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Re: [IP] Give Them a Writen List of Your Medicines ER LETTER

You've added some very good suggestions of more information we should carry
on our person in case of medical need.  It's certainly best to be over
cautious where our health condition and needs are concerned.  A doctors
signature is a real plus in relation to our pumps until he/she can be
reached in the case of an emergency.

Anyone have other ideas or important additions to add to Rodney's letter?

Shirley (NJ)
email @ redacted

Subject: [IP] Give Them a Writen List of Your Medicines ER LETTER

>         NAME             uses and insulin pump to meet his needs for
> because of Type 1 Diabetes Mellitus. The insulin pump delivers insulin in
> way that more closely mimics release by the normally functioning pancreas
> than does one or two injections a day.   NAME      's pump matches his
> insulin needs as determined by history, blood glucose levels, food to be
> eaten, and expected exercise. Normally,   NAME           checks his blood
> glucose levels with a home glucose meter and adjusts insulin deliver to
> maintain as near normal blood glucose levels as possible.
> Insulin is given two ways via the insulin pump:
> Basal Rate: a continuous insulin infusion, the amount of insulin the
> requires to maintain a normal metabolic state when not eating.
> Bolus: the insulin infused with food intake. NAME     has been taught to
> adjust this depending on blood glucose levels, food to be eaten, and
> expected exercise.
> Leave pump in place. Continue basal rate, even if   NAME       is unable
> eat.  NAME    is infusing NovoLog Human Insulin Analog U100.
> His set basal rates are as follows:
> 23:59 to 04:00  units per hour        12:00 to 13:00  units per hour
> 04:00 to 06:00  units per hour        13:00 to 18:00  units per hour
> 06:00 to 08:00  units per hour        18:00 to 19:00  units per hour
> 08:00 to 11:00  units per hour        19:00 to 20:00  units per hour
> units per month to fill tubing
> 11:00 to 12:00  units per hour        20:00 to 24:00  units per hour
> basal  bolus =/-9% =   Units
> Allow     NAME      to test his own blood glucose levels with a glucose
> meter and adjust bolus as he has been taught. Bolus will be adjusted as
> follows:
> 1 unit insulin to     grams of carbohydrate High blood sugar bolus 1 unit
> drops     mg/dl
> <70 mg/dl Subtract 1 unit from bolus
> 70 to 100 mg/dl No Adjustment
> Every     mg/dl above     mg/dl Add     unit
> Every     mg/dl above     md/dl Add     units
> If     NAME     need to bolus to counteract a high blood glucose
> NAME     will check his blood glucose levels every two hours until it
> returns to normal plus 4 hours
> If     NAME     is ketotic, it probably means that his pump is not
> functioning properly or is blocked or been removed. Have     NAME     do a
> site and pump check, if problem is found he will do a change as he has
> taught. Have     NAME     check his blood glucose every 2 hours and bolus
> above.
> As noted previously, continue the basal rates if     NAME     is unable to
> eat. Blood glucose levels should be checked, by     NAME     if possible,
> every 3 hours, and boluses adjusted as above.
> *DO NOT DISCONTINUE PUMP without giving insulin by another means.
> NAME     will have no insulin and will develop ketoacidosis. If pump is
> discontinued,     NAME     will immediately need Regular Insulin.
> *Blood glucose measurements used to determine bolus adjustments must be
> current. It's much safer to make adjustments from     NAME's reading than
> wait for blood glucose results from the lab. NAME     has been trained to
> this, and routinely does 15 times a day, so it is second nature to him.
> *The exceptions to this rule are if there is a doubt about     NAME's
> ability to perform intelligently or if there is concern about the accuracy
> of the glucose meter.
> *If     NAME     has an infection or is under stress, blood glucose levels
> may go up. Continuing the basal dose and covering high blood glucose
> with boluses is a reasonably safe way of doing things.
> NAME's Medical Problems:
> Type 1 Diabetes Mellitus, treated by external pump delivering continuous
> subcutaneous insulin infusion.
> Gastrointestinal autonomic neuropathy, with severe Gastroparesis and bowel
> dysmotility.
> Diabetic Peripheral Neuropathy.
> Diabetic Retinopathy.
> Diabetic Nephropathy
> Frequent and severe hypoglycemia and the induction of seizure activity,
> being precipitated in large part by the erratic and unpredictable
> of foodstuffs induced by the gastrointestinal motility disorder.
> Loss of Left Eye.
> Allergies:
> Name:                         ADDRESS
> PUMP:Minimed sn#
> Omaha, NE 68105-2315
> MM508
> 800-826-2009
> Health Insurance Info:
> Birthday                                birth place         mother name
> Endocrinologist:                             Clinic:###-###-####
> Endo:###-###-### Pager:###-###-##
> PCP:  Clinic:
> GI:
> Dermatology:                                     Podiatry:
> Eyes:
> Pharmacy:
> Hospital:
> Tonsils & Adenoids (1968)
> Nose DS at (1976)
> Diabetes Mellitus Type 1 (5-20-77)
> Severe Gastroparesis at (1980)
> Started on Insulin Pump 10-7-1980
> Hands: Carpal Tunnel in 1991 RIGHT - 1992 LEFT
> Trigger Fingers:
> Stopped working April 10, 1998 on Total Disability Social Security.
> Pick-lines since 1987 for Erythromycin IV on/off since.
> Port left side placed in 1998 for TPN
> Major infections 5 times in 1998
> J-tube placed 1998
> Allergies:
> Dental
> Drugs & Meds:                         (SAMPLE OF THINGS) Drug    dose
> doctor
> NovoLog Insulin
> Minimed 508 insulin pump S
> Infusion Set (Silhouette or Quickset) 1 every 3 days SHIP
> Batteries as needed SHIP
> Cartridge 1 every 3 days SHIP
> Skin Preparation: SHIP
> Skin Prep as needed
> I.V. Prep as needed SHIPN
> Unsolve as needed SHIPN
> Hibiclens Soap as needed SHI
> Transparent Dressing as needed SHIN
> Glucometer Elite Meter & Strips 14 AVE daily SAN
> Glucagon ER Kit 1mg as needed SN
> Acetaminophen 500mg as needed HUS
> Enteric Coated Aspirin 325mg 1 daily HUS
> Vitamin C 500I.U. 1 - 3 x daily HUS
> Vitamin E 400I.U. 1 - 3 x daily HUS
> Centrum Vitamin 1 daily HUS
> Flonase 0.05% 1 - 2 x daily HUS
> Allegra 180mg 1 daily HS
> Pancrease Capsules as needed Ave 12 DISE
> Metronidazole 500mg 1 - 3 x daily DIE
> Doxycycline 100mg 1 - 2 x daily DIE
> Lac_Hydrin 12% lotion 400gm 1 daily PAAN
> ---
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> ----------------------------------------------------------
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