To pump or not to pump.....

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To pump or not to pump.....

Postby Kirst » Mon Aug 14, 2006 12:29 pm

I've been T1 for 20 months and my educator has suggested a pump... I have no health care and am a single mum - does the cost outweigh the benefits? Is it really much better. I don't find the needles to bad and the thought of having a needle in me all the time is scary.. There is so much crap to wade through on the internet I was hoping someone may have some good links to some useful information... Thanks
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Postby Guest » Mon Aug 14, 2006 1:15 pm

If the question is....to pump or not to pump?

The answer is.....to pump.
"I'm the bad thing that happens to good people"
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Postby artemis » Mon Aug 14, 2006 2:55 pm

Kirst, I made the decision to get a pump, and for me that meant I had to join a health fund. You only need basic hospital cover for 12 months to get a pump, and as they cost around $8K, it makes sense to do this. Even for me, with a BIG age loading, it was the right thing to do.

My endo had been telling me for years that I should get a pump. Then I moved away to country NSW, and just continued injections but my control was always labile - low, then high, then low - no pattern. I finally went onto Lantus (with help from my Dad - he paid for that while I paid for the PHI). Even though that was much better in terms of BSLs, when I moved back to civilisation and went back to my 'old' endo, I just about had my 12 months membership up, and with help from the endo, and a great D/E at John Hunter Hospital, I went onto the pump just before Christmas last year. It's been the best thing I ever did in relation to diabetes.

If you really can't afford PHI, try approaching a local service club, such as Lions, or Rotary, to see if they would be prepared to help you obtain a pump. Good luck, whatever you decide.
Jane
Infundo ergo sum.
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Postby Rebecca » Mon Aug 14, 2006 3:14 pm

i was against getting a pump when i first heard about them when it was suggested that i get one. as i also didnt want a needle in me constantly. but i got one and i'll never look back it is the best thing that i have done. My diabetes was soo out of control before i got my pump. Now that i have moved out of home and working full time it is much easier with a pump as i dont have to worry about food and my bsls are no longer on a rollarcoaster. I have health insurance and so that helped me as i didnt have to pay for the pump. It is the best thing i have done for my diabetes. I dont have a perfect hba1c yet as i dont use the pump to the best of its abilities. but i no longer have hypos half the time and high the other half.
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Postby Tash » Wed Aug 16, 2006 10:37 am

I would vote to pump too!

I was worried about the price... but as someone else said... just get yourself private health cover and wait for 12 months... then you get your pump!

You wont regret it...my levels have been sooooo much better with a pump.... and best of all...I get alot less hypos!
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Postby Matt » Wed Aug 16, 2006 11:08 am

Pumping is definately the way to go Kirst. But in my opinion it's not worth forking out $8000 for. Definitly get Private Health cover and wait the 12 months.
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Postby Guest » Wed Aug 16, 2006 11:28 am

Yeah forking out money is no fun. Best also not to live in a country where they don't fund anything so you have to fork out for pump....and consumables...
"I'm the bad thing that happens to good people"
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Postby abs » Wed Aug 16, 2006 11:36 am

no pump here... more than happy on the 4-6 injections/day
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Postby Kate » Wed Aug 16, 2006 11:50 am

I would discourage forking out the full cost for a pump (I hope your educator wasn't suggestign this?!) but when you look at 12 month waiting period on health insurance (you only need basic hospital cover), that is a rather different amount to fork out which turns the tables.

I started pumping 5+ years ago (when it was VERY expensive as you paid full cost for all supplies, several hundred bucks a month, and I had to go through some messy stuff with my family to get them to help!) .... but definitely wish I'd got onto it earlier!

This article gives a quick sum up of the pros and cons of pumping and also compares it to to your other options:

www.realitycheck.org.au/insulindelivery.htm


Good luck, Kate
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Postby Bethylated Spirits » Wed Aug 16, 2006 12:30 pm

Can I ask... roughly how much does it cost each of you once the initial outlay is paid, as in all the supplies and so forth?

Say right now I pay $2.40 a week for insulin, $2 on bloody jelly beans, the needles and pens are free and I pay perhaps $3.20 a week for strips. So at the moment I pay roughly... $7.60 a week to manage my diabetes!

That's not including my meter because my health insurance pays for it and not including lancets because I have enough of them to last me 10 years and I never paid for them in the first place, oh also not including glucagen kit because in the last 11 years I've used one of them a total of ZERO times... if I ever develop hypo unawareness perhaps I'll start buying them again, but yeah not counting them either... so that's $7.60 a week compared to...????
Ongoing costs have been the main thing that have put me off having a pump, i always just thought they were a bit high, no?
Okay, who put a "stop payment" on my reality check?!
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Postby Tash » Wed Aug 16, 2006 12:44 pm

Well.... insulin would cost less.. because you would no longer need long acting..so you would only need to budget for whatever you pay for short acting....

