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Comment by Holly on May 2, 2013 at 11:37am

My T1 daughter is now eight. She was diagnosed at four and within two months was on the pump. I LOVE IT!!!! We did the medtronic minimed because it seemed right for us. She took right to it. She still hates site changes but hates the amount of shots she had to take even more. Sure there are good and bad things (when the sight isn't working and she wakes up at 400 and starts throwing up hello hospital) There are fluxuations(sp?) even with the shots. Normally we try to get our carbs exact but if we are out and we are not completely sure we estimate (usually under) and then test in about 2 1/2 to 3 hours and if needed give an extra bolus if she is high. I loved the fact that there was no more calculating the insulin to carb ratio etc. I stink at math and it was easier for her preschool and now elementary school. I was already on FMLA when she got her pump so I was learning and then showing her preschool what I had just learned. It was a little crazy for a few weeks but once we all got it down it was a god send. She can show anyone how to work it herself and is VERY independant and I think that helps her as well. With the shots I don't think that would've happened so soon.

Comment by Theo Pella on May 2, 2013 at 11:24am

When we decided to change over to the pump on our 6yr old son last year in August. We thought it was going to be an easy adjustment and easier overall, compared to giving two shots a day with a Long/short acting insulin mixture. The 3 biggest changes we had to deal with was counting carbs. We had always counted carbs but it was more of an estimating system, now it needed to be very precise. The more accurate the carb count, the better your pump works. Second was the complete 180 at looking at diabetes between insulin shots and pumping. Where before we were feeding the insulin throughout the day, to being able to eat when our child wanted and giving a bolus for the food. We would slip back into the habit of having a snack when he wasn't hungry or making sure he would get enough starchy carbs and protein in every meal. Where he really didn't need that with the pump. Looking back at injections and seeing exactly how the pump works with your imput, I know now that I could regulate his BG much better if we were to switch back one day. I would have much tighter control. 3rd issue is the overall handling of the pump that is required. If you are dealing with a smaller child, who is not ready to work the pump on their own. Then be ready to be hands on at all times. 2 hour testing throughout the day and night. Can last for weeks even months, until you get a basal rate set down that works. But as the kids grow, exercise, sleep, hell even breath, it will change right when you think you have it figured all out. You will constantly be changing, tweaking, calling to figure out what went wrong? "It was fine last week, we had GREAT numbers. This week we are all over the place." That is diabetes....
Lastly, if you have a small child. Be ready for it to be traumatizing for them. Ourselves and friends of ours all had experiences where the kids had a bad experience at the beginning and therefor hated each and every pump site change from then on. We are 9 months into it and our son is just now starting to not mind a pump site change. Other kids still freak out and need to be held down to do so. If they don't like needles and the shots, they will still not like the site changes. I don't blame them... I would do anything to take away this from them.

Good luck! Either with MDI or pumping, they all have Pro's and Con's... nothing is perfect and each child is different, with different needs.

Comment by Jack's Mom on May 2, 2013 at 10:02am

IMO You need two weeks of focus on the pump. So maybe one week of PTO and one week of going to work, but doing nothing else. It really took us two weeks to work out the kinks, but my son was 18 months when we went on the pump and I got no feedback. Probably shorter with an older kid.

Comment by aimeeh2oski on May 2, 2013 at 7:52am

Hi Ibkies, I personally don't think it is necessary to take FMLA time. A week of PTO sounds like plenty. My recommendation is to start off with a comprehensive pump class and training. Which pump are you going with? All the pump companies should have a trainer and hopefully you also have a CDE to consult as well. We had very little training and as a result my daughter's A1C has not improved on the pump - she is still on a roller coaster, but we have switched doctors and CDEs and are now on the right path. We will be doing a basal rate test this weekend to find out if her new basal rates are correct. We were never asked to do that before, but it makes perfect sense. Basal rates are the foundation of your child's pump therapy and if they're not right, everything else will be off as well.

Our new endo recommends the book "Smart Pumping." It's 11 years old but is still totally applicable. I have other books as well (Pumping Insulin, Think Like a Pancreas), but Smart Pumping is a very easy read and highly enlightening. Our new practice follows it pretty much to a tee. There is also a Pink Panther book about pumping and CGM you might find helpful - can probably get it from your endo's office. Good luck - let us know how it goes!

Comment by Elizabeth on May 2, 2013 at 7:51am

"Pumping Insulin" by John Walsh is required reading; my son's transition might have been a little easier if I'd found the book BEFORE we made it :\

My own book "100 Q&A About Your Child's Type 1 Diabetes" includes a summary of some of the new & different stuff you may encounter — I was writing it at the time we made the transition, so you get some of the gory as-they-happened details of the obstacles I encountered — I would probably write different things if I wrote it now, 4 years after the fact. It does not go into the how-to's of pumping because that wasn't the purpose of the book, but it may at least give you an idea of what you may expect.

Beyond that, there are groups on this site that discuss use of specific types of pumps, and I would advise you get to know the folks who participate because they undoubtedly know the quirks & the ins/outs of the specific device. Also, do a YouTube search on "insulin pump" and find all sorts of helpful videos about how to insert sites, fill reservoirs (there is a video on how to prevent bubbles in the reservoir that was a GODSEND to me) and manage living with a pump in general.

Comment by lbkies on May 2, 2013 at 7:36am

I appreciate your feedback. I know I can easily take a week of PTO off and I will do that. I can take FMLA time off - of course that's not paid but it is a possibility. I can also work from home whenever I need to. Do you have suggestions on things to read before we get started?

Comment by lbkies on May 2, 2013 at 7:32am

Comment by Elizabeth on May 2, 2013 at 6:53am

(I don't mean to sound like I regret moving to the pump — Eric's A1c numbers are vastly improved and it was worth the difficulties we had to switch over. But they make it seem really easy in the marketing materials, when it is not generally quite as easy as it sounds.)

Comment by Elizabeth on May 2, 2013 at 6:51am

Realistically? I think you probably should take the time off if you can, if only so you can put all your attention toward learning what they have to teach you. It is not that pumping is harder so much as that it is different, and there are different things you need to pay attention to. Like: with shots, you never have to wonder if the insulin is getting IN, you just have to wonder if you've given the right amount at the right time. With a pump, the calculations are made for you, but there's also the possibility that a pump site is "bad" (meaning, cannula crimped or blocked), so the whole "is the insulin getting in" factor looms much larger.

We did not have an easy transition in large part because there was information overload going on — I did not take time off for the training/transition, and in retrospect I wish I had. Read up as much as you can about it before hand, because it's not just about which buttons to push when; it is literally a different type of therapeutic regimen, and much of what you may know from giving shots is either inapplicable or less important with a pump.

Comment by lbkies on May 1, 2013 at 10:29pm

Ok Moms of pumpers - we switching to a pump after doing injections since diagnosis. I need to know honestly what to expect and how hard is it? Realistically how much time should I take off from work for the transition. I was also wondering if I should have my mom come in from another state to help. I have heard so many different accounts - some say it was easy to make the switch and others say it was a 6 week thing and they wish they would have taken FMLA for it.

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