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[IP] Re:No Pump Docs

You said in one of your last messages:

<snip>  but I don't think the fact that a 
>person is in poor control is any justification to refuse pump 

I have been following this thread and I think I might understand
what was being said and the confusion that it has caused.

In my case, the insurance company wants proof that the patient
is willing to test more often and learn "self-management." This
they describe in more detail is that the patient will show that
they can test 4+ times a day and make self corrections.  They
also will see a nutritionalist to learn carb-counting or
exchanges if needed.  The first doctor I saw, who I left after
the first visit because five weeks later I still haven't gotten
my A1C back, and other reasons (different story), was willing
to put me on a pump.  He was willing to write the letter and 
everything because I showed three months of testing 8+ times
a day, and carb counting in my logs.  However, the letter business is
another story.  THe new doctor I am going to see, requires
her patients to meet with a CDE a few times to learn more
about the pump and what a commitment to it will mean and meet
with a nutrionalist.  

Personally, I think it would be great if they were just handing
them out like lollypops at a bank.  However, I understand that 
the doctor wants to make sure that the patient is committed to
pump therapy and understands everything that goes along with it. 
As everyone knows here, and I hopefully will know first hand, it
isn't a walk in the park starting on the pump, and things come
along months, years down the road to throw you a loop every once
in a while.  Educating the person to test their blood to catch
these loops, and teaching them carb counting,  shows that they
have commitment.  If a doctors office told me to test my blood
more often and keep a record to prove to them I was committed 
to the pump I would.  However, in a previous message it was
mentioned that people wanted the pump but weren't willing to
test and keep a record to get it.  That doesn't show committment
in my eyes.  If you want something bad enough you will do all
you can to get it.  Even if it takes a little longer then you
would like. And means doing some things that might not be 
convenient.  There was a case recently of a doctor putting a 
patient on UL and trying to get things under control that way
before going on the pump.  The patient didn't like the early
results from the UL and switched back to NPH without telling
the doctor.  This doesn't seem like "committment" to me.  If
the patient isn't willing to stick out the adjustment period
to UL, how are they ever going to be willing to stick out 
the adjustment period to the pump?

I guess the thing that seemed to be misunderstood in all this
was that, in DebinNH's email she mentioned that the doctor's
wouldn't give those patients a pump.  However, it wasn't that
they would NEVER give them a pump.  Just that they wouldn't
until they showed "commitment."  Not keeping logs, just means
that the doctors don't see a commitment, they didn't see what
the patient was doing to help themselves.  It didn't necessarily
mean that the patients were in bad control of their bs.

-- Sherry
Insulin Pumpers website http://www.insulin-pumpers.org/
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