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To pump or not to pump - Help!

Discussion in 'Parents of Children with Type 1' started by Kyra's Mom, Jul 28, 2011.

  1. Kyra's Mom

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    Kyra was approved for the omnipod pump by our insurance yesterday, but I am now having second thoughts. Whenever I talk to her about getting the pump and using it she always says that she wants to get it but she will use it when she is bigger. She will not even try on the sample pods. The reason that I am anxious to start using a pump is because she is so sensitive to insulin and we are having a really difficult time controlling her BG during the night. She goes to bed at 9:00 with BG of 110 and 135 and by 2:00 am she will be anywhere between 250 to 375. Her Endo has told me that only way to get this under control is with a pump so that we can program the amount of insulin she is getting at that time of night. This has also begun to happen at school after "nap time" the teachers have told me that if she actually falls asleep her BG will be around 250 when they wake her up. So here is my question do I force her to start using a pump or is this going to be to traumatic for her. I would just go ahead and buy the pump and see what happens but the startup cost will be around $1700.00. I should also mention that for a 4 year old Kyra is very strong willed and determined. I know that since she has made up her mind that she does not want to use the pump at this time that the will be something that I will have to force on her. Any input would be great as I am really at a cross roads here.
     
  2. kimmcannally

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    At 4 years old, I wouldn't give her a choice. I never gave my 4 year olds a choice if they would get their shots, or if they took antibiotics for an ear infection, etc. I'd give her a choice of pump packs if you want her to carry the PDM, or something along those lines.

    It's important for her future health that you be able to keep her BG in range as much as possible.

    Also, have you let her look at the Ping? I'm biased - it's the pump we use :p but it comes in pink and she could get pink infusion sets. It also comes in purple and other colors she might like.
    J wanted to start pumping with the Pod, but it was just too big for him and the adhesive made him red and itchy. He has no problems with infusion sets though.
     
  3. Nobby1

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    I know it is hard because we feel that they go through so much already but I would say that you should make the decision for her and definitely get the pump. I told my dd "the doctor said so - not my decision we dont have a choice" as I knew she would kick against it just because she hates change. But I do promise you that we were on it for all of 5 minutes before she decided to never ever part with it and go back on shots. Good luck! Hope you win the battle :)
     
  4. ehacker

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    My 4 year old just started on his pump two days ago and when we first talked to him about it he didnt want it because it was new and he didnt understand it. He had just gotten used to MDI so it scraed him a little. So i told him we needed to try it for a little while and if he still didnt like it after a month or so we could stop using it. One day in he didn's want me disconnecting for him to take a shower. He is loving the fact that he doesn't have to get 6 shots a day with it. But we had the same issue with MDI with sensitivity. Being able to give 0.36 units is a godsend! :cwds: good luck and hope all goes well ((hugs))
     
  5. cm4kelly

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    Definitely pump

    I would definitely pump. My 4 year old has been pumping for about a year - we use the minimed Revel. I think it is just something as a parent you decide this is best for your child and do it. After a while it will be your new normal.

    It helps control blood sugars because you can program it to do different basal (I describe them as drip rates) at different times of the day. My son receives .150 units per hour during the nighttime, but to help prevent highs after breakfast, his pump cranks up and he receives .250 units at 4:30 AM and in the morning hours.

    The pump allows you to make adjustments to your child's insulin needs on an hourly basis. You could do this adjustment for school hours to help with blood sugars.

    I agree with the other mom about checking into different pumps. We have a revel and lots of kids have pings. I LOVE the omnipod, but a friend of mine whose child has one thinks they are better for children a little older - maybe like 10. They are a little bulky. With a different pump, you can have a cute little pump case to put it in, my son has Thomas the Train and Baseball pouches.

    Best of luck - send me a personal message if you need to.
     
  6. KylesMom

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    I know how you feel...I was thinking of posting the same topic. We have the same type of crazy numbers at night and lantus has always been a problem for us. The nurse at the endo office just recommended that he go on the pump because we could get better control. But my son wants no part of it...he says he would rather get several shots a day and be done with it than have something attached to him all the time. He too is very strong-willed. The only difference is he is going on 11, a very tough age to begin with. I think if he were 4 I would be less likely to give him the choice I would just have him try it.
     
  7. Beach bum

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    We started pumping at 4, and we made the decision. We started pumping about 8 months after diagnosis, so she was more than ready to toss the shots. We needed the different basal programs, it was the best decision we ever made. We let her pick out pump packs, my mom made some for her dolls, she picked the color of her pump and named it. She was excited to be able to not have shots anymore. I agree, look at the different pumps and ask questions, every pump is used here, so you will get lots of input. We use the Ping, love the remote option, I only wish they had had that when we first started pumping!
     
