And as far as trying to scare you, Sarah...TOTALLY WRONG approach by a doctor!!! Docs need to have excellent "bedside manner" to effectively work with their patients. Scare tactics are not the right way, and I'm sorry that you had to go through that. Hang in there, you're going to do fine. :)
I had that experience the two years I lived in Guatemala; except for other specialists I rarely went to the doctor!
I had the saline for a week too, Todd from the Animas coach. Though some people are impatient with it I really liked it because it gave me that leeway to get used to wearing and changing sets and doing all the settings and seeing what the buttons did without the stress of insulin inside.
well, this is 'that' endo whom i felt uncomfortable with, the one who literally was pressing himself against me during my, his suggestion, nearly naked exam, kept asking me if i was married (YES!) and then on thursday, asked me to 'give him a hug' when I was leaving. I went back because they have an onsite pump nurse. So many weird things, 1) i had my sun glasses on in his waiting room, yes...odd, but my BG's were high and my eyes are very little in color and very light sensitive and were hurting, he says, "ah, you look like a movie star." 2) he also said, in his office, that day, "I'm not going to exam you today." WHAT, why would that even be a thought, you just did like 3 weeks ago, exam me for what? [pervert!] 3) they took, again, a finger stick for an in office A1C, just did it 3 weeks ago, it came back again 6%, my PCP did a blood test (accurate) and it was 6.5..it's 6.5 and you don't do weekly A1C tests. 4) He kept telling me I have such good control, well..maybe but if he looked at my damn CGM I'm still waking up EVERY morning at around 3 - 4AM around 200 - 189 last night, unless I take novolog shots all day/night long, hence my wanting a pump. 5) after all this nonsense pump buddy, I told pump nurse this wouldn't work for me and I'd return to my other endo, thanked her for her time, etc.. (she was very nice!), plus he made me feel uncomfortable and just was a bit condescending, telling me I seemed stress [yeah, you're making me uncomfortable]. HE CALLED my PCP the next day and told her he thought I was stressed and maybe needed some help managing my stress! Then, my PCP's assistant calls me! Yes, I'm stressed, I should have been told prior (before wasting a POD and 100 u insulin) that their office requires a pump buddy. I can't sleep through the night and I wake up high every morning, i'm running around trying to get on an insulin pump, the pump nurse profession, at least where I live, seems very nomadic, very few out there. ugh! This doc called me on Friday, I told him, in so many words, he was 'out of line'. just ridiculous!
crackin up...! :)
Where does this need for a pump nurse come into play for you? I don't have one and I know that many folks pump without calling a nurse or a doc to confirm pump settings and such. It really is not rocket science.
I think I asked this earlier - who gave you the prescriptions for the pumps? Does your PCP support that prescription? What did he/she say about the the call from endo?? At least they have conversation...that is not often common. You may have too many docs in the pot.
Lessening the drama regarding this is something you can control...I think you should try that. I will also recommend that the pump is not going to fix your trouble with figuring out your basal and dp issues. Those should be done before you slap it on.
that's why ppl go one pumps and why it's an effect tool, where MDI - levemir is not, indeed it can fix basal needs (i.e. setting different basal rates, DP, etc..which a shot or two of levemir won't fix) My prior Endo Rx'd the Pod. I feel comfortable having someone follow me, that's just me and what I'm going to stick with. Some are comfortable starting pumps out on their own. I am not. That was the reason why they waited a week, I was to log my numbers (which I do every day anyway) to see what my basal injections are or aren't doing. Levemir won't fix my DP, taking more has made it worse.
and, i'll admit, a lot of this is 'my fault'. i've started POD and for some reason, by the end of the day...I become extremely insulin sensitive (where I'm incredibly high in the mornings) and start getting double arrows down at 70 on my CGM, it's usally around 10pm and I've already cut my basal rate back to .30...and i do 'freak out' and just take it off because I'm scared and it's close to bed time. ugh! So, I'm hoping someone would at least advise me when this happens, like 'suspend', or do a temp basal rate, or something so I feel confident at night. I tell myself, 'i'll go back to mdi and try and get a better idea of my basal needs before i start this again (which doesn't happen), by the time I'm 'ready' to retry, it seems, pump nurse has left, gone to work for Dexcom, another facility so I'm back to finding another pump nurse. IDK...!
I've never had the sort of tactical "coaching" like that from a medical person, although I've made an appointment with a new endo, at the bigger clinic which I'm thinking may have more resources available, although I'm not holding my breath on what they'll actually be able to do for me.
I don't recall your exact scenario with the basal rates and all that but there's a lot of fine tuning that can be done but I've always done it myself.
oh, well, that's what a pump nurse does, they follow you, usually for the first week especially, you'll be in contact everyday, via email, text, etc...and they advise on what to do, that's their job as a pump nurse/coach. I was to start this, of course, on thursday and pump nurse said she would also be checking w/me over the weekend.
