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Re: [IPk] RE: A big MOAN

I think I understand this attitude, but .... as professionals, I expect
them to keep up to the level where they can look at a patient and say
'A) their control isn't good (either in terms of hba1c or quality of
B) I've tried every trick in my book
C) I know sod all about pumps, but some folk are saying that they can
solve problems that other treatments can't

I'm not saying they then have to authorise a pump, or supervise its use
- just that they should know enough to say 'I don't know enough', and
refer the patient on.  

I agree with the others who have commented that the pump consultant has
very little to do.  Indeed, I think that most pumpers do not need to see
their consultant on a regular basis.  Instead, the bloodwork and
circulatory tests should be done quarterly at the GP practice, which
should alert the hospital should anything be abnormal.  

Specialist pump nurses should see a patient three or four times (to go
on saline, to go on insulin, and once or twice after) to induct a
patient, and 24/7 cover should be available from the pump nurse team,
for emergencies.  There should also be specialist dieticians and
statisticians who could be consulted (probably via email or phone,
rather than in person).  Both specialist nurses and a small number of
specialist consultants should, of course, be available for 'on demand'
appointments, phone calls and emails - which would mostly, I think, be
for advice on special circumstances such as pregnancy, etc.  They would
also be available to GPs and to other specialists treating the diabetic,
who want to know how the pump should be used during their treatments.

I am next due to see Dr. Pickup on 1st September, when I've just about
decided to be in Italy - perhaps I should suggest that he should simply
ask my GP for the blood work, and decide for himself, on the basis of
that, whether or not he can say anything of use to me?

Best wishes to all,


In message <email @ redacted>, Diana Maynard
<email @ redacted> writes
>I think from the consultants' point of view, a lot of them are scared to 
>look after people on pumps because they feel they don't have sufficient 
>knowledge, which is understandable. They have to take time to learn 
>about pumps, and many of them would rather not have to. Can you imagine 
>if they gave you some bad advice about doses or something and something 
>terrible happened? They don't want to take that risk. Of course, I don't 
>  condone this attitude, but I think it helps if you can see where it's 
>coming from. I think that's the reason a lot of consultants won't 
>recommend pumps for people, because they themselves are worried they 
>don't have the knowledge.  I know that doesn't help much though!
>for HELP or to subscribe/unsubscribe, contact:

Pat Reynolds
email @ redacted
   "It might look a bit messy now, 
                    but just you come back in 500 years time" 
   (T. Pratchett)
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