Insulin Pump placement

[NightCastle]

Hello, I have been studying Kendo for just shy of a year. (Sorry for the long post, but this subject needed quite a bit of explanation to describe the issue) I started to wear bogu at around 3-4 months into studying. I am a diabetic and use an insulin pump. It is a very important piece of medical equipment that I need in order to keep my blood sugars level. I previously used to put it as far behind me on my obi when I was studying karate and could take it off for the five minutes or so during sparring matches in tournaments, but it is not quite as easy to do this during kendo practice as getting it off would require that it either be done before putting on my dou or after I have been wearing my dou for a while and then removing the dou to get to it. Leaving it off for a prolonged period of time (the whole kendo class) is not good for my blood sugar regulation, so that is out of the question.

We have been doing a lot of dou strikes lately and it brought to the forefront of my mind something I have been trying to figure out for quite a while; the best way to place my insulin pump without it being in danger of shinai damage and also not have it be in the way. I am presently placing it on my obi between the dou and the "cardboard" piece. It is approximately the size of a deck of playing cards with a hard plastic shell and a belt clip that has a hooked end which allows it to stay in place if clipped to my obi because it goes around the obi and is hooked such that it will not easily slide off.

It has been suggested by sensei that I might try clipping the insulin pump to that cardboard piece on my back in order to get it out of range for accidental missed dou strikes. Unfortunately, the tendency for it to fall off is higher, as I have actually tried that and had the pump fall off during practice. (That experience was not fun as the small tube connecting it to my person was pulled very tight and actually hurt) On the other hand, the place that I have been putting it between the dou and the cardboard piece is more securely placed but is dangerous as it is in an area that is easy to strike for anyone who misses hitting the dou on my right side.

I have been contemplating clipping it to my keikogi in some way that it is protected by the dou, but the first places that I have been considering would possibly be putting in such a way that it could still be smashed between me and the dou. That is also a very bad thing.

Does anyone else that is in kendo have any experience with an insulin pump and the best placement for it?

Thanks for any advice ahead of time.

[Julian D]

How about sewing on a pocket to your koshita (the cardboard piece on the back of the hakama) and storing the pump there? You could close the pocket with velcro or pressure buttons.

Something like this:

http://img253.imageshack.us/img253/6797/koshita8we.jpg (http://imageshack.us)

[NightCastle]

I will speak with my sensei about possibilities for that.

Thanks for the suggestion.

[Neil Gendzwill]

The only concern with that location is the safety of both your pump and your back should you go for a roll. Unfortunately, I don't have a better suggestion other than to make the pocket padded.

[NightCastle]

Padding does make sense. Maybe I could sew a pocket within my keikogi in a less dangerous area.

Thanks again. All suggestions are welcome and will be considered.

[Julian D]

If the pocket is attached to the outer side of the koshita, and it's really the size of a deck of cards, I don't see how it could be really dangerous.

When falling/rolling I'm more afraid of the koshita itself (mine is rigid plastic, not cardboard), and let's not forget the hakama himo knot in the lower back!


100% agreed on padding or "armouring" the hypothetical pocket.

[NightCastle]

I'm thinking that it might be dangerous to the insulin pump. There is a possibility that the pump may be damaged if the fall is particularly hard and since the pump is in a fixed location with not much of a path to be moved out of the way like on the obi, where it can slide along it. Padding should help though. If the padding is kind of like "armoring" that might suffice, even in a hard fall.

I might have to look into what I might have to do in order to provide maximum protection for the pump.

Thank again.

[samurai999]

what about putting the pump inside some soft, impact absorbing material and taping/velcroing it to the inside of your dou?

Only bad part to that is if your dou comes loose and the attachment from the pump to your body becomes.. well.. messed up.. Or get a piece of hose long enough so that the hose has some slack...

oh well, just a suggestion...

[Okuryo]

Are you sure that disconnecting the pump for the duration of the practice is out of consideration?
I practice Kendo and use an insulin pump, but I disconnect it completely whenever I go to practice, and my glucose level never gets too high afterwards, even though it's usually about two hours till I connect back.
Kendo is an intensive physical activity, after all.

