I read one adult T1D offer a glucose data stream to one of their parents and the parent replied that he'd not sure he wants to roll with the ups and downs of the blood glucose. It becomes a responsibility. Should you call, if so, when.
Glad to read your wife is interested. Curious how the social reality works out.
I remember when I was married. I was often irritated with my wife when she asked if I was low. She was usually right and I was really more irritated with accepting the vulnerability that diabetes creates. It's clearer now 30 years later.
One thing I told my wife when she was my girlfriend, "you can ask me what my blood sugar is at any time," since it does affect my mood. This way, she can be ok with me.
A while ago, we lived apart, due to job circumstances, and she had the Find my iPhone app, so, if I didn't answer my phone, she could call my roommate (who worked at the same place), and have him check on me. We also had the FaceTime constantly on between us, so she could check on me in my room. (It also made it easy to ask a quick question too...)
I'm not sure I understand why your endo even has a say in what kind of pump you get!?? All pumps are basically functionally the same, they just have somewhat different interfaces. And why would she turn her nose up at a pump that has an integrated cgm? That seems very strange to me...If your insurance is paying the cost (or you, for that matter), why does your doc get the final word? That would make me crazy! (Not being critical of you at all, just can't wrap my mind around that scenario!) :)
Uh, possibly because the endo is the one who has to agree to write a prescription for the pump? You can't get a pump without a script, right? (Well, not legally, at least. ;-)
not my point---why would her endo be invested in what kind of pump she got? the endo doesn't have to live with it, why is it her decision? If she wants the vibe, the endo should sign off on it. I understand the prescription protocol, I don't understand why the endo cares what kind of pump she gets. Only the patient needs to be 'impressed' with it, imo. Also, the doc is not paying for it.
I don't understand why the endo cares what kind of pump she gets.
You appear to view pumps as "generic". That it is only "frills" which differentiate one pump from one another. Clearly this endo does not feel that way. And they are the ones with the control because they are the ones that write the scripts.
The endo is probably looking at it more from the perspective of patient management. How familiar are the others (CDE?) in his practice with this device? If there is a problem, can his staff deal with it without having to say, "Give me an hour or two to read the manual and I'll get back to you"?
Of course, you can always go doctor shopping to try to find a doctor who lets you do what you want. Some folks care enough to do that. But it's not for everyone. Others, like myself, get their care from a medical bureaucracy which covers the cost and can't justify the cost of going elsewhere. So whatever they give me I pretty much feel I have to work with unless I can successfully argue for another direction.
And as I said earlier, I would very much like to hear whatever reasons this endo supplied for not approving the Vibe. If nothing else, I am very curious.
The fact that the endo won’t sign the paperwork is strange to me too. I go to the Joslin Clinic and thought I heard my endo once say that she wasn’t allowed to “recommend” one pump over another, she could only offer a comparison of features between pumps. Maybe this is just the Joslin Clinic’s personal policy, I’m not sure.
The reason it’s strange to me is because it’s not as if she is saying she won’t sign the paperwork for a pump at all, just one pump over another.
In my opinion if she’s going to prescribe an insulin pump at all, then let the patient make an educated decision on which one he or she wants. The patient is the one who has to deal with it every day.
I know she’s not impressed with the Vibe, but did she actually recommend one that she wants to sign for?
I am glad that Animas let you return the VIBE. I cancelled my VIBE because - well - it is almost February and had not heard anything from Animas. I called at the beginning of December....
I got the insulte omnipod and paired it with the dextronic. This has proven to be a great set up as I have the meter and tr5ansmitter in one. I do have to carry the dextronic receiver which means two devices in my pocket. But since I don't have to worry about tubing it is noi big deal. I also went for the vibe upgrade as it gives me an extra pump to carry on vacation and it will read my sensor that I already have attached
I'm sorry to have written the post and then not reply to your inquiries and good points. However, I had a medical emergency with retinopathy (lots of blood in the right eye) and went to the retina specialist after posting. I am only able to answer now. Again, sorry.
Anyway, back to the Vibe. I have to have the endo's signature on the paperwork for CCS (Medicare's pump supplier), and when I asked the endo to sign it, she was very hesitant. When I tried to press her for the reason, she was very reticent (probably like one of you mentioned -- not to recommend 1 pump over another.) Finally after some discussion, I said that I liked the Medtronic pumps but not their sensors which simply don't work for me (as she knows.) She responded that she liked the Medtronic pumps, too. I think that was the main reason. She also said that she liked the the Medtronic pump printouts that I bring to her which she must have concluded couldn't be gotten from an Animas Vibe. I guess that I should have told her that I have the Diasend capability but I was so thunderstruck that she wouldn't immediately sign that I just wasn't thinking.
I mentioned to her that due to my poor vision, I couldn't see my current Medtronic's screen very well at times and that was why I wanted a colored screen like the Dex had. I even mentioned the T-Slim but she wasn't too impressed with that one either. So, I told her that I would investigate to determine if Medtronic now had a colored screen. I told her that Medtronic was to have a new pump in the US in 2016 that would have such a screen but I wasn't sure they had one now. (When I looked at Medtronic's website today, I didn't see a colored screen pump available now.) So we left it up in the air with me to check if a colored screen Medtronic pump would be available now.
When I got home, I really began to wonder why she was hesitant about the Vibe. Was she privy to something that her patients wouldn't know? What was her reasoning? It left me in a quandry. I had been working with her DCE to get the Vibe; however, the DCE quit. Now the endo has no DCE and doesn't plan to get one.
I really wanted only one device to carry around with me as I do heavy yard work at times, and 1 device would make life easier. I have been reading comments posted at this website about folks not being happy that the Dex upgrade isn't available on the Vibe and that there's no linking meter (which is a big deal to me since I can't see well at times & am concerned that I will enter a wrong number (which I did years ago that caused a boat load of trouble.)
I just didn't know what to think and thought that you folks might have some suggestions/ideas.
I've rambled long enough but I wanted you to have more background since you were asking pertinent questions to my original post.
Goodness!! Sorry to hear about your eye...I hope it gets cleared up and you are doing okay now. Your explanation makes a lot of sense. I hope you are able to get it figured out and get the best pump for you! I do love the ease of use of Medtronic pumps and used one for 11 years. I got the Ping because I was hoping for the Vibe upgrade, but like you, and several others have mentioned, I'm not sure that it's going to be worth it without the software upgrade available to the standalone dexcom. The thought of carrying one less device is so appealing, but then again, we lose the meter remote, which is terribly frustrating. I wish a pump manufacturer would listen to these concerns and make the perfect pump!! :)
Sometimes I think we give our endos way more credit than they're due. I see by your profile that you've been a this game for more than 32 years. How do you think your experience with day to day management of BGs compares with your endo? You have a PhD and she's still in high school!
I know we have to learn how to navigate the doctor relationship but, if I were you, I'd be a bit miffed. I realize that the doctor is trying to help you, but can't she just buckle down and learn another pump? Anyway, this is your choice! You've identified some valid issues, including screen readability, why you want a Vibe. You have to live with it, not the doc.
Diasend produces great integrated reports that should help you and your doctor. Diabetes data management is at the beginning of revolutionary change with grass-roots NightScout and CGM in the Cloud. Things are changing more quickly and it's accelerating. Your doc needs to roll with the punches and honor your rightful domain.
I recommend that you do your due consumer diligence and tell the doc you want a script for whatever pump you want. Failure to comply on the doctor's behalf would rupture the relationship in my eyes.
Sorry to stir things up. I hate to see any doctor railroad a patient for the doctor's benefit at the expense of the patient's. Thinking about this more, I would guess that the doctor is feeling overwhelmed by the rate of technology innovation and change. They only have so many hours in the day and they have to see X number of patients. They're feeling systemic pressure that's not fair but why should you accommodate her instead of her you?
An Endo who has recently lost their CDE sounds like someone who just may not want the hassle of a different form to look at. It drove me crazy when my CDE office made me fill in their forms by hand with all my blood readings when I had all of that data digitally in the meter and pump. I finally created a digital form to “mimic” their awfully designed form to make it work. Eventually, I showed them the new forms I could create, and now do use with Diasend and the Ping. And all is good. This office was also a “medtronic” office, so no other reps could get in the door, and I had to insist on a dexcom over the junky medtronic cgms. Once they saw how well it worked, they now have many patients with dexomcs who have seen great results, so the proof is in the pudding, and I if (always the main question and a big if), but if the animas is right for you, I suggest standing your ground and making it work.
You are the customer, and if the endo won't give you a good reason why, then I'll go elsewhere.
I have my issues with Animas as a company (I know, J&J), but their pumps work. Archaic menus, but they work. Minimed has pumps that work, and they work well. My issue with them is their proprietary connectors.
Omnipod has good pumps, and they work well. I don't like the need for a remote, but if someone gave me one, I'd take it and make do.
Tandem has good pumps, and they work. I am looking at them for my next one in two years, and I hope they have the integrated CGM, but if they don't it's not a deal breaker for me.
The point I'm making is that you are the one that has to deal with the diabetes 24/7, and the endocrinologist only has to deal with it 8-12 hours a day. They get to prescribe a pump. You should be able to decide on which pump to use, and live with the consequences (good or bad) of it.
(rant on) Doctors are advisors, not gods. They are highly skilled, but not perfect. They have human weaknesses, and one of them may be not wanting to be an expert at 4 different pumps, so they pick the easiest one, which happens to be the largest pump maker out there, Minimed. If you go with Minimed, as a doctor, you'll have all kinds of resources to call upon when you have a question. It's not laziness, it's just that the doctors have limited time, and need to make the best use of it.
(rant off)
You can get another doctor. Call up Animas, and I'm sure their sales department has a list of doctors that will more than happy to write a script for a Ping.
Plus, maybe the other doctor will understand that the patient pays their salary, and she's not asking for anything illegal, immoral, or fattening... wait... I gained 20 lbs when I got my pump. OK, nothing illegal or immoral.
