Pump "Ramp Up Time" - Type I

Responses in the body of your message . . .

On 19 Mar 2004 14:17:06 -0800, [email hidden]

(Yellowbird) said:

I have been doing some research on insulin pumps and have
read many of the postings in this group, as well as
articles on the Web. I still don't feel like I truly know
enough to know if a pump would be right for me, but I still
have questions. I am a 37 year old female Type I (since
1984), currently on multiple daily injections (5-8u Regular
and 15u 70/30 before breakfast, 8-12u Regular before lunch,
10u-16u Regular before dinner, and 18u-21u NPH at bedtime).
Lately, I have been having some issues with the peaking of
the 70/30 and post-exercise lows between dinnertime and
bedtime; I tend to have more hypos than highs and my last
A1c was 5.8.

My questions:

* What is the "ramp up" time once you have the pump? What
I mean is, is there a period of adjustment where you may
be more at risk for highs or lows as your body becomes
adjusted to the new method?

I had a wonderful nurse educator who helped me. I had a few
unexpected lows (2 or 3?) in the first week, but within a
couple of days, I had stabilized for the most part. A lot of
extra testing was needed to calculate the specific needs of
my body for insulin at different times of the day and night.

Quoted message said:

* About how long does it take to feel comfortable
(physically and mentally) with the pump?

Physically--within a week

Mentally--a couple of days

Quoted message said:

* Most pumpers say they would never turn back. Anyone care
to share experiences that might cause someone to have to
return to MDI?

I belong to the no turning back club. No unexpected, or
unexplainable highs or lows, and I have managed to lose 35
pounds of excess weight in the last year. Last A1C before
the pump: 8.3. Since the pump,
6., 5.8, 6.1.

Quoted message said:

* If you've got hypo unawareness (pre-pump), does the
awareness return to some (or any) extent once you have
been on pump therapy for awhile?

Can't comment, since I have not experienced hypo
unawareness (I was diagnosed in 1959, and went on the pump
just last year).

Quoted message said:

* Anyone in the So. Cal. area (in the Blue Cross CA HMO
plan) who can recommend a good doctor who has multiple
pump patients and who has considerable experience
working with them? Or maybe a hospital or other medical
organization for support?

Any information you are willing to share is greatly
appreciated.

Quoted message said:

Thanks in advance, Yellowbird Type I since 1984

My reply will be in line.

Yellowbird said:

I have been doing some research on insulin pumps and have
read many of the postings in this group, as well as
articles on the Web. I still don't feel like I truly know
enough to know if a pump would be right for me, but I
still have questions. I am a 37 year old female Type I
(since 1984), currently on multiple daily injections (5-8u
Regular and 15u 70/30 before breakfast, 8-12u Regular
before lunch, 10u-16u Regular before dinner, and 18u-21u
NPH at bedtime). Lately, I have been having some issues
with the peaking of the 70/30 and post-exercise lows
between dinnertime and bedtime; I tend to have more hypos
than highs and my last A1c was 5.8.

Exercising is easier on a pump than juggling the vagaries of
long acting insulin taken with most MDI regimens. You can
slow down the basal rate ABOUT a 1/2 hour before exercising.
You don't need to know hours in advance of a change in
routine or activity level. Conversely, when you eat goodies
like pizza you can give yourself an extended bolus, along
with an immediate bolus to even out your bg's very nicely.
Try that on shots.

Quoted message said:

My questions:

* What is the "ramp up" time once you have the pump? What
I mean is, is there a period of adjustment where you
may be more at risk for highs or lows as your body
becomes adjusted to the new method?

Depends how much you have read and understood pumping
related issues like "drop ratio", "insulin/carb ratio" and
how well you take to high tech gadgets. In general terms
figure a few weeks. Some of the folks here who apparently
weren't all that adept at change, struggled for months or
finally gave up. Don't let their lack of knowledge and or
enthusiasm affect your decision to pump.

Quoted message said:

* About how long does it take to feel comfortable
(physically and mentally) with the pump?

Two days.

Quoted message said:

* Most pumpers say they would never turn back. Anyone
care to share experiences that might cause someone to
have to return to MDI?

I haven't experienced the thought of ever going back to
MDI. They will have to pry my pump from my cold dead
hands some day.

Quoted message said:

* If you've got hypo unawareness (pre-pump), does the
awareness return to some (or any) extent once you have
been on pump therapy for awhile?

No, but there are few and less dramatic lows, at least for
me. I used to get Glucagon and would nearly pass out many
times. Now when I get low, it's just an annoyance.

Quoted message said:

* Anyone in the So. Cal. area (in the Blue Cross CA HMO
plan) who can recommend a good doctor who has multiple
pump patients and who has considerable experience
working with them? Or maybe a hospital or other medical
organization for support?

I'm in San Jose. There are a total of 3 great doctors for
pumpers within the south bay area.

Quoted message said:

Any information you are willing to share is greatly
appreciated.

I'd be glad to call you on the phone if you email me at

dave1812dave "at" yahoo "d o t" com

let me know when is a good time to call. My wife also pumps.
My life changed dramatically since the day I started pumping
in 1996, after 18 years of horrible A1c's and killer lows
and highs.

On a pump you can sleep in, you can take a nap in the
afternoon, you can bike 30 plus miles without carrying a ton
of food, glucagon, and tablets. A piece of fruit, a roll of
tablets, maybe a sandwich and you are good to go. That's
because you slow down your pump for the duration of the
ride, somewhere around 50-60% of the normal basal rate for
that particular time of day.

