as told by her mom, Betsy Sale email@example.com
My daughter, Stephanie, was diagnosed with diabetes when she was 4 1/2. For a little over 4 years, we attempted to control her blood sugars with a combination of multiple injections and using an exchange diet. The summer Stephanie turned 8, she asked for an insulin pump so she wouldn't have to take so many shots and so she could have more freedom regarding when she ate. I began to look into pump therapy, and we asked her pediatric endocrinologist what his thoughts were when we saw him in September. Without hesitation, he said no way, they're too complicated for a kid to manage. At that point I began to research the issues in earnest, and on March 24, 1998, Stephanie began pumping insulin.
The road to approval was a long and rocky one for us. I spent many hours reading everything I could get my hands on and doing on-line searches regarding kids and pumps. While there is plenty of hard evidence that pump therapy is very useful for adults, there was little information regarding children specifically. I compiled a dossier including anecdotal information from parents of others kids who pump (who, by the way, were very generous with their time and experiences), potential problems of pump therapy for Stephanie (along with suggested solutions if problems did occur), and a letter from Stephanie's third grade teacher attesting to her maturity, responsibility, and ability to problem solve.
At the same time, we began researching both Mini-med and Disetronic trying to determine which pump to purchase. Stephanie was quite impressed with the colors of the Mini-med, but I liked the water-proofness of the Disetronic. Our final decision ended up based on Stephanie's trial of infusion sets. She was easily successful with the 8mm Rapids, but was stymied by most of the others. Because her infusion set of choice was not available in quick release and she loves to swim, we decided to get the Disetronic.
We made the transition from MDI to the pump over Spring Break so I would have more time to monitor Stephanie, but by the end of the week, she was ready to go back to school and show off her portable pancreas! Things that worked well for us included pumping saline for several days prior to pumping insulin ( we learned the mechanics of the pump thoroughly before a mistake could have mad a big difference, having a support group of knowledgeable, experienced pumpers available to answer questions (our endo finally admitted to not having had any pump experience in the previous 12 years), and a wonderfully committed trainer who was available 24/7 if we needed her.
Although our experiences have not been perfect, after 3 months of pumping, there is no question that pump therapy was the right choice for Stephanie. She now eats when she wants to, not when her insulin says she has to. She can sleep in, and even occasionally will skip a meal! The instances of her being left out of school parties and birthday celebrations are a thing of the past, thanks to carb counting, and she even had her very first chocolate Easter bunny this year. You can see by the following note how excited I was, the day after Easter, 1998! Hurray! Stephanie got her very first chocolate Easter bunny, ever, today, and I thought I'd died and gone to heaven, just watching her face. I never felt I could give her even a little bit of Easter candy before (somehow "have some candy and an extra shot" seemed less than exciting). This morning we let her eat half of her bunny with her breakfast (okay, I got a little excited and let her have chocolate for breakfast) and her numbers are still running great! The pump has made a wonderful difference in our lives, already, and we're only 2 1/2 weeks into this! Praise God for pumps and carbo counting!
We have had several problems, but consider them all to be a part of the learning curve. Stephanie's very first infusion set got yanked out when her tubing caught on the swing set (now she never leaves excess tubing hanging out), and we had some minor skin irritation at the sites for a while (after that first set caught pulled out, Stephanie insisted on 6 pieces of first aid tape in addition to her tegaderm patch... talk about a security blanket!). It also took us almost a month to get a pretty good handle on her basal rates, and we still adjust them reasonably often, based on how active she plans to be during the summer break from school.
The pump's biggest benefit to our family has been tremendously improved quality of life for all four of us. With reduced blood sugar swings, Stephanie's easy-going personality tends to be prominent much more. Flexibility has again become part of our vocabulary... we don't all have to eat "on schedule". I would highly recommend pumping insulin to anyone with the dedication to see it through.