Clinic day tomorrow/ pump???

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Monica

Monica

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We're off to clinic tomorrow.

I'm a bit apprehensive, as we are going to ask if Carol could have the pump after all. She has been offered the pump last December and again in March (by the same consultant), but she wouldn't entertain the idea then. When we went again in July, we saw the other consultant who never mentioned the pump. I'm hoping we'll see the first one.

Carol suffers from rather a lot of hypos, hence the pump offer. Now the only thing that has changed is that Carol now is happy to get one, as she has met a couple of teenagers on a pump when she went on a "Getting Sorted" course for teenagers. Please don't ask what this course is, as Carol hasn't told me at all what she's learnt.

I'm also a bit apprehensive about the whole pump thing. I see that lots of people think it's the bee's knees, but when I see what can go wrong.... And I really struggle to get Carol to do even ONE exta blood test.

I you like, we can do an HbA1c guess too. Bear in mind she has had lots of hypos in the last 4 months. And the other day she was 21.2 (hypo rebound I think)

I'll start you off, eventhough I have insider info. I think she'll be below 7%
 
I'll guess at 6.8% 🙂 If she does go on the pump she will definitely need to learn to endure testing. Pumping, as far as I can gather, requires much more testing than MDI - 10-15 tests a day isn't unusual. I think she needs to understand this and be prepared to put up with it for all the huge benefits that a pump would bring. They are so much more flexible than injections, plus no injections at times when she might currently be embarrassed or unwilling to inject. Fewer hypos in time and so many people have related how much better they feel generally, like it has given them new energy.

Hope you get the nice consultant! Remember, she can try it and always give it back, but I've only ever heard of a couple of people doing that! 🙂
 
Hi Monica hope it all goes well for you tomorrow hun and you get the right consultant i will take a guess at 6.9% x
 
I would say that if your daughter has made the decision to get a pump - then she has put a lot of thought into it as teenagers dont do things like this unless they really want to - so seeing others on a pump must have inspired her.🙂 Use this to your advantage and make sure she is fully aware that it wont be a breeze and she and you will have to work hard to get good results. Remember a pump is only as good as its user - it is not a magic wand - it doesnt 'think' for you and it needs a lot of input. Testing is paramount as is carb counting - you wont get far if you dont do either! Make sure you ask all the relevant questions and make sure your daughter is aware of any pitfalls before she embarks on this journey as you need her to be on side to do this. The rewards speak for themselves with pumping so good luck and go for it.🙂Bev
 
See, that's the problem. Does she want a pump because she's a follower or does she want it because she needs it? I did tell her that she'd have to test a whole lot more than now, but I'm not sure she believes me. I do carb count and I think I'm quite good at it. I have to admit I do still make mistakes.

Talking about carb counting, How did you teach your child to carb count? I keep saying to Carol that it's about time she learnt, but I never get the chance to let her do it, as she injects straight after food. I don't want her to delay the injection while I ask her to calculate the carbs. I find that she can't inject beforehand, as she never eats all I give her. She does her own breakfast as that's cereal out of the box. Lunch is usually the same every day. When it isn't, I'll tell her.

Back to the pump. She won't inject into her tummy and is afraid of inserting the cannula there. So I said I'd do it for her. But I also said she didn't have to have it in her tummy all the time. On one of the threads I saw a video posted of Tom( I think) inserting one into a girls tum. If anyone remembers which thread that was, I'd love to get it back to show Carol.

Apologies for waffling on.
 
Carol, that was a video we made at a forum meet. SacredHeart probably has a link to it as it's her Tom is putting the cannula into. Inserting a cannula really isn't all that painful - no worse than an injection.

In terms of getting her to carb count, you might need to be a bit firm with it. How old is she? Even if she's a young teen I think it's really important she begins to learn these essential techniques for managing her diabetes. There's a great carb counting online course run by the BDec people (have a google) which she might find useful.

There are definitely other places she can use to put the cannula in. Basically she just needs somewhere with a bit of fat on it so the cannula sits in that. I use my sides, tops of thighs, top of my bum and you can put them in your arm too. Plenty of choice!
 
shiv said:
In terms of getting her to carb count, you might need to be a bit firm with it. How old is she? Even if she's a young teen I think it's really important she begins to learn these essential techniques for managing her diabetes. There's a great carb counting online course run by the BDec people (have a google) which she might find useful.
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Thanks Shiv,
Carol will be 14 next month. I have done the that online course, I really liked it. I have tried to get her to do it too, but that's like doing homework. She's in a not liking to do homework phase and rather go out "galliwanting" with her friends. (Ssssshhh, don't tell her I said galliwanting, she hates that word)

I'll pm SacredHeart then, just in case she doesn't see this. thanks
 
Good luck with the apponitment I hope that you can get her the pump. I'll go for 6.7% x
 
Monica said:
Thanks Shiv,
Carol will be 14 next month. I have done the that online course, I really liked it. I have tried to get her to do it too, but that's like doing homework. She's in a not liking to do homework phase and rather go out "galliwanting" with her friends. (Ssssshhh, don't tell her I said galliwanting, she hates that word)

I'll pm SacredHeart then, just in case she doesn't see this. thanks
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I sent you a PM, but Northe beat me to it!