You can eat early, eat late, skip a meal, eat more (watch
the weight gain!), eat less, eat differently, eat like
normal people (within reason of course; a big plate of
french fries and a thick strawberry shake MAY not be the
wisest choice).

And the pump shouldn't be a problem at bedtime. I have had
only ONE set come out at night in 8 years. I suggest NOT
removing your pump during

Most people will not even notice your pump if you wear it in
the open, like clipped to your waistband. They think it is a
pager. Therefore don't expect to feel geeky with it. Some
medical professionals will recognize it, but most won't.
Depends on their personal experience and their specialty.
You'd be amazed at how many doctors won't recognize it.

dave

Quoted message said:

Thanks in advance, Yellowbird Type I since 1984

Yellowbird said:

My questions:

* What is the "ramp up" time once you have the pump? What
I mean is, is there a period of adjustment where you
may be more at risk for highs or lows as your body
becomes adjusted to the new method?

In my case, I didn't have any major difficulties during the
switch. I did have a few lows, but that was a matter of
learning how to accurately predict my insulin needs on a
meal by meal basis. In light if this, I would suggest you
keep an eagle eye on your BG levels. I ended up testing 10-
12 times a day for the first week or so.

Quoted message said:

* About how long does it take to feel comfortable
(physically and mentally) with the pump?

It took me several weeks to get used to being connected to
my pump all the time. Changing my clothes, bathing, using
the <ahem> 'facilites', and all that sort of thing became
more of an adventure as I had to account for the pump.

Quoted message said:

* Most pumpers say they would never turn back. Anyone
care to share experiences that might cause someone to
have to return to MDI?

The only reason that I would even consider abandining the
pump would be if it stopped working as a means to control by
BG levels. As far as the convenience of it is concerned, I
cannot give it high enough praise. I can eat when I want,
exercise when I want, etc...

Neither of the other questions are anything that I can
comment on. I am not usually hypo-unaware nor do I live in
the So. Cal. Area.

Good luck in your search for more info. I hope that
everything works out for you pump-wise. 🙂

Peace

Yellowbird....I had an great pump trainer, she was my daily
or more buddy for a few weeks to get the basal etc. fine
tuned. I could call her at any time,,,had her home number
etc. When she got the feeling that I was on the right track
with understanding etc. she cut me loose...but still can
call her if I need any more info. I wore the pump for 3
days, pumping normal saline, but doing all the testing and
boluses etc., really gave me the feel and the knowledge
that I could and did want this pump bad. It has been 1 year
for me, just this day. Would I go back....Nooooooooo!!!!! I
have been Type I for 50 years this Easter. I am wondering
that the 30/70 insulin was the best choice, seems like
there is often troubles with that type.....but then again
(YMMV). As for hypo's I used to have at least 5-6/day
before going on the pump (gastroparsis is hell), but within
a week, I was only getting one a month. My trainer started
out with a calculated dose for the basals, and started
lower than that, hence less chance of hypo's. I had already
done the carb thing (for years) and that was not a problem,
and the testing of bg's were aleady at 10X's a day (with
the MDI). I often test the same or less, whatever I need to
do. I have a multi problems, not all related to diabetes.
So, I hope that this works out for you, good postive
attitudes and willingness to go the extra mile (at least
for awhile) is good. However, not everyone is cut out for
the pump..Good Luck......Mic E-mail me personally at the
about addy, if you wish.

Always, be, and stay AWARE!

Bay Area Dave said:

Exercising is easier on a pump than juggling the vagaries
of long acting insulin taken with most MDI regimens. You
can slow down the basal rate ABOUT a 1/2 hour before
exercising. You don't need to know hours in advance of a
change in routine or activity level. Conversely, when you
eat goodies like pizza you can give yourself an extended
bolus, along with an immediate bolus to even out your bg's
very nicely. Try that on shots.

I do it on shots and have no dead batteries, polymerized
insulin in the infusion set, plugged infusion set or water
related pump failures to worry about.

Low tech is much less failure prone. So I like low tech,
--
Jim Dumas T1 4/86, background retinopathy, rarely
hypoglycemic: <1/mo. lispro+R+U+NPH daily, moderate
exercise, typically <6% HbA1c

On 19 Mar 2004 14:17:06 -0800, [email hidden]

(Yellowbird) said:

I have been doing some research on insulin pumps and have
read many of the postings in this group, as well as
articles on the Web. I still don't feel like I truly know
enough to know if a pump would be right for me, but I still
have questions. I am a 37 year old female Type I (since
1984), currently on multiple daily injections (5-8u Regular
and 15u 70/30 before breakfast, 8-12u Regular before lunch,
10u-16u Regular before dinner, and 18u-21u NPH at bedtime).
Lately, I have been having some issues with the peaking of
the 70/30 and post-exercise lows between dinnertime and
bedtime; I tend to have more hypos than highs and my last
A1c was 5.8.

pumps allow you to set temporary basal rates, meaning you
can reduce the amount of insulin temporarily while you
exercise. This allows you an option you do not have on MDI
while exercising.

I found that reducing the basal while exercising or
performing rounds at work which was a 2 hour walk 3 to 4
times a shift, I was able to avoid hypos without having to
eat anything extra.

Quoted message said:

My questions:

* What is the "ramp up" time once you have the pump? What
I mean is, is there a period of adjustment where you may
be more at risk for highs or lows as your body becomes
adjusted to the new method?

This would depend on a few things. Your endo's knowledge
about pumping to help you set the initial basal rates and
bolus calculations. Then how much you invest in learning
about pumping and adjusting the programming.

