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[IP] My *original* instructions
- To: <Undisclosed-Recipient:@mail2.mx.voyager.net;@bzs.org;;;>
- Subject: [IP] My *original* instructions
- From: "J Hughey" <email @ redacted>
- Date: Mon, 9 Jul 2001 10:34:27 -0500
- Reply-To: email @ redacted
While rearranging some clutter, I came across page 2 of my *Insulin Pump
Therapy Criteria* from 1983. I have often said I have been kept in the
guinea-pig stage. Perhaps these instructions will help clear up my reference:
1. Physician gives patient a list of criteria he/she will have to meet:
a. Be willing to self monitor blood glucose at home and to record data 4-6
times daily until stabilized and then 12 times per week.
b. Understand potential hazards of insulin pump therapy:
b.1. hyperglycemia, ketosis secondary to pump failure, infection,
b.2. hypoglycemia - especially at night.
b.3. local infection at site of needle insertion.
c. Be willing to visit physician from once a week to once a month until
d. Understand to contact physician immediately in case of emergencies
(glucose <60 or >240).
e. Have someone in the family who understands how to manage diabaetic
f. Be willing to wear pump 24 hours a day and be willing to live with its
limitations (contact sports, changing sites of 48-72 degrees).
g. Be able to manage pump costs, maintenance, follow-up.
2. Patient given selected literature to read.
3. If patieent meets criteria and decides to pursue the pump therapy, the
physician refers him/her to the diabetic educator.
4. The diabetic educator conducts 4 sessions with the patient and, if
possible, a family member or significant other.
a. Counseling regarding pros and cons of the pump, benefits, limitations,
risks, expenses and instruction in glucose self-monitoring. Instruct patient
to obtain proof of insurance.
b. Review of diabetic management and dietary evaluation.
b.1. Evaluation of glucose record.
b.2. Visit with the Business Office re: Insurance.
Back then there were no Certified Diabetes Educators. My D.E. was one of the
first group to become Certified - then her church decided she should transfer
to a retirement home for nuns and be their director. What a waste of talent -
in MY humble opinion. This was back when most of us cut our BG strips in 1/2s
or 1/3s to cut costs and compare the results to a color strip on the side of
the container. I suppose the *12 per week* is why my endo slightly shook his
head negatively a month ago when I asked for 6-8 a day. He did it, but I could
detect his feelings it was not necessary.
One a.m. I had a BG reading over 600 and caled him. He returned my call at
5:00 p.m. I asked why it took so long. 1) The message was put on the pile
until he went through it. 2) "If you don't know what to do, I don't know what
I am seriously considering finding a new internist (don't like the other endo
in town) who deals with pumps and DM. What questions and/or features should I
inquire about when choosing one of 10 whom my ins. covers? (~_^)
Jan (62 y/o, T-1 11/5/50, pmpg 8/23/83) & Bluda Sue (MM507C 3/99)
http://maxpages.com/bludasue AND http://www.picturetrail.com/dmBASHpics
(including an album of the EVOLUTION OF PUMPS)
Sorrow looks back. Worry looks around. Faith looks UP!
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