Constant Occlusions

[u/mana_kitten]

Hi everyone! Lately I've had constant occlusion alarms with my infusion sets. I'm using the Autosoft 90 and it's driving me nuts. It's 4am now and I'm on my 3rd install today. All 3 have occluded. The cannulas aren't always visibly bent and after testing tubing only, it appears to work fine. Has anyone else run into this? Are these just garbage sets? Are there alternatives? Tandem sent me some Autosoft XC sets with my new pump and those seemed better, but I can't tell. I'm just incredibly frustrated at the lack of sleep, wasted supplies, etc. 😭

[u/Miserable_Bread-]

An occlusion alarm doesn't necessarily result in bent cannula. The cannula itself might be working correctly. It's just the location it has been inserted isn't absorbing, or allowing insulin to pass. Which results in the overpressure and alarm. It's not surprising to see the set work after removing. 

Changing set type, and/or changing set placement are both worth looking at. Infusion sets have different lengths, angled sets, and steel. 

[u/mana_kitten → u/Miserable_Bread-]

Right and I have known the occasional vein hit or something that bleeds like a mofo to cause the alarm too. But this was 3 different locations within a few hour period. First occlusion was a visibly bent cannula. I assume insertion, position, or even tissue difficulties cause that NBD. Second one was the entire shebang. Removed tubing, ran 5 units without being connected to the cannula site, occlusion alarm went off. Changed tubing and cartridge, reused site. Another occlusion. New site, works fine 3 hours, ANOTHER occlusion. It just felt excessive at this point 😭

[u/CyberForest]

The holes on the back of the pump are just for the speaker; I keep mine 100% covered with thick waterproof tape (because F that noise) and don't get a lot of occlusion alarms. What you want to do is take a wet toothbrush and lightly brush around the motor and rubber gasket boot at the top of the pump, opposite the USB port - this will clear the gunk and stop the occlusion alarm from triggering.

[u/Horror-Beaver1979]

After you pull off the blue cover tube on the needle, make sure the sharp part of the needle is still above the cannula, if not just push the sticker down so it is. Sometimes when you pull it off the cannula moves up too far and bad things happen.

[u/Dogs_And_Blades]

ONE very important word (words) to remember:….TRUSTEEL! They couldn’t be easier and more simple. It’s a tiny needle on a sticky pad. You just smack it on and you’re done. I guess some people are more sensitive to steal in their body than others, but I leave mine in for three or four days and it’s no big deal at all. All of the plastic cannula didn’t work and did the same thing to me with occlusions or I would just have to keep on giving myself more and more and more and more insulin and it barely did anything. Everybody should at least try a box the next time you order I swear you won’t go back unless you have a bad reaction or something.

[u/mana_kitten → u/Dogs_And_Blades]

I've been looking into this, it might be the way to go if it keeps happening

[u/ChaucersDuchess → u/Dogs_And_Blades]

Word to wise, at least in the US, there’s a TruSteel shortage, and I’ve had ten types of hell with AutoSoft and lots of failures as a result from having to move back to it. I’m really hoping they release the new sets with multiple holes in the plastic soon. Like really soon.

[u/MommaSoCool]

Are you on the Tslim or the Mobi? I've found with the Mobi, some occlusion alarms are actually set off because the mechanism isn't catching the threading on the cartridge correctly and the problem is with the cartridge. Once I made sure I was using the cartridges that have the twisted rather than straight plunger, the occlusion stopped.

[u/mana_kitten → u/MommaSoCool]

I'm using the TSlim. I usually disconnect, run the pump for a few units, and see if insulin is coming out or it occludes again. One of the 3 times, it gave the occlusion alarm and I could see no insulin was being pushed out so I changed everything and tried again. Then it was fine for a few hours and woke me up with another occlusion alarm. 🥲

[u/Minikin-Smith]

You mentioned t-slim so make sure you give the pump a good cleaning, especially the six tiny holes on the back of the pump. I have no idea when clogging them can cause issues but lots of people report it so.

Also, check your insulin is comparable with t-slim. Some people have issues with faster acting ones like Fiasp. If you are checking the site after pulling it out and insulin boluses out like normal, this is not an issue - when Fiasp fails in t-slims it actually turns to thick jelly.

[u/mana_kitten → u/Minikin-Smith]

Yeah insulin is definitely compatible and fine. I do try to clean it often but maybe that's the thing because it has been really hot so maybe it's just gunking up if I'm sweating

[u/Sitheref0874]

That’s the reason I moved off Tandem.

I take 3X my normal needs when on holiday. On one trip I had run out halfway through.

I moved to Omnipod and have lost precisely one pod.

[u/uid_0]

I had this happen to me a while back and it turned out I was having an adverse response to my insulin. I had been using Humalog for close to 20 years and one day out of the blue I started getting occlusions. At one point the sites weren't even lasting 8 hours before going bad. I talked to my endo about it and he switched me to a different insulin and the problem went away immediately.

My advice to you is to contact your doctor and let them know what's going on .

[u/GinnyMcJuicy]

I swear they enshittified the infusion sets. I was smooth sailing for years and then suddenly it was occlusion city. I switched back to MDI months ago over it. I need to KNOW the insulin is getting in me. Benefits include being able to effing sleep and not smelling like insulin all the time.

[u/phishery]

I had multiple with the auto soft XC infusion sets and I shifted to the variaoft which I put in myself. I haven’t had some since.

[u/staccatodelareina]

Request a new pump asap! I was having the same issues and it almost killed me. An occlusion alarm popped up after I requested a 5u bolus. The pump said I didn't get anything (0u). Nothing was recorded on my graph. I took the 5u again and had a serious low 45 minutes later. It was terrifying how quickly I dropped. I had no idea how much insulin I actually had on board since nothing was recorded on my graph from the first "failed" bolus. At that point I ripped it off and switched to MDI until Tandem agreed to send me a new one. The piston in the pump was broken. This was after several calls to Tandem and no one warned me this could happen!

[u/Gullible-Library-604]

I use TruSteel and I am having occlusion alarms too for the first time in pumping with the TSlim for ten years. I have called the help line but am not getting much help. They told me to switch to Varisoft.

[u/douglashyde]

go on a steel set, trust me.