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Pump break.

Discussion in 'Parents of Children with Type 1' started by scarral, Jul 14, 2016.

  1. scarral

    scarral Approved members

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    Now we are 9 months into this D journey. My son is 4 years 4 months old, and he has moments when he's fed up with having diabetes. During his last moment a few days ago he said he didn't want his pump anymore. I said since his pancreas doesn't produce insulin (and never will), we have to put it in his body some way. Then he said he wanted to try the pen. I've heard of people taking pump breaks. How does that work exactly? MDI wouldn't work for us because kindergarten wouldn't inject insulin (without a pump anyway), but since we have a few weeks of holiday when he won't be going to kindergarten, I thought of the possibility of trying it out. I guess we'd need a long time insulin to replace the basal, right? I'm not convinced of this idea, and since he's so young I'm also not certain that he's capable of making this decision right her and right now, but maybe sometime in the future. I think it's valid to show him all the options he will have to take care of himself when the time comes. Any ideas?
     
  2. Christopher

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    Definitely speak with his Endo about this and get their guidance. But you are correct, you will need a long acting insulin (basal) such as Lantus, to keep his bg steady in between meals, and a short acting one (bolus) such as Novolog for meals, corrections, etc.
     
  3. Lakeman

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    Is it a public kindergarten in the United States? I think that you might have a case for them injecting shots.
     
  4. mamattorney

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    My daughter took a pump break over the winter holidays this year. She was older (age 13), but she was just frustrated with her pump and wanted to try something new. It was pretty easy to do, we talked to her endo and they suggested almost a one for one swap of basal insulin (just looked at her total basal for the day and injected that much Lantus at bedtime). Then she used a Novolog pen for her mealtime boluses and corrections.

    Winter break lasted two weeks, but she was back on her pump before then. It took time away from it to remember why she wanted it in the first place!

    Since he's so little, I think you should get much more of a voice in the decision and again, you'll have the school issues. But if you decide to take a break, just call your endo and discuss it. People do it all the time. Actually my daughter was going to do it for our vacation this year, since it was water/beach based and she thought it might be better to just be on Lantus, rather than worry about replacing basal, having sites go bad from the sea water, etc. But, in the end, she decided to just stay on her pump.

    I was nervous in December, but it went well and I am ready to let her take a break any time she wants now.
     
  5. forHisglory

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    I'm sorry your little one is feeling burnout. It does seem to help switching things up. Did he mention why he doesn't like the pump? It is a bit rough going back and forth to MDI but only the first 24-48 hours. Another idea would be to try a tubeless pump like the Omnipod to change things up a bit. It might give him a little more freedom and we were able to get one for $199 out of pocket and insurance covered the pods. Instead of pump breaks we now take "tube" breaks. I hope your little guy feels better about things soon.....another idea is to take a diabetes free day where you try not to talk diabetes much and really keep it in the background as much as possible, which is easier said than done.
     
  6. rgcainmd

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    I'd avoid taking a pump break if I were you. What if your son ends up preferring MDI, and you can't make it work regarding getting his kindergarten staff to inject? Force him to return to pumping?

    I dread the day my daughter wants to take a pump break. If my daughter was essentially still a toddler, I'd still be making all the D-decisions. Yes, T1D can be managed with MDI, but the fact remains that you can't utilize variable basal rates and temporary basal rates with MDI.
     
  7. scarral

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    No, he's in a public kindergarten in Austria, and as far as I understand, the personnel is not allowed to administer injections. One of us or a nurse would have to go there every day to do that. Getting them to agree to care for him with the pump was a big enough challenge.
     
  8. scarral

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    No, he didn't say exactly what is bothering him, I think he's just tired of having diabetes. Maybe some kind of denial stage he might be going through?
     
  9. Christopher

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    I apologize for not knowing the laws where you live but I was just curious, you said they agreed to "care for him" with the pump so are they bolusing him? If so, that isn't really much different than doing it with a syringe. Yes there are a few extra steps, but I would think in terms of liability it is essentially the same. You can screw things up with a pump just like you can with a syringe. Just wondering why they are not allowed to administer injections but are allowed to administer via a pump?
     
