So, the whole "Saline start" thing...

Didn't want to hijack the other thread...

We have our saline start on the 28th, and "go live" the 31st.

I'm a bit... reluctant about the saline start for a lot of reasons including.
1. It seems mainly so you can learn to use the pump, learning to press buttons etc, which we don't need, we are very familiar
2. I've heard from MANY people that the saline stings!
3. We've sold the idea of the pump to our 3 year old mainly with 'less needles' as she doesn't like the idea of toting it around. If we force her to tote it around, PLUS give her needles for 3 days, I'm worried she'll push back, and fight it, you know?

Any good experiences with the saline start? Or not so good? If you had it to do again, would you do it, or ask not to??

Thanks...

 

I think the saline start on a toddler is pretty stupid. It confused my son. He didn't want the pump if he had to wear it and get shots. I think me wearing the pump for the saline trial should have been enough.

 

I didn't do a saline trial but my experience is that subq saline can sting a lot (it makes me tear up and I generally have a pretty high pain tolerance). You may be able to use sterile water instead. I don't think it would be very good for a 3 year old to associate the pump with pain. Maybe you could wear the pump with saline/sterile water with your daughters settings just to get used to the button pushing?

 

I'd refuse to do it. Worst case, I'd do as Meg suggests and wear the pump myself.

FWIW we went live with insulin and never looked back. I think saline pump starts are prehistoric.

Good luck!

 

We started with insulin from the day 1. No saline start thing for us...

 

We had similar concerns in our situation about our son being confused with wearing the pump AND getting shots. We pushed back on the typical saline start and agreed to a compromise. I wore the pod for the saline trial, and we did one insertion in the office with our son. The compromise worked well for us.

 

If you're going to do the saline, you could inject through the pump site to avoid the extra needles. You just stick the syringe needle into the rubber stopper of the site. There used to be a site specifically marketed to do this, I'm not sure if there still is now that pumping is so common. I had a two week saline start and did this.

 

Huh, good to know my thoughts weren't totally off on this!! I can sort of see how it might seem like a good idea, if you were really nervous about the 'button pushing' part of it, or needed to get used to carb counting or seomthing like that. But, like others echoed, with a toddler it seems super super stupid!! And I already feel like we are treading lightly on her cooperating with the idea of a pump...

So we have the 'rep' booked to do the start with us the 28th. She's the one that teaches us everything about 'how to' with the pump and puts her on saline. Then the 31st is at the office with the nurse to set the final doses and put her on insulin.

Do you think just take the training from the rep, but don't make her wear it with insulin, then go in for the insulin start on the 31st? Or do I be a totally bad parent and after the rep leaves just switch the cartridge to insulin?

Hm. Interesting re: injecting in the site. I guess it is just a sub-q butterfly essentially... Thats a possibility... anyone else do that?

 

I started my pump myself right when I got it. I went ahead with the saline thing because I was a new patient at the office and afraid they would get mad if I didn't. After about 10 hours of saline I switched back to insulin. I think it's dumb and pointless. You can learn button pressing while the pump is in training mode.

 

Put the site in yourself and be unhooked from the pump. Well at leas that is what we did with our 18 month old 8years ago.

 

We did the saline trial about 6 weeks ago. Going into it I thought it was pointless and silly, but I actually learned a fair bit during that week! We were on twice daily injections with very basic carb counting prior to our start. So it was a whole new animal to have to count to the gram for every bite. Also, remembering to bolus was a bit of an issue for us at first, as we had spent a year doing a shot before breakfast and one before dinner. There was nothing that had to be done between times, unless it was a correction or special event. So that was a learning curve as well.

Our son is 4 and didn't complain at all about either the duplication of the pump and the shot, nor did he ever mention that he felt the saline at all. It was a non issue for him, but a great training run for us. I guess for parents on MDI who are already completely proficient with carb counting, it is a different story though.

 

So interesting to read all the reactions. I am an adult and had never heard of a "saline start" till I read about it on this site. As an adult it sounds crazy. Even after hearing all the responses my thoughts are that get the education about carb counting and insulin duration and then just go live on the pump. No saline trials but make sure you have the education pre pump use. The truth is that the knowledge you need to use for a pump is really the same knowledge you need to shots effectively. But most clinics do a bad a.. Job of education. Ali

 

I'm in the 'never heard of a saline trial until I found this site' camp. We've had 4 pump starts and never done it.

If it were me...and I'm not advocating this in any way...I'd push back. If they were insistent, I think I'd do the site, then remove the pump as soon as we left the office. Let it run, press the buttons, do whatever I felt I needed practice on, but I'd basically be a non-compliant patient. It just seems an unnecessary hoop to jump through.

 

Glad it worked for you! I can totally see how it would be helpful to get used to the routine and steps etc. But yah, we do MDI, and insulin with snacks even, and carb count, so we are pretty familiar with it. In addition, we are familiar with the pump!! So for me, I'm struggling to see the benefit...

Yah, I'm thinking thats what we will do. Take the training, but not wear it until the insulin start. I know my kid, and I KNOW she will highly revolt having to do the pump and the shots... I hate how so many things are 'standard' and they don't take into account what the individual patient needs!!!

 

The revolution starts here irate:

 

Arrr, yes it does.

 

Would not do it again. Especially since the companies have such good videos to follow. Also, you can fill with saline and push all the buttons and run it through so you can visualize IOB etc. You can do all this without having the child wear it. This is what happened to us... We did saline and my daughter got totally pissed off that she still had to get her shots because we had told her that once she was on the pumps, shots would hardly ever happen. She was 4, so try backpedaling on that one...

 

Echoing everyone, no saline start here. Our endo did ask if he would consider wearing a site and pump filled with sterile water for a day or two, just to make sure he really wanted to be hooked up full time, (and he did, for about a day) but at 9, he was old enough to understand and make the choice for himself. With a toddler who wouldn't understand pump and shots, I would skip it.

 

And my little monkey is about the same age! I don't think I can explain to her, oh I know I said you wouldn't have needles, but this is just for a few days...

 

Saline start was a nuisance. You have to do double the work. We missed more real boluses during those three days than we have before or since because we were so focused on operating the pump that the pen-needle containing what she needed got forgotten.

I especially wouldn't hook a preschooler up to saline. There's no point. My kid was 11, and the practice using the pump before having insulin in it was good for her. But your child, ridiculous!!