[NightCastle]

I have relatively high amounts of insulin given to me during the day and removal for too long has always created a problem for me. Previously when I have tried to do that during other intensive physical activities, I have physical symptoms of high blood sugars by the middle to end of the activity that makes me feel sluggish and sometimes sickly. If I take it off for only about 30 minutes I don't have much of a problem. Longer than that and I have blood sugar issues.

On another note. It is good to meet another insulin pump user!:smiley:

[ZtefaNNN[K]]

Have you thought placing it behind the mune ?

( I don´t understand well how the pump should be applied to your body, but it seems like a safe place to me. )

[NightCastle]

I have thought about putting it behind the mune, but I am concerned that a good solid hit to the do or compression might damage the pump. It is fairly sturdy, but it is vital for living and I don't want to have an accident which might leave me without it for a while. That would be bad. I have considered clipping it to the keikogi behind the do, but that may produce the same possible issue.

Thanks for the suggestion.

[Dufus]

I am also a type 1 diabetic with an Insulin Pump, and I just take mine off during practice. I see you mentioned that you have problems with high blood sugars when you take yours off, but I think that there ought to be a way to deal with that. You said you're ok for taking it off for about half an hour, so how long is your practice? Also, you said you take quite a bit of insulin during the day, so what's your basal rate during your practice time? Do you make sure to check your blood sugar before practice?

With me, it took me about two and a half years to balance my blood sugars with practice. I had problems with both highs and lows, depending on what practice was like. What works for me is figuring out what my blood sugar is before practice and either eating something or taking insulin, depending on what it is.

I know this is about finding a way to wear your pump during practice, but given how expensive insulin pumps are, I think you should think about trying to go without it. You certainly don't want to damage it, because than you would be in much more trouble than if you just didn't wear it.

[NightCastle]

Hello Dufus. I understand what you mean. My practices are typically around an hour or so plus changing clothes (so around 1.5 hours total). The problem arises after the first 30 minutes. I can try to do something like what you are suggesting, where I try to make certain of what my blood sugars are before practice and see what happens when I go to practice. I might try to have my blood sugar at exactly 100 before practice to see what happens.

The main reason I am not 100 percent sure of doing that is because I have done it in the past with karate tournaments or practices where I would have been in matches for quite a while, like around 45+ minutes of off-and-on sparring. After the first 30 minutes, though, my blood sugar typically rises and I start having problems with motor functions like sluggishness with my appendages.

As you know, another problem is that during that kind of strenuous exercise, there is the possibility of getting too focused on what I am doing to notice the signs of a low blood sugar. In karate, my sensei would be able to see a noticeable change in my complexion to tell me to check my blood sugar. Unfortunately, with Kendo it is harder for others to notice those subtle changes when I have my men on. The problem that I am concerned with is that I would start practice with a certain predicted blood sugar and end up working more or less than expected and having the different problems that I stated earlier. If the problem is a high blood sugar and the pump is on, then I can easily give more insulin. If the problem is low blood sugar, then I decrease the basal dosage.

What blood sugar are you typically at when you start kendo practice?

[Dufus]

My ideal blood sugar before practice is about 130. That way, it's not so high that it interferes with practice, but I also have some leeway if it drops from exercise. Are you in bogu for your entire practice? If not, maybe you could disconnect right before you get into bogu, and reconnect as soon as you get out of bogu. All your concerns are certainly legitimate, and like my senseis say, they'd rather I take a few extra precautions than have to pick me up off the floor during practice.

You could also try giving yourself a small bolus of insulin right before practice to make up for what you would lose by unplugging your pump. It'll take time to figure out for sure what works, whether you're wearing your pump or not. Don't be afraid to try a few things out. Just make sure to be mindful of how you're feeling if you do.

[NightCastle]

First, we typically wear bogu (including men and kote) for everything but bowing in, warm up (which lasts about 5-10 minutes) and bowing out. When we bow in, warm up and bow out, we typically still wear the tare and dou. That is why I figured that it would be too long of a time without my pump.

130 does sound like a possible good starting point.

I will try that and see about what else I may need to do as I work things out.

Thanks again for the suggestions.

[Ignatz]

I have to hand it to you guys for braving hardship to practice kendo. You are an inspiration.

