Well this is a twist!

[mischloss]

So we were all ready to go to our Tuesday night pump presentation. But I had to take my son for his followup appt yesterday to look over his numbers. Now this is a group of 4 doctors, all very good I might add. We had the appt. with one that is very conservative but brilliant none the less. When we mentioned that we are going to move to the pump hopefully, he just looked at us with a blank stare and questioned our decision. He stated that my son's numbers are perfect on Lantus and Humalog and that there is no need to strap him to this device 24/7. That during the summer months with camp and swimming etc, it will be incovenient and that there is no guarantee that his numbers will be better, and might possibly cause us more headaches, since being active it could dislodge or malfunction. Also, that my son would still need to take a backup insulin pen with him all the time, since if the pump doesn't work, he needs to use the pen. Well, my son was disappointed that he won't get this new gizmo to play with (he is almost 11!). I had been "talking up" the pump to my son for months and then boom, all the air was let out of the balloon. Of course I am torn now about continuing with injections. The doctor said that since my son doesn't snack throughout the day, just has a basic meal and then even if he does take in some extra foods during the day doesn't need coverage for them, he is only taking about 3-4 shots a day which does not warrant him being attached to the pump full time. My son did mention that during school and all the social activities, he can't partake if there is food in the mornings since the clinic doesn't open until 9:30am since his insulin pen is in the clinic. The doctor said there is no reason that the school should not be allowing him to store his insulin and monitor in the classroom for him to use when he needs it. Stupid me...I didn't do a 504 plan this year, we were very naive about the whole thing and didn't know our rights. :(
Anyway, then my son said that he is a little embarrassed about doing the shots and feels that it would disrupt the class. At this point, the doctor said, well, you are going to have diabetes all your life, so you have to get over the shyness of doing shots in public. They (the other classmate and teachers) will just have to allow you to do you shots and not make a big deal about it.
Sorry for the long post. As you can tell, I am very confused. Torn between, doing what is best for my son's health and also convenient for all of us. We have never had anyone that we know on the pump, so I don't have any experience to draw from. I do know that the shots for me at least are no bother to administer. Guess, just looking for some vent time. Thanks!:confused:

[wellsfamily]

You know what - if you feel that the pump is right for you, then keep asking for it until they agree, or go to another doctor. I believe it was Jeff who told me at the conference in March that even your family ped. can prescribe a pump. We also had to push for the pump. My son is 3 and only diagnosed for 5 months. Guess what, we started using it this week with saline in it, and start it with insulin on Tuesday. I am also wearing one with saline to see how it feels, and it has been great. We have had two awesome days. He has been to the playground with it, is in preschool today, and even slept in it. We are just acting like he is using it for real, and none of us can wait to be done with the shots! Keep pushing, because ultimately it is your decision, not theirs! Good luck.
Heather

[AmyMcCracken]

I can understand why your doctor doesn't feel it's necessary for the pump. But like he said your son will have to deal with this all of his life so you should do what is most comfortable for your son. He's not going to get over his shyness about shots in public and forcing the issue could cause more problems later.

We have only been pumping for 1 month with my 6 year old daughter but I wish we would have switched sooner. It gives the kids so much more freedom. My daughter wears her pump in her pocket. She is very active and we have not had any problems.

As a parent you need to do what you feel is in the best interest of your son. FOLLOW YOUR INSTINCTS. You know your son best and if you feel the pump is best, you need to push to get it. Good luck.

[BrendaK]

I have known a few doctors with that kind of attitude about the pump. I believe that the pump is a lifestyle choice, not necessarily a choice just to lower your A1C. It is also a personal decision, and your son seems old enough to make that decision.

Carson has been on the pump for a little over a year and we chose it not to lower his A1C score (thought it has lowered), but we chose it as a lifestyle choice. He needed more flexiblity with his eating schedule, more precision with insulin dosing, and to be able to fine tune the basal rates as opposed to 1 shot of lantus a day. Yes, you are "strapped" to the pump 24/7, but it is by no means a "prision sentence" like some doctors make it seem like. The pump is so small, you get used to wearing it and hardly notice it's there. Think of all of the things we wear all the time -- eyeglasses, wedding rings, a watch, clothing, etc. Wearing the pump all the time is not torture!!!

And yes, you should carry a backup insulin pen with you (I carry one in my purse). You also have to carry a glucometer with you and emergency snacks for lows. Before the pump, we had to carry insulin vials and syringes with us all the time. Carrying stuff with you is nothing new for a diabetic.

Please don't let your doctor discourage you from this very personal decision. We are one of the many many people who switched to the pump and love it. We would never go back to shots! Best of luck to you.

