How long to get comfortable with pump?

[Liongirl4]

We got a call on Friday..looks like Sam may get her pump this week! I am trying to see when a good time to start would be..I want to be off work for a few days and have her be off from or miss school, at least for a day or two, right? I know we will doing alot of checking and learning and it may not be smooth going right away..so can anyone offer thoughts on how long it took you to be somewhat ok with it?
Samantha is 15, so she will be learning how to do everything as well as me..I am sure she will pick it up quicker then me!
How much does the school nurse need to know?
Thanks,
Rose and Samantha

[Mary Lou]

Hi Rose!

Congrats on getting your pump. I hope you find that it is something that makes living with D easier for you and your daughter.

We switched to the pump during the summer, and I was glad for the open schedule that enabled us to focus on learning the pump. However, I'm sure that with a bright 15 year old, it isn't going to be as difficult as it is for the little ones.

Are you doing a saline start for a few days? I found the saline start time to be the most hectic as you need to do both injections and pumping, and inevitably during this time, situations come up that you may be unsure of.

Everyone has to do what is comfortable for them. I'd trust your instincts to know what is best for you and Sam.

If you are using a Minimed pump, their online pump training is very helpful.

[Nancy in VA]

The learning of the mechanics of the pump went easily.

The calibrating and getting the programming right will take a while. Your CDE will probably start with basal rates and I:C ratios similar to your regimen with syringes - and you will probably find they will be off a lot and you'll have to tweak. There will be lots of extra testing until you figure out how long your insulin stays on board, how your basals need to differ during different times of day. You'll inevitably have a few bad sites or going bad prematurely, so your checking for ketones will increase. A lot of extra highs at the beginning, probably followed by some lows until you hone in on the right #s.

I'm not one to say how long to be out of school, because my diabetic is only 2, but your daughter needs to be prepared for this, including the possibility of her first site change being required at school instead of home.

[Tori's Mom]

Your daughter is older so your situation may vary. Also, like Mary Lou, we started the pump in the summer. I took 2 days off work, the day of the start and the next day. After that, my child care provider took over with "phone consultations" as needed!

[Amy C.]

My son did not stay out of school at all. He wore the pump with saline for a week and then was put on insulin.

We had no problems at school or even at home. It was a very smooth transition.

[AJsmom]

Hi Rose-

Our son started on the pump when he was 10 (he's now 15). He was dx at age 2, so we had been doing shots for a while. I definately had the routine down and was NOT looking forward to learning something new!! But, my son was wanting some diabetes "freedom" so we made the switch.
Now, I'm going to be very honest with you only because I had friends who were honest with me and I feel I was more prepared...You will hate the pump before you love it! Learning to use the pump was the easy part, but getting the insulin rates regulated took a while. I went back to checking all through the night (12:00, 2:00, 4:00) for quite some time. During the day I was at the school almost daily working with the nurse so she would be able to properly help our son. Highs were more the problem than lows...lots of ketones and feeling yuk! I was trying so hard to not show my frustration! Finally, I looked at my son (after another really high bg) and told him I didn't think going on the pump was a good idea. He looked at me and said "Mom, your not the one with diabetes." OUCH! In spite of the extra work and lack of sleep on my part, my son felt "normal" on the pump. Well, with almost daily conversations with the nurse and friends things did improve! It took about 4-5 weeks to get everything running like it should. It took me about 3 months to really like the pump! Now we all love it! My son has been pumping for 5 years and the only way we would give up his pump is if there were a cure! :)
As far as missing school...When we started the pump we started on a Thursday and took off Friday and the following Monday. He did miss a lot of school during the weeks following (about 6 over a 4 week time), but we had a 504 in place that stated that missing school because of diabetes would not go against him.
Just work closely with the nurse and her teachers so they understand the changes your daughter is going through. Your daughter will love it...mainly because she will get to sleep late (that seems so important to teenagers!). Over time you will love it as well!!!

Good luck!
Laura

[Lee]

Our transition was not so rough. We did it during summer, however, I think that during school would have been fine.

I took off 3 days of work, just because I knew I wouldn't be sleeping through the night. My daughter was fine. If your d's carb ratios are pretty stable and your ranges are pretty normal, the transition IS alot easier; however, if not, you will just have to check more frequently. That will be the main effect for your daughter and school - she will want to check every couple of hours.

Also, I do suggest starting on a Friday. That way you have the weekend to figure out if the corrections are correct and you should have a good handle on where the ratios are. Your CDE will talk to you EVERY night for two weeks (if you are lucky). He or she will help you make changes, etc.

It really isn't all that bad for your daughter. It is more stress on you trying to get it perfect.

[Nancy in VA]

Our transition was not so rough. We did it during summer, however, I think that during school would have been fine.

