Thinking about a pump

At our last visit with our new endo, she kept pushing for us to use a pump because she liked the way my son's numbers looked on his MDI routine. She told us that pumping would only make his numbers better, and that it would help to make things easier. Now, I know absolutely nothing about insulin pumps, but I do know that my two kids love to get into things they're not supposed to, and I can just see this turning into a complete disaster. Don't get me wrong. I'd LOVE to not have to give my little guy tons of shots every day to compensate for snacking, meals, etc. I'm just afraid that he'd mess with it and I'm not sure if he's quite ready for something like this. As it stands now, he only lets me give him his insulin shots in his legs or his arms. He's completely petrified of having shots given in his abdomen or his backside.

How would I even go about introducing him to something like this? I know it would be a huge change for him, and if he's not really ready for it I can always put it away for now until he gets more comfortable with the idea. I just don't want to go into this and have it turn out to be a horrible experience for him. If he had been dx'd at an earlier age, I don't see that it would have been a problem, but he's only 3 and he's always aware of everything that goes on. I'm just curious as to how some of you introduced the idea of pumping to your kids and how they received the idea. I figured that maybe starting with a CGM would be a little easier on him seeing as there's no insulin involved and if he did tamper with it, I could at least substitute with regular finger pricks. Once he works his way up to being comfortable with that, maybe then I could introduce him to the pump so it wouldn't be so intimidating? Any suggestions or advice is appreciated!

 

I'm not sure that I think a three year old needs to be introduced to a medical device as if it were optional. If you think that pumping - which basically means being able to adjust basal at the push of a button: to pull things back or push things forward, radically, if needed, or to be able to correct in the middle of the night without a shot, or to roll back basal when vomiting - if you think that a 3 year old should decide if that's the optimal medical treatment of his life threatening disease then that's your call. Personally, I don't think that preschoolers get that power but if you are concerned and if YOU think pumping will benefit your son, then you get the pump, you tell him in advance, you sweeten the deal with a fun reward and you just do it.:cwds:

 

There are lots of parents of young children on here who will probably chime in and give great advice on switching to pumping.

I just wanted to say if you are not ready to pump, don't feel pressured by your endo or anyone else. MDI works, sounds like it's working for you and can be adapted for most situations with some creativity.

Good luck!

 

We started pumping 6 months after diagnosis, when our daughter was 4. It was a decision we made for her, because we felt it was in her best interest medically. She had a say on what kind of pump pack she wanted and what color pump and infusion sets. That was it. We didn't ask if she wanted it, we told her she was getting it. We showed her the pump at the doctors, explained in the best way for a 4 year old to understand what it was and told her, you are getting one.

Let me say this. You have to be ready for pumping. You are his portable pancreas. You will be the ones getting up during the night to check (more frequent testing on pumps), you are the ones making changes. Is it more work? Yes. Is it worth it? IMO, yes. But, you have to work at it in the beginning. It is frustrating, and I will say, just about everyone during the first few weeks is ready to chuck the thing out the window, but we all worked through it and do reap the rewards of being patient and working through the rough patches.

There are books out there about pumping, "Lara Takes Charge" is a good one. You can show him pictures of ones and talk to him about it. We told our daughter that it would reduce the amount of shots she got (we never said, you won't have to have shots anymore because that wasn't true) and she could have a really fun color and pouch to carry it in. As for tampering, all the pumps have a safety lock feature. You just have to make sure your child doesn't see you doing it so they can learn how!

The biggest thing is that this is YOUR decision. The doctors can encourage, but you have to be ready.

 

I am in no way opposed to getting him the pump, believe me. I'd much rather have him pump than to have to give him shots constantly. The fact that it's able to control his glucose better than I can was a no brainer, and I'm planning on calling his endo today to let her know that we decided to go ahead with it. Our previous endo refused to write him the script for it because he kept telling me that my son was too young, so I guess that's where my concerns came from, but I've been toying with the idea for a while now. My son woke up last night during his 2am check, and I talked to him about it a little. He didn't seem opposed to it, so we'll just have to see how it goes. I guess now I just have to decide which pump is a good choice for him.

Letting him choose the pouch he carries it in is a good idea, and I know that in time he'll eventually get used to it. I was just concerned with how he'd deal with it in the beginning while getting used to it. As for getting frustrated at the darn thing and wanting to throw it out the window...I'm sure I'll have those days. I know that he's only 3, and I always tell him that whatever mommy or daddy says is what goes. Technically, D isn't a choice and you guys are right; treatment options that work better than what he's doing now shouldn't be either. We'll get over the speedbumps eventually.

