How Do I Wear a Cortisol Pump?

20 Nov, 2019 What to Expect 2

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Getting used to wearing a cortisol pump may take some adjustment. We are providing tips on how to wear your cortisol pump with the hope that it will help ease the adjustment period. If you feel that there is something that we did not cover, please contact us.

Types of Pumps

All pumps can be divided into two main categories: those with a tube and those without. The paragraphs below provide some information on both types as well as tips for wearing them.

Tubeless Pumps
Tubed Pumps

Tubeless pumps, like Omnipod, are very easy to wear. Simply place the pod on your body where it will not be bumped or rubbed by waistbands, straps, seatbelts, etc.

You will have to carry your PDM with you at all times.

Adults and/or children prone to losing things may want to opt for a tubed pump instead.

Some Omnipod users utilize technology such as a Tile to keep track of their PDM. However, while this technology is sometimes helpful at locating missing items, it is not reliable 100% of the time.

There are attractive covers available for pods that make them seem more “public friendly” when placed on an uncovered area.

Tubed pumps have the cannula attached by a tube to the infusion cartridge which is inside the actual pump. One of the benefits of a tubed pump is it does not have separate parts that can be misplaced (like the Omnipod PDM).

However tubed pumps do present some challenges, for instance you have to be careful when dressing/undressing so you don’t accidently pull on the tubing which can compromise the cannula. (It should be noted that the same thing can happen when pods are bumped.)

Most tubed pumps come with a clip, and if they do not, one can be ordered. A tubed pump can be easily clipped to a pocket, waistband, or bra. Running belts, such as Spibelt or Flipbelt are also a comfortable and discreet way to wear the pump.

There are endless products available for wearing and carrying insulin pumps, so do not be afraid to search for those.

If you choose to wear your pump clipped to the outside of your clothing it should be protected by a cover to prevent scratches and cracks.

Tips for Wearing the Pump in Different Scenarios

Once attached to the cortisol pump, it is rare that you will disconnect for long periods of time. Below are some different scenarios, each with some tricks that we hope you find helpful. It should be noted that most of these suggestions are in regards to tubed pumps. Those with tubeless pumps will not have the same issues to navigate as those on tubed pumps.

Sleeping
Showering
Sex
Swimming

Sleeping with a pump may take some adjustment. Some people just clip the pump to their pajamas. This can be uncomfortable for those who roll over onto their pump while sleeping. If you are a side or back sleeper you can clip the pump to the front of your pajamas. If you are a side and stomach sleeper you can try clipping the pump to the back of your pajamas.

Some individuals will tuck the pump into a baby sized sock for cushion and stuff it in a bra or pocket.

Others prefer to leave the pump unclipped and allow it to rest beside them. This can be problematic for those who toss and turn throughout the night, as the tubing can get pulled and potentially the infusion site can come out.

A soft, stretchy running belt, such as Flipbelt, is also another popular choice for wearing the pump while sleeping.

You will most likely have to try several ways to accommodate your pump while sleeping until you find what works for you.

Showering can be tricky while wearing a pump. Omnipods and Medtronic 600 series pumps are shower safe. Unless the pump is cracked or damaged in some way, it is not necessary to protect the pump from water.

Tandem pumps are IPX7 rated and should be safe to be submerged up to 1m in depth, however Tandem advises against this, as the IPX7 rating can only be guaranteed when the pump is new out of the box. Please note that some older model pumps, such as Medtronic 500 and 700 series pumps are not waterproof and would need to be protected or disconnected while showering. You should always consult your pump owner’s manual in order to determine if it is shower safe.

Usually while showering there is nowhere to clip the device, and running belts will get soggy. Some cortisol pumpers use waterproof arm bands or neck bands that have a pouch to place the pump. In a pinch, a pump could also be clipped to a sturdy wrist band or watch band.

