Saturday, May 8, 2010

One of Many Decisions

OK , I'm getting there with this overnight thing. The past three nights I have alternated the basal rate, which for the most part has worked out except for the fact that Thursday mornings wake up blood sugar was 189, Friday's was 60, and this morning 72!?  A little confusing, but we're getting there. I'm worried about that one 60 morning and if she sleeps late. During the day her numbers have been very good.

This situation has brought on a new dilemma for me though. S's pump warranty is up in August and she can get a new pump. We had decided to go with the omni pod. S is a very active kid and the tubing is a pain. She loves the idea of the omni pod. The problem is that it makes the same jump as the medtronic pump. You can only go from .15 to .20 and S really needs something in between. At our last dr. visit they told me that medtronic is coming out with a new pump that will include the smaller increment in delivery. Now what do we do??!!!!! S is eight now and this pump will stay with her until she is 12.
 Part of me thinks the right thing to do is get the new medtronic to ensure better control, but the other side of me thinks of S as a little girl who is growing up. I anticipate that the older she gets the bigger deal wearing a pump will be. Nothing with diabetes has ever really bothered S except for the CGM (that is a story for another post). I imagine that when clothes matter more the pump will bother her,  along with a lot of other things that we Moms and older diabetics all know suck about diabetes.I also don't think she will need that smaller increment for very long. She is a tiny thing, but as she grows I don't think that small amount will matter as much, but we will be committed  to it for four years. Of course control of her numbers is the most important thing, but I can't ignore the importance of her social- emotional well being. She is such a happy easy going kid and I don't want diabetes to change that in her. I often think about the pre teen and teenage years with D. It is usually a hard enough time for kids never mind having to monitor everything you put in your mouth, checking BS constantly, keeping track of site changes, and choosing your clothes based on some tube hanging off your body. Just to name a few.

If anyone has an opinion on my situation or thoughts on either one of the pumps I mentioned I welcome your thoughts and comments. Thanks

9 comments:

Unknown said...

Hi Yvette!

Just found you through my blog...LOVE your set-up over here!!! Nice blog.

I don't have a strong opinion on either of the mentioned pumps. I am a DIE HARD Animas lover. My son Joe (7 years old) was diagnosed when he was 3 years old...has been on the Animas pump since he was 3 1/2...and we love it. It has the "smaller" basal increments that you are refering to...you can change the basal in increments of 0.025 units/h...pretty sweet deal for sure. I am a substitute school nurse and have experience with both Animas and Medtronic...and I find the Animas more intuitive. Also, their customer support ROCKS!

Hope to see you around...I am going to add you to my blog roll if that is OK.

Unknown said...

TOTALLY fine...on adding me to your roll.

YEPPERS...we are in Vermont. So nice to have someone close to me in cyber-space. Most of my "buds" are in the South and West. So, it is nice to have someone geographically close. Looks like our kids are similar in ages...My daughter Bridget is 8 (will be 9 in the summer) and Joe just turned 7...also looks like both of our kids were diagnosed at 3.

Are you on FB?

Wendy said...

Hey There!

I just found you via a comment on Reyna's blog. I have 3 daughters -- my oldest, Addy, is 6. She was dx with T1D almost 5 years ago (7/25/05) at the age of 24 months and celiac in 12/08 at the age of 5 yrs. (On a side note, I was subsequently dx with celiac in 9/09).

She's been pumping for almost 4 years and our warranty is up in January 2011. She started with Cozmo, but we switched to the Animas Ping after they went out of business last year. We paid out-of-pocket for the Ping when they offered a very inexpensive option for Cozmo pumpers to make the switch. So...our insurance warranty is still in place and we are still required to get a new pump when the original warranty period expires.

I COMPLETELY understand your dilemma. I have been intrigued by the OmniPod since it hit the market (as you know, it wasn't an option 4 years ago). The ONLY thing holding me back is OmniPod's IOB feature because it does not keep track of active insulin for carb boluses (only for corrections)...I can't tell you how many times we've caught a low thanks to IOB. WAY TOO MANY to risk giving up this feature.

