What the heck is this?????????

[momofphoenix]

I just received a letter from the Endo saying.................


I have discussed in length with Phoenix's parents regarding moving to an insulin pump. Though use of different basal rates can be quite useful in his case, i am a bit concerned about his issues regarding anxiety and ADHD. If still interested after pump night Phoenix will undergo a thorough Psychological pre-evaluation to assess Phoenix's ability to handle the pump.


So I am thinking in short laman terms she is saying NO???? Yes Phoenix has ADHD and Anxiety issues BUT I don't feel that should be a reason for him not to get the pump... what do all of you think???

[Charmed7]

I don't think it should be a deciding factor to get the pump, but on how to handle the pump. My son has ADHD, and we decided not to let him "push any buttons" because I would hate for him to think, 2 units, and put in 12 units because he's already thinking of eating those 12 cookies. :)

Who was the letter addressed to? The insurance company? And that's weird they didn't talk to you first.

Charmed.

[WestinsMom]

I would say that he has to have insulin, why does it matter how he gets it? Will the pump add to his anxiety? That I have no experience in. I would say see what the psychological evaluation says. You might not have anything to fight. If it comes back negative, then you have something to fight about.

[Mama2H]

HUH??? Ok, I may be off here but if you are the ones controlling and using the pump why would it matter if he has ADHD or anxiety?

[Abby-Dabby-Doo]

I'm not getting the impression she is saying no, I'm getting the impression she wants him to go through an evaluation first.

I disagree with what she's saying, but I don't think it would be hard to argue that with her.

[momofsingingdiabetic]

I've seen others on here mention that their kids had to go through a meeting with the psychiatrist before they could get the pump.

[momofphoenix]

The letter was address to me. I don't get it since she said to our faces that Phoenix would benefit from the pump and now I get a letter stating she isn't sure he will be able to 'handle" it and how different basel rates would do just fine.... what the He** I'm confused....she said to go to pump night and see what it is all about then pick out our pump and then he will have the Evaluation.... why do all that if she is already saying she doesn't think he can handle it??? I think he could handle it he did a trial with the CGMS and loved it... Granted it isn't the exact same thing but the pump he picked out looks identical to the CGMS we tried and he really liked it. I know right off the bat that he will not "pass" the psych eval. he doesn't talk to strangers, he is scared of new things (like any other person on earth) but I think 5 years of MDI is more then enough for one person.... If a pump can help to control bs, help to minimise long term complications and help to keep him healthy without getting 8 shots a day I say HOOK US UP!!! I told her I know it isnt a plug em up and forget it.. I know it takes time I know it is a learning process and I know it is more technical then MDI but crap my kid deserves to have some "normal" kid time too... Sorry I just have to vent cause she said one thing to our faces then puts something totally different into his medical record.....

[momofphoenix]

I'm not getting the impression she is saying no, I'm getting the impression she wants him to go through an evaluation first.

I disagree with what she's saying, but I don't think it would be hard to argue that with her.

To me that is fine to do the evaluation but I already know he isnt going to "pass" it.... he is shy, he hates new things that deal with his diabetes, he also doesnt get that he can go without getting 8 shots a day.... I dont think that should be the make it or break it deal.. As his mom I know he would do fine with it, but to someone else it might not seem that way..

[Lee]

I would wait and see what the eval said before going off full steam (like we all want to) at the endo's office. The person he will see is a trained child psych. He/she knows about things like ADHD, shyness, etc. I don't think there is any passing or failing, I think they are just trying to make sure that he wants to and the parent isn't forcing it on him.

If the trained psych says no, then go off full steam at the Endo's office and fight it with every breath in your body.

If you are really this upset, try calling the educator also and ask her what is involved in the eval and how long before your son can get in...

[Nancy in VA]

Are you sure the letter was addressed to you? After each of our appointments, we get a letter that "summarizes" our appointment. It is written to our PCP but we get a copy. Its the summary that is kept in the file at Children's.

I do know that they make every family go through psych evaluation. At the younger ages, they aren't really basing a lot on the kids since the parents are the primary managers of their diabetes. I don't know what the age is when they are looking for more from the kids than the parents in that regards. But at some age (I think probably 12+), they will base their evaluation on what the child wants more than the parents, but I would think at his age, not so much. I'm sure that he isn't the only kid that has had fears and ADHD that they have had to deal with. It might not be that they are looking to "refuse" the pump based on the psych evaluation but more use the evaluation to give assistance in making the pump start successful.

[momofsingingdiabetic]

I will say, that Danielle didn't have to go through a psych evaluation...we didn't even have a pump night. Endo gave us the information and time to look over it and then we made the decision. She had no doubt Danielle was ready for one.

[Ellen]

If the endo is concerned that the pump may exacerbate the symptoms of anxiety then the endo may be right to at least discuss this possibility with you. Similarly, it's wise of the endo to make sure that the impulsivity is under control if that's the aspect of ADHD that presents with the most symptoms for your child. How do you feel about phoning the endo in order to have a nice conversation to understand the endo's concerns, and to voice your personal opinions?

