Pump Training Tuesday - Need Advice

[Mariel's Mom]

Hi all,

Things are moving along for Mariel - We decided on the Animus and have pump training scheduled on Tuesday 1:00 pm

We have 2 hours scheduled with the Animus CDE at our Endo's office. I'd like to make the most of this training, however, impossible to learn all in that compact 2 hour period. I want to make sure that I ask the right questions that will help us make a smooth transition starting out as well as specific information that is key to being successful. Knowing what you all know now - what are some areas or questions that I should be sure to have covered that may not be included in the basic training regarding...

infusion sets
how do you know the pump is working or better yet - if it is not
how do you make eating more normal for a 6 year old who likes to graze
Dealing with falling BS without necessarily having to "feed the child".
Any practical tips that you all have already uncovered, discovered or even invented.....That if you were conducting a pump start training you would be sure to include.

Thank you - I am nervous about this but know that just like with her diagnosis and MDI - we have to Just Do It -

[JediSkipdogg]

how do you know the pump is working or better yet - if it is not
The easiest way to tell is simply put, the BG rises without reason. Now, during your first few weeks that may be tough as you are making adjustments to the basal rates and ratios. But once you have those down pat, you can tell if an infusion site isn't working by just testing often and seeing if the BG rises more than what he ate or on it's own in a period where he hasn't eaten for a while.

how do you make eating more normal for a 6 year old who likes to graze
I really can't help you on that one. That just has to work with controlling a kid's eating habits.

Congrats on the pump and don't hesitate to ask anymore questions.

[spike]

Dealing with falling BS without necessarily having to "feed the child".
-

Falling bg's? If dropping dangerously fast, use Glucotabs and/or juice, etc.

If dropping slowly, give something like a banana, grapes, milk, etc.

If a MAJORLY serious low, inject Glucagon (unconscious, seizures) and call paramedics.

I also suspend my pump if I'm running low over a period of time, rather than only temporarily low.

I'm still pondering what you mean by avoiding feeding the child. <g>

[psilocybin]

good luck with everything...
i dont suspend mypump if im running low i use a temporary basel...

[Mariel's Mom]

We have been having very erratic sugars lately - getting lows that don't seem to respond to usual quick sugar intake - I'll provide some quick sugar and then retest and they keep falling and I know that we have have x hours of insulin action after her meal. So I have to keep giving her carbs and after a while she does not want to keep eating stuff.

We have had to pull back on her carb ratios since this seems to happen very often at night before bed. So I know with a pump you have more options and control over the insulin delivery or can suspend the delivery rather than with MDI where you can't.

[spike]

We have been having very erratic sugars lately - getting lows that don't seem to respond to usual quick sugar intake - I'll provide some quick sugar and then retest and they keep falling and I know that we have have x hours of insulin action after her meal. So I have to keep giving her carbs and after a while she does not want to keep eating stuff.

We have had to pull back on her carb ratios since this seems to happen very often at night before bed. So I know with a pump you have more options and control over the insulin delivery or can suspend the delivery rather than with MDI where you can't.

what model meter are you using, a Flash?

[Yvonne Burns]

I wish you both happy pumping. I would suggest starting with low basals. It is easier to keep blood sugar a little higher (in the very beginning) than to have so many lows. If she wants to eat then you can bolus for it. Then she won't have to keep eating and eating to feed the lows. This way the whole pump experience can start off more positively for her.

Also. I would find some peer support . It is of great comfort for all of us to know someone in the same boat. Perhaps, her school nurse would know. Maybe there is a children's group or a camp she might enjoy.

You will become very adept at this. It takes time and patience. As she matures, she will be able to handle pump management more and more. You are fortunate to live in a day and age when such technology is available. Your daughter can live a healthy and fufilling life!

All the best to you both.

--Yvonne

[psilocybin]

I wish you both happy pumping. I would suggest starting with low basals. It is easier to keep blood sugar a little higher (in the very beginning) than to have so many lows. If she wants to eat then you can bolus for it. Then she won't have to keep eating and eating to feed the lows. This way the whole pump experience can start off more positively for her.

Also. I would find some peer support . It is of great comfort for all of us to know someone in the same boat. Perhaps, her school nurse would know. Maybe there is a children's group or a camp she might enjoy.

You will become very adept at this. It takes time and patience. As she matures, she will be able to handle pump management more and more. You are fortunate to live in a day and age when such technology is available. Your daughter can live a healthy and fufilling life!

All the best to you both.

--Yvonne

your endo wil tell u what basels to start with

[Mariel's Mom]

what model meter are you using, a Flash?