  8. hawkeyegirl

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    Four year olds are not old enough to make this decision. My son HATED shots and still did not want to pump. Because he was four and had no clue what it meant to pump.

    You're the adult. You make the medical decisions.
     
  9. DsMom

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    I understand how you must feel about making her do something she doesn't want to do. Didn't see when she was dx but, if she was old enough, she probably didn't want to do BG checks or shots either when that started. I do agree that you need to make the decisions for her at this point...and she will adjust. You do know what is best for her...and she probably cannot comprehend all of the advantages she will get from the pump.

    We use the Ping...we looked at the Pod, but it just looked too bulky compared with the Ping's infusion set. We also love the meter/remote that comes with the Ping (but I hear they may discontinue that eventually)...it makes bolusing so easy when I can do it from 10 ft away instead of having to be hanging onto him and his pump. And the colors and skins are fun for the kids...may make your daughter more interested.

    Numbing cream makes site changes a breeze for us and is something to consider if she is afraid of the pain. I would try to talk to her about all of the advantages of pumping...easy between meal snacks, desserts, seconds at mealtime, only getting poked a few times a week vs. few times a day. And for you, the advantages will be huge, too. Using different basal rates at night brought my son's A1c down from the 8s into the 6s (in time...this takes a lot of tweaking). Piece of mind during stomach viruses was wonderful, too...being able to turn his basal off, down, or up as needed is invaluable.

    We are in the beginning stages of getting a CGM...and I have gotten cold feet, too. My son actually WANTS one...but of course I have my worries. I know how you feel, but I really think you'll both be pleased once you take the plunge and will wonder why you didn't try it sooner! Just be prepared, it DOES take some time to get those bolus and basal rates to a place where you want them. High BGs for a while can occur as you tweak the rates down (they start you on the high side to be safe and work down from there).

    Good luck. Your daughter will be fine once she gets used to it...and I truly believe she'll be grateful you made this decision for her.
     
  10. manda81

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    I would DEFINATELY pump. =) We got our Omnipod as soon as we had insurance that covered it, and have been very happy!

    My son was kind of back & forth as well, he watched some youtube video's of a little boy with his omnipod, and that totally helped him. :) Good luck!
     
  11. Lee

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    She's four - she doesn't get a say in these types of decisions, just like she doesn't get a say in other decisions like bedtimes, teeth brushing, and crossing the street.

    It doesn't matter what pump you choose, they are all great. What does matter is making as non-scary as possible so make sure you get EMLA to numb the area before inserting the site. We used EMLA for a few months until she decided it didn't really hurt.
     
  12. ehacker

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    Thats another thing I forgot to say that DS LOVES about the pump.... He gets to eat whenever he wants (within reason) and his snacks don't have to be limited. For kids who are constantly having growth spurts and wanting to just eat anything and everything the pump is phenominal!
     
  13. Beach bum

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    Totally agree here.

    As I posted earlier, we did let her have a say in things like color of pump, sets (certain sets come in different colors),pump packs,placement of sets on body.

    But in the end, she is 4. You are her parent, you know what is best for your child. She says she doesn't want a pump, but most likely what she is saying is that "I don't want anything that has to do with diabetes, it's a pain in the butt."
     
  14. denise3099

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    You need to be respectful of your 4 yr old's feelings. It's bad enough she has D, you should "force" the pump on her. :(

    That said, a little bribery goes a long way. :D So here's what you do. You are going to discuss the benefits of the pump and insist that she try it. You are going to say that you know it is difficult to try new things and you think she deserves a reward for being such a big cooperative girl. And you will ask her what do you want as a reward for trying the pump for a month? If she says a trip to mars, you will gently suggest a more reasonable alternative. Then you will say that you want to try it too to see what it's like, so you will BOTH try the dummy pods. You will let her do yours first and then you will do hers. After she's live with insulin for a month, you will make good on your promise. I swear, SWEAR, she will not want to go back to shots--and it won't take a month, more like a day. :cool:

    The trick is to approach it not like you're begging her to try it or like you are mad and forcing this on her, but like this is a fun new great thing and she'll like it and she'll get a great gift after a month. You need to be confident and happy and certain that this is gonna be great.

    ETA--retail therapy is as important as insulin therapy so ACCESSORIZE!!!! Have her pick out her pdm skin color, buy stickers and permanent markers to draw on the pod, get a new meter case, etc. Make it fun!
     
  15. Hayden'sMom

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    I know how you are feeling...