 

My son was dx'd at 2, right before he turned 3. We started the Dexcom about 2 months post dx, and he never messed with it. We told him this is something new, and not to touch it, and he didn't. He wears it in a pump pack.

About 5 months post dx, we started pumping with OmniPod. Same thing. Told him here's your new pump which will take away all those needle pokes. Of course he was scared at first (so was I!) but he very quickly became used to it.

Now he barely flinches when either Dexcom or OmniPod is inserted. The difference is the days in between the pokes. 3 days for the pump and about 14 days for Dexcom.

We also choose where it goes, not him. I get everything ready, and insert where I'm going to insert. He has no choice in the decision either (just like on MDI). We use thighs, upper butt/hip area and arms. Dexcom is strictly arms. We rotate every time around to a new place.

As others mentioned, it can be a lot of work in the beginning to get the settings right. We honestly had a great transition, and never for a moment regretted it. Yes, I was more tired from the night checks, but it was totally worth. All the times he now wants more to eat after I dose him is a simple push of the button to give him more insulin...no more multiple pokes or telling him he can't eat something because I don't want to poke him again.

If you're ready for it, do it! I think you'll be very happy you made the decision.

 

There are so many factors involved in diabetes that better control just because one has a pump isn't a given. Our A1Cs haven't improved at all with pumping. Part of that is due to puberty's influence. Pumping takes a lot of work, in many ways more than MDI. Instead of just one basal to set, there are many. There are highs due to failed sets that didn't occur on MDI. It's not a cure; it doesn't do the work like most non-D people seem to think. What is does do is to eliminate so many injections, helps calculate doses easily, and allows for temp basals when fighting highs or lows. We did MDI for a year, and now we wouldn't want to go back, but it bothers me when pumps are presented as an automatic way to better control. They only do what you tell them to do.

 

I know he'll still have his highs and his lows, but I'm hoping that with the flexibility of the pump and the dosing options, I'll be able to correct them more accurately. Our endo told us that dosing with a pump is much more accurate than MDI, and unlike doing whole and half units like we're doing now, the pump can do much more. It's still an electronic device just like any other, and I'm sure they have their hiccups here and there. I wouldn't expect it to do the work for me, just make it a little easier to make adjustments and change things when needed.

 

My son was diagnosed at age 3, and started pumping shortly after his 4th birthday. Frankly, I just told him, "Hey, this is what we're going to do now. No more shots! Yay!" When we first connected him, he whined slightly about wanting to take it off. I immediately produced a Reese's peanut butter cup and dosed him for it with the pump. The instant he realized that he got to eat CHOCOLATE without a shot, he got a huge smile on his face, and honestly, has not complained about it again since.

For us, the benefits of the pump are absolutely innumerable. It gave us as close to our normal life back as possible.

 

This is so true, you can really fine tune dosing. The fact that you know going in that the pump is another way of dosing and not a magic pill is huge. Some people think, oh we're on the pump, all are troubles are gone now. So not true. The problems are a bit easier to solve.

Yep, what she said. Plus, a little more. I love the fact that the pump tracks IOB (insulin on board) and does the math.

 

We made the choice for our son. After the pump arrived, we had a few weeks before the pump start, so we placed the pump in a pump belt and had him wear it, just to get used to the weight/belt. I'd say after an hour he forgot about it.

If we didn't have the pump, we could have substituted an old cell phone.

 

I think there is great benefit from starting pumping/CGM at an early age as opposed to waiting until a child is older. Younger kids accept change so much more readily than older children. Within a few weeks your child won't even remember what it's like not wearing a pump.

 

Happy 5 year old pumper!

My son was diagosed at 2 1/2 and we started pumping 6 months later at the age of 3. We talked positively about a pump, acted excited and talked about no more shots. When it came in the mail - we made a big deal about how wonderful it was and let him pick out a Thomas the Train pouch to wear it in.

When it first came - before pump training, we let him wear it around his waist without being connected, just for the excitement factor.

My son is now 5 1/2 - so we have been pumping now for 2 and a half years. I love the freedom of allowing my son to eat when he wants something and then just dosing insulin through pushing buttons. I always stressed with MDI about him wanting a snack - trying to push no carb foods so he wouldn't have to have an additional shot - and stressed when he wanted "real" food.

