Pump visit number one

As promised, we drove to Children's Hospital for our first serious discussion about getting M on the insulin pump. There was a lot of hemming and hawing about this trip. One reason we had debate and discussion: the school where I teach had had so many snow days, that M's appointment fell on the second day of the new semester. I found this very inconvenient because I do not feel great about swooping in, introducing myself to my new classes and then disappearing for a day. Not to mention that I would have to get creative and leave plans for a substitute teacher who invariably speaks no Spanish, and therefore will have a tough time getting my Spanish students to get any real work done. The excuse "but I don't get it" works very well with substitutes weak on the subject.

But then, on the day of the appointment, there was a snow day. Another one. So while there was no longer any need to worry about creative sub plans, we did have to worry about driving for what would very likely be over an hour in very dangerous conditions, with some of the country's most notoriously aggressive drivers.

So the debate became; should we go or shouldn't we?

Deciding I would rather face Mother Nature than a fully unsuccessful day with a substitute teacher, we went.

We left the evening before the appointment and stayed at a friend's house in suburban Boston. The next morning we drove to the appointment very slowly, arriving nearly an hour early.

First thing to report: M's A1C were "out of range" at 8.2,  the highest she had ever experienced. After all of the craziness of the previous three weeks, neither of us were surprised. Since we had been e-mailing our DNE for several days prior to this visit,  she was not surprised either.

Nor did she seem worried. I think I was a little disappointed that she was not more worried. I have been working pretty hard with M to keep tight control over her bg. Then to have her A1C fall apart like that was pretty upsetting.

I was worried, but I decided to move forward with our pump discussion.

After asking us a series of questions, the DNE decided to send us along the pump route. She had been encouraging us to switch to the pump, and so had the endocrinologist. M was eager to go, so I was the last hold out.  Now that I was better informed and more comfortable with the idea, I had to learn about the next steps.

It turns out that getting a pump is a months-long process, which disappointed M very much. But at least we were starting.

The first step is to choose an infusion set and a pump. Apparently we needed to have a special appointment for that purpose. I could not imagine why we couldn't do that part today, but maybe the DNE needs to put an addition on her house.

Step number two is contacting the sales representative for the pump that M chooses. Apparently the rep will talk with our insurance company and determine how much will be covered, and let us know how much we will pay out of pocket, which will likely be in the thousands of dollars (which, by the way, we don't have. I foresee a lot of phone time with the insurance company).

After that, the pump is ordered. Then we make an appointment for M to get it fitted, and for her to learn how to use it. Then she basically pretends to use it as saline is pumped into her body. Evidently, one of her parents will have to wear a pump too, so that we will understand how it works, etc. This is done for two weeks.

After the two weeks, M is then given real insulin for the pump, and she begins flying without a net, so to speak. Then she is checked at the hospital after one week, then two weeks, then one month, to make sure that she is using it correctly. This means a rather large number of drives into the Boston area, and while I have some obscene number of sick days available to me, I hate missing my classes (see above: substitutes, blah, blah, blah).

M left the appointment excited. She had brochures in hand, and a plan to talk to her friends from diabetes camp on facebook to learn which pump they preferred and why. Then we would schedule her infusion set appointment.

The long, snowy trip back home was slow, but M was thrilled with the first steps toward her new method of managing her diabetes. She clung to her brochures and flipped through them, talking about colors and designs she could have on her pump, and dreaming of fewer daily injections.

Soon enough, M. Soon enough.