Quoted message said:

* About how long does it take to feel comfortable
(physically and mentally) with the pump?

it took no time at all. for me. sleeping was slightly
uncomfortable until I started wearing my pump in a leg
pouch.

Quoted message said:

* Most pumpers say they would never turn back. Anyone care
to share experiences that might cause someone to have to
return to MDI?

I turned back for a couple of reasons. Though I was hypo
unaware before pumping I never experienced an unconscious
hypo until I started pumping. The problem was hypo
unawareness combined with gastroparesis which screwed up the
timing of insulin and food and made programming to avoid
hypos during sleep a problem.

I also experienced a sudden onset of DKA twice while
pumping. Once due to a respitory infection, and once due to
the canula being pulled out, but the infusion set and tape
remained in place. On MDI it always took longer than 24s
before DKA would set in and I would always experience high
BGs and other DKA symptoms. while pumping if insulin
resistance sets in due to infection or insulin delivery is
stopped I found I can go DKA in matter of hours.

Quoted message said:

* If you've got hypo unawareness (pre-pump), does the
awareness return to some (or any) extent once you have
been on pump therapy for awhile?

Not in my experience.

Quoted message said:

* Anyone in the So. Cal. area (in the Blue Cross CA HMO
plan) who can recommend a good doctor who has multiple
pump patients and who has considerable experience
working with them? Or maybe a hospital or other medical
organization for support?

Any information you are willing to share is greatly
appreciated.

I strongly urge you to participate at insulin-insulin-Open ↗
pumpers.org

Quoted message said:

Thanks in advance, Yellowbird Type I since 1984

gee, that's funny, my batteries last over a month, the
insulin never goes bad, the infusion sets RARELY plug up,
and I don't deep sea dive.In the course of a year I have
maybe 3 or 4 set problems. Not bad out of 365 days. I have
pump failures on average about every year and a half,
requiring a call to their 800 number. A replacement pump
arrives the next day unless I call on a weekend. I have 2
backup pumps so for me there is no "down" time.

Low tech doesn't work for all diabetics. Why do you think
pumping is the treatment of choice for today's
knowledgeable, motivated diabetic? The malcontents will
always find fault where none exists.

dave

Jim Dumas said:

Bay Area Dave said:

Exercising is easier on a pump than juggling the vagaries
of long acting insulin taken with most MDI regimens. You
can slow down the basal rate ABOUT a 1/2 hour before
exercising. You don't need to know hours in advance of a
change in routine or activity level. Conversely, when you
eat goodies like pizza you can give yourself an extended
bolus, along with an immediate bolus to even out your bg's
very nicely. Try that on shots.

I do it on shots and have no dead batteries, polymerized
insulin in the infusion set, plugged infusion set or water
related pump failures to worry about.

Low tech is much less failure prone. So I like low tech,

Yellowbird said:

* Most pumpers say they would never turn back. Anyone
care to share experiences that might cause someone to
have to return to MDI?

for one thing, insulin-pumps are a PITA with that thing
attached to you 24/7

otoh, you'll using an insulin pump is the one best way to
learn what your basal needs really are. which is invaluable
for any t1 to know

for another, pumps cost a small fortune (both initially, and
also the ongoing supplies)

not to mention the constant extra b/g checking (in order
to avoid a "no insulin" delivery problem (sometimes pump
failure, but more often user error of some kind); which
can lead to a quick/severe bout of DKA... (in under 12
hours!) which can lead to brain swelling... which often
leads to death

Quoted message said:

* If you've got hypo unawareness (pre-pump), does the
awareness return to some (or any) extent once you have
been on pump therapy for awhile?

beef insulin

as i understand it, CP's beef neutral (aka Regular) is
buffered and should work well in a pump
(cppharma.co.ukcppharma.co.ukOpen ↗)

if you want a faster meal insulin, use beef-R in the pump
and carry either lispro or aspart in two 30 unit BD syringes
(which will serve as your important backup, in case of a "no
insulin" pump problem)

by carrying *two* syringes, you'll automatically cycle thru
them. i'd fill them to maybe 25 units. use the plastic bags
(that BD puts 10 syringes in) as a wrapper with a small
piece of Scotch tape. (cut the plastic bags with a pair of
scissors for max length of the plastic bag (iow, do not tear
it at the perfs))

an interesting alternative to the 30u BD syringes are the
30u Precision Sure-Dose syringes. (at www.hocks.com)

only negative is that there are no plastic bags (each
syringe is separately packed)

Quoted message said:

* Anyone in the So. Cal. area (in the Blue Cross CA HMO
plan) who can recommend a good doctor who has multiple
pump patients and who has considerable experience
working with them? Or maybe a hospital or other medical
organization for support?

Dr. Neil Goldberg in Culver City on Venice Blvd

not sure about the HMO thing, call his office and find out.
fwiw, imo you shouldn't be worrying about that kind of
nonsense when it comes to your main doc for diabetes

anyhow, Goldberg is an MD/endo and the best i've ever met on
the subject of getting your basal insulin amounts correct
with an insulin pump

when you ask a question, be sure to ask him to if possible
avoid using buzz words (keep it simple...)

bill t1 since '57, ex 8-yr pumper, pork/beef-L 2x,
simple MDI/DAFNE

Quoted message said:

Any information you are willing to share is greatly
appreciated.

Thanks in advance, > Yellowbird > Type I since 1984

Bay Area Dave said:

I have 2 backup pumps so for me there is no "down" time.

