The 'New on Pump' thread!

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Thank you so much Adrienne. I am so happy now that i understand. I feel kind of one step ahead already! I am learning so much from you and Patricia and we have not even started pumping yet! What i have learnt already means i feel a bit more prepared and will be less in the dark when we start. As you say, once we are actually doing it then it will all make even better sense! 🙂🙂

Glad things are settling down again for you, Patricia. 8 sounds like a good number to be at, not too high but not scraping him up off the floor either! I think it is so great that E can eat to appetite (and i know how much teenagers can consume!) and not have to keep having a jab, just press a button. Has he forgot to bolus many times? I think this is possible going to be a problem for my son. I can just imagine him forgetting sometimes. But at least if he does regular blood tests then he can correct easily. 🙂🙂
 
Early bird morning -- my daughter off to France for the first time alone (a day only, but hey).

Yesterday's numbers okay-ish, but two clear hypos across middle of day (just before break, and just before lunch) -- despite us having already lowered that basal recently. This morning we will lower it again by 0.05u/hour for those three hours, and see what happens. He's been tending to dip that time of day ever since being on pump, yet rises high after breakfast: so at breakfast he is .85u/hour, and at 10am he switches to .70u/hour until 4pm. We will now slot in another rate of .65u/hour from 10-1pm. Ah the joys!

Went to bed too a little high (10) -- he wasn't happy about that! But we wanted to see how things settled out this morning (the second morning on this new set of evening rates/ratios to deal with those lows from the weekend!) before raising basal a little again...Actually we've decided not to mess with the new lowered basal, but to revert to the original carb ratio for dinner and see if that does it. We both feel he needs the basal level at this slightly low level in case he eats early etc...Want to avoid a 'feeding the insulin' scenario.

I'm beginning to see now how basal does one job, and how ratios/bolus do another. On BB (thank you Adrienne! MDI as was...)there were elements of the background/bolus which seemed almost interchangeable. On the pump they are becoming much more distinct somehow, like the basal is a firm-ish pillow, off which the bolus is pushing to a higher level with each carb... (Yes I'm thinking beds -- it's 6am!). Then dropping back down to pillow level. The big difference I think is that basal is not there to accommodate ANY carb or deal with any temporary fluctuation in levels -- that's all bolus. Like with his two hypos in the middle of day (which have become quite frequent) -- he should be able to be hungry and not be actually hypo, because the adjustments on the basal are so fine that, although low before these meals, he doesn't bottom out. In the past, we attributed many hypos to being hungry -- and that's because on BB the background has to be considerably higher than you actually need, to cushion (bed again, sorry!) a number of situations and to account for the less efficient absorption generally.

Phew. Also wanted to say that the star also managed to do exceptionally well on all but one of his (10? 12?) exams, coming 1st, 2nd or 3rd in a class of 32, across the board. Because he's my hero, gets on, and in his quiet way, won't let anything stop him.
 
He certainly is a star! Wow! What excellent results! You must be so pleased and proud! Well done E! I think he has a bright future ahead of him if he can get good grades at school and master the pump! Good for him! 🙂🙂

By reading your posts/thoughts I am slowling getting my head around the whole pump thing, so thank you so much.

My son just not doing so well at moment. He going through a phase where he not interested in achieving good blood levels and he quite demotivated. I just hope the pump makes the difference. He is a good lad, bright and has many friends but i think he struggling with the fact that he has 'd' at the moment. He so fed up of the injections. It just breaks my heart but, chin up, the pump might just make all the difference!.
 
Mand, I think the pump will make a HUGE difference to your lives. Although there is this inconvenience of a 'thing' on you all the time, the compensation for quality of life is just enormous. Simple things like not having to go to the medical room at school for the lunch injection. Being able to accept sweets/biscuits from friends (which we haven't done yet because his carb counting there isn't rock solid, but it will come), deciding as and when what he wants to eat... And no injections. Life moves along so much more smoothly as a result, honestly. You asked a couple of posts ago how many boluses E had forgotten -- none, actually. He's nearly forgotten several times, and had one or two times when he remembered after he ate -- but other than that, fine.

Also, I think any change is motivating, to be honest. When we first got the pump, we all sprung into action and had a great time. E actually suffered a little 'let down' after it was all up and running -- 'now what' kind of thing -- but he's fine now, looking forward to other things in life rather than things to do with diabetes.

