th Floor
New York, NY 10271-0007
Tel: (212) 417-5658
Fax: (212) 417-5410
E-mail: yehuda.scheff@...
NYS AG WEBSITE www.oag.state.ny.us



[Non-text portions of this message have been removed]

Which of pumps are approved exactly? Or give the link please!

Rabbi Hirsch Meisels <RabbiMeisels@...> wrote:On June 2, the
FDA approved the use of insulin lispro (rDNA origin)
injection (Humalog, made by Eli Lilly) in several external insulin pumps.
Insulin lispro should not be diluted or mixed with any other insulin when
used in a pump.

***Until now only Novolog was approved RHM***


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[Non-text portions of this message have been removed]

It's called GOOGONE not really meant for skin but it works. Magic American
Corp makes it.

Shmuel

-----Original Message-----
From: sarah levi [mailto:sarahlevi2002@...]
Sent: Wednesday, June 16, 2004 4:01 AM
To: JewishInsulinPumpers@yahoogroups.com
Subject: [JewishIP] removing insertion site tape

Can any experienced pump users advise me on how to
(easily?) completely remove all remnants of tape from
skin around insertion site after changing sites?
Thanks,
Sarah



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[Non-text portions of this message have been removed]

Can any experienced pump users advise me on how to
(easily?) completely remove all remnants of tape from
skin around insertion site after changing sites?
Thanks,
Sarah



__________________________________
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Yahoo! Mail - Helps protect you from nasty viruses.
http://promotions.yahoo.com/new_mail

On June 2, the FDA approved the use of insulin lispro (rDNA origin)
injection (Humalog, made by Eli Lilly) in several external insulin pumps.
Insulin lispro should not be diluted or mixed with any other insulin when
used in a pump.

***Until now only Novolog was approved RHM***

I think you would have to call each Kupah seperately
to find out. Probably the best would be to speak to
the Diabetes Clinic or Nurse which each Kupah
supposedly has, OR to write a letter to a high-up
administrator.

My personal experience with Kupat Cholim Meuchedet was
that 3 years ago a person could choose whichever pump
they wanted, once a medical commitee approved the
pump. As of 6 months ago I heard that the Kupah
chooses which pump they deem appropriate for the
person, and I've no idea what they base their decision
on.

By law, the patient pays for 15% of medicines
including pump supplies. However, any patient who
standardly exceeds 241 Shekel per month - as all pump
users do - can get the extra money back, or, as in my
Kupah, arrange that you pay only 241 Shekel per month,
as long as supplies are bought in the Kupah pharmacy.

B'hatzlacha making heads or tails out of the Israeli
system, and if this is l'maaseh, I wish you smooth
sailing with the pump.

Kol tuv,
Sarah



--- Yisrael Dubitsky <YIDUBITSKY@...> wrote:
> Wait..are you saying that different kupot have
> different pumps coverage?
> Does any of them cover the Deltec pump and its
> supplies? How does one find
> out which kupot cover which pumps and supplies?
>
> Rov todot me-rosh,
> Yisrael
>
> At 08:45 PM 6/3/2004 +0000, zeev3141 wrote:
> >Life in Israel with pump is beautiful! I am wearing
> the pump Paradigm;
> >I am a member of sick-fund (Kupat Cholim) Leumit.
> The monthly limit is
> >on medical supplies including pump supplies,
> insulin, test strips and
> >other medicines (excluding non necessary, for
> example, plaster) for
> >chronic patients is 220 shek. in Leumit. The
> reimbursement I receive
> >in the next month without problems regularly.
> >It should be noticed that Kupat Cholim in Israel
> pays not every model
> >of pumps. The most popular is of Minimed. Klalit
> pays Animas while
> >Leumit doesn't pay it.
> >
> >Ba-Brakha!
> >Victor,
> >Ashdod
>
>
>





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Wait..are you saying that different kupot have different pumps coverage?
Does any of them cover the Deltec pump and its supplies? How does one find
out which kupot cover which pumps and supplies?

Rov todot me-rosh,
Yisrael

At 08:45 PM 6/3/2004 +0000, zeev3141 wrote:
>Life in Israel with pump is beautiful! I am wearing the pump Paradigm;
>I am a member of sick-fund (Kupat Cholim) Leumit. The monthly limit is
>on medical supplies including pump supplies, insulin, test strips and
>other medicines (excluding non necessary, for example, plaster) for
>chronic patients is 220 shek. in Leumit. The reimbursement I receive
>in the next month without problems regularly.
>It should be noticed that Kupat Cholim in Israel pays not every model
>of pumps. The most popular is of Minimed. Klalit pays Animas while
>Leumit doesn't pay it.
>
>Ba-Brakha!
>Victor,
>Ashdod

Life in Israel with pump is beautiful! I am wearing the pump Paradigm;
I am a member of sick-fund (Kupat Cholim) Leumit. The monthly limit is
on medical supplies including pump supplies, insulin, test strips and
other medicines (excluding non necessary, for example, plaster) for
chronic patients is 220 shek. in Leumit. The reimbursement I receive
in the next month without problems regularly.
It should be noticed that Kupat Cholim in Israel pays not every model
of pumps. The most popular is of Minimed. Klalit pays Animas while
Leumit doesn't pay it.

Ba-Brakha!
Victor,
Ashdod

----- Original Message -----
From: "mordechaisones" <sones@...>
To: <JewishInsulinPumpers@yahoogroups.com>
Sent: Monday, May 31, 2004 3:59 PM
Subject: [JewishIP] Re: Life in Israel with a pump

<<< Also, we were wondering how one may acquire back issues of your
> magazine Going Forward?
>
> Thank you>>>

If you wish to download them, here is the link;
www.FriendsWithDiabetes.org  and click on Diabetes Guides
We do have hard copies available as well.  However we will need to be
reimbursed for the shipping cost.
RHM

--- In JewishInsulinPumpers@yahoogroups.com, "Rabbi Hirsch Meisels"
<RabbiMeisels@F...> wrote:
> Is there anyone on the list from Israel that could offer advice on
life in
> Israel
> with a pump in regards to insurance and such?
>
> Thanks.

My wife is using the minimed pump paid for by Kupat Cholim Maccabi.
Dr. Michael Spiro is the doctor treating her and who recommended the
pump.  There is supposed to be a 200 shekel per month limit on
medical supplies for all those who suffer from a chronic illness.
However, most kupah bureaucrats we have been dealing with claim to be
unaware of this policy, and so far we are told that we will get a
retroactive refund for any diabetes supplies exceeding that monthly
amount, once we are approved, which will happen as soon as a powerful
enough bureaucrat has a chance to scrutinize my wife's doctor's
second letter (the first one has been "misplaced").  What sort of
specific information are you looking for?

Also, we were wondering how one may acquire back issues of your
magazine Going Forward?

Thank you,

Mordechai and Laya Sones
Nachaliel