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RE: [IPk] Sasha''s consultant

Hi Abigail you wrote:

> one point in particular raises the issue that he is very ill
> informed: that
> the risk is of the pump giving too much insulin ( possible I
> suppose as any
> mechanical device can malfunction in  a numder of different ways)
> Whereas the real risk is that of DKA
> In a well informed and well motivated individual, or carer this should not
> happen except of course possibly in very exceptional cases eg
> nasty dose of
> gasro enteritis, or forced to evacuate a burning building and
> leave supplies
> behind, accidentally pulling out cannula during evacuation and no GPs/
> pharmacists available so 10 hour wait in casualty because it is busy and
> medics are too ignorant of DM to realise that a timely injection
> of insulin is
> important
> I think the point I am making here is that people with DM are recieving
> suboptimal care and advice due to an ill informed profession who
> often do not
> recall basic physiology

Yes I thought that too,  when I said that I was aware of the potential
problems, I had thought that he was going to discuss the issues of DKA and
not having long acting insulin on board, which I had thought was one of a
the main potential  problems.  He never even brought this up!

Also when I mentioned the problems that Sasha had had in the past with
Mixtards and the sezuires that she had due to too much longer acting
insulin.  He said that if thats a problem she has, it could be made worse
pumping, which of course is total  bo***cks.   Studies show that night time
hypoglycemia can be reduced.  I was my suggestion, last year, to split the
evening dose of Insultard and Novorapid which helped a great deal then I
also took Sasha off the dreaded mixtard and gave separate doses in the
morning too.  That caused raised eyebrows!!

The only thing I can say in his favour is that he is probably concerned out
of the best of motives.  He is rather fond of Sasha and always makes a big
fuss of her.  He is after all just a  peadiatritian not an endo  and hasnt
the expirences to be confident that pumps are totally safe.  He was going on
about waiting until there was a closed loop system where the BG measure was
linked to the pump and the pump delivers the insulin.  I find far more
scary, thinking about two different mechanisms that could go wrong.  Of
course the technology may be prefected in time but if I needed a pump I
would want to be in control of it thank you. Well at the moment at least.  I
can see many problems trying to prefect this sort of system.  We ended the
interview with me not really knowing what he was suggesting.  We were phoned
by the school in the middle of the interrogation, opps! interview with a
message to say that Sasha was feeling off colour and the bg was 14.8.  ( we
had given the school the telephone number of where we were)  The interview
was coming to an end and we were both repeating the same things and we had
to go and get the kids from school.  I think he was saying that he would
arrange for us to see an Endo that he recommended with a view to  reveiwing
Sashas current regimen.  We were still asking if this would be at a place
where they had pump expirence.  He then said, well go away and have a think
about it!!  I think I will have to phone our DSN who sat in on most of the
interview and ask what she thougt he meant.  I think she was unable to
interupt him once hed started with his negative stance.  I think she was
surprised by his negative attitude.

Jackie Mum of Sasha
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