Your son will also find better numbers more in reach, and that itself will feel good and probably make him press on through the adjustment period.

Hang in there Mand. Not long now before it's all change and everyone will be re-energised.

(E woke on 8.8 this morning, just for the record. His reading of 10 last night was actually taken earlier than normal for him, so not surprised it dropped 1.5 mmols. We are going to switch the dinner carb ratio back again, and see if we can get him down to waking at 6-7mmols, which is ideal...)
 
Thank you so much Patricia. Your words certainly do give me strength and hope. Roll on 7th July!

I just off to have a shower then an appointment at the local beauty place for a pedicure, ready for my hol. I think the treat will cheer me up a bit.

Look forward to your next post. 🙂🙂
 
Stupid question Mand, but where do you go for a pedicure?! I've never had one and quite fancy it...But I'm worried about 'fly by night' places, like so many nail salons are...

Take care and enjoy!
 
Hi Patricia
Just returned from my pedicure! Would highly recommend you have one! I go to a local beauty shop in our town with fully qualified beauty therapists.

My feet were soaked in a foot spa, nails cut, filed and polished, hard skin on feet removed and cuticles sorted, then a foot massage using moisture cream and finally nails painted including a base coat and top coat. Tempted? Go treat yourself! You deserve it. My mom bought me a voucher for Christmas which i had deliberatley kept so i could use for a pedicure for my hol. My feet look good and feel good! It is a real 'pick me up' kinda treatment!

Anyway, back to the subject in hand, what does E keep at school now he on a pump? Do you keep anything in a fridge at school? 🙂🙂
 
Thanks for the heads up about pedicures! Love the sound of them; will investigate...(are you N American btw? Use of 'mom'...I am American.)

Anyway: we haven't quite sussed what E has at school. Just the usual at the moment: eg pen, glucose, snack, glucogel etc locked away in cabinet. He carries an extra novorapid pen and insulin with him in his bag. I think we have sort of decided not to send him with extra set change etc quite yet, because he could get home v quickly and we both work pretty nearby and in jobs we could leave quickly. Eventually though I guess we'll send him with set and reservoir change. You can use the insulin vials in pens to draw the reservoir insulin, so I don't think we'll send separate vials. And no, we don't keep anything in the fridge at school....
 
Hi Patricia

I am English but often use mom rather than mum. 🙂

My son not allowed to carry novorapid and needles with him (school rule) so it is in the school office along with Glucogel, extra Dextrose and biscuits. He does carry with him his blood testing kit, Dextrose and biscuits.

This is another area when the pump will be better because lately he has not been coming home after school, instead he goes to the park or his friends house and he has no insulin with him. So at least with the pump he will always have insulin with him in case he wants a snack.

Do you mean that you keep a spare,filled reservoir of insulin at school in case his current one runs out? If so, then if he does not use the spare reservoir within a month then you would change it because it can only be out of fridge for a month? Is that correct?

Sorry to give you so many questions! It is just that you are one step ahead of me. After my son has been on his pump for a few weeks we will be more equal and then i hope to help you as much as you help me! 🙂🙂
 
Hi Mand

I think Patricia means that E has an insulin pen with NR in it in case the pump fails so he has a pen if necessary.

We stopped carrying all of that with us eventually. If I am going away for the weekend, then yes I take a pen for NR and a pen for Lantus and all the needles and cartridges of insulin just in case, you never know.

There isn't a spare set change at my daughter's school either nor insulin pens actually.
I live very near to the school.
 
pumps in toddlers?

