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[IP] Re: suspending when low

Hi Marion,

It's good that you are addressing concerns about pumping.  Best to 
know as much as possible up front.

In Noah's case, I wasn't concerned about the pump malfunctioning to 
the point of no delivery and causing DKA.  I was much more concerned 
about him having a severe low while on MDI, especially during the 
night or when away from home.  This is just our experience, but I had 
many more fears with MDI than the pump about reliability and quality 
of care management.

We are still using the same MiniMed 507C that he got at the outset in 
July 1999.  We have never had any problems with it except once when I 
was changing batteries and put them in backwards.  It shorted and 
wiped everything out so we had to re-program basals.  But that was an 
operator error, not a pump problem.  He has had a couple of times 
when we didn't realize the reservoir was almost empty and he got an 
alarm on a bolus.  Again, operator error.  No problem, just change 
the set and re-bolus. This problem can easily be avoided by keeping 
track either on the calendar or checking the reservoir each day for 
how much insulin is there.  We get complacent and too relaxed at 
times since his sites last four days and would last longer if he 
didn't run out of insulin!   He has also had a couple of times when 
the tubing got kinked or torn due to rough-housing with friends. 
Only one of those times did his number climb high before it was 
caught but after a site change and bolusing to correct, he was back 
to normal within a couple of hours.  We have never had any situations 
that weren't easily corrected.

Noah was 12 when he started the pump.  Prior to that, he was doing 
fairly well A1C-wise on MDI.  His endos thought he was doing 
exceptionally well.  In Noah's case, his bg's would fluctuate and I 
felt his A1C's weren't really indicative of how good his control was. 
Plus, puberty was beginning to kick in and I knew management was 
going to get more difficult with MDI.

If Gabe's control is as good as his A1C's suggest and he is happy on 
MDI, maybe this isn't the right time for him.  As I said before, Noah 
wasn't sure about pumping since he never minded doing injections on 
MDI, but he just loves the increased energy level and overall 
convenience and benefits he experiences with pumping.  After pumping 
a couple of weeks, he never looked back and didn't want to!

Keep us posted on how things are going.

Cindy, mom to 15 y/o pumping Noah, dx at age 9, and,
Micah, age 11
wife to Steve
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