  10. forHisglory

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    If I had to take a stab at it (no pun intended) I would say the issue is with the needles when the staff have to do MDI. A mom in our local support group actually had to go through testing her daughter for HIV, Hepatitis, etc. when the teacher accidentally poked herself with the used needle after giving an injection. It was a HUGE deal. The teacher completely freaked out. With a pump, you eliminate the needle.
     
  11. LauraC

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    My daughter is 5 years old and we have gone through the same thing over the past few months. She has been asking about why she has diabetes and why she has to wear a pump, etc. A few weeks ago she said she didn't want to wear the pump anymore, so I gave her a shot for the next meal (and left the pod on). She cried and said she would rather have the pump. Maybe you could try giving him a shot for a meal or two and leave the pump on for basal...just to see how he handles it. Good luck!
     
  12. scarral

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    Yes I think it's got to do with handling needles. They don't change the lancet either, and they even wear gloves when they measure his BG.
     
  13. rgcainmd

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    They wear gloves when they check his BG?!? Way to make a kid feel diseased!
     
  14. StacyMM

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    I'd start by finding out what the actual law is regarding the management of T1D in schools in Austria. The school saying that they can't administer insulin via syringe/pen isn't the same as the law saying it. If it's legitimate, you need to figure that out. If it's not, you need to figure out how you would get the school to comply.

    If it comes down to it and you CAN send him to school without a pump, then you can decide what to do. I'm in the definite minority, but I did let my 4 year decide. We got the pump, did the training, had the supplies ready...and left pump training without a pump on her. Two years later, she decided to pump (she was 6) and she pumped for two years. Over the years, she's alternated between syringes and pumps. Right now, she's on a pump break, but she did decide to wear a pump on vacation to make it easier for her grandparents. Once she gets back, though, I think she'll switch back. I tell my kids that getting the insulin into their bodies isn't optional but how they choose to get it there is up to them. I have one that uses both but has spent more time on MDI than pumps and one that has never even considered a pump break. Different families, different rules, though. You know your situation, your son and your options and you are the only one that can decide what you can and cannot do. It's tough when your kid is upset. And, his life has changed so much in the past year - getting diabetes, starting school - that maybe he is just overwhelmed and is saying he wants to stop pumping because he really means that he wants to quit having diabetes. We have taken DD to therapists a few times over the years when she is really struggling with the reality of diabetes. For her, it's been really helpful.
     
  15. Snowflake

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    The nurse trainers in Colorado have required that for my daughter's caregivers at both public school and at day camps. Despite us parents insisting it's not necessary, the nurses respond that it's for both the child and the teacher's protection. It strikes me as pointless environmental waste!
     
  16. Beach bum

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    One of my daughters takes a "semi" pump break every summer. It's called untethered. We give a shot of long acting in the morning. When she needs carb coverage or a correction, we plug in the pump to bolus. We've been doing this every summer for the past 8 years and while not my favorite, it does work well and satisfies her craving to be off the pump. Since she is older, we do need to put her on the pump overnight, but when she was younger, it wasn't needed.

    Many times my daughter asked for a pump break when she was younger. I will tell you one thing. She got very bored of it very fast. I know it's hard to reason with a 4 year old, but I would tell him, lets see how you like it. I will give you a shot every time you want to eat or we need to correct. My daughter ended up being annoyed by the fact every time she wanted a snack, she had to get a shot. Within a day of requesting a break, she went happily back to pumping.
     
  17. Beach bum

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    They do at the schools here too. It's a law in our state. Also at D camp my kids just came back from.
     
  18. rgcainmd

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    I can appreciate the "universal precautions" aspect of this, and TBH was surprised to discover that staff at the D-camp my daughter just attended for the 3rd summer (time sure flies while we're having D-fun!) wear gloves. I learn something new every day!
     

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