[Sue too]

If you have investigated the pump, want it and have the financial means to get it you should get it from your son. I personally am a huge fan of the pumps (with two kids on them). One started when she was 4 and the other when he was 11.
The flexibility it will afford your son and the discretion with which he can manage his diabetes while out in public or school can be life altering. What a shame that your doctor seemed to point out all the "cons" of the pump. He is correct on those points but if your son and you are willing and able to deal with them the ability to achieve a lifestyle not dependent on the clock, or shots 4+ times a day will (again, in my opinion) FAR outweigh the attention that must be paid to the "cons". Actually, these negative points are not that hard to deal with.
You state that the doctor is brilliant, but conservative so you may want to question his ability to manage your son on the pump. if he has little/no experience with it and is prejudiced against it, as it sounds like he is, then finding a team who is experienced at it would be a very good idea.
Best of luck.

[Hollyb]

Here's my two cents from the mom of a young teen. Your doc may be right that in the short term, especially over this summer, you might actually find the shots simpler and less hassle. It's very individual, I think. We still aren't sure whether Aaron might want to go back on injections for our two weeks at the summer, for example -- we're thinking with the constant swimming, tubing, etc. it just might be easier. (On the other hand the ability to turn down his basal when he's having an especially active day is a great thing.) Also Aaron tested/injected right in the classroom from day one and it quickly became a completely routine non-event in his class.

But longer term, your son is going to be a teen soon. If he's not snacking much now, once he starts shooting up (in height, I mean!!) trust me, he'll be snacking. Most boys have at least one year when they are just starving all the time. I've seen Aaron eat 100 carbs just for a bedtime snack -- and he hasn't put on any fat at all, just height and bone density. When that stage hits, along with the age when they start wanting to spend prolonged time with their friends, snacking and eating meals when the others do, the pump is a really great tool. I think anything that makes it easier for teens to have a normal lifestyle AND keep really good control of their diabetes is a godsend.

The other thing is that in trials I've seen comparing injections to the pump, almost no kids who try the pump decide to go back. Most really prefer it. My hunch is that adults have much more of a "mental block" about being tethered to the pump than kids. So I would base a lot of my decision on what your son thinks he would prefer. And you know, if he tries the pump and then decides it's too much hassle for the summer, it will still be there ready for him to pick up again in the fall.

Hope it works out for you!

[lisamomtotwins]

There are alot of doctors out there who have a certain notion about the pump that it is not all it is cracked up to be, i am very happy my dr's are not one of them. My husband went on the pump about 5-6 years ago he has been diabetic since 4 and he said it is the most amazing and best thing he ever did for his diabetes. He was always under great control and great A1C's in the 5's! But this was a lifestyle change for him. We are getting it for our daughter ASAP, they just put in the request so we should have it in about 1 month. Good luck and please if you and your son feel the pump is the best thing then pursue and push for what you want. My husband is a very shy man and always was embarassed to test and give shots in public and I think the pump makes his life alot easier.

[T_Adelaide]

It's not your doctor's choice- it's yours!
My daughter has been on a pump for just over a month (btw her Ac1s were great beforehand). It was hard work for a few weeks, but much better now. Having the pump attached 24/7 does not worry her in the least. It's wonderful that she can eat whatever/whenever she wants- no more limiting carbs at meals & making her eat when she doesn't want to.
Libby is still not convinced the pump is better than injections (she was on 2 a day), but I think she has forgotten the food issues!

[Ben'sMommy]

Just because his levels are good on MDI doesn't mean pumping is futile.

Using a pump really makes a difference when illness hits or when a growth spurt takes hold. He's 10 now so puberty isn't far off and his levels are likely to go bananas then (along with everything else!!! :eek: ). This is when the pump will really prove its worth.

Also, you can take the pump off for the duration of a game or sport. If the levels start to creep up you can put it back on bolus him and then take it off again!

It is very discreet and much less embarassing for a 10 year old boy than having to take a shot.

Also, he will be able to eat whatever and whenever he wants to.
I'm a bit angry at that doctor, brilliant or not.

Pumping is your familys choice - not his and it will make life easier you all.
Congratulations on having such good control on MDI but trust me keep going for the pump.

You won't be sorry.

[mischloss]

Thanks all for the replies and advice. I am thinking that for the summer, I might have him go along with the shots since his aftercare/daycamp really knows how to deal with shots and bg monitoring and are very comfortable in this regime. Also, with 4 field trips a weeks, he will be very active, with swimming etc. So perhaps being on the pump might not be visible and also going through the training at this time. But I will be talking with the other doctors in the group and seeing how they feel about my son moving to the pump in the fall. I think I will politely circumvent this doctor's opinion and just go on to the other doctors that seem to have a more positive attitude about pumping. I know my son really wants to persue it and that is have the battle right there on our favor.

You are right that moving into teenhood will mean more snacks and bigger carb loaded meals for him. I certainly don't want the shots to become an issue regarding his meals. And socially, he will be "hanging out" with other kids shortly, so again, if they stop at the mall to have pizza, why make him carry all his stuff along in a lunch bag and shoot up in public if he doesn't have to. And I also feel that in the future pumps will just get better and better regarding usage, size and intelligent management of BG. Things that daily shots just can't mimic. So, I will certainly keep my eyes and ears open and discreetly make some moves toward it.

Thanks all for the replies. Really appreciate it.
:cwds: