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Re: [IPk] Serious idea, need feedback

Nat - you hit the nail on the head. Now we must drive it home. Everyone who
goes on the pump says "Hey - wow - this is fantastic. How did I survive
before." I've been on the pump for 18 months now, and I'm beginning to
forget what hell my life was for the 20 years before that. And yet I now
find that the hell I went through is much the same as the hell everyone
else on injections goes through. Rigorously controlling activites and food
intake, whilst seeing bg's fluctuating all over the place. The freedom I
now enjoy in my life is inexpressible - and the only price I pay is a small
pump in my pocket.

How do we get this across to the professionals? As you say, we are the
experts: we know how it's done. For an inexperienced doctor to just put
someone on a pump is a recipe for disaster. There are many crucial skills
to be taught and acquired. That is the job of Disetronic and Minimed: to
train doctors, so they can train patients to be successful - and freed -
pumpers. Pump centres must be set up in each region around Britain -
centres of excellence - so everyone who wants a pump is within reach of
one. Once you are trained up, help can be just a telephone call or email away.

Many fret about the funding of pumps. This is nonsense. The money is there.
Pumping pays. It is more expensive up front and for continuing supplies,
but the total lifetime cost to the healthcare system of treatment that
person's diabetes is reduced, most importantly through reduced
complications, the treatment of which is fiendishly expensive. Harder to
price is the increased quality of life and work productivity. We are now in
a unique position of having a Labour government who are likely to be in
power for sufficiently long to see the cost benefits of this while they are
still in power: they can plan in the long term, without worrying about
losing the next election before they see the pay-back. And I believe Tony
Blair has the political will to see things in this light.

What about the disasters of the 1980's when pumps were first trialed?
(Britain lead the world here). Pumping of today is nothing like it was
then. The pumps themselves are immeasurably more advanced. The
insulin-friendly tubes. The teflon infusion sets. The convenience of
detachable infusion sets undreamt of then. Bg testing is now ubiquitous.
And the arrival of Humalog clinches it, since you can immediately correct
and control your bg.

In the 1980's, pumps were targetted as a treatment of last resort for the
difficult cases, for whom nothing else worked. The indigent. This is
misguided. Pumping needs care, and without a certain level of
responsibility it will fail. There was a famous case of an alcoholic put on
a pump. One night, after 18 pints of beer, his infusion set fell out. He
was up all night vomitting, but that was normal. In fact it was DKA. By the
morning he was dead. This really frighten the doctors: if a patient can die
this easily on a pump, we can't endorse their general use. In fact, you
must just take better care targetting who uses them. These risky people
don't make successful pumpers. But the other 90% of the population do.

The internet is a major force of good for pumping. Experiences can be
shared, advice given and taken. Incidently, I had _no_ training when I went
on the pump. None was available. I learnt all I needed through Insulin
Pumpers - the US version of this list. What I desperately want it to get
doctors - diabetes specialists - to join this list. I have invited - even
pestered - several that I know quite well, but they are reluctant to do so.
What are they frightened of? Learning something? Seeing themselves
criticised? Seeing themselves effectively done out of a job? I'm delighted
that we have several DSN's on the list now. More will join soon I believe.
This is excellent. But there is an awful lot of evangelising that we must
do to spread the word.


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