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Starting the pump 2-3 months in?

Discussion in 'Parents of Children with Type 1' started by adjusting dad, Sep 14, 2013.

  1. adjusting dad

    adjusting dad Approved members

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    Hi everyone -- I can't believe we have been living with t1d for a little more than two months. I feel like a different person.

    Here is my question to you all. Our 7 year old is still having a terrible time with injections. However, we went to pumping class and tried on an infusion set.

    Our son said he didn't feel a thing -- beaming with a huge smile he said -- CAN I GET A PUMP RIGHT NOW?

    Has anyone here started pumping even while honeymooning. We do about 10-15 unites of insulin per day

    4 lantis, about 5 humalog and about 3 NPH in the morning (he is on two injections per day).

    I know that's not a lot of insulin -- is it still possible or advisable to convert over to just humalog on the pump?

    If it prevents more meltdowns over injections, it seems like a no-brainer. I just want to be armed with stories if I get resistance from our endo.

    Thanks!
     
  2. shannong

    shannong Approved members

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    If I could have walked out of the hospital with a pump for my son I would have. It has made my son's life easier and we have gotten better control. It can dose in very small increments. My son's total daily dose is between 15 and 20 units.
     
  3. cm4kelly

    cm4kelly Approved members

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    Get your pump!

    We started pumping 6 months in - mostly for convenience. Since I was a teacher, the summer seemed to be a great time for us to start the pump while I was off from work.

    My husband is also a type 1 and already had a pump, so we were very knowledgeable before my son was even diagnosed at 2 1/2.

    To be honest, we were really ready 3 months in when my son just turned three. Especially if your child is excited, I think it would be a great idea. Just remember to advocate for your child.
     
  4. LoveMyHounds

    LoveMyHounds Approved members

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    Amen!

    My DD started pumping while still honeymooning, but it was 8 months after dx.
    Now I'm mad at myself, that we waited so long, it is so much easier with the pump. :) And the ending of honeymoon was bumpy, the pump was very helpful.
     
  5. mom2ejca

    mom2ejca Approved members

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    We started pumping 4 months after diagnosis, my daughter had just turned 7. As I recall she was using close to what your child is.

    Keep in mind that what he's using now isn't going to convert over exactly the same when using all Humalog. My daughter's TDD went up when we switched from Lantus, Humalog, & NPH. Some people use more, some use less. I do think it's advisable to pump with a child that is using small amounts of insulin. You can easily cover small amounts of carbs that would be more difficult to cover with an injection.

    Rather than stories about other people you *know*, I would go into the appointment well educated about general pumping. Your endo is likely going to be more concerned with what you know about pumping and it's benefits and negatives. Also, talk to your insurance company to make sure they don't have any rules about a 6 month wait. I've heard some doctors will throw that out there as a general rule, but not all insurance companies follow that protocol. Our endo was very much on board with us starting pumping.
     
  6. missmakaliasmomma

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    Do anything you can to get off NPH! (as you can tell, im very anti- nph) If that means pumping and your son is all for it, it's worth a shot even if he's honeymooning
     
  7. Beach bum

    Beach bum Approved members

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    We started pumping 8 months in, we couldn't get one until the 6 month mark due to insurance, then it was the holidays. If we could have gotten one walking out the door from the hospital, we would have.

    Our endo was very on board with us pumping. My daughter used a small amount of insulin to start (she was 4), but her needs varied greatly throughout the day. It made for managing diabetes so much easier.

    I suggest doing research on all the pumps out there, I find this chart helpful: http://www.diabetesnet.com/diabetes-technology/insulin-pumps/current-pumps/pump-comparison
    Then, get out there and play with them, touch them. Either at your doctors office or call the companies and they will send a rep out or tell you where they are having a pump night. Go into the appointment with your endo knowing why you want the pump and stand firm. You know what is best for you and your family.
     
  8. Mish

    Mish Approved members

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    Oh, it is totally doable. Most pumps now have basal settings down to .025u per hour. Much less insulin than your child is using now.

    If you think of it this way; take your low end 10u Total Daily Dose, and assume a 50/50 split. 5u of basal, 5u of bolus. Then take your 5u of basal divided over 24hours = .20 per hour. Won't be a problem to cover that amount of basal, at all.

    And, like someone else pointed out, bolusing a younger child on a pump is just so much easier when you can dose for fractions of units at meals and snacks.
     
