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[IP] Re:

> But, oh my gosh, I'm feeling really overwhelmed by all the stuff the book
> is saying I must do to be a "good pumper"!  Really, REALLY overwhelmed!  In
> particular, the extent of food weighing they recommend!  We're in a
> financial crunch at the moment, and I'm not even sure how I'm going to
> manage paying to see the out-of-plan CDE, much less buying a digital gram
> scale to the tune of $50-$200.  I am also so overstressed by the rest of
> life (our financial situation, both of us working full time while we also
> take classes to try to shift career gears, etc.) that I do not see any way
> I can possibly do all of the things that (apparently) will be required of
> me.  
> How realistic is the book in this regard?

The gram scale weighing is kind of a joke - we've used a scale from 
Wal-Mart that cost less than $5.  It's accurate enough - more 
accuracy is not needed because the proportions of the nutrients in 
foods isn't that precise except for some of the manufactured foods 
like Tang.   You can even do a decent job by estimating based on the 
exchanges - I don't weigh much of my food and do well.  New foods get 
either weighed or check the labels and portions.   When I bought my 
pump consultation with a CDE/pump trainer was provided as part of the 
purchase price.  I spent $80 visiting a nutritionist to update some 
information on carbo counting.  It took a few weeks to get 
comfortable with the switch to carb counting but it's going ok now.  

> I'm also very worried about the fasting tests to determine day basal rates.
>  I have severe acid stomach, for which I take Prilosec daily, and I know
> that if I have to go without food for very long during my waking hours, I
> will be positively miserable and non-functional for work.  I actually look
> forward to not having to eat at times when I am not hungry (which does
> happen, though infrequently), but that will not necessarily be the case
> if/when I am required to fast.  Has anyone else found this a problem? 
> Isn't there any other way to figure out the day basals?

The basal rates can be adjusted with some exact known foods, like the 
synthetic "nutrition drinks" - if you have a good idea of the 
carb/insulin ratio.  It just takes a lot longer and is a lot more 

> I guess now that it appears that I am actually going to get a pump, I'm
> kinda freaking out, too.  Did many of you who felt a lot of trepidation
> about being constantly attached to something, getting skin infections,
> etc., find that most of your fears were not realized?  I am very excited
> about finally being able to start pumping and hopefully get my erratic BGs
> into better control and enjoy a more flexible lifestyle, but I'm also
> really scared.  Will I be able to do it?  Will the members of my health
> team think I'm a "bad" diabetic or a "bad" pumper?

If they think you're "bad" then you need a new health team because 
they work for you.  Their goal should be to work with you to help 
you, not to condemn you...  if they want to pay you $250/hour to tell 
you how "bad" you are then you might put up with it.  If you or your 
insurance is paying them you have the right to say something like 
"your advice doesn't work - now help me get things adjusted to get it 
right" and demand realistic advice and help.  Don't let them bully 
you around and mess you up.  

> For the last three days, I have been keeping a detailed food log, which my
> CDE told me would be needed for the visit to the dietician.  I'm being
> honest, and I'm ashamed of what I've had to write down.  Yesterday was
> probably the single busiest day of my work year (I work in University
> support services; and, with graduation nearing, I've had to organize
> multiple special events on top of my regular work), and when I am under
> stress, I have little resistance to foods that I know are not good for me
> or my BGs, but represent emotional comfort.  There is too much sugar, fat,
> and alcohol.  I'm afraid the dietician is going to yell at me, or deem me
> so non-compliant that I am an unworthy pump candidate.

Then refuse to pay the dietician because they are not "patient 
sensitive" or realistic.   One of the big advantages of pump therapy 
is diet normalization.  If the dietician raises their voice or even 
gets non-cooperative start going up the chain complaining that you 
need help, not someone who is so out of date they cannot help you.  

> Okay, I'll stop now.  Thanks for letting me vent.  I sure do appreciate
> being able to read the posts to this list.  And I will welcome any comments
> you might have.

Hang in there and keep kicking.  Remember that as a responsible 
health care consumer you are the boss - the doctors, nurses, 
dieticians and all work for you - as highly paid consultants.  If 
they are not providing quality care start raising cain until you get 
decent care.

Randall Winchester

* The views expressed here are mine and do not necessarily *
* reflect the official position of my employer.            *
* There's no guarantee on anything said here...
* If I say I understand something completely the only thing
* we can both be assured of is that I must have completely
* misunderstood something. 
Insulin-Pumpers website http://www.bizsystems.com/Diabetes/
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