# To pump or not to pump



## mariamack1 (Mar 20, 2013)

My 12y son was diagnosed with T1 in Oct 2012.  He is extremely competent with injecting and every aspect of treating and dealing with it.  He is however, interested in a pump.  We haven't done much research, but have discussed it with his Diabetes team.  It seems that he needs to fill a lot of criteria, and unfortunately there is no pump resource in our area, so will need to travel to 40 miles to be fitted, trained etc.  My concern is not just that he will lose access to his local team, but is it advisable to consider the pump with all its positive implications so soon after diagnosis?  Basically, we have just about get it sorted, and the thought of starting all over again so soon is a bit scary, but my son is sure he wants to go ahead.  Advice please xx


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## megga (Mar 20, 2013)

Whats his control like?? if he has good control with injections, then i wouldn't bother.
99.9% of people on the pump love it (i'm the0.1% lol)

For's
It gives better control
It can be better if he's in to sports
you cant forget you insulin and leave it somewhere
its easy to check (if you forget) to see if you took it (might be just me that one)

Against

Canulas can come out (not when you expect, so extra stuff to carry around)
You can get blockage's and have to redo the thing, middle of the night, when your out ect (although i now use Humalog, and thats very rare now, nova rapid was bad for in imo)
If you go on holiday, then you have to re-think, well in a hot country, by the see or pool, you dont want a pump on)


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## pgcity (Mar 20, 2013)

Hiya
I got mine a year after diagnosis and its changed my life. My control is so much better. It was scary at first and it was a bit like being newly diagnosed. If you son is keen I would go for it.


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## Northerner (Mar 20, 2013)

I'd suggest having a browse of http://www.input.me.uk/ Lots of children do go quickly on to pumps and it can be a very good move, particularly at your son's age when he is rapidly growing and going through hormonal changes which can be difficult to control on injections. The pump would give him a lot of freedom with eating and activities and this might also be good for him when he is trying to fit in with his friends. I would say that, if you have the chance and it is something he is keen on, then go for it - you can always give it back!


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## HOBIE (Mar 20, 2013)

After 47 yrs its the best thing for me. I would NOT give it back. Nothings perfect but i would get my name on one if i where you.  Good luck


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## everydayupsanddowns (Mar 20, 2013)

megga said:


> If you go on holiday, then you have to re-think, well in a hot country, by the see or pool, you dont want a pump on)



Not sure I'd agree with that Megga - Trophywench has said before that she spends lots of time in the S of France baking on a beach during the summer and has never had a problem with her pump.

I'm another who has had a very positive experience on the pump. It has given me far more accuracy and tweakability in control and while I managed well on MDI, a pump is just a much more precise (and easier) tool.

Odd things surprised me as plus points - like megga said - not forgetting your insulin when you go out. And any 'injecting' in public/cafes/restaurant/cinema/train/bus etc are so much easier as it just looks like you are checking a mobile or whatever.

You are right - it does take some getting used to though!


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## Lauras87 (Mar 20, 2013)

I'd go for it, it would give him flexibility with upcoming hormone changes.
I can't wait for my pump day to come!


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## trophywench (Mar 20, 2013)

Abso ruddy lutely Go For It !

The sooner the better.

He'll get the hang of the technical aspects relatively easily - grief, how long does it take em at that age?  - about 35 seconds isn't it?

It may well take YOU longer though - but don't hold him back, pur-lease!  THAT will lead to resentment which would be 4million zillion percent the absolutely WORSTest thing you could ever do for your child or his diabetes.


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## AlisonF (Mar 21, 2013)

Re Megga's point on holidays - I'd say pumps are a massive bonus on holiday, I find them a much more sensitive tool than MDI which once you know how to use them make it so much easier to adapt to timezone changes, different foods and regimes. And you can do pretty much anything while wearing one - mine has been rock climbing, white water rafting, sailing, kayaking, trekking through rainforests etc. 

I didn't have a pump as a teenager, but looking back, it would have made the rollercoaster of diabetes and puberty a bit easier. All those hormones really do impact the diabetes and the pump makes it much easier to adjust for them.

I'd say go for it - if he hates it, he can always give it back.


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## fencesitter (Mar 21, 2013)

It's great that your son is so keen on a pump! Mine (15) is not, although he might well qualify because he has limited injection sites due to lymphoedema from the hips down. Fulfilling the criteria might be a barrier for you, unless your local area is more generous than ours? At my son's hospital (Milton Keynes) if you're well controlled you are way down the pecking order unfortunately. His team said that he would not qualify under the usual criteria as he is well controlled, so he would need to cite his other medical issues. At the moment he would rather not, but it's a possibility for the future.
If your son wants to go ahead I'm sure he'll do really well on the pump, especially as he's so motivated. Hopefully your team can advise you on putting a case together? Good luck.


