How to get a pump?

Stanimal · #1 (**permalink**) 09-21-2004, 09:42 PM

Hello,
My name is Stan and I have been lurking for a while now. I need some advice from people with much more experience than me. I just started on insulin 3 months ago. 1st lantus once a day, with little results. Now I am up to 3 novolog and my nitetime lantus. I would really like to get a pump, because the business I own does not really allow me to be discreet about injections, and carrying insulin all day in my vehicle is not something I want to do. I take quite a bit of insulin at this point. Usually 15 units breakfast, 20 lunch, and 35 dinner. Then 35 of lantus at nite. Would I be a good candidate for a pump? I would really like to talk to my Endo, but I would like,some opinions 1st. Thanks in advance.

Stan

notme · #2 (**permalink**) 09-21-2004, 10:06 PM

Hi Stan, Talk to your endo about a pump. If you find that your endo doesn't support it, I would find another endo. The insulin pump is extremely beneficial for someone who is active and on the go most of the time.

When I first started thinking about the pump, I went to my primary care physician and asked her to locate an endo that specialized in pumps. She did just that and I went to him. He gave me the information on pumps and then had me call the pump companies to have them help me decide what was best for me. Once that was done and I had made my decision, the pump company called my insurance company to get one approved. All in all it took me less than a month, but I hear it has taken many people much longer.

The one thing you need to have for your endo is a months worth of blood glucose readings. They give this to your insurance company for medical necessity. Make sure you test a minimum of four times a day and preferably seven times a day. I test first thing in the morning, two hours after breakfast, lunch and two hours after lunch then again at dinner time and two hours after dinner and bedtime. This gives your endo a good idea of what your basal rate should be in the pump. If you have all of this information on your visit it should help expedite your pump. When you are on the pump you will still have to test religiously to keep your numbers good. Count carbs and know what your carb to insulin ratio is.

I hope you get a pump soon Stan. The pump for me has been live changing. I have had type one diabetes for 19 years and 3 of those years have been pumping. I will never go back.

Nancy

HeatherP · #3 (**permalink**) 09-21-2004, 10:12 PM

Welcome, Stan, and may I say that you have a great name! (my hubby's name is Stan, too

) I'm on MDI and a pump is not my preference for now. I've heard it put two ways: 1) You have to improve control so you "earn" a pump and 2) Well, gee, your control is so good that you don't need a pump. It's going to depend a lot on what your insurance covers (assuming you're in the US). If you want one and feel that it will improve your quality of life, then you should have one. Many docs will do the paperwork for you and pre-qualify you for a pump so everything is in place when you're ready to make the switch.

I'm sure you'll get plenty of input from the other pumpers here, so I wish you the best, and hope you'll visit with us often and share your experiences. (Even though I'm not into a pump for now, I do check out what's going on in this room for the latest)

Nice to meet you,
HeatherP

Belinda · #4 (**permalink**) 09-22-2004, 04:45 AM

Welcome Stan...

I just mentioned "What do you think about the insulin pump?" to my primary care doctor and the next thing I know he is finding me an endo and making the appointment. Little did I know that this Endo existed or I would have gone to him years ago (my primary care doc is and was wonderful in caring for my diabetes but I learned soooo much more at the endo's office). I went once for the initial visit and then 6 weeks later and said "I want a pump" next thing I know it is at my house....I LOVE IT.... I just asked about the info so maybe that is all you have to do....not sure but seems to me that you have to ask to show your interest. Good luck

Littlebit63_99 · #5 (**permalink**) 09-22-2004, 05:19 AM

Stan,

In '96 my endo said "you need a pump or a transplant" he told me to get a pump to "buy" me a few years.........it worked great for the 8 years that I have had it and would recommend to anyone taking MDI's. I agree with notme and Belinda.......find an endo who specializes in pumps. They are out there and your primary should be able to refer you to one. I am now seeking a transplant......but that has Nothing to do with the pump. The pump still works great.

Take care all,
Liz

PepsiLvr · #6 (**permalink**) 09-22-2004, 07:23 AM

A pump is a great idea! Like others have said, ask your endo and if he / she doesn't support your feelings, find a different endo. All I did was ask my endo "would a pump be a good idea" he said it would. I then contacted the pump manuf. on my own (MiniMed in my case) and they did all of the legwork. Also, if you are in the US, your insurance will probably want a "letter of medical necessity" This letter will be constructed by your pump sales rep after asking you questions about things like how many highs you have, how many hypos you have and things like that. The letter is then sent to your endo for approval and a script is written. Your sales rep will then verify coverage w/ your insurance company and there you go, 1 insulin pump! Sounds easy right, that was my experience but I know others who have not had it so easy. The key is finding the right endo to support you.

Good luck, and oh yea, Welcome!!

Stanimal · #7 (**permalink**) 09-22-2004, 08:24 AM

Thanks for all the info, I have an appointment with my endo next week. I'll keep you posted!

Stan

Shalyndria · #8 (**permalink**) 09-22-2004, 07:41 PM

Hi Stan.

The trick is to not ask. Just walk on in there and say "I want to be put on an insulin pump" (or any variation). Don't give your doc a chance to shoot you down. I did this myself, just walked into my GP's office and told her that I wanted an insulin pump and if she couldn't help me then she needed to send me to someone who could. Then I walked into his office and told him to hook me up with one. And it worked

Do keep us updated on your progress!

Shy

am1977 · #9 (**permalink**) 09-22-2004, 08:25 PM

Hi Stan,

I'm glad you decided to step out of "lurk" mode and joined us. We are a very nice and welcoming bunch, if I don't say so myself :p !

I have had and still have a love/hate relationship with my pump. I guess that goes to show you that the pump isn't wonderful for everyone, though it might be for you. For a while I had a lot of problems with the infusion sets/sites leading to extremely high blood sugars. Very scary

. It kind of discouraged me and I lost a lot of faith in the pump

.

Recently, I have returned to the pump...I don't give up too easily, and I want to try to make it work for me. I am trying the "Untethered Regimen" right now. It means actually using Lantus alongside your pump...usually you would only use a short acting insulin in the pump. So far it's been ok, I still have ups and downs, but I think it's user error (the user being me

). I think it could have been from bad carb counting or over doing things at time. Anyway, I don't want to confuse you too much about this regimen. But I decided to go back also b/c I missed some of the pumps features, like just pushing a button to administer insulin instead of taking a shot everytime I eat something. This is great bc I hate injections.

My advice would be to do what you feel most comfortable with. If you feel like you are comfortable with injections and are now ready for the pump then go for it. Be direct and tell your doctor that that's the direction you want to move in. However, I would be sure that you have the injections down pat, b/c if something should go wrong with the pump, you will need to fall back on injections.

I wish you luck in getting the pump. I think it's worth trying and I certainly hope it works out for you.

soremom · #10 (**permalink**) 09-22-2004, 09:09 PM

Stan, I have heard and read that people have to what till they are more stabilized to get a pump, or because they can't stabilize they need to get a pump. It is what you want. I got mine because I wanted better control. I had good control before and have no complications. I want to keep it that way.

I had approval from my insurance company within two weeks, I believe less, from when I sent the paper work to the pump company. You just need to make sure your insurance will help pay for it, like what has already been said.

Good luck with your decision and make sure you do what you want, not what your Dr or anyone else wants you to do. You are ultimately responsible for your health and you should be able to have anything that will help you achieve the best result possible. Atleast that is what I think and try to do.

Kim