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RE: [IPk] Lantus v. pump

Hi Jackie,

By 'a safe place to put the pump', I meant a gym's business office or a 
locker, not necessarily your own pocket! You could be off shopping or having 
a coffee nearby if you could be confident that Sasha's long-acting insulin 
wasn't doing her wrong. I have been leaving my pump in gym lockers for 7 
years and never had a problem; as long as a locker is locked very few 
theives would risk being caught stealing. They'd have to break the locker 
forcibly, which would probably attract attention.

You haven't indicated that Sasha has trouble communicating (autism, 
developmental difficulties, etc.). Most children over age 8 that I've 
encountered are able to express an opinion about their well-being: 'I don't 
feel so good', for example. On a pump, I would think the first rule of thumb 
for gym would be to test if she feels funny, second to test every 30 mins. 
even if she feels all right. If Sasha is able to read a watch or a clock, 
you and Sasha could agree that she should test her bg every 30 minutes 
during the gym session (once 30 minutes before, once right as it starts, 
then every thirty minutes during, once when it's finished and once 30 
minutes later). You, Sasha, and Sasha's DSN would be able to create a 
protocol such as, 'If bg is over 10, reconnect the pump for a minute and 
bolus 1 u. [depending upon Sasha's insulin sensitivity, which will be gauged 
when she is no longer on different sorts of insulin] but wait until after 2 
more tests to decide to take another unit', to allow the Humalog to peak 
before more hits her system.

I'm surprised to hear you say you don't think think Sasha's consultant has 
meant to be difficult. The amount of frustration with him that you have 
shared has led me to believe that he is single-handedly destroying not only 
Sasha's quality of life but yours as well. Your only priority in life must 
be Sasha's diabetes control, not anything to do with your other children, 
your own hobbies, or anything else. You can never be 'busy' or go out to 
dinner with your husband, from the amount of time it sounds you spend 
managing Sasha's blood sugars. Other people would be requesting respite care 
by now, but you can't be sure a respite carer would keep Sasha conscious for 
3 hours.

If Sasha can't take care of herself, without an adult's help (except maybe a 
phone call or two), for 10 hours (say, going to school, going home with a 
friend and having dinner, after which she would go home for the night), the 
building blocks of self-confidence that she'll need to have her own room at 
university in 10 years or have her own flat someday aren't being laid. 
Within a couple of years--say, by age 12--if she can't ever predict when she 
will go unconscious she could become hypophobic, intentionally keeping her 
blood sugars at 10 just in order not to go low. Repeated severe hypos 
requiring Glucagon cause measurable *brain damage*. All that and Sasha's 
doctor seems unconcerned about her well-being. The Hippocratic oath says, 
'First do no harm'. The events and situations you've described over the past 
year+ indicate to me that Sasha's consultant is putting her life at risk 
every day...or am I missing something here?

Type 1 10+ years; MiniMed pumper 7+ years
Co-ordinator, Oxford University Student Union Diabetes Network
Oxford area contact, INPUT

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