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Pumps at diagnosis?

Discussion in 'Parents of Children with Type 1' started by MamaChrissa, Jul 30, 2008.

  1. MamaChrissa

    MamaChrissa Approved members

    Apr 20, 2007
    I was just wondering about every one's feelings about giving a newly diagnosed person (child, teen, adult...whomever) a pump, rather than starting out on MDI? :cwds:
  2. hawkeyegirl

    hawkeyegirl Approved members

    Nov 15, 2007
    If my second child were diagnosed, I'd be on the phone to Minimed before I did anything else.

    But with my first, I don't know how well I would have handled pumping from diagnosis. It is a lot more work than MDI, and there are so many more variables. I know some hospitals and doctors have really good support teams, and really good education programs, but ours is really not one of them. It certainly would have required a longer hospital stay for us (we were only in 2 nights) and a LOT more training. My brain was just in such overload at diagnosis that the pump might have sent me over the edge.
  3. frizzyrazzy

    frizzyrazzy Approved members

    Dec 23, 2006
    I also think that if my 2nd were dx (with her consent, since she is a teen) I'd be asking for a pump right away too. I kind of feel that you have to learn "something" at dx anyway and it might as well be a pump. I don't really find pumping more work, just different work. And I think the benefits far surpass any negatives - I think about the first weeks and the first sicknesses or the first lows, how much easier it would have been pumping.

    Andeefig, who posts here, her son was pumping before he left the hospital. But she's on vacation so she'll probably not see this. :)
  4. StillMamamia

    StillMamamia Approved members

    Nov 21, 2007
    My son was put on the pump at dx, and I always wished we could have started out on MDI. The reason being that I get the feeling one follows a more strict schedule on MDI, and I think for us that would have been better. Also the psychological impact of having a 'machine' attached right at dx is something to consider, IMO. I would've preferred the transition from MDI to pump.
  5. danismom79

    danismom79 Approved members

    Apr 21, 2008
    I honestly think it would be too much to handle, assuming it's the family's first time dealing with type 1. I think starting with MDI gives everyone the necessary background to work from, as well as the time to absorb all the information we need to right from the beginning.
  6. Seans Mom

    Seans Mom Approved members

    Oct 10, 2007
    This is the way I feel too. I had to learn something may have well been the pump. It would have kept us from having the Lantus/Novolog bottle mix-up last Nov.
  7. funnygrl

    funnygrl Approved members

    Nov 2, 2005
    I started the pump after 3 months of MDI. I was totally ready for it from an educational standpoint, but not at all from an emotional standpoint and pretty much broke down and started hating the pump, not realizing it was really the diabetes I hated- if that even makes sense. I went from my perfectly compliant, newly diagnosed fight-this attitude to a totally lax, denially, sad attitude. I might have otherwise, but I felt the pump was a catalyst. I wish I would have waited longer.

    TEXSONMOM Approved members

    Jun 10, 2008
    I do think it depends on the age. I did get my son all the information at DX - even had minimed and animus come out within a week and talk to him about it. He made the decision to wait until he got used to the whole D issue. (about a year). He was really bothered at first to think something would be attached 24 x 7. He was 16 yo at DX.
  9. OSUMom

    OSUMom Approved members

    Sep 10, 2006
    For us, pumping within 2-3 weeks was a blessing. ***I'd say every situation is different, and I wouldn't want anyone dictating what had to take place.

    I'm sooooo glad my son rec'd a pump so quickly (dx'd at 18). We had limited time to start that learning curve before he was living on his own on the big campus of Ohio State a couple of months later.
  10. selketine

    selketine Approved members

    Jan 4, 2006
    I wanted the pump for William about a week after diagnosis when I learned what it was - I asked the pedi endo for it right away but we still had to wait 6 months. For what? nothing really. He was on NPH and diluted humalog and I was a virtual prisoner at home with him because the NPH was so unpredictable in the morning through lunch. Then he had an afternoon nap. Then it was 4pm - pretty much day over by then! He would be in the 400's all morning then have a sudden and unpredictable drop - he would go from the 400's to 70 in 30 mins.

    He couldn't take lantus then because he did not need insulin overnight. He needed diluted humalog because his sensitivity was so great. We couldn't even correct at night - a quarter unit would have brought him down 200-250 points back then. It was about 4 months into diagnosis before he could go on lantus - that made it much easier - but the pump was better.

    He got sick the day we brought him home from the hospital after diagnosis and we had already given him insulin - we had to chase him around with sugar for hours - total nightmare.

    If the parents want it and seem capable and ESPECIALLY with little kids (babies, toddlers) - they should be put on the pump from diagnosis. Just because you have a pump doesn't mean we couldn't have been put on a "schedule" with carb requirements for awhile giving a chance to learn. With a little kid - they don't know what is what anyway - the pump just seems like anything else to them. William didn't realize everyone didn't have pumps until he was closer to 3 yrs old.

