My endo suggested pump.

[mids1999]

At my endo appt the other day my endo suggested that he would see it as very beneficial to me to go on the pump.
I agreed and he wrote me a few scripts.

So far I have a script for both a dietician and cde.
The cde script says advanced class - change in therapy.

I havent found a cde yet nor have I found a dietician. Going to do that tommorrow. (I can not drive, recurring diabetic foot ulcer.)

I contacted minimed today and they took my insurance info and said they were going to contact the endo for a letter of medical neccessity)

What do I do from here?
I know I have to make an appt with the dietician and the cde but what do I say or do with them?
What do I do after that?

For insurance coverage:
I think that medicaid should cover my pump since
According to medicaid I must

(I put an x next to those that apply to me)

X Has been on a program of multiple daily injections of insulin (i.e., at least three injections per day), with frequent self-adjustments of insulin dose for at least six months prior to initiation of the insulin pump, and

X Has documented frequency of glucose self-testing an average of at least four times per day during the two months prior to initiation of the insulin pump, and

Meets one or more of the following criteria while on the multiple injection regimen:
x Glycosylated hemoglobin level (HbA1C) greater than 7%
x History of recurring hypoglycemia
x Wide fluctuations in blood glucose before mealtime
x? Dawn phenomenon with fasting blood sugars frequently exceeding 200 mg/dL
x History of severe glycemic excursions

Last Ac was 9.8 my endo thinks my next will be 6-7.
I test an avg of 6 times daily and often more.
I have been having a hypo on avg 3 times a week.
I have DP but my levemir dose 28U prevents me from breaking 200 but keeps me going down all night and day long. It also must be timed so it peaks around 5am otherwise I was waking 200+ often.
My sugar has gone from 42 to 230 in a day.

Something else of note is that I am very sensitive going out to the store for example (I dont even walk I use a auto cart in the store) I tend to go down to the 50-60 level where otherwise I would be within 80-130 range. This is the reason the endo suggested the pump.

Concentrating on something also drops my sugars rapidly.
I dont notice the hypo coming on if I am doing something.
I have been down to 42 with no real signs until I stopped what I was doing.

[spike]

At my endo appt the other day my endo suggested that he would see it as very beneficial to me to go on the pump.
I agreed and he wrote me a few scripts.

So far I have a script for both a dietician and cde.
The cde script says advanced class - change in therapy.

I havent found a cde yet nor have I found a dietician. Going to do that tommorrow. (I can not drive, recurring diabetic foot ulcer.)

I contacted minimed today and they took my insurance info and said they were going to contact the endo for a letter of medical neccessity)

What do I do from here?
I know I have to make an appt with the dietician and the cde but what do I say or do with them?
What do I do after that?

For insurance coverage:
I think that medicaid should cover my pump since
According to medicaid I must

(I put an x next to those that apply to me)

X Has been on a program of multiple daily injections of insulin (i.e., at least three injections per day), with frequent self-adjustments of insulin dose for at least six months prior to initiation of the insulin pump, and

X Has documented frequency of glucose self-testing an average of at least four times per day during the two months prior to initiation of the insulin pump, and

Meets one or more of the following criteria while on the multiple injection regimen:
x Glycosylated hemoglobin level (HbA1C) greater than 7%
x History of recurring hypoglycemia
x Wide fluctuations in blood glucose before mealtime
x? Dawn phenomenon with fasting blood sugars frequently exceeding 200 mg/dL
x History of severe glycemic excursions

Last Ac was 9.8 my endo thinks my next will be 6-7.
I test an avg of 6 times daily and often more.
I have been having a hypo on avg 3 times a week.
I have DP but my levemir dose 28U prevents me from breaking 200 but keeps me going down all night and day long. It also must be timed so it peaks around 5am otherwise I was waking 200+ often.
My sugar has gone from 42 to 230 in a day.

Something else of note is that I am very sensitive going out to the store for example (I dont even walk I use a auto cart in the store) I tend to go down to the 50-60 level where otherwise I would be within 80-130 range. This is the reason the endo suggested the pump.

Concentrating on something also drops my sugars rapidly.
I dont notice the hypo coming on if I am doing something.
I have been down to 42 with no real signs until I stopped what I was doing.


BTW, I pump and I was 43 about 2 hours ago. Not fun. don't think that having a pump will keep you from going hypo; it just makes for the possibility that you can gain better control than MDI, but it's no guarantee. My lows on MDI were of the "call 911" type, and now I can self-treat my lows, so I'm much better off and would kill to keep my pump. :) Just don't expect it to be a perfect solution, especially if you plan on checking your bg's only 6 times a day. You can still get low (4 hours is a long time to go without checking your bg's) IF you, like me, have quickly moving bg's.

Sounds like the ball is rolling. Minimed should be contacting you when you get approval for a pump. I'm getting the feeling that your heart isn't really into this, though. It sounds like you are being "talked into" a pump. My personal feeling is that successful pumpers are those that want with every fiber of their being to get on a pump yesterday because they did the research and know that a pump will help them regain some semblance of a normal life, so they can't WAIT to see the Fedex truck pull up soon with a MiniMed or Animas or Cozmo pump package for them. It's like Christmas times 1000. What I'm saying is: YOU GOTTA BE MOTIVATED! If you are only going through the motions because your doctor suggested getting a pump, I would anticipate that if there's no financial liability for you in this, that you aren't going to give it 100%.

But I could be wrong! :)

[mids1999]

My personal feeling is that successful pumpers are those that want with every fiber of their being to get on a pump yesterday because they did the research and know that a pump will help them regain some semblance of a normal life, so they can't WAIT to see the Fedex truck pull up soon with a MiniMed or Animas or Cozmo pump package for them.


That is how I feel. I would have been on the pump years ago if could have afforded it.
At my endo appt yesterdady I literallu jumped out of my wheelchair in excitement when he brought up the pump.

Only prob is that he left me with the referrals, a brochure for medtronic,and bo idea as what to do next.

And you are right about not giving it 100%
I will probably give it 1000%!!!
Financial cost has no bearing on weather I try hard or not. Its my health that I care about.

[mids1999]

BTW since you have exprience with severe hypos what point do you pass out?

I have been down in the low 20s (not recently)
I felt dizzy and couldnt see a thing but I was concious enough to stay on my feet and self treat like crazy.
If I remember correctly this was 1hr after 4u of rapid and a 30 carb meal eaten 5 min after injection.
4u should have been the correct dose for that meal with no correction.

[spike]

That is how I feel. I would have been on the pump years ago if could have afforded it.
At my endo appt yesterdady I literallu jumped out of my wheelchair in excitement when he brought up the pump.

Only prob is that he left me with the referrals, a brochure for medtronic,and bo idea as what to do next.

And you are right about not giving it 100%
I will probably give it 1000%!!!
Financial cost has no bearing on weather I try hard or not. Its my health that I care about.

You sound like the ideal pump candidate!!

Medtronic will need a prescription from your doctor (they will contact your doctor directly). then it's just a matter of a day to a few weeks, GENERALLY for the approval to be ready, and then a couple days for them to arrange for shipping of the pump.

BEFORE all that, I suggest that you call MM for a hands on demo, brochures, a video, and an owners manual is downloadable from the 'net. I got all those thing well before my pump arrived, so that when I got my hands on it, I was somewhat familiar with it and began pumping a few days after it's arrival.

There are 2 sizes available: the 522 holds 200U and the 722 holds 300U. After priming the tubing, you will have around 175-180U on the 522. If that's not enough for 3 days, then get the 722. You'll take less insulin as a pumper, than on MDI--about 15-20%, so factor that into your model decision. The percentage reduction in total insulin dosage varies by individual. GO FOR IT!!!

[mids1999]

Which would you go with if you were me?
I am thinking I may need the 722.

On my basic meal plan with no snacking I use around 170u total insulin (novolog and levemir) in 3 days.
That is 4 60 net carb meals.
Just enough to maintain my current weight of 145.
I am a 5'8 male with a currently sedentary lifestyle and a fast metabolism.

[spike]

Which would you go with if you were me?
I am thinking I may need the 722.

On my basic meal plan with no snacking I use around 170u total insulin (novolog and levemir) in 3 days.
That is 4 60 net carb meals.
Just enough to maintain my current weight of 145.
I am a 5'8 male with a currently sedentary lifestyle and a fast metabolism.

Maybe get the 722 to be sure. It's just a tad longer, overall, and uses different reservoirs. beyond that, it's identical in appearance to the 522.

(and check your PM--I sent you 2)

[mids1999]

I recieved the pms and replied thank you.

[poodlebone]

Which would you go with if you were me?
I am thinking I may need the 722.

On my basic meal plan with no snacking I use around 170u total insulin (novolog and levemir) in 3 days.
That is 4 60 net carb meals.
Just enough to maintain my current weight of 145.
I am a 5'8 male with a currently sedentary lifestyle and a fast metabolism.

Hi,

I'd go for the bigger 722 as well. Actually, I think you said that you're covered by medicaid in which case you might not get the newest model (722) but one of the older ones. I know that when the 515/715 were the newest models, Medicaid patients were given the 512/712 pumps. Not sure why Medicaid won;t cover the newest pumps. If you do get the last model (515 or 715) it is the same pump as the 522/722 except it doesn't have the built in receiver/graphing capabilities for the continuous glucose monitor, which medicaid would allow you to have anyway!

I have the 715 with the 300u reservoir and it holds way more than I need, but it just means I change the reservoir less frequently. I use it until it's empty instead of changing it every 3 days.

I think that no matter what pump you get you'll love it. It will most definitely be an improvement over MDI.

[notme]

I'm getting the feeling that your heart isn't really into this, though. It sounds like you are being "talked into" a pump. My personal feeling is that successful pumpers are those that want with every fiber of their being to get on a pump yesterday because they did the research and know that a pump will help them regain some semblance of a normal life, so they can't WAIT to see the Fedex truck pull up soon with a MiniMed or Animas or Cozmo pump package for them. It's like Christmas times 1000. What I'm saying is: YOU GOTTA BE MOTIVATED! If you are only going through the motions because your doctor suggested getting a pump, I would anticipate that if there's no financial liability for you in this, that you aren't going to give it 100%.

But I could be wrong! :)

You know Spike, this is not true in my case. I was TOTALLY talked into the pump and I had very little motivation. I am embarrassed to say, I did very little research and knew very little when I was talked into the pump by my endo six years ago. In my case, I knew that what I was doing wasn't working, my insurance would cover it, so what the heck. My pump arrived and I unpacked the boxes and looked at this thing and started to get a little interested. The trainer showed up at my house three days before Christmas. I started pumping insulin Christmas day. (ok dumb idea). However, Christmas day I did not have one bad number all day. Now I was getting interested. The first several weeks on the pump for me were magical. I loved not having to give night time lantus shots. I loved not having to get my insulin and giving myself shots at meals. I discovered it was NICE having my insulin with me when I went out and not forgetting it all the time. Hey, it didn't bug me when I slept. My thoughts were "this thing isn't half bad". My first A1c was unbelievable for me. THAT is when I got motivated. Since getting my pump six years ago, I have totally changed my tune about diabetes care. I think the pump for me gave me hope that I could control my blood sugar and it wasn't such a burden. So..... I guess what I am saying is that some people don't start out on the pump bandwagon. I sure didn't.

Now, like you, I would NOT give up my pump for anything.

[mids1999]

Just a quick update.
I am now 1 week into the insurance approval process.
I sure hope it gets approved.

Every medical professional I talk to including the diabetes management team at my states medicaid office tell me the pump would be very beneficial to me.

[Gordonm]

Go for it. I had to take the bull by the horns and do everything myself. I just told my doctoor, I was going on the pump. He had no bearing on it at all. Not very happy with him, probably going to change. I can't wait for mine. I have been researching for about 6 weeks and am going through the insurance process right now. I'm hoping in the next few weeks to start on the pump. Good luck with it.

[poodlebone]

You know Spike, this is not true in my case. I was TOTALLY talked into the pump and I had very little motivation. I am embarrassed to say, I did very little research and knew very little when I was talked into the pump by my endo six years ago. In my case, I knew that what I was doing wasn't working, my insurance would cover it, so what the heck. My pump arrived and I unpacked the boxes and looked at this thing and started to get a little interested. The trainer showed up at my house three days before Christmas. I started pumping insulin Christmas day. (ok dumb idea). However, Christmas day I did not have one bad number all day. Now I was getting interested. The first several weeks on the pump for me were magical. I loved not having to give night time lantus shots. I loved not having to get my insulin and giving myself shots at meals. I discovered it was NICE having my insulin with me when I went out and not forgetting it all the time. Hey, it didn't bug me when I slept. My thoughts were "this thing isn't half bad". My first A1c was unbelievable for me. THAT is when I got motivated. Since getting my pump six years ago, I have totally changed my tune about diabetes care. I think the pump for me gave me hope that I could control my blood sugar and it wasn't such a burden. So..... I guess what I am saying is that some people don't start out on the pump bandwagon. I sure didn't.

Now, like you, I would NOT give up my pump for anything.

This is pretty much my story as well. I had heard of pumps but always assumed my insurance would never approve one so I didn't give it any thought. Over a period of 5 years or so I began having many control issues, loss of hypo awareness and other problems. I still never went to an endo and my primary care doctors were never any help at all with diabetes. Last March, after having 3 severe hypos 3 months in a row, I picked an endo at random and made an appointment. She changed my insulin, gave me some ratios & numbers to work with (I was pretty much just shooting random amounts at that point) and told me to come back in a month. The following month she sent me to the CDE who changed my ratios/numbers some more and suggested a pump. I finally said that if my insurance would pay for it I'd go for it but I couldn't afford any big co-pay for it. My insurance approved it immediately and covered it 100%. I got the pump the week after meeting the CDE taht first time. When it came, I opened the shipping box and looked at what was inside but didn't open the pump box, or infusion sets or anything else. I had another meeting with the CDE scheduled for June and figured I'd find out about it then (this was late April). My CDE called me in early May asking if I got the pump and told me I had to set up a sepearte appointment for training. I remember not caring how soon I could get the appointment and finally decided on mid-May. Now, I love gadgets and little electronic things but I really wasn't anxious to get started. I only opened the boxes the weekend before my training, which was a Monday.

My numbers were all over the place in the beginning. I was having a lot of high readings. Many times I wanted to throw the pump against a wall. After about 4 months things began falling into place and I was much happier with it. Then I started having problems with the Quick-Sets I was using and felt like throwing it against a wall some more. Switched to Sils in January of this year and finally, finally felt really comfortable pumping. I too would not give it up for anything now. I don't think that everyone who starts pumping is going to love it right away. It took me many months. Some people seem to think that once they hook up to the pump they'll have perfect numbers but it does take work and time. It can be frustrating if you're like me and get upset easily but I'm glad I stuck with it.

[nowellwisch]

At my endo appt the other day my endo suggested that he would see it as very beneficial to me to go on the pump.
I agreed and he wrote me a few scripts.

So far I have a script for both a dietician and cde.
The cde script says advanced class - change in therapy.

I havent found a cde yet nor have I found a dietician. Going to do that tommorrow. (I can not drive, recurring diabetic foot ulcer.)

