thinking about pumps

[loopyloo]

Hi all,

I have my review with my consultant tomorrow and I'm thinking about bring up the subject of pumps, Guess I'm not sure quite where to begin.

Stuboy, I have been very interested in your unfolding story re- obtaining a pump as you're in my neck of the woods, ( I live in petersfield and we have the same pct).

I have been very succesful in getting pretty good bg numbers using a low carb diet, but have always needed very small units of insulin, 1.5 units for breakfast, same for lunch and 2.5 for evening meal, with a split dose of levimir -5 units am - then 6 units before bed.

I already use a half unit dose pen but when trying to fine tune its impossible, feel the need for a 1/4 unit or less adjusment.

So..... do you think the fact that I have fairly good control with mdi is gonna go against me, or is the need for smaller unit adjustments a valid point.

Sorry if all that was a bit long winded, not sure what to say or ask and just trying to weigh everything up.


Cheers

 

[jopar]

Pumps can be hard in some hospitals/PCT's with bad control, but there again I've known pumps offered to people with good control?

I would just ask? Give your reasons and any problems that you can think of why it's a good idea and how you feel the pump will reslove or help these...

There is nothing wrong or even under handed about asking for a pump, but you do need to build a case for your self to reasons why a pump is the best way to go...

 

[loopyloo]

Thanks for the replies,

I think the problem is that I'm not sure if a pump would benefit me, I just know that I want to have the tightest control possible and wonder if a pump will help me achieve this.

Hopefully I will at least be able to have a conversation about the possibilities, as you said - if you don't ask, you don't get!

:roll:

Cheers.
x

 

[Stuboy]

Hi LoopyLoo,

As we have the same PCT then i feel like i can give you the best advice on here concerning our own PCT!

The route i took was to get my GP be refer me to the diabetes clinic at the QA telling them that i thought i would be better suited on a pump. The Dr i saw (I will PM you some names) told me that with the amount of hypo's i was having then i would definatly be considered. For them they are thre categories of people they consider for pumps, those who hypo a lot, those with absorbtion issues, and those who really aren't getting on with MDI at all. The fact that my A1c was 6.8 was irrelivant because of my hypo's.

When i spoke to the lead pump nurse, she asked me exactly what it was i wanted the pump to do for me, and she does that because she wants to know if your expectations are realistic or not.

So my advice to you is, go in armed with your reasons for wanted a pump, and do a lot of reading on what pump's CAN do for you. Also go in and show them your readings with the reasons why you think a pump can make them better for you. Weather you can carb count or not will not make a difference on the decision in the first stages, because at our PCT you MUST attend the JIGSAW course before being considered for a pump anyway, the things you learn on the course apparently will help anyone; going on a pump or not. It is also a requirement for their funding that the patient has done the course.

From my experience... i wouldn't expect a straight up no or much resistance, they seem to be really good and listening to you up there and working with you to get the best control. We're lucky!

 

[loopyloo]

Stuboy
Thanks so much for the info,

Feel alot more optimistic now, also encouraging to hear that your HBA1c was quite normal and yet that didn't go against you.

Like you I also have quite a few hypo's (though not as many as you, I think) but my main problem is with the fact that I find it very difficult to fine tune because of the small number of units I take, 1/2 a unit makes a big difference in my bg levels.

Also nice to hear that they were willing to listen and I hope not to get a straight up no, just a discussion about the possibilities is all I hope for at the moment!

I'll let you know how it goes,
Wish me luck

 

[miss e j]

Hi Loopyloo,

Just a tip I've picked up on the Onsulin Pumpers forum, if you use really low doses, you should go for the animas pump as it's the best make for small doses.

I use a Medtronic Paradigm 522 and find it fine for my needs - especially the bolus calculator. I'm 5 months in and still struggling to get me basal levels right - adjustments have to be made very gradually. I would definitely recommend pumping, but would always tell people it's really hard work at first!

Good luck,

Miss E

 

[blackbird]

I asked the DSN about a pump for my son as he had expressed an interest. We were told that our area weren't supplying pumps for children for at least another year.

 

[jopar]

It's isn't much whether your area is going to provide, if your son meets the ctritia for pumping laid down by the NICE guidelines then your PCT has a legal oblication to fund a pump, to say well we not going to impliment pumps at the moment is against the law...

For some getting a pump and it's funding does mean a battle, but if you and your son feel that you meet the criteria set down by the NICE guidelines, there are several things you can do..

IF the consultant agrees that your son is suitable then you can fight from here, If a consultant says you need one the PCT have tp provide the funding...

IF your consultant isn't pump friendly you can request to be placed with one that is, even if this is a different hospital...

If you google for INPUT this is a organsation that can help, they can tell you which hospitals and consultants that deal with pumps, they can help you with the information to why a pump is suitable so that you can fight the dission of/or both consultant and the funding side PCT's, help and advise you along the way...

It may not be easy battle to win, and yes it can take time to achive but not impossible

 

[blackbird]

Jopar, thanks for your reply. At this time my son has only expressed a 'slight' interest, he likes the thought that he might be mostly free of injections, and that his bg would be better controlled. He's only 13, and coming up to puberty, which means that his bg can be all over the place. At the moment, although we carb count very carefully, sometimes his bg goes right up for no reason at all, and other times he will hypo for no reason either. We do try and factor in exercise but that can be difficult in itself with a youngster. He's on Novorapid and Levemir, 4 injections a day with an extra one sometimes if he wants a big supper. I would fight his corner and insist if I thought he was seriously interested in a pump, and of course that might be the case in the near future. His last A1c was 7.5, which pleased the diabetes team, but this doesn't reflect the highs he experiences.