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Re: [IPk] RE: A big MOAN

Hi Pat,

Can you clarify the role of the statisticians?

I guess I see the consultant as the one who approves the use of the pump, 
but the specialist nurse is the one I always approach on a day to day basis 
if I have any issues regarding control....

BTW I had a dream last night about scubadiving with a pump, I still don't 
know if we have the go-ahead to scubadive, but what would I do with my pump 
(ie minimed that isn't waterproof)?



>From: Pat Reynolds <email @ redacted>
>Reply-To: email @ redacted
>To: email @ redacted
>Subject: Re: [IPk] RE: A big MOAN
>Date: Thu, 17 Jul 2003 20:10:45 +0100
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>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!
> >Di
> >----------------------------------------------------------
> >for HELP or to subscribe/unsubscribe, contact:
> >HELP@insulin-pumpers.org
>Pat Reynolds
>email @ redacted
>    "It might look a bit messy now,
>                     but just you come back in 500 years time"
>    (T. Pratchett)
>for HELP or to subscribe/unsubscribe, contact:

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