[jules12]

We didn't go to a pump class but we got to see all three types of pumps we were considering while we were still in the hospital. I agree with some others - you may not have to "fight" anything. The Endo may just be trying to cover all their bases. Maybe things are worded a certain way to be sure insurance pays for the visit with the psych?

I know someone close to my ds age and he got the pump, wore it for about a month and felt like it was a constant reminder of diabetes and didn't want to wear it anymore.....so they paid a lot of money for a pump, supplies, training, added stress learning something new - for what...to go right back to mdi. Maybe if he had a psych evaluation - they could have addressed some of those things ahead of time....just a thought.

I would call ahead and find out what they are going to talk about - maybe you could even talk with the psych ahead of time? I agree, though, you are the parents and you should have the final say in what happens.

[mischloss]

Did I miss how old your son is? Is he under 10? Sometimes it is an age thing. But then again, most of the pumps have a "lock down" mode so that no buttons can be accidentally pushed. The parent or who ever is in charge at school has the "pass" to unlock it and then administer the bolus on the pump. My son is not ADHD but he has screwed up himself two times already from being "hasty" with his insulin. One time he accidentally "double clicked" the Lantus pen and injected the 24 hour dose of Lantus twice! And again with the pump, he pushed through the buttons so fast (no it is not a video game I keep telling him!) that he accidentally over bolused by a bit. Luckily not too much though this time. It happens with all kids I think, but if it is a continued concerned for your child then like I said the "lock down" mode of these pumps should take care of the issue.

[Momof4gr8kids]

So she doesn't think that getting jabbed 4+ times a day feeds anxiety? How about Phoenix drawing that up in a syringe v.s. inputting the number? I don't know about Phoenix, but my ADHD child will hyper focus on machines. He can dial a phone number better then write it. He can type a report so much better then writing it. I'd have less fears with a child with ADHD and anxiety on the pump then MDI.
If he is anxious about the pump, but is willing to try it I think the anxiety will diminish after time.
As for the phych exam, I think each endo has their deal for figuring out if it is what the child wants, or can handle. A lot of endos will not allow a parent to choose for the child to pump if the child is opposed to it when the child is old enough to understand in their own terms what they want. Our endo was very strong on treatments being Julia's choice, and I feel he is right in this.

[Ivan's Mum]

here it's standard, every kids going on a pump needs to see a shrink to check that they're 'ready'.

Yeah... right.

I think it's to check the kids wants it, not just the parents.

[Charmed7]

here it's standard, every kids going on a pump needs to see a shrink to check that they're 'ready'.

Yeah... right.

I think it's to check the kids wants it, not just the parents.

Or maybe that it isn't being treated as a quick fix... I would call the endo and get the full story. I would insist you attend the meeting with your son, and understand that being shy won't make him ineligible. Maybe find out what they are looking for. Keep us updated.

Charmed

[momofphoenix]

Thank you for all the responses, I am hoping that the Eval will be successful in helping make pump start a good start but I am worried they will take what Phoenix say's more then what we say. I dont want anything that would make Phoenix more anxious but I do want to make every effort possible to make him healthy, I will call his Psych tomorrow and ask if he does any of these evals and what they are all about..... Hopefully they wont say anything that will scare him.

Thanks again

BTW Phoenix just turned 8 in Aug. Jan 3rd will be his 5 year anniversary with D

[Mary Lou]

Good luck! We had to have a shrink sign off on us getting the pump, Brian met with her individually, and then we all met as a family. They told me it was standard. We also had to "prove" we could carb count and had to turn in accurate food logs for a period of time to our nutritionist and she had to sign off on us getting the pump, too. It's a big decision, and I think that a little prior preparation can go a long way into making the transition successful.

[momofphoenix]

Good luck! We had to have a shrink sign off on us getting the pump, Brian met with her individually, and then we all met as a family. They told me it was standard. We also had to "prove" we could carb count and had to turn in accurate food logs for a period of time to our nutritionist and she had to sign off on us getting the pump, too. It's a big decision, and I think that a little prior preparation can go a long way into making the transition successful.

Ok so what does this Eval intail? I would like to have some sort of an idea before going in and being blind sided with strange questions/concepts. I would appritiate any info you have.....

Thanks

[Mary Lou]

Ok so what does this Eval intail? I would like to have some sort of an idea before going in and being blind sided with strange questions/concepts. I would appritiate any info you have.....

Thanks

I'm trying to remember. What I remember most is that the four of us were jammed into a very tiny office! :D

She just asked us and asked Brian questions about how we felt about the pump. Specifically, about wearing it all the time. About how Brian planned on wearing it. i think she talked to him about handling questions from the other kids at school. Pretty basic things, nothing really stood out.

I remember the nutritionist more clearly, because she threw "scenarios" at us and we had to estimate carbs without using sources (like calorie King). She also questioned us about recent meals and my philosophy toward cooking/feeding the family, etc. We had to guess the number of carbs in a regular-sized bagel, which is something I would never feed a child, personally. (Brian was 6 at the time):eek: