# Got the call today



## stephknits (Mar 31, 2017)

Got off a tedious work call to discover a missed call on the mobile.  My pump funding has been approved and I should expect a package in the post next week. 

As our clinic's pump DSN applied back in august, i had begun to resign myself to being rejected.  

Am very excited


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## Lucy Honeychurch (Mar 31, 2017)

Congratulations!


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## Lindarose (Mar 31, 2017)

Wow Steph. That's great news! Pleased for you


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## Ljc (Mar 31, 2017)

That's Fantastical news


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## Martin Canty (Mar 31, 2017)

Great news Steph


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## trophywench (Mar 31, 2017)

Year end - we haven't spent all our pump budget, who's next on the list?

Don't question it - just accept it !  LOL

Best ring DSN and make an appt to get it all set up.


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## grovesy (Mar 31, 2017)

Well done and good luck,


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## Northerner (Mar 31, 2017)

Great news Steph!


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## Steff (Mar 31, 2017)

Steph top news happy for you x


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## SB2015 (Mar 31, 2017)

Excellent news Steph.
It will be well worth the work in tuning it to you.
Loads of help available on here with the fine tuning.

I look forward to hearing how you get on.


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## Matt Cycle (Mar 31, 2017)

Good news Steph.


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## Wirrallass (Mar 31, 2017)

Great news Steph - really pleased for you x


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## pottersusan (Mar 31, 2017)

That makes two of us with good news today!

You will love your pump


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## Flower (Mar 31, 2017)

Good stuff Steph, lovely news


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## AJLang (Apr 8, 2017)

That's brilliant news. I'm so pleased for you.


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## Pigeon (Apr 9, 2017)

Good news! Out of interest Steph, on what grounds are you getting a pump? I ask because my HbAic is similar to yours and I am also waiting for the decision of  a pump panel, but the DSN was not optimistic that I would be eligible as my control is "too good". That too good control is made up of an average of nightly hypos if I take 2u levemir or a steady rise overnight and waking to levels of 14 if I take 1.5u levemir. So I feel a pump would help because I would then have much smaller increments of insulin available, and be able to adjust the timing better. Hope you get on well with yours.


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## stephknits (Apr 9, 2017)

Thanks Pigeon.  I think I am lucky in my area as I agree, i don't fit the criteria.  I didn't even ask or think about getting a pump, as i believed i wouldn't get funding for one.  The DSN for pumps at our hospital said that they have never had a pump application refused and we're happy to apply for me, as long as I went on an education course.  I have no idea on what grounds they applied on my behalf, sorry.


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## everydayupsanddowns (Apr 11, 2017)

Pigeon said:


> Good news! Out of interest Steph, on what grounds are you getting a pump? I ask because my HbAic is similar to yours and I am also waiting for the decision of  a pump panel, but the DSN was not optimistic that I would be eligible as my control is "too good". That too good control is made up of an average of nightly hypos if I take 2u levemir or a steady rise overnight and waking to levels of 14 if I take 1.5u levemir. So I feel a pump would help because I would then have much smaller increments of insulin available, and be able to adjust the timing better. Hope you get on well with yours.



I would imagine that all that threat of hypoglycaemia means that you think about it quite a lot of the time @Pigeon - NICE TA151 is only half about HbA1c - it really frustrates me that so many HCPs are so hung up on it (my emphasis):
_
1.1 Continuous subcutaneous insulin infusion (CSII or 'insulin pump') therapy is recommended as a treatment option for adults and children 12 years and older with type 1 diabetes mellitus provided that:_

_attempts to achieve target haemoglobin A1c (HbA1c) levels with multiple daily injections (MDIs) result in the person experiencing disabling hypoglycaemia. For the purpose of this guidance, disabling hypoglycaemia is defined as the *repeated and unpredictable occurrence of hypoglycaemia* that results in *persistent anxiety about recurrence* and is associated with a significant adverse effect on quality of life 

or
_
_HbA1c levels have remained high (that is, at 8.5% [69 mmol/mol] or above) on MDI therapy (including, if appropriate, the use of long-acting insulin analogues) despite a high level of care._

https://www.nice.org.uk/guidance/TA151/chapter/1-Guidance

You will notice that A1c is the second reason. It is highly likely that this is because the evidence around hypoglycaemia is more robust and stronger. 'Disabling hypoglycaemia' sounds dreadful - but in this context it really only means that worn-down feeling you get from having to worry about it all the time, and the compormises you have to make to work around MDI in order to keep yourself safe.


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## Pigeon (Apr 14, 2017)

Thanks for that, Mike. I'll quote it back at them when the pump panel come back with a "no". I did say that I felt having a hypo every night was a quality of life issue and they seemed surprised by this...


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## Northerner (Apr 15, 2017)

Pigeon said:


> Thanks for that, Mike. I'll quote it back at them when the pump panel come back with a "no". I did say that I felt having a hypo every night was a quality of life issue and they seemed surprised by this...


Sometimes you just think 'they have no idea, really'  I'm sure that even a lot of seasoned diabetes healthcare professionals still believe that the real problems we face are having to give ourselves 'painful' injections, not the whole impact of trying to balance blood sugars within tight constraints using something as crude as half- or one-unit variations in dosing - a working pancreas governs BG by using TINY variations, and does it all automatically, using all the full complement of hormonal and other bodily inputs that we have to 'imagine' and factor in (stress, exercise, sensitivity, digestion rates etc. etc.). 

And something that very much pertains to your situation, @Pigeon - when I stopped needing the lantus (5 years ago now, remarkably - a consultant told me I'd need it again after a month or two! ) one thing that really struck me was the way the subconscious fear I had had EVERY night about going hypo and not waking up, just lifted!  I really hadn't been aware of what a stress it had been in my life until the worry went. If you are feeling conscious fear all the time then this is truly a significant factor that MUST be considered. I think you can only truly understand the depth of this fear if you experience it  I'm not saying a pump would solve the situation, but it would be a significant step in the right direction!  Have you tried getting some help from INPUT ?


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## stephknits (Apr 17, 2017)

The box was ready waiting for me at the post office on my return from Belgium and Holland!  I have *read* about half of the manual and looked through all the accompanying leaflets and paperwork.  Can't wait to get started!  Am hoping to be up and running before I go to Prague in May.  Am hoping it won't be wasted on me - there seems to be a huge amount of settings that I wouldn't really have a clue how to use.  I dare say I will get there in the end


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## grovesy (Apr 17, 2017)

stephknits said:


> The box was ready waiting for me at the post office on my return from Belgium and Holland!  I have *read* about half of the manual and looked through all the accompanying leaflets and paperwork.  Can't wait to get started!  Am hoping to be up and running before I go to Prague in May.  Am hoping it won't be wasted on me - there seems to be a huge amount of settings that I wouldn't really have a clue how to use.  I dare say I will get there in the end


Good luck.


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## Steff (Apr 17, 2017)

Good luck with it all @stephknits  x


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## everydayupsanddowns (Apr 25, 2017)

Hope the transition goes well Steff. Don't worry if you have a few panicky moments and half want to lob it out of the window in the early weeks. Quite normal and stick with it - you will soon winder how you coped for so long without!


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