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So, the whole "Saline start" thing...

Discussion in 'Parents of Children with Type 1' started by KHS22, Mar 7, 2014.

  1. MyPumpkin

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    Wow, we are starting the saline on Wednesday and just thought this was how everyone did it. That was the way the pump trainer made it seem. We are on MDI and do carb counting for everything so that part will not be new to us. Me and my son were both a little disappointed that we couldn't start with insulin right away but thought that was just how we had to do it. I did let him know that I was told on here, that the saline may sting a bit so he could be prepared. He was not too happy about that.
     
  2. cm4kelly

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    My husband nor my son - both wearing Medtronic Revels - never did a saline start. We went right to using insulin in the pump on day 1.

    Can you push for a straight pump start?
     
  3. KHS22

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    :( Thats sucks. At least he is old enough you can sort of explain it to him? HOw long did they want you to do the saline for?
    I don't think I *really* have a choice. The appointment with the pump trainer (saline start) is 3 days before the appointment with the diabetes team (insulin start) . But, I'm thinking now we'll take the training, but not put her on the pump, until 3 days later when we see the team for her "insulin start". Or, I could still give her the levemir and use the pump to bolus for those couple days, but not use it for basal? - I don't know what their final decision on basals on the pump was. Or, I could just press them for #'s and just go ahead and put her on insulin after the 'saline start'. I mean really, what are they going to do?
     
  4. mamattorney

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    I liked the saline trials. We did them before we even settled on a pump. I thought it was good to go through the screens on a couple of different pumps over a couple of different days. It was also a good way for my daughter to really see what it felt like to wear a pump 24 hours a day before we made a final decision to get one. For the t:slim, they also gave us an extra infusion set so that she could wear it into the 4th and 5th day and do a complete site change. I wouldn't have wanted to make a pump decision without doing it.
     
  5. Sarah Maddie's Mom

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    They way I see it is that we have only two options: MDI or a pump. Once you've decided that MDI isn't meeting your needs ( and for some it does perfectly) and opt to try a pump the whole saline thing is arcane. If pumping is the next logical step in insulin delivery then the whole "get used to being attached via saline" is for me, specious. You get a pump and to quote Tim, "you make it work".

    The whole saline start thing sees to predate all the zillions of button pushing devices upon which we rely - if you can use a smart phone or your tv remote you're golden. It's old and endo should stop subjecting people to it.
     
  6. Debdebdebby13

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    No saline start for us either, we just jumped right in, no issues either.
     
  7. mamattorney

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    I guess we hadn't decided MDI wasn't meeting our needs since I think it's a crucial need that the person wearing the pump feel comfortable wearing a medical device 24/7. How better to see if that's the case than to try it out before you make such a huge decision?
     
  8. Sarah Maddie's Mom

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    But why do a phantom try? If you're going to try pumping then one should try pumping insulin. Pumping the real thing doesn't make the pump any less returnable.

    The saline start thing is all about people not screwing up and pushing the wrong buttons - no one gave me a saline start option for syringes, they just gave me a vial of insulin and sent us on our way. The saline start thing is based of the assumption that people won't understand the technology - to me that's dated.
     
  9. mamattorney

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    I guess the wearing it was the key point for us and the button pushing was good for us, too. It was interesting to do MDI using the algorithm of a pump. We had never had such precise IOB to work with when dosing; of course using a pen, we could only dose to the half unit, but it was still beneficial. It actually really improved her numbers on MDI. And wearing the pump while still on Lantus and having OK numbers gave my daughter the opportunity to wear both the Medtronic pump and the t:slim pump without adding the first week of "work in progress" basals and the associated yucky physical feelings that go with them. She was really high those first few days on a live pump.

    Finally, I thought it was worthwhile to saline trial two pumps before purchasing any one pump. You are correct that you can return a pump, but I wonder how insurance would have felt if we had bought a t:slim, used it for a few days, returned it simply because we wanted to try the Medtronic, bought a Medtronic, used it for a few days, decided we liked the t:slim better and returned the Medtronic only to re-purchase a t:slim? Best case scenario, it would have greatly delayed the real pump start since you'd have to keep going back on MDI in between. I don't know if an insurance company could dictate which pump you kept if you kept buying and returning pumps or if they could charge you for open boxes of incompatible infusion sets, cartridges/resevoirs, etc, but I wouldn't even want to deal with the possibility.

    I found it very worthwhile to "try before you buy" and did not think that seeing the demonstration at my dining room table for an hour would have given me the same amount of confidence in choosing as three to five days of hands on trialing did.
     
  10. Sarah Maddie's Mom

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    Interesting perspective... and unusual, too.

    I think most people pick a pump and then some are required to go through a saline trial to "prove" that they understand it. That just seems dated to me.

    As for the highs, yeah , most people have a few days of highs when they transition but it's short lived and in no way prevented by a saline trial.

    I'm very glad that it worked for you but I think you are a particular sort of buyer and most people just make up their minds and want to get on with it and I think endos should let them. JMHO.
     
  11. MomofSweetOne

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    My daughter has already informed me that next pump shop, she wants trials WITH INSULIN because she doesn't want to wear two pumps. I doubt it's allowed, but she's thinking like you: the actual use of button pushing varies enough that she wants the trial, just not saline.
     
  12. RomeoEcho

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    I think if you're new to pumping, a trial with insulin could be harmful. Because the transition from long acting to basal is not a 1:1, the first few days are often rocky and overwhelming. If this is the only look you get at pumping and give it back after the first few days and then decide whether you still want to do this, it's less likely to be a positive experience. If you've already got pumping experience, this doesn't apply.
     
  13. shannong

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    Our diabetes team had a procedure we had to follow: first saline start where we are shown how to insert the site and then we had to go back a week later and my son started on insulin. But here is what we did: my son got a site inserted at the saline start and then shortly after at home, we just pulled the site. It seemed pointless for him to wear the pump and do injections. When we went back for the start date, we just told them that he didn't want to keep wearing it with saline and they had no problem with that.
     
  14. 3kidlets

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    I never understood the saline start. We got Hana's omnipod in the mail, bypassed our endos office because it was going to be a 3 week wait for a nurse to meet with is to just go over the system, not even put it on her and then a second meeting a week later to start. Instead I made an appointment with Gary Scheiner. Went to his office and were up and runnjng on the pod in less then an hour.
     
  15. KHS22

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    Yah, I can get that for sure. But, I'm a CDE, have experience with all the pumps. My husband has been on a pump for years... and we already do the carb counting etc. Also, its not a 'trial' for us - we bought the pump, we're doing it! :) Going all out, no option!!!

    I may just do that....
     
  16. mmgirls

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    I don't think Romeoecho was responding to you but rather another poster in the thread that stated that the next pump choice go around their child want to trial the various pumps with insulin.
     
  17. missmakaliasmomma

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    I just don't see the big deal in doing a saline start if that's what the endo wants their patients to do. It's not harmful and it does get you used to it. My daughter didn't care doing the saline. She was 4. However, she continues to ask me to go back on shots, so I feel she's just a tad bit different from others lol. She never had an issue with needles, and I know many other kids hate shots.
     
  18. KHS22

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    Got it! :)

    I will try, because I trust them. I'm just worried like I said, that if she's getting shots too, or the saline hurts, that we'll have a bigger battle on our hands than i would care for ! ;)
     
  19. Michelle'sMom

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    We had already decided on the Ping, & our endo's office knew that. We drove 7 hrs to a required class, did the insertion...& got hooked up with saline to a Medtronic pump for a week.
     
  20. Sarah Maddie's Mom

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    What a brilliant plan! LOL
     

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