Tuesday, April 19, 2011

Getting Started on the Insulin Pump

 Silverberg Family Tae Kwon Do Picture
Nathan ~ Rachel ~ Zach ~ Jason
Abigail ~ Mom ~ Dad ~ Anna Marie

The following is an excerpt from my book, "Reflections on Childhood Diabetes."

Getting Started on the Insulin Pump

            My two oldest sons have been on the insulin pump for five years, and they love it.  The pump has made managing their diabetes so much easier, especially through the teenage years, when many adjustments in insulin are necessary.
            However, getting started was not a piece of cake.  For myself and the boys, the decision was easy.  We listened to our doctor, read the information he gave us, and watched the video.  We were fired up and ready to go.  My husband was not so sure.  He had a fear of the pump malfunctioning.  He also loved to wrestle with Jason and Zach and believed the pumps would put an end to their kung fu days.  Our doctor helped to calm his concerns and get him on board.
            Getting the insurance to approve the pumps was another challenge.  They attempted to deny payment because the children were already in good control.  That hurt.  How dare they refuse us better control, because the boys were doing well?!  They were denying us more effective medical help, and in essence, punishing us, for our diligence in regulating diabetes.  Our doctor, God bless him, was not easily dissuaded from his good opinion.  He battled the insurance for months on our behalf, until at last victory was achieved.
            Jason and Zach were so happy the day they got their insulin pumps.  We went to the doctor’s office and then to a conference room at the hospital where we received operating instructions.  We graduated after a few hours of training on the pumps.  We were very excited when we went to lunch.  It was kind of scary on our own for the first bolus, but we got through it.  I was totally confident that we were going to make the transition smoothly.
            In reality it probably took two months to conquer the new routine, which meant lots of testing, phone calls with the doctor, re-adjusting basal rates, and formulas for bolusing.  It wasn’t as easy as I had thought it would be.  All three of us were a bit discouraged.  I was tired from getting up at night to check blood sugars, but I wasn’t ready to throw in the towel.  I think the boys would have quit, if I had let them.
            Then at a school event, I talked with a mother whose child was on a pump.  She asked me how we were doing.  I slowly responded, “Okay.”  She must have heard the hesitancy in my voice, and she told me her experience.
            She explained to me that after a couple of months she was ready to bring it back to the doctor and say, “Here, take this thing!” but how they had stuck with it, and now were doing great.  She gave me the encouragement, my second wind if you will, to persevere.  We did just that, and in a short time it was mostly smooth sailing.
            Jason and Zach loved their pumps and the new freedom that came with them.   Now they had a lot more flexibility in their schedules, especially when it came to eating, and our living room is still bombarded by the sounds of kung fu fighting – all the kids against Dad, having the time of their lives.
            When the boys chose to disconnect from their pumps for our annual week at camp, I wondered how they would feel when it was time to go home.  Before we left for home, they both commented to me, “Mom, I can’t wait to get back on my pump!”
            Some time after making the switch to the pump, Zach came to me with a very interesting comment.  “Mom,” he said, “The pump is like a key to a bigger room.”  I didn’t understand his meaning, so he repeated, “It’s a key to a bigger room.”  You can imagine the puzzled look on my face.  “Having diabetes is like being locked in a room,” he answered.  “The pump is like a key that has let me into a much, much bigger room.  It’s still a room, but with a lot more space.”
            How profound!  It saddened me to get a glimpse into the sense of confinement he felt because of his diabetes, but I was so happy that the pump had loosened the restraints.
            Then there was the donut incident.  Unbeknownst to me, my two oldest boys challenged each other to a donut-eating contest!  Yes, that’s right, a donut-eating contest!  After a Sunday evening service, our church was serving those delightful Krispy Kreme confections.  What possessed two diabetic boys to engage in such a foolish activity, I’ll never know, unless I can attribute it to a common occurrence in teenagers I call brain dump.  (Regretfully, their mother occasionally suffers from this condition as well.)
            Zach ate a whopping eight donuts.  Not to be outdone by his younger brother, Jason triumphed with nine!  He still insists it was the ninth donut that made him sick; the first eight had nothing to do with it.  Zach’s testimony of not feeling too bad afterwards only reinforces Jason’s belief.
            You can imagine how shocked I was when I learned of the incident, and my disbelief only added to the boys’ amusement.  “Do the words ‘diabetic coma’ mean anything to you two?”
            I made a mental note to calm down.  I want the boys to be able to talk to me about anything, and I don’t think freaking out will encourage this, I told myself.  Slow down … breathe in … breathe out …
            “Boys, do you have any idea what that could have done to your blood sugars?”  They both assured me that their pumps had taken care of it.  They had counted carbohydrates and bolused accordingly for each donut as they were eating them.  When they tested two hours later their blood sugars were just right, and they woke up the next morning in the normal range.
            Wow!  I could hardly believe it, but I knew it was true.  I had no reason to doubt them.  I’m sure they would not have fared so well had it not been for their insulin pumps.
            “Well, I’m glad you were careful to bolus correctly, and I’m very thankful everything turned out so favorable, but I want you to consider what might have happened if you had bolused too much.  Your blood sugar could have dropped, and then you would have needed to take in more sugar.  Think of how sick you would have been.” 
            Both boys assured me they had no intention whatsoever of engaging in any similar contest ever again.  With that I had to be content, but I was very impressed with the insulin pump.
            Years later, both boys suffered major injuries, requiring months of recovery time.  Their insulin needs rose dramatically, and their diabetes entered a phase of high maintenance.  I was so thankful for their pumps.  It made all those adjustments and extra doses of insulin so much easier.  I believe their pumps, along with their dedication to recovering, kept their diabetes from interfering with their healing. 
            Three cheers for the insulin pump!

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