Jumping Hoops

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Akasha

Akasha

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Relationship to Diabetes
Type 1
Hi all.
I am aware that all hospitals set different rules, but what sort of hoops are you normally expected to jump through to be eligable for a pump?

I have done Carb counting. (2 years ago)
I have a consultant appointment tomorrow, and want to ask to be put forward for a pump.
 
Some consultants are pro pump and will be happy to request funding for you (remember, as long as the consultant writes to the PCT to say you need a pump, they cannot, by law, say no to funding). If he says no, ask him what he is going to do to help you better manage your diabetes without a pump.

They will need to see you check your BGs often, you are capable of carb counting, you can adjust insulin, etc. You also need the willingness to focus on your diabetes a fair amount - pumping requires a lot of mental energy!
 
You are right, jumping hoops is very dependant on the clinic your are attending!

And you really won't know until tomorrow when you ask your consultant about pumping, what sort of hoop jumping you are agoing to have to do or not..

Couple things to keep in mind..

I would take a look at the NICE guidelines tonight, and remember that you don't have to fit all the criteria nor can your team select parts of the criteria they want to use!

Another thing to keep in mind, is that pumps aren't magic wands, they are just a insulin delivery system so are only as good as the user using them..

If after tomorrow it looks like you may have a battle on your hands, don't worry as battles can be won and there are people out there who will help, us here who can guide you on how to build your case (I'm very good at this) and organisations like INPUT (please do google them) as they are very good and supportive in battlement..

Let us know how you got on, hopefully you've got a very pro-pump clinic who will sort a pump out for you very quickly
 
I have been checking my blood at least every 2 hours. I have adjusted my insulin as i see fit to combat my sugar spikes. (Adjusting ratios) and still seeing strange readings.
I've got a half unit pen for the small doses. and although i have no problem doing correction doses, its just really wearing me down.
I have really started cracking down on looking after the diabeties in the past year, As i'm getting marring in 8 weeks, and want to start a family. (Decided the earlier i get level the easier it will be)
 
If you dont ask you dont get so go for it, just make sure you have all the answers to any questions they may have about your control..........

What are the main problem areas at the moment......?
 
Best of luck, let us know how it goes!

With my team, before considering a pump they kept giving me adjustments/changes they wanted me to make before they would think about a pump. I obviously did all of them, to show them that injections still weren't working. So don't be disheartened if they ask you to do x, y and z first - if they do that, ask to see a DSN say every 4 weeks so that you can monitor the changes you are making. And basically prove to them that they are not working and that a pump would help 🙂
 
As already stated go well armed Read the NICE guidelines and make sure you take detailed bs readings and a food diary with bolus/corrections given.
Tell consultant why you think a pump will help you.

I have been checking my blood at least every 2 hours. I have adjusted my insulin as i see fit to combat my sugar spikes. (Adjusting ratios) and still seeing strange readings.
I've got a half unit pen for the small doses. and although i have no problem doing correction doses, its just really wearing me down.
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The above statement does not bode well though :( you have a lot more testing and adjustments to make whilst on a pump. It's a lot more challenging than MDI

So have a good think about what you want.
Bottom line is the pump is not plug and play, and is only as good as the user.

If you accept that you can manage the pump 24/7 and are happy to put the work in then pumps are life changing 🙂
 
I got my pump on Monday after trying for 18 months, I have been on MDI for 15 years. My consultant said to me originally my control was too good to be considered for a pump as I didn't meet the NICE guidelines. I then suggested (tongue in cheek) that I would let my control go and therefore would meet the criteria! She then suggested I attend a 'DAFNE' type course and prove that my carb counting, insulin ratios were good etc. That is what I did, I nagged and nagged and finally my consultant wrote to the PCT recommending a pump.......I now have one! 🙂
 
At my hos you are not even considered unless you have attended a DAFNE , then they are different criterias that may apply , i know i was offered one because of my hypo unawareness and Dawn Phenomonon , and one of the other diabetic ladies i was with had needle phobia which was proving to be a real problem , hope this helps ~ Jenny 🙂
 
Akasha and Sue

I think I know what Akasha means. It's such a palava (palaver?) having to have another jab and another jab and another jab. Get needle, affix needle, prime needle, locate suitable spot to jab, ram in some more insulin, cap needle, take needle off, place in sharps bin, resume ironing .... Or all of that under cover of your desk.

