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RE: [IP] Almost a week with this pump.



Patience, patience!

You have to give yourself time to learn.

 First, how often are you checking your blood glucose? Maybe you could have
caught that rise and
 dealt with it sooner. While you're learning, it is especially helpful to test
often.

 Would you perhaps have gone high even had you skipped the meal (and its
insulin)? Was your blood
sugar rising even before the meal?

 At one week, I would expect you to still be having troubles with your basal
rates and carbs ratios.

 Did your doctor give you the numbers to use for basal rates, carbs:insulin
ratio, and sensitivity?
And it's not working?

 Then why are you blaming the pump? Why not go yell at your doctor? Or better
yet -- take charge of
the situation, and figure this thing out?

 Why this anger at this inanimate device that just does what you tell it to do?
It just delivers the
 insulin that you tell it to. And it does it better than you can do it yourself
-- more precicely,
 and with basal insulin spread out over time. How can the pump suck? Syringes
suck! Diabetes sucks!
The pump just pumps.

So, pull yourself together, and figure this thing out:

 1) Is there a problem with your preparation? Did you do the Minimed online pump
school? Read John
 Walsh's Pumping Insulin book? Do you know how to handle high blood sugars with
the pump, how to
 check your site, etc? You won't know everything yet (!), but if there's an
obvious hole in your
 preparation, fill it. Otherwise, be patient with yourself -- give yourself time
to learn!

 2) Is there a delivery problem? Start with the obvious -- no insulin, air
bubbles, or my favorite --
 forgot to hook the pump back on after a shower? Check the cannula of the set,
make sure it's
actually inserted. Disconnect and do a fixed prime -- does insulin come out?

 It's possible you had an air bubble -- one of the trickier things is learning
to get all the bubbles
out of the reservoirs when you fill them.

 3) Is there a settings problem? At less than a week, your basal rates are
probably not correct, and
 until you get your basal rates properly tested and adjusted, nothing else is
going to work right. So
 focus on that first. Getting your carbs ratio and sensitivity set right depends
on having your basal
rates set properly.

 4) Is there something else going on? (E.g. error in estimating carb content,
high level of stress,
 illness, forgot to wash your hands before testing... Did you check that you
actually remembered to
bolus for the meal? Yes, I forget occasionally...)

 You don't have to just put up with a reading of 321 mg/dl. You can always give
yourelf a shot with a
 correction bolus (allowing for insulin on board, and remembering that the bolus
wizard doesn't know
 about the insulin you just gave). I inject perhaps once a month or so --
generally the problem has
 nothing to do with the pump, but I inject just to be SURE, and sort it out
later. (In my case, it
 generally has to do with steroids). That's sort of an extreme position --
generally, the advice is
 to go to injections if a correction bolus or a change of infusion site doesn't
cure the problem.
But I don't like to wait.

 There is a technique called a superbolus, to lower the spike after a large
meal. (Don't worry about
 this just yet -- for one thing, you need your basals and ratios set properly
first). But this
technique is simply NOT POSSIBLE without a pump.

 Anyway -- you can do this! You've been dealing with diabetes for 9 years;
you've only been dealing
 with the pump for 6 days. Do the basal rate testing and adjustment, and give
yourself time to find
what works.

-----Original Message-----
 From: email @ redacted
[mailto:email @ redacted] On Behalf Of
Michael Levisay
Sent: Saturday, July 22, 2006 22:50

  I am 20 years old, and just started using a Medtronic Minimed Paradigm last
Monday. I got the pump
 because I was having many lows. I have had an avg. of 7.0 a1c's since I was
diagnosed at 11, I was
 hoping to get a 6.0 avg during my 20's in the hopes of avoiding complications.
So far this P.O.S.
 has not proven worthy to me and right now wish I could send it back and get a
refund. I know this is
 not possible, but I ate a meal for dinner today and my eveing time insulin was
321. Using 14 units
 of humalog, my blood sugar would have most likely ended up in the 80-120 range.
I know that this
 meal could not have been more 90 grams worth of carbs. It was a gyro sandwhich,
side of homous and a
 piece of pita bread. This pump sucks, I am horrified that this thing cost
$6,000 ($950 out of
pocket). My blood sugar has been hell since I started using it.
  If anyone has any thoughts, or can help, I would like to hear it. .
.
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