Why yes, we are using the flash - why do you ask?

[spike]

Why yes, we are using the flash - why do you ask?

Because that's the one meter on the market that will tend to read a bit high in the hypo range. You might catch the hypos quicker with any of the LifeScan meters. My wife and I both use the Flash with great trepidation when we are under 80. When we feel hypo (around 50 something), the Flash will sometimes (not always) read about 70-72. I'm a prolific bg tester for many years (I've gone through well over 110,00 strips, we have over 18 meters in the house, and through repeated testing have found that the Flash is the one meter we can't count on to read accurately at low levels.

OTOH, the Compact reads much higher than other meters once other meters hit 230+. The Compact tends to read 30-50 points high. It's really easy to figure out which meter is accurate by the body's response to therapeutic changes (taking a corrective bolus, for example). If I go by the Compact, I'll take way too much insulin to correct a high.

Now if you disagree with these findings, that's your perogative--please be respectful though, as I was rudely and persistently attacked by a small contingent of mothers who have some sort of cultlike love for the Flash, on another website. I gave up trying to explain how I'm not the only one who has found the Flash to run high at low numbers. Bear in mind, the Flash isn't consistenly high at the low end, just often enough to make me leery of using it when I'm low. I assign absolutely zero validity to anyone who argues this point based on just a few readings. That's not the nature of the problem.

[Mariel's Mom]

Spike,

Always respectful - I have found the people here so knowledgeable about so many intricate things - Sounds similar to what I have been experiencing - 4, 5 7 gs sugar would not seem to raise BG more than a few points. Frustrating. Interesting that I know a few mothers who you guessed it - love the flash - I got two meters at the hospital - the OneTouch Ultra and the Flash - Like the flash because of the size - It does have the cuteness quotient - but I want to use the best meter in terms of accuracy. Now that I have actually overcome the weird mindset that the meters and lancet devices are somehow linked umbilically -(my daughter would scream when she saw the One Touch lancet device - it was painful to her) - should I go back to the One Touch? (BTW I ordered the Accucheck Softclix lancet device and it is great)

[Harold]

(my daughter would scream when she saw the One Touch lancet device - it was painful to her)
What depth do you have dialed in?

[Shotokan]

Spike,

-(my daughter would scream when she saw the One Touch lancet device - it was painful to her) - should I go back to the One Touch? (BTW I ordered the Accucheck Softclix lancet device and it is great)

You can use whatever lancet device you want to use. Just because you use the One Touch meter does NOT mean you have to use the One Touch lancet device.

[jeggeman31]

Because that's the one meter on the market that will tend to read a bit high in the hypo range.

I have never had that problem with my flash at all.

[Funnygrl]

Everytime I have had my meter tested against the lab my Flash has been right on. My Ultrasmart does read quite a bit higher than my Flash though. In my opinion, the Flash is the meter I trust, but when you get into sorta-low blood sugars, treating by symptoms is sometimes a good idea.

[spike]

Spike,

Always respectful - I have found the people here so knowledgeable about so many intricate things - Sounds similar to what I have been experiencing - 4, 5 7 gs sugar would not seem to raise BG more than a few points. Frustrating. Interesting that I know a few mothers who you guessed it - love the flash - I got two meters at the hospital - the OneTouch Ultra and the Flash - Like the flash because of the size - It does have the cuteness quotient - but I want to use the best meter in terms of accuracy. Now that I have actually overcome the weird mindset that the meters and lancet devices are somehow linked umbilically -(my daughter would scream when she saw the One Touch lancet device - it was painful to her) - should I go back to the One Touch? (BTW I ordered the Accucheck Softclix lancet device and it is great)

We use the Flash at the theatre--it's great in the dark and rarely am I hypo, so the issues at the low end are irrelevant. I'd feel more kindly towards the Flash if it always read higher at the low end, rather than just sometimes reading falsely high. If that's the only meter that I've got with me when I'm getting low, I have to second guess the numbers and that's not cool.

I don't think you should switch meters unless YOU feel more comfortable with the US. Personally, I always rely on the LifeScan meters, but to each his own, and as long as you have my comments in the back of your mind, you at least may consider that someone is already well into a hypo when the Flash is still showing 70+.

[HollyB]

Does anyone one know if the Freestyle mini is prone to the same problems? That's Aaron's meter right now.

[spike]

Does anyone one know if the Freestyle mini is prone to the same problems? That's Aaron's meter right now.

That's the SAME meter. different name for non U.S. distribution.