Alternatively, many pumpers choose to disconnect their pumps while showering or bathing. This obviously disrupts cortisol delivery. In these cases, it is advisable to bolus the amount of missed medication prior to disconnecting the pump. For example, if the basal rate for that specific time block was 1 unit per hour, and you expected the entire amount of time you would be disconnected from your pump to shower was going to be 30 minutes, then you would bolus 0.5 units prior to disconnecting for your shower.

When you disconnect to shower, if you suspend delivery, sometimes the solu-cortef crystallizes and you will find that you are not getting proper delivery of your medicine once you reconnect. A way to avoid this is to put the end of the tubing inside an alcohol wipe, folding it over the end and putting that back inside the alcohol wipe wrapper. Just let the medicine flow, do not suspend delivery, and this should eliminate that problem. This not only prevents crystallization, but keeps the connector sterile while disconnected.

Of course, this will need to be based on time of day, and the length of time disconnected. For instance, if it is late at night, when your pump rates are extremely low, you may not need to bolus for your shower.

If the pump is disconnected, it is critical that the pump user remembers to restart the delivery of cortisol.

It is easy to simply reconnect the tubing and forget to resume the basal flow. This is very concerning if showering at night and the pump remains suspended while the patient is sleeping. The pump will alarm anytime the delivery is suspended, but in some cases, the pump user may not hear this if they are heavy sleepers or if the pump is under thick bedding. This is another good reason to not suspend delivery when you shower, and instead use the alcohol wipe tip above.

How to wear the pump for intimate time is a common question among pumpers. Running belts are an excellent option here. Stashing the pump in a running belt keeps it protected from being snagged or pulled.

There are stretchy garter belt type bands for the leg or waist, such as those sold by Stashbandz, that may be a desirable solution for female pumpers. The pump can also be clipped to a corset or other lingerie.

The pump can be simply unclipped and set aside, but take extra caution to not pull on the pump or tubing while it is attached to the individual.

The pump may be disconnected like discussed in the showering section. In this situation, it is prudent to bolus for the basal missed prior to disconnecting the pump.

Keep in mind the pump will alarm while delivery is suspended, and the pump user must remember to resume delivery after reconnecting the tubing.

Individuals must also mind their infusion site during intimacy. This is especially applicable to Omnipod users. Do not put excess pressure, continued rubbing, or bumping on the infusion site. This can cause the site to leak, bruise, bleed, or to fall off completely.

Swimming may require extra precautions depending on the type of pump. All of the latest models of infusion pumps are waterproof to some degree. It’s important to note this only applies to undamaged pumps with no cracks or broken covers, etc. If the pump is damaged, its waterproof integrity is compromised. You should always consult your pump owner’s manual in order to determine if it is water safe.

Older pump models may not be waterproof and should be kept away from possible water or excess sweat exposure.

Omnipod is a favorite for those who love water activities. It works with any swimsuit and the device is water proof up to 25 ft. However, spray-able sunscreen should be completely avoided with Omnipod. The propellant will crack the plastic and destroy the pod. The regular rub on sunscreen is just fine.

The Omnipod PDM is not waterproof and should be kept away from water exposure.

Medtronic pumps are IPX8 rated and can be submersed. “At the time of manufacture and when the reservoir and tubing are properly inserted, your pump is waterproof. It is protected against the effects of being underwater to a depth of up to 12 feet (3.6 meters) for up to 24 hours. ” (MiniMed™ 630G Insulin Pump System, medtronic.com)

They can be clipped to a swimsuit and can be operated underwater.

“Tandem pumps are watertight (IPX 7), tested to a depth of three feet for up to 30 minutes. Users can have peace of mind knowing that their pump is safe in the event of accidental submersion. However, we do not recommend users shower, bathe or swim with their pump.” ( Summer-Friendly Tandem Pump Features, tandemdiabetes.com)

All pumps and PDMs should be kept out of direct sunlight to keep them from overheating in high temperatures. More information can be found in the pump’s user guide or on the manufacturer’s website.