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[IP] training



Tom wrote
> I had minimal training for my pump. I spent about an hour with the 
 > trainer....SNIP I had read "Pumping Insulin" - well, actually I pretty
much
 > skimmed through it SNIP  if I had to contact somebody every day about
what
 > I was doing, I'd have gone bonkers. I appreciate the fact that I was
turned
 > loose with some good advice. I would have hated it if I had to go through
the
> intense counselling and training this author describes.

 Yes, you are right, it is a YMMV issue, and is this a great country or what
when you have the freedom to take care of yourself however you want, and you can
choose to read the manual, get training or not?  However I think Jan has
nailed it - Tom, you were diabetic a full 12 years before you got a pump - I was
diabetic for 18 years, and we both had years of experience dealing with highs
and lows, figuring out what went wrong, compensating for food and exercise and
heat.  I think the article is speaking specifically about newly diagnosed
patients, and I consider under 3 years as newly diagnosed, and NOT just kids,
who simply won't be able to grasp ALL the minute details that go into taking
proper care of oneself.  And adding a mechanical device that is subject and
prone to user error into the mix?

 Figuring out basal rates and Insulin to carb ratios and how to adjust for sick
days and how to trouble shoot a high blood sugar are NOT things everyone will
just pick up after being given the diagnosis.  For those first few years,
there is a learning curve...you find out peanuts don't raise your blood sugar at
all for about 8 hours...you find out black coffee makes you go high if you don't
take insulin for it. You find out the difference between eating an orange and
drinking orange juice. You find out what happens if you go to the gym without
breakfast or glucose tabs.....

 Oh sure, lots of people are tech savvy and can pick up the ins and outs of the
mechanical device quickly enough...They can probably plug in their DVD players
and have the sound come out over the stereo speakers!!  Maybe they already
know lots about diet and how their body works, and can carb count an I/C ratio
of 1:17 (not easy math, but I can do it), but I agree 100% with Jan. 
Simply throwing a pump at someone who has not been diabetic a while, and saying
"here - this is the best way to take care of yourself....here is how you fill it
up and attach it" is like throwing the keys to the HUMVEE to the kid who, just a
few months ago was going to his senior prom.  We work up to situations we
can handle.  Yeah, I had formal, in-hospital training 15 years ago - many
might consider that excessive and unnecessary, but back then, the insurance
companies paid for it, and I left that training and drove up to Disneyworld the
same day.  I
  was confident enough in my abilities and knowledge of how things worked so I
did my first site change in the medical clinic of Future world (how
appropriate), and I ate junk, junk and more junk and never had a problem
adjusting my insulin.  Since then I have never had a pump related issue I
couldn't trouble shoot myself. I did not have formal training for the subsequent
507 or 508...but I knew enough about how longer acting insulins worked to figure
out how to do a square wave bolus, and I knew how my body reacted to Chinese
food, so I was able to figure out the dual bolus.

 With my new 522, there is a lot of new stuff, and Medtronic provides the
training free of charge...the trainer will have it easy with me, as she won't
have to explain things about insulin on board, or kinks in the cannula or air
bubbles or how to make the canula stick to my sweaty belly....we can stick to
the technical advancements in the pump itself, and hopefully soon, the CGMS...

 I am so grateful for the pump, as I know many of you also are, for yourself and
for your child, but I bet most of us who "suffered" along with testing our pee
and using the exchange diet and the old style "sliding scale" on insulin and
juggling NPH and MDIs had a quicker understanding when we finally did get a pump
most of those who have been diagnosed for less than a few years.  And yes,
I know there are some pretty amazing people out there who take to the diabetic
lifestyle immediately, no problem, but personally, i have always pushed the
envelope....see how much chocolate I can eat before my meter says HI...how long
can I run on a LO Battery warning before the pump completely dies....how long
can a really good site last.....how to figure out if I am low cuz I worked out
too long, or if I just ovulated, which has the drastic effect of lowering my bg
about 100 points from no matter WHERE it was.

 Time and experience will never be replaced by a manual...and good training is
key. Yeah I would hate for the training to be mandatory, but I would also hope
that everyone knew their own capability and knew when to ask for
help....watching the video and reading the manual are NOT enough to troubleshoot
some of the questions that arise, and which as Jan pointed out, people come here
are constantly looking for help....."I can't seem to get my sugar down." 
and all the same responses...canula kinked, site old, insulin bad, air bubble,
gastro, pms, are you sick......sure, it is great to commiserate here, and get
ideas and suggestions and share experiences, but some of the bottom line issues
are simply solved by Time and Experience...and good training :-)

and YMMV 

SSP
.
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