Why can't I have a pump?

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JonathanGi said:
Is it possible just to use arm(s) only? How much insulin can go into these things?
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I have the Tandem T:Slim X2 and I use my upper outer arms for infusion sets in rotation with my upper outer thighs and upper butt/lower back. All three sites work well for me, but I'd suggest trying out a few different sites once you get a pump to see how you rate the comfort and absorption. Everyone is different.

Tubed pumps tend to offer more options for infusion sets (the angle the cannula goes in, or if a steel infusion set can be used). Some people find certain infusion sets work better than others for them. I use Autosoft 90s (plastic cannula in at 90°) and occasionally TruSteel (steel needle in at 90°).

Tandem T:Slim can be filled with up to 300u. I fill with 100u and after the tubing is filled (I use 60cm tubing), there are 60-70u available (some insulin always disappears in the pump). Filling with 100u (60-70u available) lasts me three days.

I was hesitant at first about using a pump, mainly because of the tubing, but now I love it. I loop with Dexcom G6 & Tandem T:Slim X2 and I'm glad I made the switch.
 
Are you not getting a bit ahead of yourself trying to choose which pump you’d get along best with when you haven’t even been given approval for a pump and were told you don’t qualify? Or have I missed something and you have now been approved?
 
Yes, of course! I am human. Thanks for grounding me again! But thanks all for your replies.
 
JonathanGi said:
Yes, of course! I am human. Thanks for grounding me again! But thanks all for your replies.
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The only reason I mentioned is because maybe it’s best to focus on how you meet the criteria first to get the go ahead, then find out which pumps are available at your hospital. I don’t qualify for a pump myself though so haven’t been through the process just read of others experiences.
 
Yes, as @Lucyr suggests, your focus for this appointment really needs to be on how you fit the criteria for a pump, rather than which one you want. Your clinic may only offer one or maybe a choice of just 2 pumps so little point in getting into the detail of which one you would prefer. The important thing is to make a really good case for how it would help you overcome issues you struggle with on MDI. It maybe particular practical issues to do with exercise or nocturnal hypos or DP but it could also be the long term mental toll of managing your diabetes and how that affects you. You certainly don't automatically qualify just because you have had diabetes for a very long time and probably best not to even mention that because it isn't part of the criteria. Ultimately, pumps cost a lot of money so they have to prioritize people who will benefit most from them, with their limited budget.

Even if you meet the criteria and get a "yes" it can take months or even a year to actually get one and there will be quite a significant learning curve when you do, so you may find your current good management suffers at least temporarily and your current, extremely impressive HbA1c may actually rise a bit as a result of the pump as it may centre your levels a bit higher than you do manually. Will you be happy with that? It is certainly important to understand they are not "plug and play".
 
JonathanGi said:
Is it possible just to use arm(s) only? How much insulin can go into these things?
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Like on injections best not to overuse same areas.

If you were offered patch pump then you can stick it in fair few places, arms legs bum abdomen sides, sometimes place mine on breast area which gets good absorption.

Omnipod pump holds 200u but you Can put less in, from memory think minimum is 125u or something like that.
 
Yes, thanks for all that. I'm not convinced that a pump will be any advantage to me. Must admit though that it would nice not to have to inject myself after all these years. Going well today. Another Parkrun personal best!
 
JonathanGi said:
Yes, thanks for all that. I'm not convinced that a pump will be any advantage to me. Must admit though that it would nice not to have to inject myself after all these years. Going well today. Another Parkrun personal best!
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I hope you are sucessful getting a pump, if you decide that is the way you want to go, but do bear in mind that the criteria do change over time, so a 'no' know does not mean a 'no' in a year or so's time.
 
JonathanGi said:
Endocrinologist appointment tomorrow. Do I want a pump?
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I wasn't sure before I got my first pump.
The clincher was being told I could give it back if it didn't work out for me - it is not a decision for life.

When I started pumping, I was not a fan. But I am also not a quitter so I persevered and would not be very very reluctant to return it. However, I understand why some people have a pump break.

But, only you can tell. There is no harm in learning what the endo has to say and you don't have to decide tomorrow. There is usually a fair wait between starting the pump application process and getting a pump.
I recommend being well versed in the values you believe a pump can bring you. Given your excellent HBA1C and TIR, I expect this will need to be based on quality of life and the amount of effort you spend in achieving these results.
 
I'm seriously wondering if there'll be any advantages for me. Not having to inject myself? I'm also slightly concerned about using my abdomen - too many scars.
 
Only you can answer that question @JonathanGi And remember that you don’t have to use your abdomen 🙂 I loved my pump within a few days, but they’re not for everyone. Do what’s best for you.
 
No pump for me! Too well controlled. Far too well! Blood pressure low. Resting heart rate 42. Cholesterol levels excellent. Weight 52k. BMI 22. Probably correct. I'm not at all sure if there'd be any advantage for me.
 
JonathanGi said:
No pump for me! Too well controlled. Far too well! Blood pressure low. Resting heart rate 42. Cholesterol levels excellent. Weight 52k. BMI 22. Probably correct. I'm not at all sure if there'd be any advantage for me.
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As I mentioned before, if you would still like a pump then you need to think through the benefits of a pump for you and how they meet the funding criteria, and then you can explain those reasons in your next appointment. There are circumstances when people with a good a1c would meet the criteria.

If you don’t meet any of the criteria (I don’t as not T1), and have good control, then it’s more a case of waiting to see if criteria change in the future and asking again then.
 
I thought it all was more than reasonable. There won't be any further appointments. I think it was a case of if it ain't broke et cetera. But thanks very much for your replies. I really appreciate it.
 
JonathanGi said:
I thought it all was more than reasonable. There won't be any further appointments. I think it was a case of if it ain't broke et cetera. But thanks very much for your replies. I really appreciate it.
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Just been catching up with your messages. Sorry it didn’t work out for you with the pump. I was kinda rooting that your positive experience gaining access to this tech could also help as a “gateway” for me with my quest. Best wishes, moving forward.
 
JonathanGi said:
No pump for me! Too well controlled. Far too well! Blood pressure low. Resting heart rate 42. Cholesterol levels excellent. Weight 52k. BMI 22. Probably correct. I'm not at all sure if there'd be any advantage for me.
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That all sounds great @JonathanGi If you’re happy with that then that’s the most important thing 🙂 Impressive resting heart rate!
 
I also think that cancer diagnosis and treatment has opened a few doors. I really don't think I would have got as far as this before cancer. Funny old world.
 
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