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[IP] My CPI/Lilly Betatron IV trial review

Re: the labwork I received 2/17/03 from medical records that were
confiscated from my former endo's office.

This is a letter I wrote on Dec. 27, 1988 and was in the file, about a trial
pump. I do NOT recall anything of this except I still have one of the awful
reservoirs. I can't even tell you what the pump looked like. The letter is
self-explanatory and I thought maybe some of those interested in the history
of pumping would like to read it. Remember, this 14 years ago and quite a
few things have improved, so keep in mind what we had at the time - not

Research and Development Department
Cardiac Pacemakers, Inc.
Insulin Infusion Pump Division
St. Paul, Minnesota

To whom it may concern:

Recently I received, and operated, a Betatron IV CPI Insulin Infusion Pump.
Subsequently, I returned it and continued to enjoy the use of the Betatron
II pump, as I have for five years after changing from the 9100 pump. The
reasons for rejecting the use of the B-IV are listed:

1) Having a clock in the pump is the same to me as running my life by a
clock (for daily insulin injections - timed by a clock). I have enjoyed the
*freedom of flexibility* for 5 years. Infused or injected insulin cannot be
sucked back out -- my life would be controlled by this pump's timing - NOT
MINE! Non-diabetics have freedom and I have enjoyed sleeping in on Saturday
mornings -- something I hadn't been able to do for 33 years. There is no
clock telling me it is time for another action.

2) For three hours (supposedly between 8-11:00) each morning I run a 46
supplemental rate. ((Jan now: This was the ONE basal rate that could be
interrupted with a supplemental for a period of time which would make a
second rate, needing to be set every day)) Depending on my BG I sometimes
start it at 6:30 a.m. With B-IV the higher rate would be started the same
time every day -- unless I geared my mind to reprogram it each time. That
would also be taking away my freedom as I would be *bound* to consciousness
of the clock. Once the three hours is up on the B-II I am back on the 21
rate ((21 units per 24 hours for a basal rate - delivered in whole units
only)) without any attention from me to be concerned about when it will
start the next day. My supplemental rate is set at my choice to begin
anywhere from 6-9 a.m.

3) The B-IV denies .05 unit of infusion (prior rates of 17, 19, 21, etc.)
((I don't know what that was about))

4) The B-IV syringe is very bulky and uneasy to handle.

5) The needle on the syringe is tooooo long. Whoever came up with that idea
should be relegated to withdraw the last 100 units of insulin out of a vial
everyday for two weeks to experience the inconvenience of it. (I understand
patients were withdrawing insulin too fast with the shorter needle -
THEREFORE, I am punished for their lack of prudence. I was instructed by Joy
Shelton to fill the syringe slooowly.)

6) The width of the syringe on B-IV is such that the amount is easily
miscalculated. I don't like to waste anymore insulin than I have to (as in
throwing away the tubing) and the way I fill my syringe presently is to last
for three days -- finishing at the proper time of day. If my BG is such that
I require more insulin (illness, etc.) I take injections instead of boluses
to preserve the infused insulin.

At the end of my "tryout period" with the B-IV I waited for the syringe to
empty before changing everything. Time was fleeting and I had to change it
anyway. I always push the syringe when I am unhooked and it is out of the
pump. This time the "last 10 or so units" in the B-IV was NIL! It LOOKED
like there were 10 or so units left bit it was EMPTY! I think that is
unhealthy. I was waiting for an empty syringe to empty.

7) It is very easy to misjudge the amount of insulin BETWEEN the lines of 25
units on that little bulk syringe.

8) I have a hypersensitive system and cannot tolerate a bolus of more than 3
units at a time (had no problem with 45u injections). I take 2+2 or 3+3 with
the B-II pump by placing the second half in "hide." Reprogramming the B-IV
was not that easy for me.

9) The B-IV tubing protrudes from the top of the pump when programming it.
This is opposite of B-II. It seems to put a strain on the hub when holding
the pump to do the program. It seems awkward.

10) B-II has many features on it for the convenience of the patient. I even
had my doggy trained to awaken me when the 10-hour alarm went off and I was
asleep. If I forget to clear the pump in the morning when I changed
batteries I am reminded by the alarm that is set at 40 units. ((We had to
clear the TDD each a.m.)) If, I was told, patients do clear their pumps or
use these other features - it is THEIR CHOICE. I feel that MY CHOICE has
been taken away for THEIR convenience. If within five years a pump is not
available for me to use with the extreme ease, comfort, features, and
flexibility such as the B-II offers, I am willing to begin to use the *poor
man's pump* -- 5-6 injections daily.

If the features on the B-II pump were too much for some of the patients they
did have the choice of the 9205 model. The Cadillac Company offers customers
more than one choice. I am disappointed my choice has been removed.

I was of the understanding that the criteria for receiving a pump included
intelligence/maturity. If the insulin is withdrawn indiscriminately, the
keyboard not cleared, etc.  these do not appear to manifest the
requirements. When I sold Tupperware for 10 years it was stressed that a
party start at the designated time. If not, the ones who arrived on time
were punished while the late ones were rewarded for tardiness. That is what
it seems to be in this case. Those who follow instructions have the
privileges taken away and those who do not are rewarded resulting in all
having to follow others' actions.

On the positive side for the Betatron IV pump I must say it does offer some
A) Smaller size
B) Last bolus recall

Jan Hughey

This pump would have replaced my Betatron II 9200 pump shown on my
PictureTrail - the one the size of a king-sized pack of cigarettes. BTW, I
have used 5 pumps since 8/23/83

\(/ Jan (63 y/o, dx'd T-1 11/5/50, pmpg 8/23/83) & Bluda Sue (MM507C 3/99)
Dialyzing since 7/8/02
http://maxpages.com/bludasue  AND http://www.picturetrail.com/dmBASHpics
(including an album of the EVOLUTION OF INSULIN PUMPS)

I never forget a face, but in your case I'll make an exception ~ Groucho

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