[IP] AN excellent piece to read~
I don't know how many of you read the Diabetes Self Management blog, but I do,
mainly cuz one of my dear friends is one of the contributors and she is a
fiendishly funny and spot on writer. I wanted to post something here
that she wrote there, so, to credit my source, the author is Jan Chait, and
the URL for the piece is, in case you want to read it in full (I have snipped
it some here).
I Just received my new 522...and it is still in the box...having used a 508
for the last 11 years and a 506 for 4 years before that....I know I am gonna
want a little guidance on the bells and whistles...yeah I can figure it out on
my own by playing with it, but that is what I say about the VCR and yet, I
still have not managed to get the beginning AND end of any show i have ever
tried to record....So wayne, if you are out there...I may want a lesson
on how to refurbish my 508 if this tricked out model is too much for my
old brain :-)
Pump Up Your EducationIt never fails to amazeand shock and appallme when a
person posts a question on the Insulin Pumpers mailing list asking how to
operate a pump or what to do about one problem or another; questions that
indicate his lack of training.
While some are benign (e.g., "what do I do with the pump
during sex?" or "I'm getting married; where do I hide my pump?"),
others are not so harmless: "My numbers have been running high for two
days. What do I do?" for example. The answers to the first
two are easy enough: Detach during sex, put it under your pillow so it
won't get embarrassed, or forget about it; it isn't going anywhere. Or,
in the second case, clip it to your garter, have a pocket sewn into
your slip, or even hide it in your hairdo (as one bride is said to have
done). But the factors that contribute to hyperglycemia
(and therefore the answers on how to deal with it) are varied and can
include having bubbles in your tubing, a bent cannula, bad insulin, an
infection, and more.
Where, I ask myself, are these people's diabetes
teams (albeit more for the last question than for the first two)? Did
they not get training, during which trouble-shooting is generally
discussed? Is there nobody on the team who cares, or is knowledgeable
enough, to help figure out what the problem is and to assist in fixing
It was hardly surprising to me, therefore, when a
doctor at the U.S. Food and Drug Administration (FDA) reported last
month that 1,594 injuries and 13 deaths among children and adolescents
on the pump had been collected by the agency over a 10-year period.
According to an editorial
by Dr. Richard Hellman, immediate past president of the American
Association of Clinical Endocrinologists (AACE), "The most common
single issue was lack of education and, neither the patient nor the
responsible adult knew enough about how the pump worked to avoid the
injury or death that resulted. Although there were some cases due to
mechanical malfunction of the pump, most problems were the result of
human factors involved in the use of the pumps."
And, he added,
injuries and death related to insulin-pump usage are likely not
confined to children and adolescents; they extend to the adult
population, too. "Unfortunately," he writes, "the FDA has
not yet provided similar data regarding the numbers of serious injuries
in the larger group of pump users, adults who are using insulin pumps."
Who is responsible for the lack of education? The medical
community? The insulin pump industry? Us? Before I got my first pump in
1998, my clinic required me to undergo a
screening process to determine the level of my diabetes education and
whether I was emotionally and cognitively able to handle an insulin
pump. Had I not passed the knowledge portion, I would have received the
necessary education before getting approval to seek a pump. Had it been
determined that I could not emotionally or cognitively handle a pump,
the approval would not have been given. After I got my pump, I was
required to attend a training session, then do a saline trial before
putting insulin in my pump.
Had I not been required to go
through training, would I have done so? Maybe not. After all, I can
read the manual. I can watch a video. I can figure it out, darn
it! SNIP I don't know how I would have reacted to starting
out with insulin
instead of a saline trial that allowed me to make the inevitable
mistakes without consequence.
After I "went live" with insulin, I was in daily contact with
my pump trainer as she helped me adjust my basal rates and determine my
insulin-to-carbohydrate ratio. It's beyond my ken how a medical
professional can approve a pump for
somebody and just turn that person loose with no support. I did not get
training on my second pump. The pump company had a fit,
but my endocrinologist determined that I had been pumping for more than
four years at that point and, while the new pump was a different brand,
it didn't do much more than my old one. For my thirdand
currentpump, I asked for training. So many features had been added to
insulin pumps in the five years since I began using the last one that I
knew I needed to sit down with somebody and learn how to operate it.
SNIP In other words, I've finally matured and know that getting the
advice and support of an expert is in my best interests.
It's up to us to insist on proper training and support if it's not
offered to us. Don't be bashful: It's our health and our well-being and
nobody cares about that more than we do. We are the ultimate
determiners of what is best for us.
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