The Pump arrives

The pump has arrived!

Since such an expensive piece of equipment requires a signature upon delivery, we opted to have it delivered to M's school. One can never predict when one will be home, but the owners of M's school not only own it, but also occupy the upstairs. Someone is nearly always there.

I received the phone call from Wanda, the school's director, letting me know that the pump has arrived, and that I can pick it up at my convenience.

My husband Bill and I take a drive to the school to pick up the pump. I bribe him to come along by telling him that we can look at motorcycles - an annual spring ritual that sometimes ends up with us actually buying a motorcycle. Being a good husband and father, Bill has sold his last motorcycle when M was diagnosed, so that we could pay her medical bills. The previous one he sold so that we could pay Big Brother's tuition. It's probably about time to get another one.

Bill agrees, and we take the half hour drive to the school to pick up the pump. We nervously leave it in the car while we browse the motorcycle selection. We look at stupid bikes, ugly bikes, and nice bikes. Then we leave so that M can view her new pump.

When she climbs into the car and sees the box, she makes little happy squirrel noises. She wants to rip the box open right then, but we ask her to wait until we get home.

We tear open the box immediately.

Inside is the pump ( a Medtronic Revel), a lot of manuals, a HIPAA policy, four boxes of infusion sets, four boxes of reservoirs, four AAA batteries, a One Touch Ultra Link glucose monitor, and a USB stick.

I had been told by the area rep for the pump company that M would be okay if she wanted to start pressing buttons on the pump. She wouldn't hurt it.

She pulled it out and pressed buttons, while I showed my parents what the infusion sets looked like. They had been reading up, and understood how they worked. I didn't have to explain that the infusion set is not surgically implanted.

Then I pulled out the reservoirs. All of this equipment looked pretty confusing. I figured I would have to read all of the literature that came in the box before I understand it all.

The first booklet of literature was called "The Basics of Insulin Pump Therapy". I read through it. There was no news in there. Check bg a bunch. You will still have to take injections once in a while. Bg is affected by diet and exercise. Basal is the constant insulin, bolus is the insulin you take to cover food that enters your body or to cover a spike in bg. Lows are caused by insulin. This was diabetes 101.

I figured I would learn more in the next booklet, "A Step-By-Step Guide to the Minimed Paradigm REAL-Time Insulin Pump." On page four, I found a diagram of the pump and all its parts and functions.

This helped a lot.

Now I understood what all this other stuff did.

Evidently, we were going to go back to purchasing vials of Humalog, instead of the cartridges that we had been buying for M's super cool insulin pen. The reservoir has a little plunger on it that sucks the insulin out of the vial for easy storage in the pump. According to the information in the booklet, the reservoir should hold about two or three days worth of insulin.

The screens and buttons on the pump can be locked or protected.

There is an airport card that can be given at airport security so that you don't have to remove your pump when you go through screening.

The bg meter will communicate with the pump, which will help it to calculate which dose you should give yourself, but will not administer the insulin until you tell it to.

Cold insulin tends to form air bubbles in the reservoir and the tubing, so it is better to fill your reservoir with insulin that is at room temperature.

There are "alarms" on the pump for empty reservoir, weak battery, failed battery test, and no delivery.

There are "alerts" for low battery and low reservoir.

M has been playing with the buttons. She has put the correct time and date on her meter. She has been wearing it, even though it is not attached to her body yet. She can't wait to show it off.

Now we wait for the trainer to call us to schedule M's "saline start", her week long practice with the pump using saline ( "It's like salt water" she told her grandparents.)

I can hardly wait to learn more about diabetes management with the pump: something I never thought I would have to know, nor did I intend to know anything about.