Finally

Have you ever lost touch with a close friend?

Ever let so much time go by without talking that you just didn't know where to begin?

And even when something truly wonderful happens, your shame at having let this friend fall so far out of your life prevents you from sharing it with them.

Well, that's how I've been feeling for quite a while now.

About this blog-- and about all of you.

So I'm just gonna jump in where I left off and see what happens...

Joseph loves the Ping-- we all do.

His new pump and meter arrived over the Christmas break and turned out to be quite the gift.

"Mom, look at this screen!" my boy exclaimed after we powered up the pump, "it's... beautiful."

I had to agree. Definitely more readable than its predecessor.

In addition to the fabulous color screen, I love that we can use his meter to see how much insulin Joseph has on board from another room. And as I mentioned in my previous post, giving him a corrective dose of insulin while he sleeps is sooo much easier now.

So yeah, we're happy.

Now.

This is not to say that the Ping is perfect...

When we opened the box and pulled out the pump, I noticed immediately that the Ping is considerably bigger than Joseph's IR 1200. (Bear in mind, one of the things that drew us to Animas in the first place was the small size of their pump. So this was a surprise.)

Also, I was looking forward to Joseph having the food database in the pump.

You see, shortly after we purchased his IR 1200 four years ago, Animas released the IR 1250--the first of their pumps to include that database.

Sadly, the Ping only has the food database on the meter-- which seems kind of nutty (at least for us) as we don't send the Ping's expensive, somewhat large meter to school with Joseph (where I think he'd most benefit from having access to that food database).

Ah well.

In other news, Evan lost her first tooth!

AND I got a job!

Which is part of the reason I've been MIA.

It's part time (20-30 hours a week) extremely flexible-- and dang cool.

I'll tell you more about it soon.

One last thing.

Joseph is just shy of my height and closing fast... which is sort of freaking me out.

An Early Present

Here we are coming to the end of the year, and what have I been doing?

Stressing about money.

Money for our property taxes, money for Joseph's orthodontia, miscellaneous medical bills, our insurance premiums, CHRISTMAS...

Money for a new insulin pump.

That's right, Joseph's current pump will soon be out of warranty-- and given our history, there's no way we can afford to be without a warranty. Thus, we have to choose a new pump and purchase it before the end of this month.

After much discussion -- and a brief look at the competition -- we've decided to stay with Animas.

Initially I had some reservations about this decision, but we have gotten excellent customer service and Joseph does indeed love his current pump.

And we're all very much intrigued by the new OneTouch Ping system.

This latest technology from Animas includes a glucose meter that is able to wirelessly communicate with the pump.

You can actually operate the pump from the meter.

What exactly does this mean?

Well, for us it means that when we check Joseph's blood sugar every two hours overnight and have to give him a correction when he's high or decrease his basal insulin when he's low, we won't have to:

• Pull back his blankets;
• Roll him over (if he happens to be lying on his pump case);
• Remove his pump while untangling his tubing (which always seems to be wrapped around the clip on his case);
• Give a bolus or change his basals while keeping one eye on the pump, the other on Joseph (because any sudden move can easily rip out his infusion set);
• Maneuver the pump back into it's case as Joseph flails about in his sleep and then rolls once again on top of said case.

Nope, we won't have to do any of the above.

Rock. On.

Ahhh, but there's more...

No, not about the Ping-- but rather, about paying for the Ping.

While we have insurance and have met our deductible for the year, unfortunately, we're still left with a 10% coinsurance payment.

Something like $660.

Uh huh, this is where the stress part comes in.

Or maybe not.

I got a call last Wednesday afternoon from Animas.

"Sandra, we're still waiting for prior authorization from your insurance company, however, we were able to verify your benefits. It looks like you have a 100% benefit."

"Excuse me?"

"A 100% benefit."

"Really?... Seriously?"

"Yes, you see- "

"But wait-- how can that be? Our insurance covers 90% once our deductible is met. I don't understand."

"Well, it looks like you've also met your family's annual out-of-pocket maximum."

"Holy Cripes! Then you are serious."

And now I'm up out of my chair.

"You've just given us an early Christmas present, you know that? This is AWESOME!!!"

The minute I hang up the phone, I'm punching in another number.

"Ryan? Honey, we're getting the Ping for Joseph-- and it's not gonna cost a thing! Can you believe it?!"

I still can't.

Parents of Prospective Pumpers

Try saying that three times fast.

So, upon waking this morning I found a number of wonderful, encouraging comments in response to last night's post. Thanks guys. I feel better already. I wish I could say the same for Joseph-- his fever is up again. But we kept his sugar from going completely nuts last night-- just one spike to 257, that was stopped in its tracks with an aggressive correction. He stayed in the low 100's the remainder of the night, then dropped to 79 at 5am. Okaaay. We nudged his basal rate up a bit, and he was back in those low 100's...

