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Re: [IP] Them's FIGHTIN' words!!!!

At 05:37 PM 10/03/1998  email @ redacted wrote: 
>The folowing excerpt was sent to me by a fellow Pump Proponent 
>(mom of a successful pumper) who was outraged by the response 
>given to an inquiry about pump therapy by a 12 yr old. Anyone 
>else care to tackle this? By the way, the doctor who responded 
>2nd (be sure to scroll all the way down) had responded in 
>comparable fashion about 6 months ago. 2 other "pump moms" and
>all wrote to express our dismay at the MISinformation being 
>disseminated regarding kids on pumps. Needless to say, he did
>take too kindly to our criticism!!!.....Now that this IP group
>nearing 600 members, including some "pint-sized pumpers" who
>considerably younger than 12, I think this Dr. needs to
>his horizons".

My initial reading of these doctor's statements was that they
were just covering their backsides. Since they were responding
to a 12 year-old, they had no idea of what parental involvement
was involved behind the question. If they came right out and
said "sure... go for it, kid", then they could potentially have
two angry parents crawling all over them. Changing therapy is
truly a family decision... after all they are going to pay for
it and they will have to monitor what is happening after the
pump is installed. 

With that said, I disagree with their descriptions concerning
the complexity of the pump. If you don't mess with the basals,
then bolusing is parallel to taking a shot. If you can manage
MDI, you can manage pumping. Learning how to suspend the pump
and basic care takes about 30 minutes. Even a reasonably bright
6/7-year old can learn it. If a parent helps with set changes,
then even that is not terribly complex, especially with a little
bit of education from a doctor or a CDE.

I also think that some doctors just assume that the average
patient is pretty dense. Maybe from their perspective it may
seem that way... but based on this group, pumpers seem to be way
ahead of the curve. Any diabetic who is not self-motivated and
ready for managing his/her own therapy is in deep trouble. 

I know that doctors assume that most patients are non-compliant.
But I think that "non-compliance" is too broad of a term. Yes,
there are some people who are in total denial and have very
self-destructive behavior. But I'll bet that some non-compliant
people just live life-styles that make compliance very
difficult, if not impossible. Other so-called non-compliant
people are really trying the best that they can, but MDI just
doesn't work well enough for them.  Pumping could actually be an
answer for many of these people. The problem is that most of
these doctors are not diabetic. If they were, things would look
a lot different to them. 

Because of their prejudices, these doctors seem to think that
pumping is only for reasonably compliant people who for some
reason seem not to "take" to MDI therapy. What I really disagree
with, is the attitude that pumping is a therapy of last resort.
Only if nothing else works, then try the pump. I understand that
not everyone has the financial resources or the insurance
coverage to manage the extra expenses of pumping. But, given
that a family can afford to obtain and maintain the pump, then
the pump should be held no less than fully equal to MDI therapy
(I personally think it is better). 

Basically people fear what they don't understand. It is obvious
that these doctors do not truly understand either pumping or the
psycho/personal aspects of the disease they are treating.

[now stepping down off of my soap box...]

Insulin-Pumpers website http://www.bizsystems.com/Diabetes/