I'll be completely honest with you, I was terrified of trying that out. But it REALLY isn't as bad as you might think. Half the time I wore it, I forgot it was there, and I felt like I'd made a big deal out of nothing beforehand 🙂
 
SacredHeart said:
I'll be completely honest with you, I was terrified of trying that out. But it REALLY isn't as bad as you might think. Half the time I wore it, I forgot it was there, and I felt like I'd made a big deal out of nothing beforehand 🙂
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I was like this until I started (I didn't know anyone one a pump so couldn't try in advance as it were) Really don't notice it now. Youngest daughter pulling on it is a swift reminder but not a painful one thankfully! 🙂
 
purpleshadez said:
I was like this until I started (I didn't know anyone one a pump so couldn't try in advance as it were) Really don't notice it now. Youngest daughter pulling on it is a swift reminder but not a painful one thankfully! 🙂
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OOOh, I remember Carol at one point saying no way she'll have a pump, because someone had their cannula ripped from one side to the other of his tummy leaving a big gash. I had to reassure her, that that wasn't possible.
 
I would just go slow when trying to teach her about carbs...........ask her how much every dinner time (and meal) and get her to explain why? then its just casual dinner time (breakfast, lunch) discussion................that might not get her up to speed in time for the pump though.........:(.....hope all goes to plan.....🙂
 
Monica said:
OOOh, I remember Carol at one point saying no way she'll have a pump, because someone had their cannula ripped from one side to the other of his tummy leaving a big gash. I had to reassure her, that that wasn't possible.
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I've caught it on door handles, children getting various limbs caught in it when playing or when being put down having been carried, only ripped it out once and it was like someone removing a plaster quickly when you are not expecting it. Was a little red for a bit but nothing more 🙂

I'm sure she'll be fine. At her age I'm guessing a lot of it will be down to fear and denial. a pump is new and scary and it would mean she will be less able to forget about being diabetic so she would need to accept it. Of course I could be wrong as I'm only going on my own experiences 🙂
 
I'd like to pick up on the points made about the pump requiring more testing & effort.

Pumping has certainly meant much more testing and effort from me. I think this is mostly because the hard work pays off on a pump, whereas on MDI I got nowhere and it was very de-motivating.

When I started pumping, I was told as a general rule to test first thing in the morning, before every meal and just before bed, as a bare minimum. In practice, I test on average 10 times a day. (This is mostly because I test 2 hours post-meal to see how the spikes are doing - previously I avoided testing at these times because I didn't want to know just how high I was!) Obviously, the frequency of testing increases when doing a basal test.

Having said all of this, I distinctly remember my DSN saying that even for someone who is not particularly good at carb counting & controlling BG a pump is still better than MDI (in her opinion - provided the person does test a few times every day). The major benefit of the pump is the ability to vary basals throughout the day. In my DSN's opinion, this would be a benefit to anyone with type 1. Seeing what my basals are set to now, I don't understand how the hell I ever managed with one basal injection a day. As long as testing is done a few times a day, this will identify any problems with delivery which may result in ketones - when I started pumping, I was told this was the main reason for regular testing. Carb counting is important, but since Carol is carb counting to some extent on MDI, the adjustment to pumping from the meals point of view may not be too difficult.

Regular testing is required on a pump - but I wonder how often Carol is testing at the moment?

If carb counting is part of your daily routine anyway, I wouldn't stress too much about this aspect. And if Carol does test regularly, i.e. the "bare minimum" I was advised at the start, this shouldn't pose too much of a problem, either.

When I was Carol's age, I didn't give a hoot about my diabetes. I think my A1c was around 10%. The fact that she's decided to go for a pump is a good thing - it means diabetes is a priority for her (it wasn't for me). I imagine this is a very difficult age from a parent's point of view - she probably doesn't want you to be controlling it all for her, but doesn't really want to do it herself either. My advice would be to just keep talking to her, talk to your DSN, and give it a go - if Carol doesn't like it after a couple of months, you can always switch back.

I hope I've made sense - looking back this seems a bit of a ramble 😱
 
On MDI, I find myself testing as much as a pumper, this is purely down to curiousity and to see how the sugars are doing with the tweaks and dose times.............I think people pumping are the same.....they want to know if what there doing is working as opposed to a requirement all day every day, and why not........:D
 
bigpurpleduck said:
I'd like to pick up on the points made about the pump requiring more testing & effort.

Pumping has certainly meant much more testing and effort from me. I think this is mostly because the hard work pays off on a pump, whereas on MDI I got nowhere and it was very de-motivating.

When I started pumping, I was told as a general rule to test first thing in the morning, before every meal and just before bed, as a bare minimum. In practice, I test on average 10 times a day. (This is mostly because I test 2 hours post-meal to see how the spikes are doing - previously I avoided testing at these times because I didn't want to know just how high I was!) Obviously, the frequency of testing increases when doing a basal test.