As for pump supplies... this is my break down

Lines cost $12.50 for 10... so if you budget for 3 a week... this covers any mess ups... bad sites etc... thats $3.75

Reseviours are bout $8.00 for 10...you can re use these big time... but even if you use say one a week thats 80c

Batteries are the biggest expense I guess..mine takes 3 357 batteries about every 3 to 4 weeks....I get them for free as a mate owns a Mister Minute...but if I paid they would be $10.50 for 3.... so thats $3.50

I also choose to use IV prep pads to cover my site..making it last longer in showers.... they are $75 for a box of 100...Id use 2 a week... so thats $1.50

Alcohol swabs (if you choose to use them) are $5 for 200...so 2 a week would be *thinks*... 5c!

Thats a grand total of: $9.60 a week (not including my insulin and test strips)

Yah for the NDSS! *grins*
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Postby Kate » Wed Aug 16, 2006 8:59 pm

Or if you have a Paradigm, you use normal AAA batteries which last about 6 - 8 weeks each (and I use the backlight heaps, so probably shoudl last longer) - and they're about $2 each I think, so 25c a week instead of Tash's $3.50. Also I only use 1 set a week so that's $1.25/week, so that comes to, $3.85/week for pump stuff. Plus insulin and strips.
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Postby Mrsmac » Wed Aug 16, 2006 10:37 pm

Another vote to pump here! I got mine just over 2 years ago and it has changed my life completely. I joined private health insurance mainly so I could get one, waited the 12 months then did my homework. As expensive as private health insurance is, when you are given a $8000 insulin pump, it kinda makes paying those premiums not so bad......!

I find have a lot more flexibility - some days i am so busy with the kids, I would be hypoing all day long if I was still on injections. Instead I just run my basal at a reduced rate until I can grab a meal. I also do a lot of fitness training and this makes life a lot easier too.

Good luck with whatever you decide!!
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Postby AndrewR » Thu Aug 17, 2006 10:31 am

I'm debating about this move too.

Costs are not too much of a concern, I've been on top table Private cover since the 'lifetime health cover' came in.
Interested though in the pro's and con's of going for the pump...
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Postby Kirsty » Thu Aug 17, 2006 11:13 am

I am doing the deed!!! Pump Day 12th September YEH YEH
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Postby kimmy » Mon Aug 21, 2006 12:06 am

I'm also considering going onto hospital benefits purely to get the pump. Have been insulin dependent for 22 years and needles don't bother me, have been in great control up until now (2 kids has destroyed my diabetes!).

I have never heard anyone say they don't like the pump. So I'm convinced it's good. But carrying it around 24/7 concerns me - sleeping with it and not being "free" bothers me. I suppose though, if it will help control, who cares?

But I haven't yet heard anyone say it has improved their HBA1c levels. This is my ultimate goal - could anyone on the pump give me an idea on how their overall control (ie: HBA test results) have improved, or not?
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Postby abs » Mon Aug 21, 2006 1:17 pm

Kimmy, there have actually been a handful of people who have stopped using the pump, at least temporarily !
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Postby Phil » Mon Aug 21, 2006 1:45 pm

Kimmy

It has improved my feelings of control and so I think this has helped overall. I have been on the pump for just over 12 months and my results have gone from 8.4% in July 2005 to my last reading of 6.8% without really trying. The figure from July was the best I had ever achieved and prior to this I usually hung around the 9% mark. I think the pump suits my personality. I feel more able to influence what is happening. With MDI, I always was behind the 8 ball as I woke up high and battled all day to get it down to a good level only to find myself high the next day. I cant see myself ever wanting to go back.

Phil
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Postby Carlie » Mon Aug 21, 2006 3:03 pm

Hi Kimmy

Ive also been pumping for just over a year now. My HbA1c went from around 9.3% I think it was to my first three month check of 7.2%. I was ecstatic to say the least. Pre pump I never was under 9% (in 15 years of D) and since the pump my level has hung around 7%. I still love the pump and 'carrying it around 24/7' as everyone says really hasnt been an issue for me.
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Postby melbel » Mon Aug 21, 2006 4:04 pm

Hi Kimmy

I have been pumping for two and a half years now...my hba1c pre pump was 8.6 (my highest ever being 10.5ish at one stage) and dropped to 6.5 at my first post pump Hba1c...with alot of intial effort going into the finetuning but after that very little effort on a day to day basis. As for having something attached 24/7 I pretty much forget its there until it buzzes at me to remind me to test or something and only have to really attend to it once a week when I do a site and reservoir change. BTW as far as cost go the Cosmo also uses AAA batteries (one of ) so also is cheaper than some other pumps battery wise
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Postby Anne » Tue Aug 22, 2006 8:23 am

Hi Kimmy,
I have been pumping since 1996, except for about one 'year out', when i took a year out, went on Lantus and decided to stay disconnected.

The pump allows very fine tuning which means you get 24/24 cover, without highs or lows even if you fast, if you manage to get it really right.

Being connected 24/7 is quite strange if you think of it, but after a while most people forget they are attached to a pager. The advantages outweigh the occasional inconvenience. For me, thinking I have a hoice makes it more acceptable. See George's experiment off the pump in a different thread.

