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Re: [IP] When to Start a child on pump

In rebuttal:

>     It never ever ever goes away.  After about 5 years, I
>     ocassionally could have stood a night or two off.  By the time I

You can disconnect and go on MDI for a few days at a time without 
long acting insulins and with the same degree of control. It is a 
little more hassle but it does work. I know, I have participated with 
my daughter in doing this and I know another pumper who does this for 
a week at a time while on vacation (he swims and this was before the 
QR was available).

Rather than pumping, as a child, teen or young adult, would you truly 
preferr to get up every morning at 'exactly' the same time, never get 
to sleep in. Take a shot, eat, snack, take a shot, eat, snack, take a 
shot, eat, snack, go to bed at 'exactly' the same time, etc... 
instead forever or until you let your control go to H***??

>     was in my mid 20s I could no longer imagine myself unconnected
>     and this made social life pretty tough for a while.  Would have
>     been easier if there had been lots of help:  emotional support,
>     parental support etc around. 
I agree 100% that emotional support is necessary, but what does that 
have to do with a pump?

Depression and difficulities with self esteem are common among 
diabetics and they need support. These complications are not as 
common among pumpers specifically because of better control and not 
having to go 'hide somewhere' to take a shot.

> In other words, if you start a pump at 5 or 10 or 12 for your
> child be prepared to provide emotional support for many many years.
> I have the sense that grown ups diagnosed with diabetes, even after

I repeat above!

>  Cost:  Few americans in their late teens, twenties and thirties
>     have health insurance.  While all diabetics really need health
>     insurance, pump supplies are out of reach on most salaries.  On
>     top of which, fewer insurance policies cover pump supplies.  If

I must disagree. Private insurance does cover those things and is 
available at relatively low cost for a young person.
For example, a fully paid PPO plan for a person age 29 and under is 
available for $90 per month that covers pumps, supplies, etc.... with 
an 80% co-pay. The cost rises to $131 per month for ages up to 
39. That is far less than the cost of the supplies themselves much 
less any other medical expenses that might come along. Current law 
'mandates' that if you have coverage under a policy, insurance 
companies must accept you for coverage immediately with whatever 
pre-existing conditions you may have.

> A child who started on a pump
> at 6 0r 9 or 13 is not going to remember at age 17, 18, 21, 24 etc
> what a great difference this is from shots so the gratitude may not
> be outweighed by the frustration of practical insurance concerns and
> life choices. 
The lack of appreciation of a youngster may be an interesting topic 
of conversation, but from a practical standpoint is not the issue 
with respect to health. That appreciation will certainly resurface 
at a latter time when the mature adult realizes the hassle their 
parents had to go through to keep them alive. This applies to any 
diabetic, or any child with a chronic illness. I have two kids that 
have experienced chronic illness (one diabetic) and have spent over 
a year sleeping on the floor of a hospital, under or beside my son's 
bed. I don't regret a minute, but I guarantee you I am not in his 
eyes his best buddy at age 8 but rather the one who tells him no he 
can't watch another epsiode of the Simpsons at 9:00pm or eat half a 
box of ice cream after skipping dinner. I don't really care about 
that, I love him and some day I'm sure he will appreciate the 
sacrifices his mother and I made for him as any parent would under 
the circumstances. I don't look for or need any thanks from my 
children for doing my job as a parent, I simply wish them good 
health, long life, etc... What is more important, is that in spite 
of the immediate desires or short term future attitude of my 
children, certain thing are better for them that they might not 
like. Specifically with regard to a pump, Renee's 
daughter already has evidence of kidney damage at age 15 and is on 
ACE inhibitors. Imagine how much worse and how rapidly that condition 
would progress without a pump. Lily's last attendance to Diabetes 
camp 3 years ago was accompanied by a visit by the prior years' 
counseler to her cabin. That young lady, age 20, announced that she 
was about to undergo surgery to BOTH eyes because she was loosing her 
vision due to complications of diabetes. She was not a pumper. I 
truly believe that a pump could have prevented or surely reduced 
those complications for her. As a parent, I would not knowingly avoid 
the use of the 'best available treatment' for diabetes for my child 
simply because they might not like it when they get to be in college. 
Give me a break!

> Again, its a great path, but if you   choose it, you
> need to think long term.  Can you provide financial help or adequate
> medical coverage?

Gotta do it anyway, whether there is a pump or not. See comments 
above about cost of insurance.
>     A pump is a lot more work.  It provides better control and more
>     flexibility.  It does not make life easier although it does make
>     it nicer and makes it easier not to impose on others.

A pump is NOT more work than the same degree of control using MDI, it 
is much simpler, particularly for a child. I speak for my daughter in 
this respect and for other children on the list who I quote "I would 
not go back to shots for anything". Their messages are in the mail 
archives and their stories on our website and Ellen's.

If you are lax or lazy about control, sure, that is a lot less 
work..... but look at the price you pay in terms of long term 
>     These are not meant to be reasons not to pump -- only things to
>     consider.

Consider the reasons, do not use them as a parental excuse to avoid 
the extra work involved learning to carb count and regulate tight 
control. Every diabetic and in particular, every responsible parent 
of a diabetic child shoud be using tight control to mitigate the long 
term adverse effects of diabetes. The easiest way to do this is with 
a pump.

There are numerous other non-diabetes reasons to pump. Primary among 
them is the ability to carry on a more normal lifestyle. Eating when 
and what you like as a normal person would. The effects of the rest 
of the family of a diabetic, re: schedules, food, etc... For a child 
this returns the freedom of sleep-overs, sports, camp, diet and food 
choices such as: real candy, ice-cream sundaes, sodas and burgers 
with friends on a hot afternoon. i.e. being a 'real' kid again.

I rest my case and climb down from my soapbox. As you can see, I 
really believe that every diabetic child should be able to pump.
And I will do what I can to see that this becomes a reality.

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