Having said all of this, I distinctly remember my DSN saying that even for someone who is not particularly good at carb counting & controlling BG a pump is still better than MDI (in her opinion - provided the person does test a few times every day). The major benefit of the pump is the ability to vary basals throughout the day. In my DSN's opinion, this would be a benefit to anyone with type 1. Seeing what my basals are set to now, I don't understand how the hell I ever managed with one basal injection a day. As long as testing is done a few times a day, this will identify any problems with delivery which may result in ketones - when I started pumping, I was told this was the main reason for regular testing. Carb counting is important, but since Carol is carb counting to some extent on MDI, the adjustment to pumping from the meals point of view may not be too difficult.

Regular testing is required on a pump - but I wonder how often Carol is testing at the moment?

If carb counting is part of your daily routine anyway, I wouldn't stress too much about this aspect. And if Carol does test regularly, i.e. the "bare minimum" I was advised at the start, this shouldn't pose too much of a problem, either.

When I was Carol's age, I didn't give a hoot about my diabetes. I think my A1c was around 10%. The fact that she's decided to go for a pump is a good thing - it means diabetes is a priority for her (it wasn't for me). I imagine this is a very difficult age from a parent's point of view - she probably doesn't want you to be controlling it all for her, but doesn't really want to do it herself either. My advice would be to just keep talking to her, talk to your DSN, and give it a go - if Carol doesn't like it after a couple of months, you can always switch back.

I hope I've made sense - looking back this seems a bit of a ramble 😱
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This isn't a ramble, thank you, it made me laugh, because you hit the nail on the head!!
At nearly 14 she does want to be independent, but doesn't want to do it herself. She has been naughty at the beginning of diabetes when only on 2 injections a day, which left us with trust issues. But she now insists that she'll never do anything silly like that anymore, because she knows how important it is to look after herself. We carb count properly, she tests before every meal and at bedtime. And if hypo occasionally.
At half term we went to "big town" to buy some winter boots. In the shop she said she was hypo. Without testing she had the glucotabs. But would she sit down???? No, we had to walk to Pizza Hut (5 Min)!! We were in a quandary whether to go to Pizza Hut or somewhere else nearby. But we had to go to Pizza Hut, because Carol said that she urgently needed to sit down. I made her test. She was 2.6.

So you see, mum doesn't always know best! I should have made her sit in the shop!
 
Carb counting. Alex has been doing carb counting since he was diagnosed aged 10. It is not hard to do once you get the hang of it and I would urge you to stop doing this for Carol as there is only one way she will learn and that is to do it for herself - she is old enough to be doing it so its the perfect opportunity to start with the bribe of letting her have the pump.🙂

Alex has an ipod with the carbs and cals application on so if he is at a friends house he can use it to help him if he is unsure.

Start by asking Carol how much she *thinks* the carbs are for the meal and then let her weigh it to see if she is right - its a good game and she will learn quicker this way.

Bolusing before a meal is the only option when you are on a pump. There is no reason to bolus after a meal as you can give less on the plate and then if Carol wants more you can add on the insulin. Alex knows he has to eat all the carbs on his plate and so is quite good now at not asking for more than he can eat! Once Carol starts doing this a few times you will both get used to what portion sizes she is happy with. You can always make up the difference with either a carb drink or a piece of fruit if the insulin is too much for the amount she has eaten.🙂Bev
 
Monica said:
This isn't a ramble, thank you, it made me laugh, because you hit the nail on the head!!
At nearly 14 she does want to be independent, but doesn't want to do it herself. She has been naughty at the beginning of diabetes when only on 2 injections a day, which left us with trust issues. But she now insists that she'll never do anything silly like that anymore, because she knows how important it is to look after herself. We carb count properly, she tests before every meal and at bedtime. And if hypo occasionally.
At half term we went to "big town" to buy some winter boots. In the shop she said she was hypo. Without testing she had the glucotabs. But would she sit down???? No, we had to walk to Pizza Hut (5 Min)!! We were in a quandary whether to go to Pizza Hut or somewhere else nearby. But we had to go to Pizza Hut, because Carol said that she urgently needed to sit down. I made her test. She was 2.6.

So you see, mum doesn't always know best! I should have made her sit in the shop!
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I hate nothing more than a hypo interrupting a shopping trip!

Since I started pumping this hasn't happened to me as I use temporary basal rates. The flexibility & quality of life is much better.

Bev's point about bolusing before food is a good one - I had continuted the habit from MDI of bolusing after food until just yesterday, when I started bolusing 15mins before. The difference in the BG spike is astounding! Great suggestion to put less on her plate so she can then go back for more later. Also a carb-counting app if she has a phone/ipod which uses apps is a great idea.

Anyway, I say go for the pump. You never know until you try, and I'm sure it will make a big difference. I worry sooo much less about hypos (& highs!) than I did on MDI.
 
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