I find that at times I want to disconnect and discovered after 6-7 years of pumping that I can take a day off (go on old fashioned MDI, I just guess some doses) so that I can wear a special dress for a special occasion, or even take a week off for a holiday by/in the pool with my family . Saying that, this year I chose to stay on the pump, just because I sleep so much better on it without the 4am nypo.

Best is to get your hands on one and get it shown to you. I have seen new pumpers wearing a pump without connecting it to get used to the idea. Personally, I walked into hospital one day, was connected a few minutes later and was sent home with the manual. Not the best way to get to know all the benefits of it but eventually I learnt to use it properly.

Counting carbs is essential to make the most of it, so make sure you are confident with this (apparently this was not the fashion in France when I was diagnosed, but on a pump it is really useful).

Many people achieve excellent control on MDI, a pump helps more with the quality of life, flexibility . And with people who have big variations of the insulin needs depending on the time of the day.
Carpe diem
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Postby kimmy » Thu Aug 24, 2006 1:23 pm

Thanks so much everyone! I'm pretty well convinced to join the pump club now.

Just need to post in my hospital benefit cover application and in 12 months I hope to "be connected".

K :)
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Postby Kate » Thu Aug 24, 2006 1:54 pm

Kimmy - Large scale research papers say the average drop is between 0.5% and 1% in HbA1c. I am a proud contributor to such stats as my A1c dropped a whopping 3% from 10.5 to 7.5 in first 6 weeks of pumping, and has sat somewhere between 7.5 and 8.5 ever since whereas before I had major struggles to get below 10. Cheers, Kate
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Postby Kate » Mon Aug 28, 2006 9:01 pm

kimmy wrote:I have never heard anyone say they don't like the pump.


Kimmy - Some people certainly find the pump isn't for them. You might enjoy reading George's thread in the "Beta Cell" part of the Forum. It's called - I'm off the pump, and charts his prorgess on that over many months to the present. I won't ruin the punch line for you, but check it out.
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Postby Nicholas » Tue Aug 29, 2006 10:37 am

I haven't been on here for a while...

I've been pumping since December last year. I've almost forgotten that I'm diabetic and feel like I'm ageing backwards :). I have to confess I haven't had a HbA1c done since then (it was 6.7), but I believe control is tighter now with less effort.

Cheers,
Nicholas
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"We can rebuild him - faster, stronger than before..."
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Postby Jen (nli) » Tue Aug 29, 2006 11:10 pm

A pump was suggested to me because i wanted to get pregnant and was finding it difficult to get within cooee of the recommended hba1c of less than 7%. As I didn't have PHI, and because I was in my mid 30s and was full of fear that I was no longer fertile, I decided to bite the bullet and commit to getting a pump. I took on three jobs for a year to earn the "spare cash" to purchase one. Was it worth it? Well, for me, YES, mainly because not only did I get the pump, I also got pregnant and had a healthy baby... and the pump was great during my pregnancy. I don't know how I would have managed on injections. I'm glad it lived up to my (perhaps rather high) expectations. I guess that is why I love the pump - to date it hasn't let me down.

One of the things that swung me towards getting a pump was a line that a pump company had on their website - that basically even though you might have to put in a bit more effort initially, you will most likely get better results for the effort you put in. That's all I needed to convince me. I had felt with injections that I was constantly putting in effort and it just didn't come together. Whilst my Hba1c could get to around 8% - I was testing frequently, and carb counting and dieting and ... agghh! I was on the pump for a month and my hba1c came down to 6.6% - which was the best I'd had for years. In the third month of having the pump it got to 6.4%. Since then its been even lower, but is now sitting around 7% (but my lifestyle has also changed a lot - I have a little baby to run after so am finding looking after myself more of a challenge).

But, as others have mentioned, the pump isn't for everyone - and whilst it has been the most positive thing I have done for my diabetes (it helped me to like my diabetes - sad I know) - some days I just wish i didn't have to "plug myself back in". And there are days when I wish I didn't have tubing to tuck in, or a little box to manipulate when turning over in bed... But, these are fleeting thoughts. Much the same as I used to wish I didn't have to inject four times a day!

Its a very personal choice and one which is hard to *know* before you try it out. I think George's experiment on the Beta Cell is really worth reading.
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Postby Spike » Tue Aug 29, 2006 11:21 pm

Okay my experince with the pump and Hba1c is alittle diffrent to everyone elses!!, my control was good and endo's where happy, the natural conf. company where happy cause i had lots of hypo's, all was well in the world.

i decided to give the pump a whirl, manily cause every one else was getting one and i'm a sheep!

i have found my Hba1c is slightly worse and i have fewer hypo's, i don't like that the pumps performance deteriorates as the site deteriates, if you stick to the 3 day chage regime its usualy no drama, but every now and then i have site issues after a day and my BSL's are crap.

the lifestyle issue with a pump was'nt as bad as i thought, but i'm much more aware of things poking out in my path as the lines get caught on everything.
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