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## megga (Mar 22, 2013)

AlisonF said:


> Re Megga's point on holidays - I'd say pumps are a massive bonus on holiday, I find them a much more sensitive tool than MDI which once you know how to use them make it so much easier to adapt to timezone changes, different foods and regimes. And you can do pretty much anything while wearing one - mine has been rock climbing, white water rafting, sailing, kayaking, trekking through rainforests etc.
> 
> I didn't have a pump as a teenager, but looking back, it would have made the rollercoaster of diabetes and puberty a bit easier. All those hormones really do impact the diabetes and the pump makes it much easier to adjust for them.
> 
> I'd say go for it - if he hates it, he can always give it back.



I have been told by my DSN, although it is water proof its more splash proof, and as a young lad, in the pool, out the pool all day, in my mind would be the problem.

I get married in Greece next year, and there's no way i want that thing bothering me when i go for a dip in the pool, its just where to put it, down the trunks?? not for me.
Great if you get on with it and it dont  bother you, but this would really bother me.


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## AlisonF (Mar 22, 2013)

I've honestly never found it a problem megga. 

When I've been to water parks with the pump, I just take it off when I go in the water. I find the exercise offsets the insulin I miss, or you can always take an extra bolus before you go in. If I'm going to be in the water for a long time, I try and reconnect every hour or so to give a bit more bolus. That mostly coincides with me getting out to get a drink/top up sunblock etc anyway so isn't really a problem. 

When I go sailing, I just clip it to my bikini bottoms, and take it off if I want to swim - some pumps are waterproof, but if I'm going for a swim of an hour of less I'd rather disconnect than keep it attached. 

If I want to wear my pump in the water eg for white water rafting, I use an Acquapac - it's a waterproof pack that keeps the pump dry but allows you to stay connected to it.

I saw someone the other day saying they saw a pumper on a nudist beach wearing nothing but their pump, attached via an elastic belt round their waist. I've never take it that far!


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## pgcity (Mar 22, 2013)

I have an animas vibe that is waterproof and I don't take it off when I swim or shower. I clip it to my bottoms. Not tried the beach yet but I don't imagine I will do anything differently


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## trophywench (Mar 22, 2013)

AlisonF said:


> I saw someone the other day saying they saw a pumper on a nudist beach wearing nothing but their pump, attached via an elastic belt round their waist. I've never take it that far!



I have - but I use a lanyard!  When I'm actually lying about I usually have it to the side of me, shaded by whatever's handy, it's just for walking about it's on the lanyard.  So I stick it on that under me tee shirt to walk down to the beach if we aren't somewhere that's totally naturist.  I remove it for swimming.


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## ch1ps (Aug 18, 2013)

AlisonF said:


> When I've been to water parks with the pump, I just take it off when I go in the water. I find the exercise offsets the insulin I miss, or you can always take an extra bolus before you go in. If I'm going to be in the water for a long time, I try and reconnect every hour or so to give a bit more bolus. That mostly coincides with me getting out to get a drink/top up sunblock etc anyway so isn't really a problem.



I'm going to Florida in 6 weeks and hoping to do a water park.  Have a medtronic so will disconnect.  Should I put the guard cap over my set?  

I'm worried as I will need to put the pump in a locker as do not want it stolen, how long is it ok to stay disconnected?

Thanks


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## HOBIE (Aug 18, 2013)

As Alison said, if you are being active & have not just had a meal. You can dissconect for a while. A bit trial & error but depends on what you are upto Have a good HOLI !


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## ch1ps (Aug 18, 2013)

HOBIE said:


> As Alison said, if you are being active & have not just had a meal. You can dissconect for a while. A bit trial & error but depends on what you are upto Have a good HOLI !



Thanks - cannot wait


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## HOBIE (Aug 18, 2013)

There big portions in the usa ! Was in a supermarket in california once & they where selling 4ft sandwiches.


