Nervous about switching from MDI to pump

Hstntxag · #1 01-29-2013, 09:25 AM

We are 1 1/2 years into the T1D journey and our son has started showing a lot of interest in switching to a pump.

This should be great news, right? But I am having a hard time with the idea of changing from MDI and having to start from scratch, so to speak. He has pretty predictable numbers on MDI and I feel like we are in a pretty good groove. And there just doesn't seem like there is a 'great' time to carve out the weeks it'll take to adjust to the learning curve. He's an athlete and his season run back to back most of the time.

Now, I understand HE is the one that lives with all the shots each day and is most affected... Of course, I want what is best for him...but how do I communicate to him what all it entails so he is prepared for those first weeks/months getting the kinks worked out? Maybe I have just read too much...I am very nervous about switching.

Thanks in advance for input! I am pretty sure I'm not alone on this one

Sarah Maddie's Mom · #2 01-29-2013, 09:42 AM

Change is hard, but as you note it's your son's body and it's really important to listen when a pre-teen asserts his/her preference in self-care.

And I think you are exaggerating the time it takes to get up and running with a pump.

MomofSweetOne · #3 01-29-2013, 09:58 AM

I had a hard time, too, with the security of giving up Lantus for the unknown. An acquaintance had told me about a failed set that caused 675 BG, and I wanted nothing to do with it. But, switching with puberty was the best thing that we could have done. We need the different basal amounts, but more than that, the ability to raise the entire profile by temp basals during growth spurts has saved my sanity and her feeling good. We do CGM, and I wouldn't want to give up the benefit of having bad sites caught early.

The pump...makes life much easier. Mealtimes are so much less stressful without having to do injections, etc. Seconds here are not frequent after a year on MDI, but available at all times. Things like parties where the mom brings out food at three different times no longer provoke tears.

The transition can be hard and bring out lots of emotions. It did for me, but I'm thankful we have the pump now. Come back and we'll help you ease through the transition as best we can.

And thank you for reminding me that I do really like the pump! Our morning started off with a 4th no delivery in two weeks and I wasn't in the mood for another call to the UNhelpline.

MHoskins2179 · #4 01-29-2013, 10:03 AM

Agreed with everyone else's comments so far - change is hard, but you and he can do it.

I actually just went from pumping to MDI for my latest pump hiatus for a couple months, thinking it would actually help me get back on track. But it wasn't like my past breaks, and that change was too much. So I've now gone back to my pump as of yesterday, and feel like I've finally gotten back to where I need to be.

Eventually, once you get the hang of it and go through the trial and error on all the nuances, it'll become the norm.

Good luck transitioning!

MelissaAL · #5 01-29-2013, 10:31 AM

My daughter has been pumping for almost 2 months and FOR US, the switch was virtually painless. We were in contact with her endo every other day or so that first week or so working out dosing, but it truly wasn't a big deal.

We were eager to switch b/c Lantus was not a great fit for DD. Her numbers are much better with being able to do different basal rates at different times of day. If your son is doing well on Lantus, I can understand your hesitation to switch.

DavidN · #6 01-29-2013, 11:05 AM

I could have written your post two months ago. In fact, I might have and you simply stole my text?

We switched just over a month ago. Was it difficult? Yes. Is it still difficult? Sometimes. Do I maintain certain trust issues with the pump vs MDI? Yes. Was I happy to dial back my son's basal when he was vomiting with diarrhea all day on Sunday? Absolutely. Do I think our A1C will be better in the short-term? Probably not. Will our A1C be worse in the short-term? It's a coin toss. Is my son's safety more at risk now that he's on the pump vs MDI (maybe an irrational thought but mine nonetheless)? Don't think so, we check him too regularly for this. So perhaps most importantly, would my son put up a fight if I tried to switch him back to MDI? Absolutely!

So despite all my initial and continued (although reduced) reservations about the pump, I'm trudging through the transition period because I can count on one hand the number of times my son has complained about D since dx. But I can guarantee you I would certainly hear about it if put him back on MDI. Maybe this will change at some point, but right now he's a pump convert and I'm glad I gave him the opportunity to choose for himself.

Now I have to figure out this whole CGM thing ....

zoomom456 · #7 01-29-2013, 11:59 AM

Both MDI and pumping have pros and cons. It ends up being a personal preference. Many people do have smooth pump starts and really enjoy the freedom of eating when they want with a few button pushes. Also, if your son changes his mind about the pump, then you put it away in a closet somewhere. You can try again later or even switch back and forth between the pump and MDI. The pump is easy to learn, it just takes longer to "tweak" some of the settings.

The pump can be scary, particularly if you read some of the stories that exhibit the downsides of pumping. However, even with a nightmare of a start, most choose to continue pumping. The nice thing is, you can choose not to later as well.

Good luck

Mish · #8 01-29-2013, 12:21 PM

I think knowing that it's new and scary and that there will be some adjustment is a good thing - far better than people who think a pump (in the words of one of my d mom friends) is like a crockpot and you set it and forget it. It's not.

But, it's not really weeks and weeks of challenge either. the first few days are weird getting basals set, and you'll be revisiting those things for a few weeks, but it's nowhere near like at dx where it took you weeks to get your footing. It's not going to be as much of a disruption as you think it's going to be.

momof2marchboys · #9 01-29-2013, 09:44 PM

I was ready for our son to switch to a pump and so was he but I also dreaded making the change as I read on here prior to some of the posts about making the switch and was not sure I was ready for the highs and lows. I will say that our pump switch experience has not been like the stories I read on here - we have had a great switch and I truely do believe it is due to the trainer we had from Medtronics and the good records of his readings I kept for a month prior to the change so she could work with our Endo team on getting the correct basal settings to start with and our continued commitment to tracking is readings and seeing trends and working with our endo team to make adjustments when necessary.
We did our training on a Thursday afternoon hooked him up to saline and on friday night he pulled the site out so we went live with insulin then and to a bull sale in the middle of no where, with limited cell phone service on Saturday.
Yes we have had our ups and downs during this but it has not stopped us from going on with our lives and doing this - we just handle the highs and lows like we did before and keep on living our lives with our new normal routine of testing and correcting if needed or testing and finding a snack.

Good luck with your switch and let your son pick out his pump and if you can skins to go on it to make it more personable for him and something he can have a say in.

MomofSweetOne · #10 01-30-2013, 07:18 AM

Quote:

Originally Posted by DavidN

Do I think our A1C will be better in the short-term? Probably not. Will our A1C be worse in the short-term? It's a coin toss.

In regards to the A1C, ours DID NOT drop from MDI. The pump is a tool and does not do anything other than what you program. Diabetes has lots of factors that affect control. In our case, we switched to the pump just as puberty was entering its most intense stage, so I consider maintaining her A1Cs an improvement, because I could not have maintained them on MDI without the ability to temp basal rapidly up or down as the need presented. It bothers me when I read insurance companies, etc. expect improvement in A1Cs when life with diabetes is so unpredictable and curveballs in life have the potential to affect BG control.