Hi, can I ask if anyone has any idea how feasible a pump is in a 2yr old - ie. is it fairly easy for them to ignore, how easily is it dislodged. We're hoping to be referred for one in July so trying to learn as much as possible. Feel control at the moment is out of reach - not sure how good we should be expecting things to be but having at least one hypo every other day but often 2 a day. the weeks without hypo's invariably have the same number of readings 14+. Most folk i've spoken to think a pump will give better control and my diabetologist friend (unfortunately not in our hospital) thinks for children its the only way to go. Must admit it sounds a bit daunting but would do anything to get on an even keel - though i fear another change may mean all babysitters disapear off the face of the earth - here's to quiet nights in!!
Ruth
 
HI,
Yes it is absolutely feasable for a 2 year old to have a pump. I am on another forum for children with diabetes, and there a lots of toddlers on pumps and they get used to wearing them very quickly! Also, it may be easier to get a babysitter as they wouldnt have to do needles! lol. I have been on holiday with 38 type1 children and have seen toddlers wearing pumps and climbing trees and jumping on trampolenes etc - just like a 'normal' child would - pumps are very robust and very rarely break, also the very worst thing that could happen is the canula comes out - but the sticky stuff holding it on is very good so it would be quite rare for this to happen. I have also seen a few teenagers wearing them and play fighting etc - no problem at all! If i were you i would bite their hands off for a pump - i am desperately trying to get one for my 11 year old son. 🙂Bev
 
Hi Ruth

Totally agree, the younger the better. If our children were in Europe they would be offered a pump with no problems. Infact I think either in Sweden or Denmark they just put them on pumps immediately.

I know lots of tots who were on pumps. They wanted my daughter on one at 6 months old but the local hospital blocked it, back then it was harder than it is now.

You can get comfortable harness' so they can wear them on their back and they don't even know its there. Take a look at :

http://www.angelbearpumpstuff.com/s...46E2C5C4-A4D1-4F04-BFBBC278038D5E3C&killnav=1

and

http://www.pumpwearinc.com/index.php

These are just a couple of the companies I have used, there are loads more.

Go for it, if she starts now, then she will grow up with it being around her and she future due to better control will be fab.
 
pumps in toddlers?

Thanks for that guys. Ben has been very accepting of everything so far so I did think any major changes would be best made now. Was speaking to canadian doctor recently and he was horrified that kids aren't automatically started on pumps as thats they way they do it too. Did have my doubts earlier today when i had to rescue him from the botttom of a tangled heap consisting of him his 2 brothers and the dog but i feel somewhat reassured now. next appointment on 2nd july so will see how we go.
Ruth
 
Thanks Adrienne. 🙂

Hi Ruth, as has already been said, in some countries (inc Canada and Sweden) kids are automatically put on pumps. My son (12) due to start on one 7th July. It was not easy to get one so if you are offered one then i would seriously think about it. Because Ben is so young, he would grow up with it being a normal part of his life and would have good control from a young age which can only be a good thing for him.

If you do get one then we can all compare notes! I have found Patricia's and Adrienne's posts so invaluable and we have not even started on the pump yet! 🙂🙂
 
Hi all

This is so exciting! So much pumping! Ruth, the only thing I can add is that truly the sets do seem robust and easy to manage --as per earlier post, the pump (too!) frequently gets left behind when my son stands up, and even dangling there it has never dislodged at all -- just a little 'ouch', then sorted. Also, and this was one of my secret fears so I'm glad all has worked out -- the sticking stuff for the cannula is just brilliant AND has not caused any reaction. Both my son and I have allergies to various 'hypo allergenic' plasters, both having ended up with blisters from the super duper good stuff in hospital. Oops. But this has caused no problem. Taking it off is not so great really, but he's now getting quite blase, and I think that with the 'count to three and rip it off' approach (like you do for plasters), it would be extremely simple. My son does tend to 'tease' it off, which I'm sure is more painful...

When my son was first diagnosed, we contacted via a friend of mine in the States, a very high up and experienced pediatric endo -- former president of American Diabetes etc... -- and she was quite appalled that the UK seemed so far behind for pumps. She said that literally everyone in her hospital was put onto pumps *from diagnosis*. She also indicated that her research showed (anecdotally, mind) that excellent early control seemed to prolong the honeymoon period -- and as we know, ANY time of good control contributes to future health.

Anyway, she was a real inspiration, talked to us while making her coffee and heading out the door to work...she lived and breathed diabetes, and helped spur us to action...

Update on numbers this end is that midday hypos have gone (yay!), so we'll watch that over next days. The super-reaction to his massive low last weekend needs shifting down, so we are reverting fully to previous ratio tonight for dinner -- last night he was at 14 at 9.30pm, so we were forced to correct (under correcting from bolus wizard), trying 1 unit. At 3am he was only down to 11, so we did a small correction again. This morning he was at 9 -- still too high, but what this does show is the incredible stability now of his basal rate at night: he responded almost exactly as he is 'supposed to' to corrections in the night. As Adrienne says, we probably should have trusted the pump, which said to give him 1.2 units at 9.30! We've never encountered this, have always found any extra insulin to just make him plummet...So a useful learning thing.