This is like the doctor demanding that you take Tylenol, and not Acetaminophen from Walgreens. Same thing, different branding.
So, I told her that I would investigate to determine if Medtronic now had a colored screen. I told her that Medtronic was to have a new pump in the US in 2016 that would have such a screen but I wasn't sure they had one now.
I realize that this discussion is about the Animas Vibe and I have no intention of making it about Medtronic pumps. But I figured it was best to reply to the above directly and to provide potentially too much info rather than to be too vague.
No, Medtronic does not currently offer a pump with a color screen in the US.
Aside from some test studies in the US ... which I think are already finishing up ... their newest pump, the Minimed 640G, is only available outside the US. You can find more information about that at the links below:
For whatever it's worth, here is a list of some aspects of the upcoming 640G pump which I think might be of interest to Animas users. I base it on what I think I read in the marketing materials from Medtronic Australasia. If nothing else, it might be of interest as an indication as to how Medtronic is responding to the other pumps such as the Animas.
Full-color, auto-brightness display
Remote Bolusing. The (included?) Bayer Contour Next LINK 2.4 meter can send bolus commands to the pump. (I have no idea what this interface is actually like or how much flexibility it allows.)
Louder, volume-adjustable alerts
Waterproof at 3.6 meters for up to 24 hours
Intuitive screen navigation (I'm just copying what it says in their brochure. Note: This is still NOT a touch screen device. ;-)
In my opinion, Medtronic continues to try to catch up with Dexcom and has several updates (improvements) to its CGM devices in it's pipeline. How much of a difference there will be I await to see with bated breath.
While it indeed seems possible that the 640G might be available in the US in 2016, I am not sure how early in 2016 this could happen. I don't think you should expect it to be available sooner than the end of next year.
The US availability probably depends on how much bureaucratic infrastructure now exists at the FDA for devices such as the 640G which can turn themselves off & on based on external CGM data. My speculation is that one of the reasons the (current) MiniMed 530G took so long to be approved was because the FDA felt it had no precedent to base their decisions on.
The bottom line as I see it is that if you need a CGM capable pump with a color screen right now, then you have to convince your doctor to go with either the Animas Vibe or the T-Slim. The 640G is not going to be an option in the US for a while yet.
-iJohn T1 LADA since ~1978; first pump 1997: Minimed 507; currently: Paradigm 723 + CGM
Minimed has pumps that work, and they work well. My issue with them is their proprietary connectors.
Not trying to advocate for anything here. Just posting this information in case it might be useful to anyone.
If the issue is that you can't use a Luer connector infusion set with the Minimed pumps, there are workarounds available.
The one I am familiar with and have used myself is sold by an outfit called FIFTY 50 Medical, Inc. They sell a reservoir with a Luer connector which will fit the (current) MiniMed pumps.
Thank you, Terry, for your input. I appreciate your taking time to respond.
You're right. I've been diabetic for 33 years and have had 3 endo's in that time span. (My first retired, the second moved her practice, and my current one.) I do like this endo. She spends time with me, usually one hour, which other doctors don't seem to do anymore. She has been selected as the best endo in Phoenix several years running.
She has always given me good advice before, and I respect her. That's why I was so taken aback when she wasn't too keen on signing for the Vibe. I wondered if she were privy to something negative about the Vibe which professionally she couldn't divulge. I was hoping that someone on this site might know if there were such a thing. Thus far, no one has mentioned anything negative about the Vibe that wasn't already known.
Unless I discover something new that would reverse my decision by Wednesday, I am pretty sure that I will order the Vibe and request that the paperwork be signed for my doing such.
Thank you for your input concerning my Vibe post. In my response to Terry's post above, I mentioned that I do respect and like this endo. She has given me good advice thus far and helped me way more than my previous endo (who didn't do much except say that she didn't know what to do for me which certainly didn't give me much confidence in her expertise.)
I did have some concern that the Animas company might be sold since J & J had tried doing so some time back but there were no takers. I thought perhaps that might have been why my current endo was not keen on signing for the Vibe if she were privy to info that Animas might not be around. However, I haven't found any info on the internet about that possibility. I would like to think that Animas would be around for a while especially since the Vibe is being launched in the US.
Right now, I'm pretty sure that I will request the Vibe as I really can't see very well the Medtronic screens, and the current Medtronic has the same screen type as my current one.
I have read some of your other posts and know that you do quite a bit of research. Have you learned anything negative concerning the Vibe that I might have overlooked?
I agree that the wait for the new color screen Medtronic to arrive in the US is too long, especially for my needs. I require a pump which I can read now, especially since my vision is diminishing quite a bit each year.
Since I really do respect my endo and the advice that she has given me thus far, I was just wondering if there were anything that she might have known about Animas or the Vibe that isn't general knowledge and which she couldn't share professionally with me. No one has mentioned anything thus far; so maybe there isn't. Sure hope so.
As I mentioned in previous responses, I'm pretty certain that I will go ahead with the Vibe. I know that I'm locked in for 4 years as most of us are due to insurance.