Hmmm. I don't need backup pumps.
--
Jim Dumas T1 4/86, background retinopathy, rarely
hypoglycemic: <1/mo. lispro+R+U+NPH daily, moderate
exercise, typically <6% HbA1c

and I don't need or want MDI.

dave

Jim Dumas said:

Bay Area Dave said:

I have 2 backup pumps so for me there is no "down" time.

Hmmm. I don't need backup pumps.

I don't consider my pump to be a PITA. I consider it a life saver. The
cost of a pump is often covered by insurance. My first pump cost me
nada. The last upgrade, about $600. and then there are some folks with
enough money that the cost is inconsequential. Not everyone is as broke
as you, wildbill. Which would you rather have: better health or a few
more bucks over the years to spend on some trivial pursuits? Some
people just can't get their priorities straight, huh? 🙂

dave

willbill said:

Yellowbird said:

* Most pumpers say they would never turn back. Anyone
care to share experiences that might cause someone to
have to return to MDI?

for one thing, insulin-pumps are a PITA with that thing
attached to you 24/7

otoh, you'll using an insulin pump is the one best way to
learn what your basal needs really are. which is
invaluable for any t1 to know

for another, pumps cost a small fortune (both initially,
and also the ongoing supplies)

not to mention the constant extra b/g checking (in order
to avoid a "no insulin" delivery problem (sometimes pump
failure, but more often user error of some kind); which
can lead to a quick/severe bout of DKA... (in under 12
hours!) which can lead to brain swelling... which often
leads to death

Quoted message said:

* If you've got hypo unawareness (pre-pump), does the
awareness return to some (or any) extent once you have
been on pump therapy for awhile?

beef insulin

as i understand it, CP's beef neutral (aka Regular) is
buffered and should work well in a pump
(cppharma.co.ukcppharma.co.ukOpen ↗)

if you want a faster meal insulin, use beef-R in the pump
and carry either lispro or aspart in two 30 unit BD
syringes (which will serve as your important backup, in
case of a "no insulin" pump problem)

by carrying *two* syringes, you'll automatically cycle
thru them. i'd fill them to maybe 25 units. use the
plastic bags (that BD puts 10 syringes in) as a wrapper
with a small piece of Scotch tape. (cut the plastic bags
with a pair of scissors for max length of the plastic bag
(iow, do not tear it at the perfs))

an interesting alternative to the 30u BD syringes are the
30u Precision Sure-Dose syringes. (at www.hocks.com)

only negative is that there are no plastic bags (each
syringe is separately packed)

Quoted message said:

* Anyone in the So. Cal. area (in the Blue Cross CA HMO
plan) who can recommend a good doctor who has multiple
pump patients and who has considerable experience
working with them? Or maybe a hospital or other
medical organization for support?

Dr. Neil Goldberg in Culver City on Venice Blvd

not sure about the HMO thing, call his office and find
out. fwiw, imo you shouldn't be worrying about that kind
of nonsense when it comes to your main doc for diabetes

anyhow, Goldberg is an MD/endo and the best i've ever met
on the subject of getting your basal insulin amounts
correct with an insulin pump

when you ask a question, be sure to ask him to if possible
avoid using buzz words (keep it simple...)

bill t1 since '57, ex 8-yr pumper, pork/beef-L 2x, simple
MDI/DAFNE

Quoted message said:

Any information you are willing to share is greatly
appreciated.

Thanks in advance, > Yellowbird > Type I since 1984

Bay Area Dave said:

I don't consider my pump to be a PITA. I consider it a life
saver. The cost of a pump is often covered by insurance. My
first pump cost me nada. The last upgrade, about $600. and
then there are some folks with enough money that the cost
is inconsequential. Not everyone is as broke as you,
wildbill. Which would you rather have: better health or a
few more bucks over the years to spend on some trivial
pursuits? Some people just can't get their priorities
straight, huh? 🙂

dave

pardon? you are claiming those who choose not to pump
because of the expense do so because they simply want more
money in their pockets rather spend it on pumping?

you truly have no clue about the state of health care
and the general public's ability to cover the costs in
this country.

The number of people who can afford pumping out of pocket is
extremely small compared to those who can only afford it
with the help of insurance. Mack©® Type 1 since 1975 alt-support-alt-support-Open ↗
diabetes.org insulin-pumpers.orginsulin-pumpers.orgOpen ↗

In tribute to the United States of America and the State of
Israel, two bastions of strength in a world filled with
strife and terrorism.

"To announce that there must be no criticism of the
President, or that we are to stand by the President
right or wrong, is not only unpatriotic and servile,
but is morally treasonable to the American public."

...Theodore Roosevelt

Quoted message said:

willbill said:

Yellowbird said:

* Most pumpers say they would never turn back. Anyone
care to share experiences that might cause someone to
have to return to MDI?

for one thing, insulin-pumps are a PITA with that thing
attached to you 24/7

otoh, you'll using an insulin pump is the one best way to
learn what your basal needs really are. which is
invaluable for any t1 to know

for another, pumps cost a small fortune (both initially,
and also the ongoing supplies)

not to mention the constant extra b/g checking (in order
to avoid a "no insulin" delivery problem (sometimes pump
failure, but more often user error of some kind); which
can lead to a quick/severe bout of DKA... (in under 12
hours!) which can lead to brain swelling... which often
leads to death

Quoted message said:

* If you've got hypo unawareness (pre-pump), does the
awareness return to some (or any) extent once you
have been on pump therapy for awhile?

beef insulin

as i understand it, CP's beef neutral (aka Regular) is
buffered and should work well in a pump
(cppharma.co.ukcppharma.co.ukOpen ↗)

if you want a faster meal insulin, use beef-R in the pump
and carry either lispro or aspart in two 30 unit BD
syringes (which will serve as your important backup, in
case of a "no insulin" pump problem)

by carrying *two* syringes, you'll automatically cycle
thru them. i'd fill them to maybe 25 units. use the
plastic bags (that BD puts 10 syringes in) as a wrapper
with a small piece of Scotch tape. (cut the plastic bags
with a pair of scissors for max length of the plastic bag
(iow, do not tear it at the perfs))

an interesting alternative to the 30u BD syringes are the
30u Precision Sure-Dose syringes. (at www.hocks.com)

only negative is that there are no plastic bags (each
syringe is separately packed)

Quoted message said:

* Anyone in the So. Cal. area (in the Blue Cross CA HMO
plan) who can recommend a good doctor who has
multiple pump patients and who has considerable
experience working with them? Or maybe a hospital or
other medical organization for support?

Dr. Neil Goldberg in Culver City on Venice Blvd

not sure about the HMO thing, call his office and find
out. fwiw, imo you shouldn't be worrying about that kind
of nonsense when it comes to your main doc for diabetes

anyhow, Goldberg is an MD/endo and the best i've ever met
on the subject of getting your basal insulin amounts
correct with an insulin pump

when you ask a question, be sure to ask him to if
possible avoid using buzz words (keep it simple...)

bill t1 since '57, ex 8-yr pumper, pork/beef-L 2x, simple
MDI/DAFNE

Quoted message said:

Any information you are willing to share is greatly
appreciated.

Thanks in advance, > Yellowbird > Type I since 1984

the only point you made that is reasonable is in your 3rd
paragraph. The rest, as usual is bunk. Life is a matter
of priorities. Those who have a financial hardship
purchasing a MiniMed pump can get a price break, or do
you "have no clue"?

you are an intractable idiot.

dave

Mack©® said:

Bay Area Dave said:

I don't consider my pump to be a PITA. I consider it a
life saver. The cost of a pump is often covered by
insurance. My first pump cost me nada. The last upgrade,
about $600. and then there are some folks with enough
money that the cost is inconsequential. Not everyone is as
broke as you, wildbill. Which would you rather have:
better health or a few more bucks over the years to spend
on some trivial pursuits? Some people just can't get their
priorities straight, huh? 🙂

dave

pardon? you are claiming those who choose not to pump
because of the expense do so because they simply want more
money in their pockets rather spend it on pumping?

you truly have no clue about the state of health care and
the general public's ability to cover the costs in this
country.

The number of people who can afford pumping out of pocket
is extremely small compared to those who can only afford
it with the help of insurance. Mack©® Type 1 since 1975
alt-support-diabetes.orgalt-support-diabetes.orgOpen ↗ insulin-insulin-Open ↗
pumpers.org

In tribute to the United States of America and the State
of Israel, two bastions of strength in a world filled
with strife and terrorism.

"To announce that there must be no criticism of the
President, or that we are to stand by the President
right or wrong, is not only unpatriotic and servile,
but is morally treasonable to the American public."

...Theodore Roosevelt

Quoted message said:

willbill said:

Yellowbird wrote:

>* Most pumpers say they would never turn back. Anyone
> care to share experiences that might cause someone to
> have to return to MDI?

for one thing, insulin-pumps are a PITA with that thing
attached to you 24/7

otoh, you'll using an insulin pump is the one best way to
learn what your basal needs really are. which is
invaluable for any t1 to know

for another, pumps cost a small fortune (both initially,
and also the ongoing supplies)

not to mention the constant extra b/g checking (in order
to avoid a "no insulin" delivery problem (sometimes pump
failure, but more often user error of some kind); which
can lead to a quick/severe bout of DKA... (in under 12
hours!) which can lead to brain swelling... which often
leads to death

>* If you've got hypo unawareness (pre-pump), does the
> awareness return to some (or any) extent once you
> have been on pump therapy for awhile?

beef insulin

as i understand it, CP's beef neutral (aka Regular) is
buffered and should work well in a pump
(cppharma.co.ukcppharma.co.ukOpen ↗)

if you want a faster meal insulin, use beef-R in the pump
and carry either lispro or aspart in two 30 unit BD
syringes (which will serve as your important backup, in
case of a "no insulin" pump problem)

by carrying *two* syringes, you'll automatically cycle
thru them. i'd fill them to maybe 25 units. use the
plastic bags (that BD puts 10 syringes in) as a wrapper
with a small piece of Scotch tape. (cut the plastic bags
with a pair of scissors for max length of the plastic bag
(iow, do not tear it at the perfs))

an interesting alternative to the 30u BD syringes are the
30u Precision Sure-Dose syringes. (at www.hocks.com)

only negative is that there are no plastic bags (each
syringe is separately packed)

>* Anyone in the So. Cal. area (in the Blue Cross CA HMO
> plan) who can recommend a good doctor who has
> multiple pump patients and who has considerable
> experience working with them? Or maybe a hospital or
> other medical organization for support?

