Thinking about calling it quits

[karyns mom]

My 13 year old daughter has been on the pump for four years. We started her on the Minimed because we weren't getting good control through injections and we thought that this would be the solution. Since being on the pump, we have seen some improvement with her A1C's, but not what we expected. During this time we've just kept tweeking her dosages and trying new things. Now that she's a teenager, she is even more self concious about her diabetes and she didn't like the idea that people could see her pump or the tubing. She is now on the OmniPod. I don't have any real issues yet with the device since she has only been on it for a month otherthan the occlusions that we have had on a couple of the pods. Now we are facing another issue in regards to my company's insurance plan for 2011. We are being forced to switch to a high deductable plan next year and diabetes supplies will not be covered until the $2,500 deductable is met. This means paying out of pocket for pods at $300+ per month. We could swing it, but it would be extremely difficult for us financially.

Since her A1C's are not where we want them to be and now that she's older and more responsible, we are considering going back to MDI. With the new insurance plan Humalog and Lantus will be covered at 100% We would however, need to pay out of pocket for syringes, but this is minimal in comparison to pump supplies. Has anyone else seen better A1C results with MDI than with pumping? I've talked to my daughter about switching and she seems to be ok with the idea. I just worry that she won't always give herself insulin for her meals when she's out with friends since she will no longer have the ease of bolusing through her pump.

I just want to do what's best for her and not just what's best for us financially.

[wilf]

Originally Posted by karyns mom

..
I just want to do what's best for her and not just what's best for us financially.

So what does she want to do?

[Lisa P.]

I'd eat weeds from the ditch to get insulin to my kid, but if you're not seeing real improvement or real preference for pumping I don't see any problem with figuring family finances in to your decision. After all, something isn't necessarily the better choice just because it's the more expensive one.

Honestly, if I were looking at still wanting to improve numbers and I had limited resources, I'd probably look at paying out of pocket for a CGMS before I'd pay for the pump. Then you could have it on hand, use it during those times you need it, and only pay for supplies all the time if you wanted to.

Looks more like a cell phone than a pump does, too, so cooler for teens.

I guess in your shoes I'd work on finding the root of the problem first, assuming there is a problem and it's not just life with diabetes , and then once you know what will make her feel better you'll know whether you need the pump or not.

Another thing to look into is what happens after you meet the deductible. On our high deductible plan, once you meet it EVERYTHING ELSE IS 100% PAID FOR. So over the course of a year, you may come up even, I know even on low deductible plans our copays and out of pocket usually added up to thousands over the course of a year.

Good luck with your decision.

[karyns mom]

Originally Posted by wilf

So what does she want to do?

After discussing this with her, she said that in her opinion she likes the OmniPod because it pretty much does all of the work for her, but she also enjoys the freedom of having nothing attached to her at all. She was on injections for a day about a week ago and she called it a vacation from the pump. I'd never seen her so happy to have nothing on. I think that the frustration that she has with occlusions, bad sites, canula kinks, alarms and scheduled site changes is starting to wear on her a bit and she likes the idea of being free from all of that.

[karyns mom]

Originally Posted by Lisa P.

I'd eat weeds from the ditch to get insulin to my kid, but if you're not seeing real improvement or real preference for pumping I don't see any problem with figuring family finances in to your decision. After all, something isn't necessarily the better choice just because it's the more expensive one.

Honestly, if I were looking at still wanting to improve numbers and I had limited resources, I'd probably look at paying out of pocket for a CGMS before I'd pay for the pump. Then you could have it on hand, use it during those times you need it, and only pay for supplies all the time if you wanted to.

Looks more like a cell phone than a pump does, too, so cooler for teens.

I guess in your shoes I'd work on finding the root of the problem first, assuming there is a problem and it's not just life with diabetes , and then once you know what will make her feel better you'll know whether you need the pump or not.

Another thing to look into is what happens after you meet the deductible. On our high deductible plan, once you meet it EVERYTHING ELSE IS 100% PAID FOR. So over the course of a year, you may come up even, I know even on low deductible plans our copays and out of pocket usually added up to thousands over the course of a year.

Good luck with your decision.

Thanks Lisa. My company actually puts in $1500 seed money in the high deductable so I would only need to come up with the other $1000. After the deductable is met they will only cover at 80% until the $5,000 out of pocket is met. After that they will cover at 100% I've also considered maybe taking a break from pumping until our finances get back on track. Then we can get her back on the omnipod and just pay for three months of supplies so that we meet the deductable.

[Caldercup]

With a teenager, I don't think I could do without the flexibility of adjustable basal rates... or the pump's ability to determine and dose for IOB.

But if she loved being on MDI, then I'd let her have that control.

[wilf]

Originally Posted by karyns mom

After discussing this with her, she said that in her opinion she likes the OmniPod because it pretty much does all of the work for her, but she also enjoys the freedom of having nothing attached to her at all. She was on injections for a day about a week ago and she called it a vacation from the pump. I'd never seen her so happy to have nothing on. I think that the frustration that she has with occlusions, bad sites, canula kinks, alarms and scheduled site changes is starting to wear on her a bit and she likes the idea of being free from all of that.

So maybe a pump vacation is in order..

[NeurosurgeryNP]

Originally Posted by wilf

So maybe a pump vacation is in order..

Just becasue you go to MDI, doesn't mean you have to stay on MDI. Why not give it a try again?

[timsma]

Originally Posted by karyns mom

Thanks Lisa. My company actually puts in $1500 seed money in the high deductable so I would only need to come up with the other $1000. After the deductable is met they will only cover at 80% until the $5,000 out of pocket is met. After that they will cover at 100% I've also considered maybe taking a break from pumping until our finances get back on track. Then we can get her back on the omnipod and just pay for three months of supplies so that we meet the deductable.

Does your company offer Flex Spending? If so, I'd check into that. We use that and it's great, but once the 3 grand that we sign up for as flex is used up the next 1500 oop is on us as well. But it has an individual cap too, so Tim's end up being free for most of the rest of the year, just have to pay the expenses for the rest of us up to that 1500.

[Traci]

Dh's company is also switching to a high deductible plan for the new year... However, our premium will be less than half what it was this year. For us, that will make up a portion of the out of pocket monthly expenses. Is your premium changing by much?