Disappointing the nurse called again....

[thebestnest5]

Ped Endo tells me that we can do the pump trial with Novolog at noon.

Diabetes nurse calls back at 6pm and says she talked to the Dr. and he doesn't want us to do Novolog, just saline...because Livia is on a small amount of insulin and the pump will clog. :confused: I find it weird that he would talk to me and say "just fine" and talk to her and change his mind. :confused:

Everytime she calls "out of the blue" it's not something good. :rolleyes:

Maybe it will clog and it's for the best...but this nurse just seems like she's got an agenda of some kind.... the..."that's not how we normally do things"....agenda....

[Ben'sMommy]

That's weird.
If he had changed his mind he really should have called to tell you himself.

Sorry for my ignorance but what do you mean when you say the pump might 'clog'???

[MrsBadshoe]

Ped Endo tells me that we can do the pump trial with Novolog at noon.

Diabetes nurse calls back at 6pm and says she talked to the Dr. and he doesn't want us to do Novolog, just saline...because Livia is on a small amount of insulin and the pump will clog. :confused: I find it weird that he would talk to me and say "just fine" and talk to her and change his mind. :confused:

Everytime she calls "out of the blue" it's not something good. :rolleyes:

Maybe it will clog and it's for the best...but this nurse just seems like she's got an agenda of some kind.... the..."that's not how we normally do things"....agenda....


That doesn't make sense....the pump will "clog" what the heck does that mean? Did you ask? Never heard of such a thing.

[Tamara Gamble]

What does that mean? I have never heard of that either. Maybe you need to contact the pump co's and give them the approx amount your child uses and ask. How will it clog? You prime the pump and it gives what is needed so the cartridge and line are already filled as well as the canula. It is not as if it has to blow a small amt all the way up the line to reach where it needs to go. It's already there and waiting for instruction. I don't understand. Ask her how? Ask her for in deapth explanation. I am confused. Sorry. There are infants put on the pump and they usually receive very little insulin so I am hesitant to believe this explanation. Maybe I'm wrong but I think this nurse needs to bud out and if the doctor can't stand on his own two feet maybe you need a new one. I don't know. Let us know what you come up with.

Good Luck! Tami

[thebestnest5]

Ooops! My laptop was acting up when I tried to change the title and I posted this original post twice under different titles. *embarrassing*


**update**
Just got off the phone with the pump rep.....

It's office politics....the nurse told the pump rep..."No insulin in the pump"....not realizing the Dr. had told me it was OK to do insulin in the pump.
So, the nurse decided to have it her way..........................:rolleyes:

[thebestnest5]

That doesn't make sense....the pump will "clog" what the heck does that mean? Did you ask? Never heard of such a thing.


I did ask and she wouldn't answer....just kept repeating that it would clog and that we had to do saline first. She's one of those...."that's not how we normally do things" types.

Plus, she had told the pump rep no insulin.....the dr. told me that insulin was Ok.....but the nurse made sure it was her way.....

[Ben'sMommy]

Ooooh, she sounds like a total nightmare.....:(

[thebestnest5]

Ooooh, she sounds like a total nightmare.....:(

She has really been a busybody. Come on, "pump clogging" ???? She was just being prideful because she told the pump rep "no".....I had actually asked the doctor an hour or so earlier and he said "yes".....so when she found out the doctor had told me yes.....she made up this theory of "pump clogging". Nice!!

When I asked her to explain....she couldn't...explain it!

How in the heck do people do untethered pumping??? They must clog all the time, huh? :rolleyes:

I don't even have anyone that we can switch to....our HMO only covers this ped endo. ugh!

I can't even believe the doctor didn't stop this fiasco from going any further. He should have stood by what he said. I feel the nurse really stepped out of line....which seems to be her "MO".

After I talked to the doctor at noon; I told Liv what he said....How disappointing for her! I feel like my hands are tied....if I do any confronting this nurse could make it very miserable for us. Obviously the doctor is run around by this nurse; or he would have stopped this from happening! I just think this puts the entire practice in a very bad light.

[Momof4gr8kids]

We only have one pedi endo in our erea. So to change we would have to go through a regular endo. However I did find out about a doctor a few towns away who is an regular endo, and has type 1 himself. A few of the people that I know with kids with T1 go to him. So if I ever have to change that is who I will go with.

I would suggest researching other docs just incase it gets out of hand, and starts to get in the way of Liv's health. I belive it is great to have a pedi endo, but at the same time, if the pedi endo isn't working out, and the nurse is having her way with you, specially if it was something that could put liv in danger, then a reagular endo, or even a regular doc with a working knowledge of type one would be better. The nurse at your office really scares me since she is going over the doctors head.

I am sorry you are having to go through this with the nurse. She really shouldn't be like that. Good luck, I hope she will keep her nose where it doesn't belong in the future.

[wendyc]

What a bummer!
I hope you told the nurse that your child was prepped and ready to be trying the Novolog. The pump clogging because of too little insulin, that's a new one. Isn't that why we prime the pump prior? Kind of a clear the tubing out proceedure? I did hear the term clogging in relation to the pump once, but that had to do with suspending the pump.

Well, at least you have the pump and are going through the proceedure. At least they can't deny you that. When it comes time to actually hook up and do formal training, I'd tell them you want straight Novolog for bolusing since you already did the saline trial!

Good luck, happy pumping:)

[Mariel's Mom]

Ped Endo tells me that we can do the pump trial with Novolog at noon.

Diabetes nurse calls back at 6pm and says she talked to the Dr. and he doesn't want us to do Novolog, just saline...because Livia is on a small amount of insulin and the pump will clog. :confused: I find it weird that he would talk to me and say "just fine" and talk to her and change his mind. :confused:

Everytime she calls "out of the blue" it's not something good. :rolleyes:

Maybe it will clog and it's for the best...but this nurse just seems like she's got an agenda of some kind.... the..."that's not how we normally do things"....agenda....


Maybe it will clog???? - with what? I'm not a doctor but i would think it would "clog" more with saline than insulin. I'm surprised that an Endo Nurse would use the very scientific term "clog". I don't know it just struck me weird.

[Hollyb]

The thing is, if it's going to clog NOW because of a trial with insulin, won't it also clog LATER when you're really hooked up? It's just ridiculous. If clogging were really a big issue, they wouldn't be putting you on a pump at all.

Oh well, at least you're still on your way. People like her should have to be flies on the wall and witness the disappointment when we have to tell our kids about her little power-trip decision...

Hope it all goes well, with the saline AND with the insulin!

[jeep_bluetj]

Clog is nonsense. I would refuse to discuss your child's care with the nurse anymore. Insist on direct contact with the Dr. The rationale is that she is obviously not properly trained if she thinks that pumps clog.

I've NO IDEA why folks are started on saline. Is there hard data out there that indicates that the first day of wearing a pump most users bolus 40 units or something? Somebody point me to the studies that show a saline start is going to be more successful than actually using insulin.

For somebody that was basal/bolus with lantus - switching the boluses over to the pump sounds like a great idea to me. (Untethered - and we all know it works fine)

Do you have reservoirs?
Do you have a vial of insulin?
Are you 100% positive in your ability to bolus correctly?
I would. (and did) But you've got to be sure of what you're doing.

[Amy C.]

I was grateful for the 7 days on saline. We had not had a chance to even look at the pump before training. I was able to watch the video, play with the settings, and most importantly, put in three sites that didn't matter if they were correct or not.

[thebestnest5]

I was grateful for the 7 days on saline. We had not had a chance to even look at the pump before training. I was able to watch the video, play with the settings, and most importantly, put in three sites that didn't matter if they were correct or not.


I would have been fine with saline. I just didn't like the clogging scare tactic that was used for a reason for the over-riding the doctor's original orders. I had also told my DD that we would be able to bolus Novolog since the doctor said it would be fine...how disappointing for dd to have the dietician decide after the fact. This is the same woman who thought it was "unfair" for me to have more than one pump rep come to my home and talk with me about their pump and company...and do more than one "trial" if we so choose. This woman, who by the way, is not a nurse...I just found out she's a dietician..is very much into trying to decide things for me. I would welcome her opinion; I just don't like the tactics she uses to get her way. She's making issues of things that should not be issues and it's frustrating. I shouldn't have to justify why I want to look at more than one pump company. The reason she gave was "that's not how we normally do it".:rolleyes: Then she pointed out that the reps had to travel to meet with me. :rolleyes: I believe it's the reps decision to travel...she doesn't need to decide for them.

[hrermgr]

Not sure which pump you will be getting, but I'd re-think my choice if I knew the pump would "clog", even during testing. Weird rep to even say such a thing.

[EmmasMom]

I think you should send her an ugly letter!!! Does she have a child with diabetes that has to be poked all of the time, a child who would enjoy a day or two w/o being poked since she'll already be poked with, and wearing a stupid infusion set with a perfectly good cannula that the insulin could go through, (with out clogging)!!!:mad: What a big stupid meany!!!
OK, that might sound immature, but I only slept two hours last night, it's the best I could come up with.;)

Hopefully you can avoid dealing wit her in the future. She obviously has some issues with easy pump transitions!!

[jeep_bluetj]

YetAnotherPost...(sorry)

The dietician is effectivly running the practice? Is the dietician a CDE? Seriously, I'd refuse contact: that's lousy care you're gettting. (EmmasMom is right on the money with her sleep-deprived rant, IMHO)

Our dietician is so useless that nobody but new diags talk to him. And they really shouldn't either cause he's less than competent.

[wendyc]

Ok, nobody's looking, take a vial of Novolog from the pen and fill it with insulin, you can do it, it works with the cartridges.
Quick, do it.

I won't tell...I promise:D

If the doc originally said it's ok, I would just go ahead and do it. The nurse/dietician whatever title she's going by today isn't standing over you, so she won't be any the wiser. The only prob you might have is if the rep has written orders. In that case, they will have you fill it with the saline, but again, once they leave and if they leave the pump with you, you can fill with Novolog.

I'm still stumped on this clogging thing. If insulin will clog, why wouldn't saline?

[thebestnest5]

YetAnotherPost...(sorry)


The dietician is effectivly running the practice? Is the dietician a CDE? Seriously, I'd refuse contact: that's lousy care you're gettting. (EmmasMom is right on the money with her sleep-deprived rant, IMHO)

Our dietician is so useless that nobody but new diags talk to him. And they really shouldn't either cause he's less than competent.

update: I called the ped endo

She's a dietician, CDE, and she runs their pump program. However, she does not do the pump training, thank goodness! She does the dietician stuff. I wish I could avoid her.... I called the doctor today and he said that they have had pumps clog "in their practice" with running zero basal. I told him that I respect the decision to do saline; it's just that the reasoning of clogging was not something that I believed was actually founded. I told him that I had already told Liv she would be spared a few pokes....he was undaunted....kept mentioning "it's only for three days", (so it's not that big of a deal ot just run saline only). I told him that I just didn't want to get caught up in office politics because the dietician/CDE had told the pump rep "NO" unbeknownst to me... He said he didn't know anything about that. Then, the Dr. tells me that he can talk to her; but they "make decisions as a team". :rolleyes:

Well, both pump reps know about the office politics and this dietician/CDE having to run things her way only. Ugh!!!! And, I am forced to work with this woman if we want to pump.

I am so tired of the office politics and issues being made of things that aren't issues. When is my daughter and her care going to come first.

I can't believe this woman feels the need to be so controlling...I have been reminded by the pump reps that "it is her program and we have to follow her rules". Well, it's my daughter's diabetes, life, feelings, care....and my money as well.

Thank you Amy, I didn't feel it was so wrong of me to want to spare Livia a few extra pokes, if it was possible to do so. I was so disappointed when even her doctor didn't feel it was a big deal, though. He's sticking by the clogging issue (in their practice) of:

small boluses + zero basal = pump clog

Pump reps told me this happened more ten years ago, but not now....and it was more likely with really slow delivery and regular insulin ten years ago...

Wendy, you made me laugh!!! They do have to have written orders. If not, I would be so tempted to fill it with Novolog.

I wonder if Carol has purchased that chicken suit...and can I borrow it...:D :p

[Tamara Gamble]

Wendy, that is so wrong and so stinkin funny!

Tami

[EmmasMom]

Hey Sheree,

I was reading through some insulin info earlier today, (the things I do with my "free time":rolleyes:) and the Novalog site says that "Novalog is less likely to cause pump clogs than regular insulin". SOOO, maybe there used to be issues with regular clogging pumps. I'd never heard of that before, but I've also never known anyone who used regular in their pump! Who knew...

[Pammers]

Yes .... it also refers to that in the book i'm readin "think like a pancreas" that novolog is the only insulin approved for pump use because it doen't have the clogging problems. We use humalog. go figure! :rolleyes:

[thebestnest5]

That's what one of the pump reps told me; that is was regular insulin with slower delivery in the older minimed pumps...like ten years ago.

Yesterday I asked if we could do the first trial with saline and the second company with Novolog....I outlined my reasoning so I hope you takes that into consideration. I will respect her decision, whatever the outcome. I just hope Livia likes the pump and it goes well.