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Ever heard of an endo saying this?

Discussion in 'Parents of Children with Type 1' started by MommyofMany, Jan 21, 2010.

  1. MommyofMany

    MommyofMany Approved members

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    Cole and I had our first actual meeting with his endo today. She didn't do blood work or anything like that-it was mainly just to discuss any questions or concerns. I figured it was worth a shot (no pun intended) to bring up pumping. MDI isn't really bothering Cole but i think we should try anything that could make this disease easier. So, when we asked about the pump she said she likes for her patients to wait a least 6 months. I was expecting this from all that I have read here. I was okay with that though because we aren't quite ready to do it anyway but it is nice to know how long she likes to wait before she allows the start of the process. But, I was a bit surprised at WHY she likes for her patients to wait 6 months. She said she doesn't like to prescribe pumps as she doesn't feel that they are "medically necessary". :eek: I can understand an insurance company saying that but the endo??
     
  2. Jessicas mom

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    Waiting for pump

    I have never heard of an endo saying that it isn't medically necessary. My daughter was diagnosed in May of 2006 when she was 8 years old. She was just fitted with a pump today. Although the wait was very frustrating and we were very anxious to get her on a pump I am so glad that we didn't do it right away. I really think knowing how to count carbs and calcuate insulin is really important to learn and when there is a pump you don't have to do that anymore because the pump does it!! I would definately wait the six months to get familiar with this condition and get in tune in what foods affect your childs blood sugars and how. I think the learning curve will be much easier. Good luck!!!
     
  3. Noel

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    I have never heard this from our endo....but I have heard some strange things from our previous endo....

    Also I wanted to comment on your children's names, I am also the mom to boys named Austin and Aidan! Just wanted to share that with you :)
     
  4. hawkeyegirl

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    Well, pumps AREN'T really medically necessary. Many people survive just fine without one.

    That being said, I don't understand what that has to do with anything. It's not like they magically become medically necessary 6 months after diagnosis.
     
  5. Kayeecee

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    Personally, I'd change endos. I daresay this endo is in the minority of endos in this country with that opinion. As for waiting 6 months, I haven't run into any parent on this board who didn't understand how to count carbs and give mdi after 6 HOURS. If you want to pump, you need to find an endo that has a philosophy that is a better match. Shudder to think what her opinion is about cgms....
     
  6. Flutterby

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    I've never heard of an endo saying that either.. I wonder though, maybe its because in the beginning, a lot (but not all) kids are honeymooning, for some, especially if they are heavily honeymooning, things are easier.. after the honeymoon stops things go crazy.. after the honeymoon, for some, the pump makes better sense?

    The only reason why I can see waiting, is to learn the whole MDI routine and to know how to draw up, inject and figure out insulin dosages incase there is ever anything wrong with the pump.. that being said there are people who leave the hospital on pumps..
     
  7. Michelle'sMom

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    I think a comment like that would have me wondering how much compassion the endo has for my child.

    While it may be true that the pump isn't necessary to our CWD's physical health, I believe it's obvious from the many, many posts here that the pump improves the quality of life for many CWDs. The endo only has to be concerned with the medical health of my child. I have to be concerned with all aspects of her life. The psychological impact of this disease is a very big concern, IMO. Anything that makes it easier for my DD to deal with this is a necessity.

    (I'm not knocking MDI at all. I think we each have to find what works best for our children, & I'm very thankful for the options we have.)
     
  8. RosemaryCinNJ

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    Becky...yes I have...I think its because endos want you to be comfortable counting carbs, and all that good stuff that comes along with type 1..6 mos is not too long too wait..we switched endos cause we were still waiting 2 and a half years later...ughhhh!!!
     
  9. sneakermom

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    We started the paperwork at our first 3-month follow-up following diagnosis. We had to push a little bit for this because our endo was originally of the mindset that everyone should wait before pumping. It's a personal journey. When you're ready, you're ready, and you shouldn't let anyone tell you when you are ready.
     
  10. Darryl

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    People have also posted here about endo's who say that a person should wait 1 year. The reality is that at dx, a child is more sensitive to insulin than they will be at any time in their future. ISF's are high, I:C's are high, and during the honeymoon, it is often necessary to shut basal off completely.

    Long acting insulins are an irrevocable 12-24 hour committment to basal insulin that might not be needed, and are in my opinion (and in my personal experience with NPH) dangerous for a newly diagnosed child. None the less, most newly dx are placed on long acting basal insulin, and are then subject to recurring lows from syringe-measured corrections that are hard to dose accurately less than 0.5u at a time, and from excess basal insulin that could be avoided by using a pump.

