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[IP] Endo says YES to pump, but... >

Carolyn  wrote:
>She said that she would support me with the pump. 


> I told her to try and have bloodsugars in the 80 - 150 range before 
>  meals. She said it isn't going to happen on the pump....She said that 
> after having type 1 for 22 years and being 41 yrs. old that my bgs are 
> somewhat unpredictable and that there are other factors like hormones 
> and endorphins (and other stuff) that start playing a bigger role in 
> affecting my bgs. 

well DUH!!! what an idiot your doctor just proved to be!!!  You may not 
ALWAYS have a bg between 80 and 150, but then neither does an 8 year old who 
was diagnosed last week!  Yes, the hormones and "adult" stresses your are 
faced with are DIFFERNT than some whipper snappers, but that is the whole 
point of pumping.  You figure out good basals, then adjust as necessary for 
those unpredictalbe days, those hormones,

> She said it would be like this until I go through 
>  menopause then things would even out, 

I will be willing to bet there are woman on IP who are already writing to you 
to tell that it did NOT even out after menopause.  The BOTTOM line with 
diabetes and especially diabetes with a PUMP is that the ONLY constant is 
change.  You think you have it figured out and hte next day it does not work 
and you have to figure it out again.  The REASON we have the pump is so that 
we CAN adjust for those day to day bumps and groans!!!  Does she think 
menopause will be EASIER on MDI!!  How would you like to have to be battling 
the NPH peak in the middle of a hot flash?  How will you know the difference 
between a hot flash and a low - i personally get really hot and sweaty when I 
crash...and i am no where near menopause!

>  She said she would be happy if my bgs were between 80 
> and 210. 

Pooh - split the difference with her and be happy with 100 - 190!  anyway you 
cut it it is still better than a range of 60-450 or whatever your current 
range is!!!

>  My HbA1C is 6.4 but that is from a lot of lows so she wants me to 
>  get it higher. She said that I can't go on the pump until I am down to 
> two lows/week. 

pooh again.  though I do see her point.  "they" say pumpers have a tendancy 
to have a lot more lows, but in MY opinion, it is cuz stupid doctors 
encourage their new pumpers to aim for 80-120...When you are aiming for 
80...it is only a 10 point drop to 70...If you make your bottom number 100, 
then it is 30 points to 70 - more margin for error as you are perfecting your 
basals and insulin ratios!!!  

You need to raise your target range from that 80 number to no lower than 
100...and you will regain some awareness after a couple of weeks (according 
tp those with experience on this list).  Then when you go on the pump you 
will have better awareness 

>  in the past I have had a pronounced dawn phenomenom. She says that 
>  this can change and she doesn't think I have it anymore

well chart your bgs and you can tell for yourself if you have it...test 
before you go to bed, around 2 or 3 inthe morning, then again around 5 or 6 
for several days when you are eating a normal diet, not a lot of fat or 
exotic food.  If you have a pronounced rise in bg around 5-7am, then you do 
have it still.  This is not a reason to exclude you from a pump.  If you know 
what your insulin needs are for that time of the morning you can program your 
basals accordingly and WAKE UP AT 120!!! whooo hooo

>  She wants me to rent the pump for 3 months first 

whatever...it does take at least 6that long to get going comfortably on 
it...and then what, it is snatched away from youand you have to start over?  
why not find out if your insurance will PAY for it...get her to write the 
letter and tell her you will gibe HER three months to help you use the pump 
properly and if she can't do it by then, you will find a new endo!!

>  She said I was obsessive about my diabetes, probably because I 
> was so well organized with detailed records so we could talk about the 
> pump.

well i and my endo call people who shoot for super low A1Cs 
"insulin-o-holics" but since you already KNOW yours is a little low due to 
too many lows, I don't think you fit into that category...I bet she just 
feels dumb in comparison to you -she KNOWS she oughta know all this stuff, 
but she has been too "busy" to stay abreast of current trends...PUFF those 
sails back up...kick her ass and get your pump!  With 5 kids, you need all 
the flexability and door opening possibilites a pump allows!!

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