Last week we had our last of 3 insulin pump education sessions. This Thursday we head off to hospital with little Miss Chief in tow and come home with a $9000 life saving insulin infusing super computer which the Chief will carry with her at all times. We will learn a new way of dosing and managing insulin and spend the following few weeks doing a lot of testing and tweaking to get it set up just for her.
When our lovely diabetes educator, Claire, first told us about the pump, during those first crazy days in hospital, I wasn't particularly interested. The thought of my daughter being permanently attached to a life-saving medical device was extremely confronting. It felt like it would be a constant reminder of her condition. I liked the fact that we could just inject her and forget about it. I really couldn't understand why anyone would want a pump.
Of course they're such a big technological advancement in the field of diabetes and are becoming increasingly popular that I couldn't just forget about them. As I was exposed to more and more T1 families I noticed that a considerable number of them used pumps. As our own family members became more aware of the disease they would say things like "so and so has a pump. Have you heard of them? Would you get one?"
One of my initial concerns had been that it wasn't really my place to decide something so huge for someone else even if she was only 3 years old. I wondered how it would fit with her clothes, especially dresses and whether it would be a total pain on one of those days where she's playing dress ups or just getting changed 20 times. By the same token, it didn't seem fair to rule it out for her without introducing the idea to her and giving her some say in the matter. And as time went on I realised that injections don't allow you to forget about your diabetes. Anything but. It's constant and with injections any time you want to eat you have to figure out whether you should or shouldn't eat carbs or dose some insulin.
As I mentioned in a previous post, at the end of last year I took Miss Chief to a JDRF-sponsored family bowling event and we met a little girl, Miss M, just a little bit older than Chief who had recently started using a pump. The two girls became friends and Miss M and her mum showed us her pink Animas Vibe pump and how it worked. Miss Chief marvelled at how little Miss M was able to share a bag of teddy bear biscuits with her friend whilst her mum casually punched her BGL and 8g carbs into the pump. Meanwhile Miss Chief and I wandered around the bowling alley looking for a quiet spot for her to lie down and bare her buttocks for her injection. Her lunch was carefully planned to match her dose and at this time I had only a fair idea about carb counting and very little clue how to match insulin doses to carbs. There was very little room for flexibility. As we found a quiet comfortable sofa Miss Chief said to me, "but Mammy. I don't want my injection. I want a pump." And that set the wheels in motion.
By the time I told our educator and paediatrician at our clinic visit a few weeks later that we wanted to discuss moving to a pump, we were getting pretty good at carb counting and weren't far off calculating an insulin to carb ratio which would allow us to give more accurate doses. This doesn't mean that the pump was no longer useful to us. On the contrary it meant that we were well on our way to pump preparation as accurate carb counting is essential to pumping. The medical team were very supportive of our decision even though I wasn't 100% certain of it myself. We were warned we could wait up to 6 months to get the pump due to limited clinic times for pump education and start sessions so I got us onto the waiting list so I could spend at least part of that 6 months figuring out if it was the right thing to do. The paediatrician signed the approval forms as soon as I told her we were thinking of it, saying, "It'll be great for you guys. I'll sign this now so I don't hold you up later if you decide to go ahead. Remember, it's a lifestyle choice and you, as the parents of a 4 year old, should be the ones making the decision, not her."
To a certain extent I agreed with the doctor as we are managing Chief's diabetes for her, but at the same time a diagnosis of diabetes had meant such a huge change to the Chief's life and we couldn't control or change that. I didn't want to introduce another unwelcome change, one that we did have control over, just as she was getting used to things being the way they were. I spent the next few months making sure that it was the right decision for all of us. This meant not just researching the different pumps but talking to other parents, especially of girls, about how their children wore their pumps with different types of clothing, looking at different infusion sets and cannulas and reading books about pumping insulin. The books were a great source of information on how to manage diabetes and got me, as our educator put it, "thinking like a pump."
Chief and I try out cannulas.
Over the past few months we've attended information evenings and played with different pumps. We settled on the Animas Vibe, primarily for its waterproof feature. I met some amazing mums who allowed me to bolus their children , ie administer their insulin via their pump. Map Man and I have each tried a couple of different cannulas and even the Chief has tried a steel cannula and decided that's what she's going to use and there's no need to try again until she gets her pump. Fair enough. I can't believe it's come around already and it's fair to say we're pretty excited about it. Only three sleeps to go...