# Got me a specialist appt - any advice on how to get this pump thing started???



## SilentAssassin1642 (Dec 7, 2009)

Ok, so on 17th I'm up the RSH for my clinic appointment and obv need to bring up the subject of a pump. Anyone got any advice?

Obviously the whole 14 years thing will be on my side, as will the constant swings, lifestyle etc. However, will my hba1c count against me????


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## sofaraway (Dec 7, 2009)

read up on the guidelines. Your A1c will rule you out on one of the criteria, so you will have to demonstrate how you meet on the hypo's part of it. I'd say about the complications you have recently been facing too.

I can't remember have you done a carb counting course? Might be worth asking about doing that aswell, might also be one of their criteria of allowing people to go on to the pump.

Good luck with the appointment


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## Sugarbum (Dec 7, 2009)

I'm itching to reply in a war and peace styleee to this one Sam, but I am just on my way out to 1981 so I will reply later or send you a PM.

xxx


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## SilentAssassin1642 (Dec 7, 2009)

I've not done a carb counting course as of yet, but my DSN is itching to get me on one.

Ah of course, the complications! That should help alot too.

I am having a LOT of hypos at work. And in general. I just cannot seem to get decent numers, mostly always low. Losing hypo awareness too, found myself at 1.8 again earlier and no symptoms at all. So I reckon that should help a bit.

Its mainly just gunna be a chat, cuz its not specifically a pump clinic but I really want to get the ball rolling!


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## rachelha (Dec 7, 2009)

I was approved for a pump despite having an Hba1c just below 8 at the time.  I have a lot of hypos (especially night-time ones) and I think that is why I was approved.  Also I have problems with the dawn phenomenon and high sugars in the mornings.  

I think you lifestyle/work will be a major factor in why you should get one too.  

Also I am not sure if this is even vaguely relevant to you, but if you are planning a pregnancy in the future that seems to swing it.  I had barely no help at all from my clinic until I mentioned kids, since then I have been on a 1 day carb. counting course, a DAFNE course, had CGMS for a few days and am now on the waiting list for a pump.

Hope the appointment goes well - let us know how you get on


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## shiv (Dec 7, 2009)

sam- you could argue that your hba1c is not good because you have consistent 'good' levels, but in fact because you are swinging between high and low.

also, they will probably make you do a carb course before they give you a pump. i remember looking at the guidelines once and that is part of it (i think it reads 'to have exhausted all other options' and carb counting is an option).

but good luck!!!


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## Adrienne (Dec 7, 2009)

Hi

Whatever you do, don't say that you know you need to go on a carb counting course.

Most of the kids I know on pumps their parents, including myself, have never been on a carb counting course in their lives.  Some have learnt it themselves (including me), some have had basic quick lesson from dietician.   These DAFNE and DESMOND courses are all well and good but I really think that some clinics and teams use them as a cop out or lazy excuse.   Carb counting is easy, seriously it is a doddle.    What you have to remember is that even going on one of these courses you will never get it right every time.     It takes time to understand carb counting and it takes time to understand what food does to your levels and even thinking about carb counting is daunting but with help from books and people like me and others on here, it is easy peasy so don't let the team fob you off by saying you need to go on a course.

You just need to prove that you can carb count.    None of us ie me, Bev, Patricia, Mand etc have been on courses.    

Take a look at the NICE guidelines.    If you can't find them then they are on the INPUT website and the www.childrenwithdiabetesuk.org website.    You can qualify under the fact that MDI has broken down and is not working, ie too many hypos etc etc.    

Go for it.


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## SilentAssassin1642 (Dec 7, 2009)

ah, cheers Adrienne. I'm a self taught carb counter as it is - plus, with help from Shiv too! So I guess that qualifies 

I'll definitely take a look at the NICE guidelines again. Because i seriously believe that MDIs dont work for me in the slightest. Too many swings from too many hypos!!!!


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## Adrienne (Dec 7, 2009)

Excellent, you are halfway there then.   They cannot use carb counting as an excuse then.

If they won't give you one, tell them you will find a centre that will or find out where they do and then you can say you would like a referral to such and such as they do provide pumps and see what they say, ball back in their court.   Just an idea.


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## SilentAssassin1642 (Dec 7, 2009)

Adrienne said:


> Excellent, you are halfway there then.   They cannot use carb counting as an excuse then.
> 
> If they won't give you one, tell them you will find a centre that will or find out where they do and then you can say you would like a referral to such and such as they do provide pumps and see what they say, ball back in their court.   Just an idea.



ooooooooooh fighting dirty  i like it!!!

Talking to nursey, she reckons I'd be prime for pumping. So hopefully the ole doc will see it the same way. We shall see. What with various complications starting to rear their ugly heads and whatnot...

*toddles off to read the guidelines*


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## Patricia (Dec 7, 2009)

Well that would be fab. I know what you mean about highs and lows -- this is something we battle with all the time, despite good hba1c. So do push that card. Quality of life. When we first went to pump, E had 7.4 hba1c -- but at a cost.

re carb counting: don't know anything other than what we know and what we gather. Good for you (and us)!


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## rachelha (Dec 17, 2009)

Just wondering how the appointment went?


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## SilentAssassin1642 (Dec 17, 2009)

not well AT ALL!


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## Adrienne (Dec 17, 2009)

Come on then, spit it out and lets see what we can do............


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## Adrienne (Dec 17, 2009)

Ok, being a dunce here, ignore last message, you have posted on the main list.


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## SilentAssassin1642 (Dec 17, 2009)

I can rant in two places


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