I took off 3 days of work, just because I knew I wouldn't be sleeping through the night. My daughter was fine. If your d's carb ratios are pretty stable and your ranges are pretty normal, the transition IS alot easier; however, if not, you will just have to check more frequently. That will be the main effect for your daughter and school - she will want to check every couple of hours.

Also, I do suggest starting on a Friday. That way you have the weekend to figure out if the corrections are correct and you should have a good handle on where the ratios are. Your CDE will talk to you EVERY night for two weeks (if you are lucky). He or she will help you make changes, etc.

It really isn't all that bad for your daughter. It is more stress on you trying to get it perfect.

I would NOT start on a Friday. The first couple of days, you need your CDE available - and she probably won't be over that weekend.

And, we had stable Lantus and I:C ratios and they have ALL been different on the pump - I think we found intracacies of being on Lantus that we didn't see until we went off it and onto strictly Humalog.

[liasmommy2000]

Your daughter is older so your situation may vary. Also, like Mary Lou, we started the pump in the summer. I took 2 days off work, the day of the start and the next day. After that, my child care provider took over with "phone consultations" as needed!

Did the same here. Luckily we never had any mechanical problems when I was at work. I left Novolog and syringes in case there were and figured that would work until I got there. Really the mechanics of it went much smoother than I anticipated. Tweaking, well, that takes time and is and always will be ongoing I believe.

[LJS118]

Ryan was 5 when he went on the pump, so its a lot different than 15. But he got started I believe on a Saturday...and by Monday is was back in school. Of course it was only preschool then and the teacher was taught how to bolus for snacks.
Keeping to a regular routine will actually help determine the basals, staying home may make it longer to set them.

[Momof4gr8kids]

I would NOT start on a Friday. The first couple of days, you need your CDE available - and she probably won't be over that weekend.

And, we had stable Lantus and I:C ratios and they have ALL been different on the pump - I think we found intracacies of being on Lantus that we didn't see until we went off it and onto strictly Humalog.

We started on a thursday. We had our pump trainer, our normal CDE, and our endos office all happy to take calls over the weekend, day or night. That was one of my worries, too. I've heard a lot of parents that so start on a weekend, or right before that they do get the same supervision because it is understood that you need that support. Of course there are always CDEs and endos that wont go that extra mile, so it is probably better to ask about avalibility over the weekend before setting your start day in stone.

[Hollyb]

Hi, we started on the Thursday of March break so had a few days home before school started. Again, our team was accessible by pager over the weekend if needed.

I think it's really different with a teen -- Aaron practically had the pump programmed before we went in. The training will probably be directly with your daughter, with you as the backup.

We were lucky in that the transition, numbers wise, was pretty smooth. We had adjusting to do, but nothing drastic and the return to school was just fine.

If you're accessible at all during the work day, I wouldn't worry about having to do a first set change at school. You will plan for when to do the changes (they will seem daunting and long at first, but Aaron can do one in under 5 minutes now), and if something crazy happens like her set ripping out in gym class (been there -- tell her to disconnect for dodgeball!) you can either keep her pens/syringes at the school for her to get through the day with or have her call you and go help her out.

Good luck. I hope things go well!

[Lee]

We started in Friday becuase it was one less day of work to miss. Our CDE WAS VERY ACCESSIBLE. If yours is not accessible over the weekend - i.e. you do not have her or his pager/cell #, I would not recommend starting so late in the week because you will be talking to them every day!

[Abby-Dabby-Doo]

I don't know that I would have her miss school. That's going to be her normal pattern, and I wouldn't change that. That's what your trying to figure out, is her normal pattern.
We started on a Wednesday afternoon, for both the saline trial (one week) and when we went to "live" insulin. It gave our CDE two days to deal with the problems before the weekend. But our CDE was available 24/7 by cell phone. That is a question you'll want answered before you start.
I think if you do the saline trial first you'll be convinced it's much easier than you think. I would still take a couple days off. The over nights can either be easy or hard.
I would INSIST your school nurse take the on line class that MM has on there web-site. Anyone should that is going to be dealing with the pump.
Good luck! I hope you have a wonderful pump start!

[piratelight]

I dont remember what day we started but we only missed for the training and saline start then insulin start, so two days. I didn't get a lot of sleep at first but for the first 3 days of the insulin my DH took leave and was home to alternate middle of the night checks with me. We loved the pump immediately. Yes, it took some time to get all the rates in etc but we knew that going into it. Heck, we still have to tweak things here and there. I'd say go with what you are comfortable doing.

[Jensmami]

we started early Monday morning, because she does not work on Mon/Tue. We are 3 weeks into it right now and we love it. My dd would never want to go back to MDI. During the Saline period, she ripped out one site, which was a good thing, because I knew with her lifestyle it has to stick better, so for the pump start we had skin tac - so far we did not loose another site. We are still working on optimizing the numbers. She always carries a pen with her, just in case something happens and I am not there.