Dr. Neil Goldberg in Culver City on Venice Blvd

not sure about the HMO thing, call his office and find
out. fwiw, imo you shouldn't be worrying about that kind
of nonsense when it comes to your main doc for diabetes

anyhow, Goldberg is an MD/endo and the best i've ever met
on the subject of getting your basal insulin amounts
correct with an insulin pump

when you ask a question, be sure to ask him to if
possible avoid using buzz words (keep it simple...)

bill t1 since '57, ex 8-yr pumper, pork/beef-L 2x, simple
MDI/DAFNE

>Any information you are willing to share is greatly
>appreciated.
>
>Thanks in advance, > Yellowbird > Type I since 1984

Bay Area Dave said:

the only point you made that is reasonable is in your 3rd
paragraph. The rest, as usual is bunk. Life is a matter
of priorities. Those who have a financial hardship
purchasing a MiniMed pump can get a price break, or do
you "have no clue"?

you are an intractable idiot.

dave

how much of a price break? and if the price break is
available to everyone with a financial hardship why isn't
the pump simply lowered in price? what about the on going
costs of supplies? The pump makers will drop their costs
permanently for someone who cannot afford the current price?

minimed charged 5000 for my pump, my insurance covered all
but 500.00 of the pump and the first 3 months worth of
supplies, minimed wrote off that 500.00. Minimed was
supposed to honor the agreement with my insurance company,
that stated all I would have to pay for on going supplies
was my co pay. Minimed did not honor that agreement. I paid
the copay then got billed for the uncovered amount the
insurance didn't pay. Then minimed sent several bills to the
insurance company that were already paid by the insurance
and myself.

Now you tell me, clearly, how someone who makes less than I
do without insurance, say someone working for minimum wage
is going to afford a pump.

Mack©® Type 1 since 1975 alt-support-diabetes.orgalt-support-diabetes.orgOpen ↗
insulin-pumpers.orginsulin-pumpers.orgOpen ↗

In tribute to the United States of America and the State of
Israel, two bastions of strength in a world filled with
strife and terrorism.

"To announce that there must be no criticism of the
President, or that we are to stand by the President
right or wrong, is not only unpatriotic and servile,
but is morally treasonable to the American public."

...Theodore Roosevelt

Quoted message said:

Mack©® said:

Bay Area Dave said:

I don't consider my pump to be a PITA. I consider it a
life saver. The cost of a pump is often covered by
insurance. My first pump cost me nada. The last upgrade,
about $600. and then there are some folks with enough
money that the cost is inconsequential. Not everyone is
as broke as you, wildbill. Which would you rather have:
better health or a few more bucks over the years to spend
on some trivial pursuits? Some people just can't get
their priorities straight, huh? 🙂

dave

pardon? you are claiming those who choose not to pump
because of the expense do so because they simply want
more money in their pockets rather spend it on pumping?

you truly have no clue about the state of health care and
the general public's ability to cover the costs in this
country.

The number of people who can afford pumping out of pocket
is extremely small compared to those who can only afford
it with the help of insurance. Mack©® Type 1 since 1975
alt-support-diabetes.orgalt-support-diabetes.orgOpen ↗ insulin-insulin-Open ↗
pumpers.org

In tribute to the United States of America and the State
of Israel, two bastions of strength in a world filled
with strife and terrorism.

"To announce that there must be no criticism of the
President, or that we are to stand by the President
right or wrong, is not only unpatriotic and servile,
but is morally treasonable to the American public."

...Theodore Roosevelt

Quoted message said:

willbill wrote:

>Yellowbird wrote:
>
>
>>* Most pumpers say they would never turn back. Anyone
>> care to share experiences that might cause someone
>> to have to return to MDI?
>
>
>for one thing, insulin-pumps are a PITA with that thing
>attached to you 24/7
>
>otoh, you'll using an insulin pump is the one best way
>to learn what your basal needs really are. which is
>invaluable for any t1 to know
>
>for another, pumps cost a small fortune (both initially,
>and also the ongoing supplies)
>
>not to mention the constant extra b/g checking (in order
>to avoid a "no insulin" delivery problem (sometimes pump
>failure, but more often user error of some kind); which
>can lead to a quick/severe bout of DKA... (in under 12
>hours!) which can lead to brain swelling... which often
>leads to death
>
>
>
>>* If you've got hypo unawareness (pre-pump), does the
>> awareness return to some (or any) extent once you
>> have been on pump therapy for awhile?
>
>
>beef insulin
>
>as i understand it, CP's beef neutral (aka Regular) is
>buffered and should work well in a pump
>(cppharma.co.ukcppharma.co.ukOpen ↗)
>
>if you want a faster meal insulin, use beef-R in the
>pump and carry either lispro or aspart in two 30 unit BD
>syringes (which will serve as your important backup, in
>case of a "no insulin" pump problem)
>
>by carrying *two* syringes, you'll automatically cycle
>thru them. i'd fill them to maybe 25 units. use the
>plastic bags (that BD puts 10 syringes in) as a wrapper
>with a small piece of Scotch tape. (cut the plastic bags
>with a pair of scissors for max length of the plastic
>bag (iow, do not tear it at the perfs))
>
>an interesting alternative to the 30u BD syringes are
>the 30u Precision Sure-Dose syringes. (at www.hocks.com)
>
>only negative is that there are no plastic bags (each
>syringe is separately packed)
>
>
>>* Anyone in the So. Cal. area (in the Blue Cross CA
>> HMO plan) who can recommend a good doctor who has
>> multiple pump patients and who has considerable
>> experience working with them? Or maybe a hospital or
>> other medical organization for support?
>
>
>
>Dr. Neil Goldberg in Culver City on Venice Blvd
>
>not sure about the HMO thing, call his office and find
>out. fwiw, imo you shouldn't be worrying about that kind
>of nonsense when it comes to your main doc for diabetes
>
>anyhow, Goldberg is an MD/endo and the best i've ever
>met on the subject of getting your basal insulin amounts
>correct with an insulin pump
>
>when you ask a question, be sure to ask him to if
>possible avoid using buzz words (keep it simple...)
>
>bill t1 since '57, ex 8-yr pumper, pork/beef-L 2x,
>simple MDI/DAFNE
>
>
>>Any information you are willing to share is greatly
>>appreciated.
>>
>>Thanks in advance, > Yellowbird > Type I since 1984
>

ask MiniMed; don't ask me. I don't work for them. Why do
seniors get a discount at movie theaters and restaurants?
Everyone else is subsidizing them, according to your logic.

