Saturday, April 08, 2006

Why we chose the pump

I was on the CWD chatroom yesterday and there was a couple of mom's up there who had a lot of questions about the pump. I thought I would post a little about the pump and why we chose it for Riley at such a young age. (These are not in any particular order.)

#1) The ability to give tiny, tiny doses of insulin. The pump has the ability to give as little as 0.05 unit of insulin for a bolus. That's 1/50th of a unit. It just blows my mind that I can give such a tiny amount of insulin. When Riley was on injections, the smallest we could give was 0.5 unit (and that was not accurate dosing. His syringes measured everything in one unit increments. So, you really had to guess as to what a half was.) I had drawn up 0.5 unit before when he was on injections and squirted it into my hand just to see how much it was. It was the drop about the size of the head of a pin. So, once again how the pump can give such little doses just amazes me.

#2) The ability to adjust basal (background insulin). Before the pump, Riley was on Lantus as his background insulin. He took 1.5 units at breakfast. That dose was supposed to last for 24-36 hours. I really don't think it did most of the time. In theory, he got the same dose of background insulin for every hour of the day. With the pump that dose can be adjusted to fit his needs. I think most people are on a couple of different basal rates a day. Riley starts out from 12 AM-3AM with a basal of 0.075 unit per hour. Then, from 3AM-8AM, he goes to 0.025. That's because his sugar tends to drop quite a bit during this time. When he was on Lantus, we had to wake him a lot of times in the middle of the night to eat, because his sugar was too low. Not anymore, if his sugar is too low in the middle of the night now, I just decrease or suspend (stop) his basal for a couple of hours. So, you can completely stop giving him insulin if the need arises. This has happened before between the hours of 3-8AM. He's already on the lowest basal rate possible. So, I've had to completely stop the pump in the middle of the night before because I couldn't give him a lower rate. This hasn't happened but a couple of times. Not nearly as much as it did when he was on injections.

From 8AM-12PM his basal is the highest it is all day, .150. If his sugars are going to run high it's usually between these hours. From 12PM-3PM, he goes to .0125. His sugar also tends to drop late in the afternoon, so 3PM-9PM, he's at .075 again. Then back up to .10 from 9PM until midnight. So, you see that you can be very precise with how much insulin he gets at certain times of the day.

I will also mention adjusting basals are useful for periods of activity. This has come in handy for Riley, but not as much as I think it will for teenagers. Riley is pretty much always active. The only time I decrease his basals are if we go to the park and he's running around a little more than usual. But, with older kids and teens the pump can come in handy for sports and other activities.

#3) He can eat when he wants and what he wants. Now, that being said, I don't let him eat sweets but very rarely. That's how he ate before he got D. I didn't let him eat sweets often. They are not good for you or your teeth. But, the thing I like best about the pump and eating is he can eat 10g carb. at a meal or he can eat 50. It doesn't matter. The pump can bolus accordingly. When he was on injections, his carb coverage was 0.5 per 25g carbs. This meant that if he only wanted 15 g of carbs, you couldn't give him any insulin (because you can't give less than .5 unit). If he didn't get any insulin at all, his sugar was sure to go up too much. On the other hand, if he decided to eat 40g, he had to take only 0.5, but that wasn't quite enough to cover the carbs he ate. Once again, high sugars. I do not miss the days of crying and begging him to eat more so I could give him insulin. Or trying to get him to stop eating so he wouldn't go over 25g. I am so glad those days are over. Now, he eats, I dose, we're done. There is no arguing. If he eats 1/2 sandwich, it's OK. If he's really hungry and eats 1 1/2 sandwich that's fine too. His pump will figure out how much he needs to cover whatever he eats and dose accordingly.

#4) Less needle sticks. When Riley was on injections, he was getting anywhere from 4-5 per day. That was about 28-35 needle sticks a week. (Oh my, that sounds like a lot when I put it that way. I can't believe we used to do that.) Now, his needle is changed every three days. That's 2-3 needle sticks per week. What a difference. But, we are checking his sugar more often since the pump, so there are more finger sticks than before.

These are just a few reasons why we chose the pump. This is an individual decision for each person/family. First, you have to make sure your child wants the pump. I know some don't. Holden has a boy in his class with D. He's 15 and has no desire to try the pump. Riley decided he wanted the pump as soon as he found out he wouldn't have to get stuck with needles every day.

There are negatives with the pump also. They are a lot of work and they are more expensive than injections. But, I wouldn't give this pump up if someone paid me. The first few weeks were hell (to put it mildly), but it was worth it. Even though the pump is more work, I'm actually less stressed than I was when he was on injections.

On a side note, today is Michael's birthday. I just want to wish him a happy day and many, many more to come. ( I love you Michael Alexander.)


Megan said...

Your reasons for pumping are very similar to why I want to start. I made my list here:

Megan said...

Eh, link got cut off. It's on first page of my blog if you want to see it.

prayergal said...

HAPPY Birthday to Michael!
Belated......but I really didn't know when his b-day was. Hope he had a great day!
Aunt Linda