I guess the other hesitation I have is that you can't give a bolus from the pod itself. Not that we're careless people, but, admittedly, we've forgotten Addy's Ping remote when switching bags or whatever...with a traditional pump, you can still bolus from the pump itself. We tend to keep back up meters all over the place so chances are pretty good there's a One Touch Mini and strips somewhere around for sugar checks. Unfortunately, if you forget or misplace that OmniPod PDM, you can't bolus. Period.

Anyway, I've heard conflicting information that Omnipod is considering a change to the IOB feature...until that happens, that one will not be an option for our family. We must have IOB for carb boluses. Period.

Having not had access to the micro dose with Cozmo and then switching to Animas where it was an option, I can honestly say that it has made a HUGE difference. I didn't realize how much we needed that 0.025u. She's almost 7 and I honestly don't see us NOT needing that increment anytime soon.

Anyway, sorry to hijack your post :) It's nice to "meet" you.

If you're on FB, you can connect with other D Moms here:

http://www.facebook.com/#!/group.php?gid=115286298509368&ref=ts

God Bless!

Wendy said...

Me again...sorry...

I forgot to address one of the issues you brought up.

Having a daughter, I completely relate to the "clothing issue". On Cozmo, we had to access her pump for everything, including sugar checks.

It made dresses kind of complicated.

The Ping remote has revolutionized that issue. Unless I'm making changes to her pump settings, I don't need to access the pump AT ALL. She wears jumpers and other stuff that we'd hesitate with before, because of needing easy access to the pump. I also found a pump pack that keeps the pump close to her body and lays flat -- you wouldn't ever know she's wearing one.

I'm not kidding when I say that she'll go through several site cycles and I don't touch the pump itself ONCE!!!! It's really nice at night when you need to give a correction :)

This is the pump pack she wears most often:

http://www.pumpwearinc.com/pumpshop/index.php?l=product_detail&p=1284

It expands and could easily hold her remote, clicker, strips, and some Starburts/sugar tablets if you wanted to put it all in there.

Also, since Animas is waterproof, we don't worry about the pump around water. If she's at a splash pad or water park, we just leave it on and keep the remote protected from water (the remote isn't waterproof). If, however, she's swimming hard -- like for swim lessons or spending alot of time in the deep end, I'll take the pump off simply to balance blood sugars with activity.

Ok...I think that's all. HAPPY MOTHER'S DAY!

katerina said...

Omnipod is going to have a new pod by the end of this year-they say- 40% smaller and improved. If I were tou I would check this out as you are talking of long term commitment. Actually another D-blog mum wrotte about it today if you want I can look it up and tell you who she was. Anyway happy mothers day!!

Wendy said...

Hey There :)

Thanks for the sweet comment!

To answer your question regarding the IOB issue...

OmniPod does NOT keep track of active insulin from carb boluses. So, if you were to give multiple boluses to cover carbs close together, it will NOT keep a running tally of how much insulin remains active.

It will NOT consider IOB after you enter a blood sugar when calculating the next dose....UNLESS that insulin was given from a correction. It will ONLY provide IOB information for correction doses.

That was the dealbreaker for us. Losing the PDM is just another reservation I have, but I wouldn't rule out the OmniPod based on that alone. IOB, however, is a different story.

No IOB for carb boluses = No OmniPod for Addy.

Wendy said...

Feel free to contact me anytime!

You can leave a comment or e-mail me...
candyheartsblog@hotmail.com

Also, here are a couple of moms who have experience with the OmniPod in case you'd like to contact them with questions:

Lorraine - http://thisiscaleb.wordpress.com/
Laura - http://thehoustonfive.blogspot.com/

Nice to "meet" you :)

Sarah said...

Happy Mother's Day to one of the most giving, caring, loving, considerate, moms I admire!

Rick is okay, kind of out of it but in a good facility. i hope you enjoyed your day.

Anonymous said...

I've been reading your posts and your concern regarding basal increments. Have you considered or tried alternating the basal rate each hour? ie: .15, then .20 then .15, then .20, etc. Over a longer period you would achieve the same total insulin delivery as with .175 over the entire period.

Caleb has used the OmniPod for more than three years. He or I are happy to answer any questions you have. Feel free to email me if you would like. Good luck with your decision!

PS - Thanks for the shout out, Wendy. :)