That would be so nice if we could just get our 'stuff' without the hassle. My doc calls me to remind me it's time for a check up. LOL - I might call if I need some help with an illness, but otherwise I have better things to do. I really like my doctor, she recognizes that this is my condition and it is my job to manage it. I am glad to learn I am not the only one.
good for you. the amount of 'care' endos provide, whether they want a newly Dx pumper to be autonomous in their pump start or they micro-manage it, has to do with the endo team and office. one can look for a lot of support or very little, depending on who they're seeing. it's been my experience, the pumper doesn't set the tone, the office who is putting them on an insulin pump does. some of these endos will 'das boot' pumpers who don't follow their guidelines (i.e., a 'pump buddy'). and, for those who do want the support (ME, gladly!)...so what. i'd say an A1C of 6 or 6.5% percent, never higher, suggests a pretty well managed T1 dealing w/a messed up MDI levemir basal rate(s). That's what Endos, CDE, pump nurses do! I'm fortunate to have great insurance...I'll accept their skilled advice, if and when I need it or ask for it, absolutely! The more the merry! HA! And if we felt like we could 'manage this on our own all the time, well....Tudiabetes wouldn't exist nor would the continued reaching out from T1's asking for suggestions, guidance, etc...so if it comes from a paid health care provider or done through a website, it's still us (some rookies some novice T1's) asking for support to help us manage this and get feedback, etc... It's fantastic that you have this all nailed down and don't need any 'help'...that's perfect and inspiring, some of us do not and haven't been at this for decades, we went through honeymoons, extreme insulin sensitivity, etc...
there are many on here who have other related T1 issues, hypo phobia, needle-med/insulin phobias, T1 eating disorders, true and valid issues and reach out here for support as well as 'health care providers' who specialize in helping and guide them through this, thank goodness we don't make them feel like 'it's their job to manage this alone'. if one has cancer (example) and is having problems with radiation, chemo, etc...they're not left alone to manage it. if one's, example, pace maker is malfunctioning, certainly that person would reach out to their health care provider for help. geez! if one needs and wants guidance through an insulin pump start...so what, that's what a D TEAM specializes in. An insulin pump isn't some toy, it keeps us, we type 1's, alive everyday.
i'm also a bit confused, really, 'karen', if you're so intent on managing this on your own, have everything nailed down - perfect control, continue to be dismissive to those who need or want support (via it be a medical team or here - this site), what do you get out of coming on this website everyday and posting comments continually? there's always a premeditated actions - consequences...so, I guess you only know the answer.
I've never heard anyone report the sort of tactical adjustments that I've seen people recommend online. I think the whole thing is to be figured out and that the pump SalesNurses are very good but very limited in what they do.
I recall your thread with the pump issues but I think you decided to stop pumping and switch endos so there was not a "conclusion" but I can't tell where you're at, whether you're pumping or not. I would not pump with the "pump buddy" guy (although it's not really a bad idea...right after we got my pump there was an earthquake in Southern IL that we could feel in Champaign, where we lived at the time, and MrsAcidRock woke up and said "OMG, wake up, you're low, the bed is shaking!!" which was kind of funny...) just because but, if you want to pump, it's a good idea to have a doctor and get sort of solid. I would probably figure out the fancy fine points (basal to 200% to get site changes going, .3U to cover showers, how to read the reports to make changes...) to figure out yourself. If you bring data to the doc and talk about it with them, they'll come up with solutions but, if you do it a few times, you'll get the hang of it. I am very intrigued to start with a bigger clinic in a couple of weeks (although I will bring them a bunch of $#!++@ numbers...) as I would like to think I will get more bang for my copay bucks but I'm very skeptical as to what they'll do for me that I don't already sort of do for myself.
AR, I am not sure that bigger is always better. But I do wish you good luck with the bigger clinic. I'm old school, my clinic although affiliated with the Joslin is run by 2 endos, a nurse practioner, a dietitian and a CDE. All of them are familiar with me but there really isn't a whole lot you can teach an "old dog".
When I got my pump there was no DOC, there were no books about pumping insulin, thinking like a pancreas, calorie king, etc. There was me, my doc, and then I met some other diabetics at the pump class. We learned how to figure all the pump stuff and were sent out on the journey to stay alive and well. Pumps have changed a whole lot, and they are much improved. I do understand the need for some training. I don't understand the expectation for a doc to hold our hands.
I found the DOC many many years after I started pumping and I have been entertained and blown away at all the issues I never knew existed. Yes, newly dx'd folks need support and 'help', and this place is an excellent resource.
I hope you will eventually come to learn how to manage your own diabetes, and what other issues you may have. I just happen to know that it can be done. Pump or not! I survived mixing insulin so I am living proof.
Just because I avoid going to the doc does not mean to suggest that others do so. If you need that kind of help and support and guidance then okay. I simply don't need it or have the time. Once you gain some level of control you will hopefully lose some of the other related issues or at least the fear of them.
Yes, I do feel it is my job to manage this gig. You assume that just because some of us have had this for decades we haven't been through some of the troubles so don't understand them. Um....NOPE!! In fact, I manage plenty of other stuff, have survived some pretty hellish shenanigans and feel blessed to wake up and be able to sing and dance and blaze a nice trail every dang day.
As I said and will say again and again and again, this thing can be managed, we need to own the responsibility for our control, and we are allowed to feel amazing and be well. And we can even eat pizza if we wish. And to be sure...I have no fear / and a t-shirt to prove it LOL!
Hi again, Sarah. I noticed you made an appeal to Zoe for pump advice (on the get up and go post) and you have put your pod on. Gives me shivers. I also saw where you have an appointment with the pump nurse. YAY, that is where you need to find answers to those questions you posted.
I did want to give you this resource in case you were not aware of it: http://www.myomnipod.com/customer-care/interactive-training/ and maybe it will help some. Many folks recommend the books and I will agree they are excellent. Have you read them? Pumping Insulin and Think Like a Pancreas and Insulin Pump Therapy Demystified: An Essential Guide for Everyone Pumping Insulin.
I hope you will find success with pumping, I can't help but continue to question what kind of training and who provided it for your previous pumping experience. Even after decades I find I have to change my regime, and can't pinpoint a reason. Knowing how to do that is key. Trial and error is true always, and for the rest of our diabetic lives.