With pump yes you still need to correct we wouldn't argue with that but it's a simpler procedure - look at pump screen (or remote) press appropriate buttons for what you want it to do tell it to do it and carry on doing ironing, typing, holding conversation with colleague or child - whatever.

Or am I grossly and completely mistaken about pumping? - I have worn one 'dry' for a week to see if I could get to grips with button pushing and was asked to match what I bolussed/corrected with and play with multiwave and delayed and all the rinky dinkies, then the info was down loaded to see what was recorded and I hadn't cocked it up, which I hadn't and I had had a go at most things! I know I have one heck of a lot to learn when I go live and afterwards, but that was the procedure explained to me by my DSN ..... the procedure seems most simple!
 
trophywench said:
Akasha and Sue

I think I know what Akasha means. It's such a palava (palaver?) having to have another jab and another jab and another jab. Get needle, affix needle, prime needle, locate suitable spot to jab, ram in some more insulin, cap needle, take needle off, place in sharps bin, resume ironing .... Or all of that under cover of your desk.
I wouldn't know as used the simple syringe. Took 2 sec's to inject 😛 With a pump you need to change your cannula, fill the cartridge as well.
With pump yes you still need to correct we wouldn't argue with that but it's a simpler procedure - look at pump screen (or remote) press appropriate buttons for what you want it to do tell it to do it and carry on doing ironing, typing, holding conversation with colleague or child - whatever.
You have a lot to learn :D There is a lot and I do mean a lot of testing and adjusting to be done. Which means stopping and testing and or waking through the night to test. You have to be ahead of yourself to sort a potential problem. Once you have made that change you need to then repeat the testing to see if it has worked. This is an ongoing thing as many find that basals do not stay the same
Or am I grossly and completely mistaken about pumping? - I have worn one 'dry' for a week to see if I could get to grips with button pushing and was asked to match what I bolussed/corrected with and play with multiwave and delayed and all the rinky dinkies, then the info was down loaded to see what was recorded and I hadn't cocked it up, which I hadn't and I had had a go at most things! I know I have one heck of a lot to learn when I go live and afterwards, but that was the procedure explained to me by my DSN ..... the procedure seems most simple!
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Personally I think you have been misled by your DSN. Pumping involves a lot more work than MDI and a lot of comitment. There is very little room for error either due to using only short acting insulin, DKA is a real risk if you can't be *rsed to test and just use guess work. The same for hypo risk.

Yes quality of life is stacks better no denying that but you have to realize it involves a lot of work.

Some people think a pump is plug and play and all is cured. Then a rude awakening hits them hard. I know of one pumper who has just been taken off of their pump due to not doing the work involved to attain control. IE, no basal testing. 😡 No basal tests = no control as if that's wrong everything else is as well.

So IMHO I think the facts should be pointed out to anyone who wants to pump.......... It's a lot of hard work and not plug and play.
If the prospective pumper is not prepared to do the work, then let the pump go to someone else who is. Pumps are expensive, the NHS is strapped for cash etc.

Ask all the Mum's with children on pumps, how much time and effort goes into it.
Ask other pumpers as well 🙂

Good luck with your pump start. If you haven't got the book pumping insulin by John Walsh. It's a good idea to invest in it as it's known as the pumpers Bible.
 
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Pumping is hard work , and just when you think you have it sorted you may find you need to correct basal doses all over again , the hard work pays off in the end but you do need to be committed 🙂
 
No no no no no! - I meant when you just need to Correct!! - I don't mean anything else!

And you need to test and change your basal rates on MDI every time there's an R in the month or the weather changes - yes I know you can have 24 of then instead of 2 but that is the attraction of the pump do in its favour not against it because your flipping body doesn't play by the same rules as Levemir or Lantus or whatever! - that's why I want to pump in the first place!
 
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I have used simple sringes, and you have to take the time and effort to:
Uncap sringe, draw air into sringe, insert into insulin vial, inject air, draw out insulin, remove sringe from vial, inject into self.
Not far from an insulin pen, just a lot more drugie like 😛

I am not trying to go for the easy route of a magic wand pump. Just something tat makes it a little easier to control my levels. Nurse said that the fact i was testing up to 20 per day is proof that i wouldn't abuse a pump.

As it stands i am having to split my insulin doses as due to my small frame, 1U:10gr isn't enough, Yet 1.25U:10gr is too much in one dose.

Thanks for all your pointers and tips, and my nurse is starting the ball rolling with consultants for me :D
 
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