Someone making minimum wage can't afford to purchase the
pump at full price. You question is, as usual moronic.

for your feeble brain, I repeat: MiniMed will give a
financial hardship discount.

you are an argumentative mental midget! give it up.

dave

Mack©® said:

Bay Area Dave said:

the only point you made that is reasonable is in your 3rd
paragraph. The rest, as usual is bunk. Life is a matter
of priorities. Those who have a financial hardship
purchasing a MiniMed pump can get a price break, or do
you "have no clue"?

you are an intractable idiot.

dave

how much of a price break? and if the price break is
available to everyone with a financial hardship why
isn't the pump simply lowered in price? what about the
on going costs of supplies? The pump makers will drop
their costs permanently for someone who cannot afford
the current price?

minimed charged 5000 for my pump, my insurance covered all
but 500.00 of the pump and the first 3 months worth of
supplies, minimed wrote off that 500.00. Minimed was
supposed to honor the agreement with my insurance company,
that stated all I would have to pay for on going supplies
was my co pay. Minimed did not honor that agreement. I
paid the copay then got billed for the uncovered amount
the insurance didn't pay. Then minimed sent several bills
to the insurance company that were already paid by the
insurance and myself.

Now you tell me, clearly, how someone who makes less than
I do without insurance, say someone working for minimum
wage is going to afford a pump.

Mack©® Type 1 since 1975 alt-support-alt-support-Open ↗
diabetes.org insulin-pumpers.orginsulin-pumpers.orgOpen ↗

Bay Area Dave said:

ask MiniMed; don't ask me. I don't work for them. Why do
seniors get a discount at movie theaters and restaurants?
Everyone else is subsidizing them, according to your logic.

Someone making minimum wage can't afford to purchase the
pump at full price. You question is, as usual moronic.

for your feeble brain, I repeat: MiniMed will give a
financial hardship discount.

you are an argumentative mental midget! give it up.

dave

and again you conveniently avoid the ongoing costs of
monthly supplies.

Mack©® Type 1 since 1975 alt-support-diabetes.orgalt-support-diabetes.orgOpen ↗
insulin-pumpers.orginsulin-pumpers.orgOpen ↗

In tribute to the United States of America and the State of
Israel, two bastions of strength in a world filled with
strife and terrorism.

"To announce that there must be no criticism of the
President, or that we are to stand by the President
right or wrong, is not only unpatriotic and servile,
but is morally treasonable to the American public."

...Theodore Roosevelt

Quoted message said:

Mack©® said:

Bay Area Dave said:

the only point you made that is reasonable is in your 3rd
paragraph. The rest, as usual is bunk. Life is a matter
of priorities. Those who have a financial hardship
purchasing a MiniMed pump can get a price break, or do
you "have no clue"?

you are an intractable idiot.

dave

how much of a price break? and if the price break is
available to everyone with a financial hardship why
isn't the pump simply lowered in price? what about the
on going costs of supplies? The pump makers will drop
their costs permanently for someone who cannot afford
the current price?

minimed charged 5000 for my pump, my insurance covered
all but 500.00 of the pump and the first 3 months worth
of supplies, minimed wrote off that 500.00. Minimed was
supposed to honor the agreement with my insurance
company, that stated all I would have to pay for on going
supplies was my co pay. Minimed did not honor that
agreement. I paid the copay then got billed for the
uncovered amount the insurance didn't pay. Then minimed
sent several bills to the insurance company that were
already paid by the insurance and myself.

Now you tell me, clearly, how someone who makes less than
I do without insurance, say someone working for minimum
wage is going to afford a pump.

Mack©® Type 1 since 1975 alt-support-alt-support-Open ↗
diabetes.org insulin-pumpers.orginsulin-pumpers.orgOpen ↗

I'm not 'avoiding' ongoing expenses. I pay them as
necessary.

dave

Mack©® said:

Bay Area Dave said:

ask MiniMed; don't ask me. I don't work for them. Why do
seniors get a discount at movie theaters and
restaurants? Everyone else is subsidizing them,
according to your logic.

Someone making minimum wage can't afford to purchase the
pump at full price. You question is, as usual moronic.

for your feeble brain, I repeat: MiniMed will give a
financial hardship discount.

you are an argumentative mental midget! give it up.

dave

and again you conveniently avoid the ongoing costs of
monthly supplies.

Mack©® Type 1 since 1975 alt-support-alt-support-Open ↗
diabetes.org insulin-pumpers.orginsulin-pumpers.orgOpen ↗

In tribute to the United States of America and the State
of Israel, two bastions of strength in a world filled
with strife and terrorism.

"To announce that there must be no criticism of the
President, or that we are to stand by the President
right or wrong, is not only unpatriotic and servile,
but is morally treasonable to the American public."