    Our son did not want the pump at all.... (I think that is because he might have overheard us in our early days when we were scared of the pump)... anyways, he had never actually seen a pump or met any other kids with a pump. So when we went on the diabetes walk this year, I made sure he connected with some boys his age that had a pump. They were amazing and showed him how they wore it and all the buttons on it etc. AFter that he thought it might not be so bad. In the end it was our decision, not his to make...but at least he felt more comfortable with it. And when it came to the day to put it on...he changed his mind. This is where bribery came in and the dude got some new cool rollerblades...but now that it is on and working so amazing, I know he would never want to go back to shots (he is 5). It really has changed our lives! Meal times are easier, getting accurate doses is possible now, and for the past week we have had the best numbers since diagnosis... it is a win win:)
     
  16. TheFormerLantusFiend

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    I think there's a problem if your endo thinks there's no way to get better control without a pump without better evidence than what you've given.
    What happens if you raise the Lantus by half a unit? If that's too much, what happens with a dose half a unit higher, plus a bedtime snack?

    I think that if it really needs to happen that your daughter have a pump, then it needs to happen, and that's that.
    But I don't think it really needs to happen.

    Your description of your daughter as strong willed makes me wonder- for a lot of kids, for most kids, bribes and rules work. For some kids, they don't. I was an oppositional defiant (and very smart) kid, and forcing me to do something would not have worked. Even when I was four.
     
  17. hawkeyegirl

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    I bet it did. Your parents probably "forced" you to brush your teeth, go to bed at a certain time, chew with your mouth closed, and say please and thank you. ;)

    A four year old with diabetes is "forced" to tolerate finger pokes and shots and other stuff. They don't know that a pump is any different. You don't present it as a choice. You say, "We are going to use a pump now," just like when they got diagnosed you said, "We are going to do finger pokes now." If it is a godawful disaster for one reason or another after you give it a fair shot, you reassess. But in my opinion, this is not an instance where you give your four year old decision-making authority. They are simply not old enough to make an informed decision about pumping, and you're frankly doing them a disservice by thrusting that upon them. That doesn't mean that you don't listen to their concerns and do everything you can to make it a positive experience for them. But it is not an appropriate decision for a 4 year old to be making.
     
  18. NJPHV

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    My 8 year old was very resistant to the idea of a pump. He was diagnosed in February, and said he'd rather have shots. We attended Friends For Life in Orlando this year, and it changed his mind! He met kids with pumps, got to see some samples, and met with some reps in the exhibit hall. We are waiting for the insurance to get back to us now--fingers crossed, we'll see what happens!
    Good luck :cwds:
     
  19. TheFormerLantusFiend

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    They didn't, actually. I refused to do anything if I was asked to say please for it- if something was offered on condition of saying please, I insisted I didn't want it even if I very much did. I considered it the height of rudeness to offer me something and then put a condition on it. I definitely wasn't forced to eat with my mouth closed, although my mother said it was disgusting the noises I made when I ate. I didn't brush my teeth. Brushing teeth is a huge sensory issue for me and I still don't brush my teeth. I did go to bed on a time, because my parents put on a production of bedtime singing and I loved lying in bed, at least when I was four.

    I was reasonably compliant if somebody suggested doing something, and I really wanted to please people, especially adults. But when there was more than a hint of coercion, I dug in my heels.

    I was not just a bit strong willed. I am autistic (diagnosed with Asperger's) and I think I fit the criteria for Oppositional Defiant Disorder, although I was not diagnosed with that and I doubt somebody who liked a child would diagnose him as such. I was forced into a very few things, which I sill can't remember without a bit of indignation, including having my temperature taken when I was sick, which took both of my parents sitting on me (they took it rectally).

    I don't know what would have happened if I had had diabetes at age four. Nothing good, I don't think.
     
  20. sarahconnormom

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    Connor was 6 at dx and we knew right away we wanted him on a pump, partly because his basal needs varied so much from day to night (night needs were double what he needed during the day).
    Pumping was not an option IMO so I did not give him a choice. I simply told him that as soon as everything was approved he was getting a pump. However, I told him he was allowed to choose the pump he wanted. I was less concerned with brand and features at that point than I was with him feeling he had some power over the decision making. Over the next few weeks I contacted the reps for Minimed, Animas, and Omnipod and set up meetings. We talked to them at length, Connor got to touch all the pumps, and Connor and I both tried on sets (and a pod). In the end Minimed was his favorite so that is what we went with. Almost 3 1/2 years later we are both still happy with his decision and just recently upgraded to the MM Revel with CGM.

    Even though pumping was ultimately my decision for him I knew he would accept it better if he felt like he had some power in the decision making. At 6 I did not feel he had the maturity to make a decision about what was best medically for him but giving him the power to choose the pump HE wanted made all the difference.
     

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