I contacted minimed today and they took my insurance info and said they were going to contact the endo for a letter of medical neccessity)

What do I do from here?
I know I have to make an appt with the dietician and the cde but what do I say or do with them?
What do I do after that?

For insurance coverage:
I think that medicaid should cover my pump since
According to medicaid I must

(I put an x next to those that apply to me)

X Has been on a program of multiple daily injections of insulin (i.e., at least three injections per day), with frequent self-adjustments of insulin dose for at least six months prior to initiation of the insulin pump, and

X Has documented frequency of glucose self-testing an average of at least four times per day during the two months prior to initiation of the insulin pump, and

Meets one or more of the following criteria while on the multiple injection regimen:
x Glycosylated hemoglobin level (HbA1C) greater than 7%
x History of recurring hypoglycemia
x Wide fluctuations in blood glucose before mealtime
x? Dawn phenomenon with fasting blood sugars frequently exceeding 200 mg/dL
x History of severe glycemic excursions

Last Ac was 9.8 my endo thinks my next will be 6-7.
I test an avg of 6 times daily and often more.
I have been having a hypo on avg 3 times a week.
I have DP but my levemir dose 28U prevents me from breaking 200 but keeps me going down all night and day long. It also must be timed so it peaks around 5am otherwise I was waking 200+ often.
My sugar has gone from 42 to 230 in a day.

Something else of note is that I am very sensitive going out to the store for example (I dont even walk I use a auto cart in the store) I tend to go down to the 50-60 level where otherwise I would be within 80-130 range. This is the reason the endo suggested the pump.

Concentrating on something also drops my sugars rapidly.
I dont notice the hypo coming on if I am doing something.
I have been down to 42 with no real signs until I stopped what I was doing.
I changed pumps to the newer MiniMed after being awaken three times in a two month period surrounded by reflective yellow legs and fireman boots at three am. After the third Lbg "incident" my endo took me off all supplemental insulin and put me on the pump 24/7/365 exclusively.

The result is not a single paramedic incident in ten months, A1C's starting to come down, feeling better and living easier. I have had three sub 60 Bg's but no headaches or fainting. Much better with the newer technology. Of course, testing 8 times a day helps, too.

[mids1999]

I got insurance approval for the Animas pump in the mail today!!! :biggrin:

What is the tyipcal time from insurance approval to pump start?

[JediSkipdogg]

Usually less than a month.

[mids1999]

So I have to wait about another month?
And here I was thinking the long part (approval) was over.

[Funnygrl]

The long part is over. You can schedule training as soon as the pump ships. It jsut depends when the trainer can get you in.

[JediSkipdogg]

My answer was fast but yet, there are many things to consider. One, you have to wait till they get the A-OK to ship the pump. Then once they ship it you have to wait for a trainer to call you. Then once the trainer calls you it's up to when you two can fit into the same schedule to get trained. I the trainer is in your city, it goes alot faster thanif they have to travel say 2 hours. Then it all depends if they make you do saline first or not. So it could be a week or a month, I was saying month max.

[mids1999]

The pump co sets you up with the trainer?

[Cyborg]

I got insurance approval for the Animas pump in the mail today!!! :biggrin:

What is the tyipcal time from insurance approval to pump start?

:party: :party:

You will be assimilated.

[gettingby]

LMAO Cyborg

[pooh3465]

Just a quick update.
I am now 1 week into the insurance approval process.
I sure hope it gets approved.

Every medical professional I talk to including the diabetes management team at my states medicaid office tell me the pump would be very beneficial to me.
You will love having the pump I am going on the 4th year with mine and can not wait to upgrade according to medicare or caid not sure which I can upgrade every 5 years. just watch it it is easy to gain weight with the pump because you bolus when you eat and if your eating gets out of control you will be bolusing alot more so just remember it's a new luxury and to enjoy it keep it under control with your diet and finger sticks...hmmmm someday I may take my own advice lol...good luck