Pumping with 3 year old Adam
by Linda Culumovic, Adam's mom lculumovic@cogeco.ca

Hello, my name is Linda, and our son Adam was diagnosed in November 1997 when he was 21 months old. He has been pumping since he was 3 with the Minimed 508 (Jan 25, 2000). Our endo is very pro-pump, and we had no trouble putting him on it.

There certainly was a learning curve - we were not really counting carbos, and had no idea what his insulin to food ratios were, etc. We also tested about 4 to 6 times a day, rarely at night unless there was a lot of activity or something unusual the day before. (He was on H & N at breakfast, then H at dinner). He had pretty good A1c's, his last pre-pump was 7.2.

We are now experts at carb counting, weigh and measure his food more (instead of guessing). We test between 8 to 12 times a day - including at night when we go to bed. I usually test once in the night again, unless he was high and we were checking to make sure he is coming down (and praying it's not a site problem!) So we definitely were sleeping better pre-pump. However, we certainly have more of a handle on his blood sugars, cutting down the lows considerably (which he is starting to feel again), the highs and have over 50% of his tests in range. The first two months were very hard, with 2 hour blood checks all day and night, and numerous site problems.

But we gradually learned how to do things and what to expect (insulin in new site absorbs better sometimes and we have to watch for lows), setting basal rates, which infusion sets work best where. His A1c has also improved, after an initial higher one (8.0 the first one after the pump), but the next one a month ago was a wonderful 6.9!!!

The benefits with food and timing of meals and sickness are more than worth the extra work. If Adam doesn't want to eat, or eats only two hot dogs, then that's what he eats. The sick days have been great, as he usually does not want to eat, and we would have trouble with the N insulin kicking in mid-afternoon! We have also kept him home with vomiting illnesses. The load off me with no more food battles - "just one more piece of bread, drink your milk, if you eat this you can have.." - I enjoy mealtimes now, and he eats what he wants. We don't let him go crazy, but if we go to a birthday party and he is grazing with all the other kids, and wants 3 glasses of juice and pizza and cake - he has it, and has come out of it with perfect blood sugars!

Adam has never complained about wearing it, and is doing well with the site changes. I can do one now in less than 10 minutes, and we change every 3 or 4 days. We are using the Minimed Silhouettes, after numerous kinking problems with the Soft-set micros. We use Emla cream to numb him, and have found the Sils stick great in the pool, bath and even on hot humid days.

I hope this has been helpful, if anyone has any questions I will answer them.

Linda Culumovic lculumovic@cogeco.ca