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Pump Referral Appointment

Discussion in 'Insulin Pump Forum' started by Lordy100, Sep 6, 2017.

  1. Lordy100

    Lordy100 Type 1 · Well-Known Member

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    Hi everyone,

    I've got an appointment on Monday after being referred for a pump, can anyone tell me what to expect?

    Thanks
     
  2. Kim Possible

    Kim Possible · Guest

    Thankfully, I did not have to jump this hurdle to get my pump.
    However, if I did, I would arm myself with knowledge about the benefits of the pump and why I believe one would help my diabetes control. "I'd rather not inject", "I keep forgetting to take my insulin out with me and it would be good if it was attached", "why can't I have the latest tech?" and "I need better control" (without defining what this means) are not great reasons.
    I would consider the value of
    - changing basal throughout the day to match your body's needs. If you have some evidence your basal needs vary (such as frequent morning/night time hypos), this would be good.
    - changing basal for short periods of time to account for ad hoc variance for exercise or stressful meetings. This was the main reason I qualified for a pump - I would often hypo after exercise.
    - need to spread out bolus with your food. Instead of multiple injects for something like pizza (although saying you need a pump in order to eat pizza is probably not a great idea!), the pump provides the flexibility to spread the dose over a few hours.

    The other thing to consider is that a pump does not come for free. You need to invest time understanding how to control the pump and you need to be more accurate with carb counting. For this reason, my local team insisted anyone going on a pump must attend a DAFNE-type course. So think about how you can prove you are willing to invest the time and effort to get the best out of a pump.

    Sorry if this all sounds a bit much ... I am just speculating. But I have read about people thinking pumps are the saviour to all their diabetes problems and, although it helps a lot, it still requires effort from the patient.
     
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  3. himtoo

    himtoo Type 1 · Well-Known Member
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    Hi @Lordy100
    I think the answer can vary

    In my case it was an appointment to discuss my suitability for a pump and if I was committed to the testing and very accurate carb counting that goes hand in hand with being on a pump.

    I also agree with @helensaramay about going in to the appointment clued up as to why you want a pump , the benefits you would see, and the impact that multiple daily injections are having on your quality of life.
     
  4. noblehead

    noblehead Type 1 · Guru
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    It may vary as @himtoo says above

    My first appointment after being referred was to discuss which pumps were available through the clinic and to talk through the features of each one, the appointment was quite brief and we booked a further appointment to discuss preparing for the actual start date.

    To help prepare you for moving over to a pump do purchase the book Pumping Insulin by John Walsh & Ruth Roberts, it's a must read for anyone on a pump or in the process of moving to one, some of the book may not make sense now but when you actually start pumping insulin it will do @Lordy100

    Good luck and hope all goes well.
     
  5. Lordy100

    Lordy100 Type 1 · Well-Known Member

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    Thanks for that info.

    I have already done the DAFNE course so got that one ticked, so to speak. I realise it requires a lot of work so was just trying to arm myself with information before I get there on Monday.
     
  6. Lordy100

    Lordy100 Type 1 · Well-Known Member

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    Thanks very much for that, I'll try and get hold of the book prior to my appointment.
     
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  7. noblehead

    noblehead Type 1 · Guru
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    If you don't get hold of a copy just have a read of Think Like a Pancreas, it too has some great info & advice on pumps, the author is a pump user himself.
     
  8. Lordy100

    Lordy100 Type 1 · Well-Known Member

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    I've got the book on my android smart phone so just wading my through it. I went to the appointment and from the discussion with the consultant I suspect I don't fit the criteria. Given adjustments to make and an appointment with Dietician and DSN in December. Further appointment with consultant in March. Apparently the Trust I come under are also going to be issuing pumps so I'm going to investigate that option as well to cut down cost of travelling and time off work.
     
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  9. noblehead

    noblehead Type 1 · Guru
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    If you don't fit the NICE criteria the Consultant can still push for pump funding if you fall under one or more of the ABCD recommendations, here some info on those recommendations:

    ABCD recommends that insulin pump therapy is also considered in the following situations:
    • Pregnancy
    • Acute painful neuropathy or symptomatic autonomic neuropathy if
    conventional treatment fails to enable adequate blood glucose control
    • Hypoglycaemia unawareness
    • Extreme insulin sensitivity
    • Needle phobia
    • Severe insulin resistance with poor blood glucose control
    (especially if type 2)
    • Specific quality of life issues:
    – Pathological fear of hypoglycaemia
    – Marked glycaemic excursions/dawn phenomenon
    – Excessive number of injections for optimised control
    – Impaired exercise capacity, abnormal eating behaviour or an unacceptable number of sick days
    – Shift work or frequent travel across time zones
    – In children: sub-optimal school performance, exclusion from aspects of a full school life; behavioural problems (for example, mealtimes); adverse impact on family dynamics

    http://www.inputdiabetes.org.uk/alt-insulin-pumps/nhs-funding-pump/
     
  10. Snapsy

    Snapsy Type 1 · Well-Known Member

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    @Lordy100 I didn't fit the NICE criteria, but the above information from @noblehead was extremely helpful when I put my case to my local diabetes centre for consideration for a pump.

    It was quite a journey from my initial approach (April) to agreement to apply for funding (July) to getting agreement (August) and then starting on my pump (October), but I haven't looked back!

    :)
     
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  11. Amy993

    Amy993 Type 1 · Well-Known Member

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    Mine got resolved within a few months. We first discussed the pump in May, had the first appointment in June, pump trial in July then started in August!
     
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  12. Lordy100

    Lordy100 Type 1 · Well-Known Member

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    Crikey that's quick. So what were the vital points that swayed it for you?
     
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  13. Lordy100

    Lordy100 Type 1 · Well-Known Member

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    Thanks everyone for all your help with this.
     
  14. Lordy100

    Lordy100 Type 1 · Well-Known Member

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    Thank you very much
     
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  15. Amy993

    Amy993 Type 1 · Well-Known Member

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    I know! They wanted to let me try the pump and get it sorted before they move me to adults next year, as i will be 18 soon. The main reason i went onto a pump was to help my control as i am very active, with college and hobbies.
     
  16. andi140373

    andi140373 Type 1 · Active Member

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    I asked for one on a Thursday at my antenatal clinic and got one the following Tuesday! They mentioned that I had it to support the pregnancy and could keep it while breast feeding so I breast fed my son until his second birthday! By then, I'd had it for almost three years so it had become my established treatment method and I was allowed to keep it. I've now been on it for over 6 years.
    Recently I was talking to the nurse about pumps and asked about their frequency of use. When I first got one, pump clinics were always on a Monday but now there are several each week to cater for the massive increase in number of users. She made it sound as if you could have one to try if you requested it.
    This week I went to my annual review and was given a freestyle libre reader and sensor to try. She said that they recommended them for all pump users and that they should be available on the NHS soon. This was two days before the announcement about 1st Nov!
     
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