    My post applies to those with kids dx'd as babies/toddlers more than older kids. I think if the kid is agreeable and the parents then do it. The pump is a different issue for a newly dx'd 8 year old or teenager and I can understand why they might not want it - and hate it - if put on it right away.

    I still think if the (older) child and family want it though - and seem to be teachable - they should be given the choice.
  11. Thoover

    Thoover Approved members

    Feb 5, 2007
    If anyone in my family was diagnosed we would be pumping as well. I know I would be pumping if ever diagnosed.
  12. tandjjt

    tandjjt Approved members

    Sep 14, 2006
    I think everyone should do MDI long enough to get the hang of everything that goes with the shots, including the child getting adjusted to getting shots throughout the day from parents or other caregivers. This timeframe would probably vary by person/patient/parent.

    My reason for this is that if you ever have a pump failure, you have to do shots until the replacement arrives. Even if you only have to go back to MDI for just a day or so, you still need to have the background experience to know how to handle.
  13. Sari

    Sari Approved members

    May 19, 2006
    We went on the pump before leaving the hospital. I am glad for it too. I would dread having to give Ross a shot. But on the down side, I do know one day we will have a pump fail and I will need to give a shot and I have no idea how to do it! They have gone over it with me at the endo office, but when the time comes, I am going to be terrified.
  14. Lee

    Lee Approved members

    Oct 5, 2006
    I think that pumps should be available at diagnosis. I think the argument that it is so much to learn is not a valid one. Anything is tough to learn in the beginning. I have seen over and over again that starting pumping is like starting over - why even bother!

    The only benefit I can see for starting pumping later is to gain appreciation for how great pumping is!
    Rick likes this.
  15. Caydens_Mommy

    Caydens_Mommy Approved members

    Mar 24, 2008
    I think it should be a personal choice on which to start with, with that being said I am glad we were started out on MDI, which we are still on.. The pump just seems so much harder then the MDI. We do go to a pump class in Aug though, so not sure what will come of that..
  16. danismom79

    danismom79 Approved members

    Apr 21, 2008
    I think all the reasons why and why not have been valid, since they have mainly been personal in nature. I would have lost my mind if I had to fiddle with new machinery, set and reset basals, put in sites incorrectly, worry about the insulin not being delivered, etc. All this on top of the emotional toll.

    Starting pumping might be like starting over, but you have that prior knowledge about how insulin works, and more importantly how it works in your child. And knowing that, you could make more informed choices about the kind of pump to get, and what features would be most suitable.

    But I do think it should be offered as a choice right from the start. I don't like the idea of doctors assuming they know what's best for everyone. I should add here: especially since this is a self-managed disease.
    Last edited: Jul 30, 2008
  17. zell828

    zell828 Approved members

    Feb 20, 2008
    This is how I feel. Our hospital told us their policy was to teach MDI first, then the pump because it is important information to know how to give injections as well. I tend to agree. However, it doesn't take long to learn to give a shot and so I think a person doesn't necessarily have to wait a long period of time when going to the pump after shots either.
    Last edited: Jul 30, 2008
  18. jules12

    jules12 Approved members

    May 26, 2007
    I agree that everyone is different and what works for some doesn't for others - however, Our experience is such that I wish we went on the pump much sooner. I think with the experience of drawing the insulin in the reservoir and putting in sites and now sensors, would enable you to do shots in a pinch (we did shots for about 3-4 weeks). If I could have received a pump in the hospital, I would have done so.

    IMHO, the pump was so much easier because it helps with the calculations until you really get your head wrapped around it. We were fortunate to have a great cde who got our pump settings right on the first try. Whether you are on MDI or pumping, there is a learning curve...I wish I only had to learn the pump - it would have been easier for grandparents, school, etc. at the very beginning.

    I also think that while some kids do not like having something hooked to them 24/7, that adults or older teens seem to have more issues with the something attached to them arguement. My son doesn't even think about his pump anymore - it is just an extension of him.

    I am not trying to start an arguement but I do feel that having to start on MDI will soon be similiar to those who had to start on NPH. Having said that...I still believe that if it isn't broken, I don't try to fix it! So do what works for you!
  19. TripleThreat

    TripleThreat Approved members

    Oct 31, 2007
    2nd went on Minimed Pump and CGMS the day of diagnosis. Doctor wrote script and handed it to pump rep within hour of official Diagnosis
  20. Darryl

    Darryl Approved members

    May 8, 2008
    One benefit of starting with MDI is that you learn to survive without technology.
    It's hard to imagine what might happen if you lost access to your pump, even
    for a day, and did not know how to administer MDI.

    Having said that, if we had to do it all over again, we'd be on the omnipod in a
    matter of weeks, not months.

    Probably the best solution would be a mix - such as starting on the pump for
    basal but still administering boluses by MDI for a short period of time, or vice-versa?

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