As to the small of the back under the koshita I can tell you that when I practiced and later taught jujitsu I had the students turn their obi around so that the knot was in the small of their back. If they did back falls improperly the knot would let them know and if they did rolls improperly the knot would let them know. (I understand that some teach rolls as straight over, we did not).
Once the technique becomes habit then your chance of smashing the small of your back and the pump go way down.

Again, keep on keeping on.

[NightCastle]

Thanks Ignatz. And thanks to my fellow insulin pump users and others for your advice. When I started having some trouble with the blood sugars in the national karate championships, my sensei made me a pump cover that made the pump not noticeable by the judges. I thought that his ingenuity was great.

I will see what I can do to work things out with blood sugar. If not, then I will try some of your other suggestions with my pump.

I second the "Keep on keeping on".

[bullet08]

i'm type 2. being avoiding insulin with diet, pills, and kendo. been thinking about this for few days. i think putting the pump in padded case and strapping across the stomach, little above belly buton and below mune, might work. unless your do is very tight on your mid section, this should protect the pump from getting smashed. tho.. you will have to make sure that people don't hit you across the front of do, and learn to hold center and not open up for do.

pete

[NightCastle]

My dou is kind of loose, but I'm not certain that there is enough room between me and dou for the pump with the kind of padding it would need. Thanks for the suggestion.

[PhilMcLaughlin]

IM impressed by your determination !

How long is the tube ?

I wonder if you could place the pump in your zekken, behind the tare in the front (it would need some securing there though). It should be out of the way

Alternatively a pocket on your keikogi on the side, down low on the thigh so its not in the way if you fall ?

if the tubes not long enough then how about inside the do (the do attachd to the do) on the lefthand side as its much less likely to be hit than the right ?

best of luck

regards

Phil..

[NightCastle]

Thanks for the idea PhilMcLaughlin. I was considering a placement in the keikogi. If my bloodsugar issues can not be overcome; I will more than likely consider either, koshita placement in a padded (armored) pouch or attached within the keikogi. The placement you suggested within the keikogi might be a really good location. The tube is 43 inches long and that could work.

Thanks again.

[Hai_hai]

First thought that came to mind was "You can shove it in your a$$"... as a joke, of course.

On a serious note, I can't think of any place to put it where you don't get struck with the shinai, the opponent's body, or if you fall to the ground other than behind the dou. So, you could place it in front of your body on the gi where the dou would cover it.

[tounyoubyou]

I am a diabetic and I have been practicing Kendo for a little over 2 years. I wear my pump under my uniform so that it is under the left side of my Do. The case has an elastic strap and a pocket with velcro. I adjust my pump before practice and it keeps on pumpin' all through my 1.5 hour class. The case can be found for a variety of pump models here:
http://www.diabetesnet.com/ishop/product_info.php?cPath=45&products_id=643

Under the left side of the Do is the safest place I can think of as there is a little space between the Do and your ribs and the left side does not get hit that much since most techniques for Do cuts are on the right side. I am new to doing the forum thing....one of my sensei told me about your post and asked if I could sign on and let you know what I have been doing.

Hope this helps ;)

[satsumaruma]

Just a thought from someone who is not diabetic.

If the tubing is 43" long is it possible to 'strap' the pump somehwere out of the way like, say, the back of a thigh.

This area never takes a hit even accidentally and if you fall this area tends not to be the place of impact. Sideways - arms and knees tend to brace the fall; forwards - hands and knees; backwards - bottom and hands or bottom then back.

I don't think it would cause much hinderance and I think it is something you would get used to.

Don't know if this helps - just trying to be practical.

Lee

[Navyguy]

I never knew even such equipment existed!!!

In reading most of the posts, I note that most people seem to trying to "hide" the pump. I have never seen any of these before, so perhaps my comment is not even valid.

What about making a "shirt" with a pocket in it somewhere near the shoulder blades or slightly lower. You could wear it under your gi top. The himo from the dou could help support the pump and it should be totally safe from any sort of impact. I have never been hit in the back and for the few times that I have been tripped up or even knocked around, I can't see any damage to the pump.

You might require some "padding" where the pump may sit just to protect you back from rubbing.

Again, I have never seen one of these so perhaps there are reasons why this cannot be done.

Cheers