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FW: [IPp] suggestions for toddler pump start

email @ redacted

-----Original Message-----
From: David Jensen [mailto:email @ redacted]
Sent: Monday, May 05, 2003 8:45 PM
To: email @ redacted
Subject: re: [IPp] suggestions for toddler pump start

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Hello Lisa,

Our daughter Sigrid started the pump last month at the age of 17 months 
- which is very different in a lot of ways from 2 1/2, but hopefully we 
can help anyway.  When your son sees you wearing the pump, that should 
help somewhat.  However, when he's wearing it, it may be best to be 
"out of sight, out of mind".   Sigrid wears her pump in a little fanny 
pack with the pump under her tummy, and the whole apparatus is then 
tucked into her pants/shorts/whatever she is wearing.  She wears 
overalls a lot.  Partly this is to keep the tubing from catching on 
anything, but partly it's to keep the pump out of sight (from her and 
her playmates at daycare).  She still knows it's there, but it bothers 
her less.  We put the sites high up on the buttocks (with a tegaderm 
patch over the site to keep it clean in the event of voluminously 
stinky diapers).  The buttocks are good, mainly so she can't get at the 
site.  We haven't yet had a crimped or clogged Quickset.

She was rather spooked by the pump at first, (she would cry when she 
saw it, especially when she realized it was attached to her) but now 
she's much more accepting of it.  "Pump" is one of the words in her 
limited vocabulary (25-50 words?).   She doesn't complain about the 
pump - except when we're programming it (which means that we're both 
ignoring her and inhibiting her from running around at the same time, a 
combination she deplores).  She is protective of it when the daycare 
playmates get curious about it.

Don't be discouraged if your son's sugars are out of control at first, 
while you get the basal and bolus rates set correctly.  The rules in 
"Pumping Insulin" are a great place to start on guesstimating these, 
but you will need to test and correct.  You probably have a good idea 
of how much Humalog you need for corrections, but you probably don't 
know how much insulin your son needs  to cover carbs.  Sigrid uses 1 
unit for 440 points, and 1 unit for about 32 grams carbs (but she's 
only 27 pounds; your son's numbers will be different).

DO discuss diluting the insulin with your endo team.  We have found 
this to be tremendously helpful.  We dilute Sigrid's insulin to U25, 
using diluent which our pharmacist obtains from Lilly (for free!).  It 
allows better precision with small doses, and minimizes the adverse 
effects of "champagne bubbles".  We have a friend who dilutes her 
daughter's insulin (different brand pump) and found it helped 
tremendously also.  She uses U50.

We have found that the pump is NOT more work than our 4 shots/day 
routine was.  The fact that we no longer have to schedule Sigrid's 
eating has made a world of difference in our lives - and now we trust 
the insulin dosing enough that we usually allow ourselves to sleep 
through the night (when she was on shots, we always set the alarm for 1 
am to check her sugars) - and of course we don't have to give 
injections anymore (but really that's the least important of the 
benefits).  You will love this!   Feel free to write to us if you have 
other questions.

David and Maria
parents to 18 m.o.Sigrid, dx'd @ 11 mos., pumping w/Cozmo 1 mo.

Date: Mon, 5 May 2003 14:14:55 -0700
From: Lisa Clement <email @ redacted>
Subject: [IPp] suggestions for toddler pump start


Jake's pump finally arrived and we (his parents, that is) are very
excited about it! My husband and I plan to start using the pump this
week (with saline), and Jake will get started next week. Jake is 2
1/2. While we are waiting to start, we have been talking about the
pump with Jake, and letting him push buttons and hold the pump. At
this point he is mildly curious about the pump, but when I suggest he
try it on (we have two different pouches for him), he refuses, and is
not at all interested in wearing it. He is pretty clear that he
doesn't want to use the pump, even when I tell him that it means no
more shots.

Do any of you have suggestions for me? I am a bit worried that, among
all of the other pump start worries,  he is going to complain (have
tantrums) about wearing the thing in the first place!

Thanks for any ideas!

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