It's a dance. And we're getting a lot better at it.

Now, this morning I also discovered a comment to a previous post, He Found Out, from another fairly new blogger-- Type1Dad. As per usual, I was going to respond to his response in a comment. But then I realized that his request for information about how we began prepping for the pump might also be of interest to others who were looking for the same.

Soooo..... here's the deal:

Yes, we did put in quite a bit of time in preparation for the pump. One of the first and best things I did was to subscribe to Insulin-pumpers.org (see my very first link). These people are amazing. "Pumpers," as I like to call them, are an online community of pumpers AND parents of pumpers. There are almost 5,000* folks currently subscribed to this group. And I cannot say enough about the wealth of information and support they provide. Even if you're shy about posting, just following the threads will provide a ton of info. I was one who posted looking for answers, especially before we settled on a pump for Joseph. These people gave me an inside look at the various pumps out there, helped me articulate the important questions for our care team, and really just got us through the whole saline trial period.

It costs nothing to join, but they do have fundraising drives. I always contribute, because I think the work they do-- bringing people together who might otherwise have never connected -- is invaluable.

Moving on...

I also read several books about the subject. If you haven't read them already, start with:

Insulin Pump Therapy Demystified by Gabrielle Kaplan-Mayer

Initially, I looked at others (and actually starting reading Pumping Insulin-- see below), but found that reading this book cover-to-cover first was the best way to get my "feet wet" with the whole idea of pumping.

Next, I read:

Smart Pumping by Howard Wolpert

This is my favorite book on pumping. The writing is so well done, so accessible. It doesn't read like a text book-- more like having someone, a very personable someone, sitting there with you, explaining the basics. In fact, using this book, I was actually able to determine Joseph's starting basal rate, insulin-to-carb ratios and sensitivity factor before we even got the pump. And they matched the ones set by our CDE!

And finally, I read (and still consult):

Pumping Insulin by John Walsh

A fantastic resource, but very intimidating if you haven't read the previous two first. John Walsh is considered by many in "pumping" circles as the "guru" of insulin pumping. This book certainly bears that out. His website is also a terrific place to visit for comprehensive articles on the subject, an extremely useful pump comparison table, or just to buy books and other diabetic supplies.

The last component here, and it was really the first, most important, and an on-going one, was to spend time talking with Joseph about the idea of pumping-- exposing him as much as possible, without overwhelming him (which can be really hard, I know) to the whole concept. Then we did saline trials with three different pumps. The first trial was with a Minimed at a terrific ADA camp in October for newly-diagnosed families. I actually wore a Paradigm pump along with Joseph. Quite frankly, there was no way I was going to even consider having my son wear a pump without knowing first hand if it would hurt him. (BTW, it didn't hurt.) Next up, Joseph tried the Cozmo and Animas pumps in December.

Now, at times, Joseph did express some resistence to the idea of wearing a pump, but I believe that having faith that this device would be the best choice for him, and conveying that faith in every conversation about it, was key. After all, if he was not on board with this, there's no way it would work. And we would have certainly delayed putting him on an insulin pump if that were the case. Happily, it was not.

After thoroughly researching all of these pumps (and finding pros and cons with all three), and to further strengthen Joseph's commitment to such an important step, I decided to let him make the final choice. After all, he was the one who would have to wear it. 24/7.

Joseph chose the Animas 1200 . It was the smallest, lightest pump available. And extremely user-friendly. He loved it from the moment he started using it with saline. And, (for mom!) it had the lowest basal rate increment-- .025 units/hour. Because Joseph was (and still, apparently, is) honeymooning, this was an excellent choice. We are now back to running a .025 basal from 10 am to 8pm.

As a result of all of the above, we went into our training with confidence. We'd received our pump almost a month before the training actually took place, so we had some time to play with it a bit. Joseph and I had also messed with the virtual pump on Animas' website, so we were pretty comfortable with the real thing. At our training session, we came in with Joseph's pump loaded with a battery and already programmed. Ryan, Joseph and I had worked with the training DVD, practiced filling the cartridge (with saline, of course), loading it into the pump, and priming. The only thing that made me nervous was inserting the cannula-- but, I think anytime you have to stick something into your child, you're gonna be a bit shaky. Thank heavens we took to that quickly as well.

I won't lie, we've had some scary moments since Joseph started pumping. Just read some of my previous posts. But despite this, he still says that he will "never go back to shots."

There you have it. Sorry for the incredible length, but the process of choosing an insulin pump and learning how to use it-- of becoming emotionally ready to take this step-- can be daunting. Hopefully, this post gives you some guidance along the way.

If you have any other questions, just ask.

* this is a correction-- originally I posted that there were (only!) around 500 subscribers-- this is actually the number of subscribers to the parents-of-pumpers list alone.