Adrienne, I've a question for you: do you bolus last thing at night ever? So far we always check if there's been a last minute bolus, either for correction or for bedtime snack -- do you bolus last thing, and if you do, do you test 2 hours later regardless?

I must confess that I'm now wondering if he actually *could* bolus for a small snack or small correction without having to be tested. Last night we were just all on our knees; what we wouldn't have given for a night of undisturbed sleep!

Also, Mand, to answer your question from some time ago. He is now testing bgls at breakfast, at 11am (snack time), 1.45 (lunch time), 4.30 (return from school), before dinner, and bedtime. At least. But this is his usual routine, even on MDI. I would say it's more than likely that he tests at least another two or three times in the day. At the moment, most night we then test him either at 12am and 3am, or just at 3am. Several nights we've not tested, but that has been when he's a) on a good level and b) has no significant active bolus insulin in him.

Okay. To the garden!
 
Patricia said:
Hi all


Adrienne, I've a question for you: do you bolus last thing at night ever? So far we always check if there's been a last minute bolus, either for correction or for bedtime snack -- do you bolus last thing, and if you do, do you test 2 hours later regardless?
Click to expand...

Ahh right, well what I am going to say is not the proper protocol. Jessica has sensors and from midnight I can just look at the sensor to see what she is rather than test her unless it has alarmed she is getting lower then I test.

I correct anything over 10.0 (when the pump rules allow me to that is). So if at say 11 pm she is 11.0 I correct and I stay up till midnight and test her again. However if I test her at midnight and she is too high ie 11.0 I correct but I don't deliberately get up and hour later to test. The rules say you should do and whilst you are tweaking things you definitely should do.

However I always end up waking up anyway at some point in the night and going in and checking her - well looking at the sensor. The majority of my friends all test over night, you just cannot guarantee what is happening and especially to a growing child. Its a hard one.

Occasionally when I am totally done in and she is say 13 or 14 I won't correct and I feel terribly guilty but I need to sleep. If I don't sleep sometimes I am not good to my daughter in the day at all. This doesn't happen often but I do that occasionally, don't know anyone else that does but when you are a single parents needs must. I would be no good to my daughter if I was ill.
 
Thanks Patricia. We testing around that many times at moment. Think we will need to do one or two more and certainly in night too at the beginning.

Sounds like you still doing well and learning how to tweak things. Keep up the good work! Hope you got to do some gardening!

🙂🙂
 
More and more gardening underway today, though showers predicted -- we have 30 for dinner tonight! Ack. Department end of year thing.

Numbers looking good, though a little high yesterday morning (9,11), a hangover from waking up a little high. We'll see what today holds. However there was also another mild hypo at the 'usual' time of 1.30pm -- frustrating! Will leave it as such for the moment, because not every day is the same of course...But my instinct is to raise carb ratio from 1:10 to 1:12 or something; he has a snack at 11am, and this adjustment may see him to lunch...

Woke on 7.5 this morning, after a 3 hour pasta dual wave last night. Unheard of on MDI, when he used to invariably wake on 10+ after pasta the night before. Was at 10 after the 3 hour dual wave, then must have dropped slightly after (which is what happened last time) and stayed there...all night.

For now! Also, more boasting: just had text from him. Top of class in English. He had a rocky year last year in English, even though it's always been a strong subject...lots of different teachers. He had come to believe he wasn't good in English, though we felt in our hearts of course that he was really so good at it...Anyway, after the teacher has stabilised this last term, he's just thrived. So delighted for him, such a boost. And all this while starting the pump. Again, I take my hat off.
 
Shoot, forgot to reply to Adrienne -- many thanks. We are on the list for a sensor, because it would indeed help so much.

I think you are right to keep the balance between yourself and your child. You simply must. And a cranky, ill mother is not a good trade. She needs you as her mother as well as her carer.

But you know this.

Adrienne, I'm sure you are doing a really amazing job. Get yourself some sleep when you can.
 
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