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## Redkite (Aug 18, 2013)

ch1ps said:


> I'm going to Florida in 6 weeks and hoping to do a water park.  Have a medtronic so will disconnect.  Should I put the guard cap over my set?
> 
> I'm worried as I will need to put the pump in a locker as do not want it stolen, how long is it ok to stay disconnected?
> 
> Thanks


Officially you can be disconnected for up to an hour.  My son has been off the pump for longer (as long as he has plenty of insulin on board from a recent meal bolus for example).  Just plan to check your BG levels at regular intervals, and either temporarily hook back up to your pump for a bolus or inject while you're off the pump.  It's no big deal, just a bit of planning and forethought as for all things type 1!  He does put the guard cap on his cannula when the pump is disconnected, but you don't have to.


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## Redkite (Aug 18, 2013)

mariamack1 said:


> My 12y son was diagnosed with T1 in Oct 2012.  He is extremely competent with injecting and every aspect of treating and dealing with it.  He is however, interested in a pump.  We haven't done much research, but have discussed it with his Diabetes team.  It seems that he needs to fill a lot of criteria, and unfortunately there is no pump resource in our area, so will need to travel to 40 miles to be fitted, trained etc.  My concern is not just that he will lose access to his local team, but is it advisable to consider the pump with all its positive implications so soon after diagnosis?  Basically, we have just about get it sorted, and the thought of starting all over again so soon is a bit scary, but my son is sure he wants to go ahead.  Advice please xx


To answer the OP's Q: don't hesitate, go for the pump while you have the chance.  Pumps are the closest approximation to a healthy working pancreas.  Basal insulin can be programmed to exactly fit the individual's needs, and is delivered in hundreds of tiny increments throughout the day, much more like a pancreas than the one or two basal injections you would have on MDI.  This feature alone will come into its own when your son's teenage hormones get to work!

You can more easily manage foods like pasta and pizza which take hours to digest.  You can adjust your basal rate for sport, and for the after-effects of sport.  You can more easily manage illness.  The benefits are endless.  I would NEVER give up my son's pump and neither would he - they would have to prise it out of my cold dead hands!


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## Redkite (Aug 18, 2013)

P.S. Re moving hospital, we had to do this anyway as the care from our local team was so poor.  We now travel into London, about 1hr 15 mins compared to 20 mins to the local one.  But well worth it!  Depending on your local set-up, some hospitals will keep your routine diabetes care local, and you would just attend a regional pump specialist hospital for the pump training and appointments.  I believe this is the case with the Leeds paed service for example.  In other areas, you'd have to have all your care from the team at the pump centre.


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## Tony R (Aug 22, 2013)

*Most Important Reason For Going On A Pump In Your Teens*

One thing and perhaps the most important reason for your son going on the pump at his age is because there's a direct correlation between someones average glucose levels HbA1c and the risk of complications in later life like heart disease etc. The key years are the teens when you're growing (apparently until your teens it doesn't have such a great impact). For this reason it's important that he gets his HbA1c as low as possible as he enters puberty and the pump really enables you to do this. 

It's important to realise the pump is a powerful tool which enables you to really manage your diabetes but to get the most out of it as with all tools you really have to be prepared to learn how to use it. The pump won't do it by itself, you have to be prepared to put the effort in.

Just to give you an idea, my son's HbA1c was always around 9, within 6 months it had gone down to 7,2 and now we're aiming for the 6's.


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## Redkite (Aug 22, 2013)

Tony R said:


> One thing and perhaps the most important reason for your son going on the pump at his age is because there's a direct correlation between someones average glucose levels HbA1c and the risk of complications in later life like heart disease etc. The key years are the teens when you're growing (apparently until your teens it doesn't have such a great impact). For this reason it's important that he gets his HbA1c as low as possible as he enters puberty and the pump really enables you to do this.
> 
> It's important to realise the pump is a powerful tool which enables you to really manage your diabetes but to get the most out of it as with all tools you really have to be prepared to learn how to use it. The pump won't do it by itself, you have to be prepared to put the effort in.
> 
> Just to give you an idea, my son's HbA1c was always around 9, within 6 months it had gone down to 7,2 and now we're aiming for the 6's.


I agree with all the positives you've said about the pump.  We too saw a marked decrease in his a1c, which couldn't have been achieved on MDI.  

But, it's NOT true to say that poor diabetes control has less of an impact before the teenage years.  Sadly there are still dinosaur consultants out there who say such things, and who believe that children under 12 do not need screening for retinopathy etc.  The truth is that damage occurs in susceptible individuals at anything higher than normal glycaemia, and the longer one has had diabetes the more chance there is.  My son's highest a1c was 8.7 and he has been in the high 6's/low 7's ever since he went on the pump aged 7, yet he has early kidney damage, and protein leaking in his urine.  If we had been slack and sat on our laurels in the belief that damage can't occur until the teenage years, he would be much worse off.


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