    Pumps provide accurate micro-dosing (accurate to 0.05u), and the ability to shut off insulin as needed. For a parent of a newly dx child, they remove the need to draw up, measure, and inject insulin for each meal. The ability to correct 0.05 units at a time removes fear of over-correcting. Basically, unless pumps are not a good option for you due to cost or discomfort with the device itself, a pump is an excellent choice to start with at the time of dx. There is no legitimate reason for an endo to push you away from using one.
     
  11. Seans Mom

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    Which pump are you using?
    Because I've not seen or heard of the pump that counts carbs for you. And the only pumps I know of, will only calculate the insulin at the I:C ratio,basal rate and/or ISF the user or parent has programmed into it.
     
  12. momtocharlotte

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    Awesome point! I hadn't ever really thought about that before, but it makes perfect sense! We had Charlotte put on a pump 1 year after diagnosis and the micro-dosing has made all the difference in the world!!! We're fortunate to have the endo we do here...the others in the area will not put a child her age (6 years old) on a pump...let alone start one on a pump at the age of 3 (her age when she started pumping).
     
  13. wilf

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    This says it all! :cwds:
     
  14. CassiesMama

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    we were told that we could start looking into a pump for my daughter about 6 months out from when she was diagnosed. main reason they told me was cause they wanted to wait for the honeymoon to be over.
     
  15. Kayeecee

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    Again, hogwash, because the crazy ups and downs of honeymooning are exactly the time that you could best make use of the smart pumps and the ability to correct oh-so-quickly.
     
  16. ScottB

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    I agree as well. Neither Justin's endo or dietitian/CDE brought the subject up much until around 6 months after dx and even then it was only brought up as a treatment option Justin could choose from if he wanted to. Not once was it ever referred to as a medical necessity nor did his endo or CDE insist on it because it was a personal choice. There could be many reasons for some endo's to suggest that you wait 6 months but in Justin's case we never ever questioned the sincerity or commitment of his endo or CDE during that 6 months in fact his CDE had T1 and was on a pump herself. She never hesitated to show Justin her pump and explain how it worked when he asked but at the same token she never made any notion what so ever that a pump was necessary.

    Once Justin did feel he wanted a pump, that's when his endo sent us home with a whole arm full of literature and informational DVD's from all the pump manufacturers at that time.
     
  17. Beach bum

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    Perfect! The only thing medically neccessary about pumping is the insulin.

    Now, I wonder why the endo would say something like that? Makes me wonder how well versed they are in pumping???

    Our team basically said "most families start looking into the pump about 6 months in" reason being is they are going through all the stuff that is new to D, getting the hang of dosing, using carb ratios etc. We pretty much said we wanted to look into a pump at our first meeting(our good friend pumps so we were familiar with it), they were fine with it, gave us info, told us to take our time and read. By the time we had gone through all the hoops with insurance, pump meetings with endo, social worker etc. we were at the 9 month mark. We were still honeymooning too.
     
  18. Toni

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    Even at our progressive diabetes center in the City, they don't just prescribe a pump, they have conditions you must fulfill. Which is definitely not cutting edge because there is a theory that putting a child on a pump shortly after dx can preserve beta cells. We were able to get the pump in three months, but we had to have many appointments during those first three months to do it. Endo in town makes you wait a year. Sis did want a pump immediately but had to wait a month to even get in to see the endo. She theorized if she switched again, it might be another month or two to get in to a new endo and she was very satisified with the D care she was getting at the center otherwise.
     
  19. ScottB

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    I feel that "information overload" was the main reason for our 6 month wait because both our endo and CDE did actually mention a pump on our very first visits but said they would wait till later on to discuss it more because they were probably well aware that we were already being overwhelmed with info because we already had 2 notebook pages of questions we were asking. Now 1 could argue that eliminating MDI from the start reduces that overload of info and that would be a valid point but for us it was beneficial to have the time to be accustomed to MDI because it now gives us a "plan B" if and when Justin has a pump failure. Justin's pump has only failed once but when it did he immediately went right back to MDI till the new pump arrived and did so knowing exactly what to do and how to do it. I think it's fair to say that certain situations may have an endo that would normally wait 6 months suggest a pump from the start instead but in regards to the OP I wouldn't question an endo's sincerity from the start simply because the endo wants you to wait 6 months. The fact that your endo is aware of a pump as being a viable option to choose from and isn't arguing against it other than wait 6 months should tell you that your endo cares.
     
  20. chbarnes

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    This article, http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&cmd=Retrieve&dopt=Abstract&list_uids=18333891, cited on the CWD homepage, certainly implies that pumping provides superior control compared to MDI for most people. There are also other articles that support this conclusion.
    There are also quality of life issues for many people that push them toward pumping. So I think your doctor has a narrow definition of "Medical Necessity."

    We started the Omnipod about 2 and-a-half months after diagnosis. Chris would have started sooner if we had the paperwork done.

    Chuck
     

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