  9. obtainedmist

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    Go for it! If your insurance denies until 6 months, appeal! We did and won and dd was pumping at 3 1/2 months in! ;)
     
  10. Momontherun

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    We started pumping at 4 months and love it - so much easier especially at small doses. The pens would like and i always wondered if the med was going in. I would of started pumping sooner if given the option. It is easier to dose for meals and snacks. I say if your child is especially ready and is not a fan of the shots I say go for it. I think the lantus or levemir can really burn for some people.

    Good luck.
     
  11. coeen

    coeen Approved members

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    We started pumping around 6 months after diagnosis and he was still honeymooning. Would have done it sooner if we could have. To this day his total daily insulin is about 10 units.
     
  12. Sarah Maddie's Mom

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    I think this is really great advice.

    Pumping lets you control the dose so much more precisely than you can on MDI. Read up about pumps, ask questions here and don't take any "policy" as set in stone, either from your insurance company or from your endo.
     
  13. obtainedmist

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    And even if the insurance does follow the Medicare protocol...APPEAL!! As long as you can supply bg logs and get a letter from the endo, it can be accepted!
     
  14. adjusting dad

    adjusting dad Approved members

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    Thanks for the comments everyone. You are confirming what I seemed to understand. Our insurance has already pre-approved and for us the t:slim seems like the way to go. My son thinks it looks cool and I love the interface. I know it doesn't link to a meter, but we are ok with that.

    Any other reasons besides having to manually enter in glucose that t:slim doesn't work for kids?

    The reality is that we will be entering everything for him.
     
  15. Shopgirl2091

    Shopgirl2091 Approved members

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    I would go for it to - I started pushing for it as soon as we left the hospital - my son only goes through about 45 units of insulin every 4-5 days, and the pump has been wonderful. Our insurance had the 6 month rule, but I submitted for it anyway and they approved it at the 4 month mark.

    Go for it - you will love it!
     
  16. momof2marchboys

    momof2marchboys Approved members

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    Our DS had a very strong honeymoon so we didn't start pumping until 11 months as he was not on insulin except for Lantus from middle of March to Sept and then once he went back on more humalog and lantus we requested a pump. I did all the leg work by contacting my insurance company to see which brand they would cover since his deductible was met and then called his endo with a request to do it. It has been the best thing we have done as it is less fighting for us when he wants to have a snack or we are out and about. Instead of pulling out a needle and insulin we just reach over and punch a few buttons and he is good to go!

    Good Luck!
     
  17. glko

    glko Approved members

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    I am having the same questions/concerns about my son dxd 1 month ago. He is on 3U Lantus daily and 2-4U Novolog, so low doses for a 9yo 75lb boy. On the one hand managing the BGs is pretty easy with MDI but there are days when he gets angry if there are extra snacks/minimeals where he needs to take an extra injection or needs a correction. I also wonder if it is best to start pumping sooner vs later as my dh has tried pumping twice but never stuck with it. I think partly because he was used to MDI for 15+ years and it is hard to change once you are used to something.
    Appreciate the input, sorry I don't have any advice since we are in the same boat.
     
  18. MomofSweetOne

    MomofSweetOne Approved members

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    We did MDI for a year because my daughter didn't want anything attached to her. Once she switched, she completely switched and now has no interest in MDI breaks at all. Diabetes is not a one-plan-fits-all condition, and your son may prefer to manage differently than your husband. In a couple years, your son will hit puberty, and the pump with its temp basal options makes life so much...less difficult.

    Pumping does require an adjustment. The insulins don't transfer over exactly and the basal works differently. We saw far more 50s in the weeks after pump start with exercise because of how differently the pump basal works with exercise.
     
  19. Mish

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    Manually entering the glucose isn't really a big issue. :) Many of us who's kids pumped before 'linked' meters have always just done it this way. It just requires a little more supervision when entering, and that should be done anyway, with a 7 year old.

    I really like the t-slim and I've heard very positive things about it. It's one we'll be looking at very closely when our warranty is up early next year.
     
  20. mamattorney

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    The t:slim has been working great for us. Not having a linked meter is no big deal, but you may want to think about using a t:connect compatible one. We don't use one now and so when we upload the pump, the average BG is off by a lot. It also tells us we test a lot less than what we actually do. You can enter just a plain BG with no carbs/bolus/correction but we rarely do.

    I'm thinking about switching, but I like our accu check nano and we have about about a 500 strip backstock built up and it seems wasteful to just not use those.
     

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