I think pumps are also easier for family members to learn too. As a parent - you just make the decision of what is best for your child. I wouldn't let the child make a decision. Just act excited about it if you decide to pump.

Like anything else - there IS a learning curve, similar to new diagnosis. But most people wouldn't go back and change it. Our A1C runs from 7.0 - 7.3.
Good luck!

 

And for tampering . . .

I know Medtronic pumps like we use have a pump lock - which is a button sequence that adults push and another button sequence to unlock. This way, even if you child pushed buttons, nothing would happen.

I am sure that most pumps have something like this that is child proof. To be honest - my son never really messed with it, but it is already available on the Medtronic Revel.

 

Yes, and yes. My son's pump (blue, as per his instructions) arrived on his third birthday. There was no discussion about it. He has never tried to fool around with it, nor has he ever pulled out a site. We have the MM with the child lock, but it has been at least a year since we turned it on!

Yes and yes again, except K got to have a whole ice cream cone in the middle of the afternoon, at a time when his NPH insulin regimen would have never allowed carbs like that. He was sold!

And, as hawkeyegirl said, it gave us our lives back. We had been on a difficult insulin program, and life had become almost continually focused on getting the right number of carbs in K at the right time. Finally, we could think about other things!

 

I did some research online today, and I think my preference lies with the Ping. I love the fact that it can be controlled remotely, and I'm not 100% sure, but I think it does have a child lock on it. I checked out the all in one sets that they sell, and it looks like a pretty easy application. Our endo showed us some other sets that looked like they would be a little much for our little guy, but I really liked the ones on the ping site that they advertised.

We had some potty training issues, so our son didn't get into the 3 yr old program this past fall, but he will be going into the 4 yr program this coming fall. He has interacted with a few other children who have T1, but they were all on the same regimen that he's on. In the beginning, our original endo never gave us a correction factor or an I:C ratio which really killed the snacking and made things so incredibly hard. He never even mentioned the fact that I was able to give him snacks so long as I covered with insulin, and I felt so bad for telling my son that he couldn't have that piece of chocolate or that he couldn't have crackers here and there. In fact, I found out about covering for snacks here on CWD, but always thought that it was considered 'stacking'. I did some adjusting and was finally able to figure out what his ratios were, so he does eat almost as freely as he did before his dx, but there are still certain restrictions that we have in place for certain foods that just make him skyrocket, even with extra insulin to cover them.

He doesn't mind getting the extra shots, but he's still really sensitive about where he gets them. I've tried pushing the full rotation (abdomen, backside, arms and legs) so we don't overuse one area, but he still wants nothing to do with getting the shots in his abdomen or on his backside. Of course, if I ever have to do a correction after he goes to bed for a stubborn high, I give it to him in his abdomen and he never wakes up (go figure!). I just want to make things a little easier for him, and I really think that this is the way to go. Now I just have to get all the paperwork out so I can get this on our insurance before it rolls over after Jan 1st. Children's Hospital offers classes about pumps and the basics on them, and I signed up to take that so I'd at least have the basics down. My husband's still a little apprehensive about switching him to the pump because of the possibility of our son messing with the sites, but I figure that the first time he decides to mess with it and gives it a good tug, he'll figure out really quickly that it's not something he wants to do.

I appreciate all the advice and information you folks have given me. I'm sure once I start using the pump, I'll have difficulties here and there, but I'm definitely ready to make things around here a little easier on everyone.

 

child lock

Yes the Ping has a lock function, we use it all the time. I'd suggest locking/unlocking it out of his sight if you don't want him to learn how to unlock it. My son is 8 now and can lock/unlock it (and program it, which is great), but I just leave it locked so that if a friend tries to touch it or it gets bumped, it won't give any insulin.

I can't believe endos are telling people that toddlers are too young for a pump; it's so much easier to have a pump on a toddler than doing shots, just for the way they eat (grazing, unpredictable). Mine had a pump by age 2, so he was too young to notice one way or another. I'd suggest earlier rather than later. Good luck!

 

I don't have anything to add, as my daughter was older when she got her pump, and people have already covered a lot. But I wanted to say that I'm happy you got a new endo, and you have a really great attitude and outlook about everything, and that's helpful when starting the pump. The first few days to weeks can be really frustrating.

 

Good luck. My daughter has been pumping 4 days and we love it so far. My only word of warning is about insurance. It took us a good 6 weeks from beginner pump class (required by our endo) to having the pump approved through insurance. Hopefully your insurance is great, ours are covering it no problem but are very slow to approve things.