...Theodore Roosevelt

Quoted message said:

Mack©® said:

On Sat, 20 Mar 2004 23:22:56 GMT, Bay Area Dave
<[email hidden]> wrote:

>the only point you made that is reasonable is in your
>3rd paragraph. The rest, as usual is bunk. Life is a
>matter of priorities. Those who have a financial
>hardship purchasing a MiniMed pump can get a price
>break, or do you "have no clue"?
>
>you are an intractable idiot.
>
>dave

how much of a price break? and if the price break is
available to everyone with a financial hardship why
isn't the pump simply lowered in price? what about the
on going costs of supplies? The pump makers will drop
their costs permanently for someone who cannot afford
the current price?

minimed charged 5000 for my pump, my insurance covered
all but 500.00 of the pump and the first 3 months worth
of supplies, minimed wrote off that 500.00. Minimed was
supposed to honor the agreement with my insurance
company, that stated all I would have to pay for on going
supplies was my co pay. Minimed did not honor that
agreement. I paid the copay then got billed for the
uncovered amount the insurance didn't pay. Then minimed
sent several bills to the insurance company that were
already paid by the insurance and myself.

Now you tell me, clearly, how someone who makes less than
I do without insurance, say someone working for minimum
wage is going to afford a pump.

Mack©® Type 1 since 1975 alt-support-alt-support-Open ↗
diabetes.org insulin-pumpers.orginsulin-pumpers.orgOpen ↗

Stephanie Kolban said:

Mack, Thanks for my morning giggle. I about spat Diet Big
Red on the computer screen! Steph

they say humor can make a relationship. if that be true, I
never have to worry about my other half wandering off.

Mack©® Type 1 since 1975 alt-support-diabetes.orgalt-support-diabetes.orgOpen ↗
insulin-pumpers.orginsulin-pumpers.orgOpen ↗

In tribute to the United States of America and the State of
Israel, two bastions of strength in a world filled with
strife and terrorism.

"To announce that there must be no criticism of the
President, or that we are to stand by the President
right or wrong, is not only unpatriotic and servile,
but is morally treasonable to the American public."

...Theodore Roosevelt

Quoted message said:

"Mack©®" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

On Sat, 20 Mar 2004 18:57:27 -0500 (EST),

(Micki Webber) said:

OMG.....another pissing match between the boys!!! Mic

Always, be, and stay AWARE!

aren't you glad you are not plagued with testosterone
issues.

Mack©® Type 1 since 1975 alt-support-alt-support-Open ↗
diabetes.org insulin-pumpers.orginsulin-pumpers.orgOpen ↗

In tribute to the United States of America and the State
of Israel, two bastions of strength in a world filled
with strife and terrorism.

"To announce that there must be no criticism of the
President, or that we are to stand by the President
right or wrong, is not only unpatriotic and servile,
but is morally treasonable to the American public."

...Theodore Roosevelt

Bay Area Dave said:

I'm not 'avoiding' ongoing expenses. I pay them as
necessary.

dave

poor attempt at avoiding the question. very transparent.

Mack©® Type 1 since 1975 alt-support-diabetes.orgalt-support-diabetes.orgOpen ↗
insulin-pumpers.orginsulin-pumpers.orgOpen ↗

In tribute to the United States of America and the State of
Israel, two bastions of strength in a world filled with
strife and terrorism.

"To announce that there must be no criticism of the
President, or that we are to stand by the President
right or wrong, is not only unpatriotic and servile,
but is morally treasonable to the American public."

...Theodore Roosevelt

Quoted message said:

Mack©® said:

Bay Area Dave said:

ask MiniMed; don't ask me. I don't work for them. Why do
seniors get a discount at movie theaters and
restaurants? Everyone else is subsidizing them,
according to your logic.

Someone making minimum wage can't afford to purchase the
pump at full price. You question is, as usual moronic.

for your feeble brain, I repeat: MiniMed will give a
financial hardship discount.

you are an argumentative mental midget! give it up.

dave

and again you conveniently avoid the ongoing costs of
monthly supplies.

Mack©® Type 1 since 1975 alt-support-alt-support-Open ↗
diabetes.org insulin-pumpers.orginsulin-pumpers.orgOpen ↗

In tribute to the United States of America and the State
of Israel, two bastions of strength in a world filled
with strife and terrorism.

"To announce that there must be no criticism of the
President, or that we are to stand by the President
right or wrong, is not only unpatriotic and servile,
but is morally treasonable to the American public."

...Theodore Roosevelt

Quoted message said:

Mack©® wrote:

>On Sat, 20 Mar 2004 23:22:56 GMT, Bay Area Dave
><[email hidden]> wrote:
>
>
>
>>the only point you made that is reasonable is in your
>>3rd paragraph. The rest, as usual is bunk. Life is a
>>matter of priorities. Those who have a financial
>>hardship purchasing a MiniMed pump can get a price
>>break, or do you "have no clue"?
>>
>>you are an intractable idiot.
>>
>>dave
>
>
>how much of a price break? and if the price break is
>available to everyone with a financial hardship why
>isn't the pump simply lowered in price? what about the
>on going costs of supplies? The pump makers will drop
>their costs permanently for someone who cannot afford
>the current price?
>
>minimed charged 5000 for my pump, my insurance covered
>all but 500.00 of the pump and the first 3 months worth
>of supplies, minimed wrote off that 500.00. Minimed was
>supposed to honor the agreement with my insurance
>company, that stated all I would have to pay for on
>going supplies was my co pay. Minimed did not honor that
>agreement. I paid the copay then got billed for the
>uncovered amount the insurance didn't pay. Then minimed
>sent several bills to the insurance company that were
>already paid by the insurance and myself.
>
>Now you tell me, clearly, how someone who makes less
>than I do without insurance, say someone working for
>minimum wage is going to afford a pump.
>
>Mack©® Type 1 since 1975 alt-support-alt-support-Open ↗
>diabetes.org insulin-pumpers.orginsulin-pumpers.orgOpen ↗