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Dr. Bill's Commentaries

PS-Day plus a month   (July 27, 2008)

Last month, I started using an insulin pump (see I'm pumped and PS-Day plus 7).

And the past few days, I've gotten another obvious question from my wife Steph: "Don't you think you should have started the pump sooner?" After all, it's been two years of diabetes, and all along, I've been saying "maybe someday I should start a pump" (See my essay from February, 2007 Time For A Pump?).

Before tackling an answer to that question, let me say that I'm now used to having a little black box attached to me. It stays attached about 23.75 hours a day, and quietly chirps when it's time for another blood sugar, or another bolus, or the battery is low, or when it thinks the Red Sox might be beating the Yankees (okay, I made that last one up).

And I'm finding new and creative ways to keep my BG levels where I want them (for instance, breakfast of peanut butter on English muffins is better treated with a combination bolus: about half is delivered immediately, and half delivered over the next hour).

Thus far, no nasty lows -- which is the main reason that my endocrinologist suggested I start a pump.

Actually, things are going very routinely thus far -- no need for any insulin injections by syringe (although I religiously keep a vial of insulin and some spare syringes in my "go-bag"). The go-bag goes everywhere I go, if further than a restaurant or movie theater. Besides insulin and syringes, it has spare pump supplies, glucose gel, and all sorts of odds-n-ends. And my doctor's business card, as well as that of my pump trainer.

But I digress.

But should I have started pumping sooner? My simple answer is "no." Starting insulin pumping is a decision not to be taken lightly, and not to be rushed into. It's a life-changing experience. One has to be motivated to use these things, and it's quite a leap of faith to trust one's life to a little mechanical and electronic wonder. And I needed to be convinced that using a pump would be somehow "better" than multiple daily insulin injections. I'm now convinced, sure, but it took a while to build that mind-set.

So, if you are considering an insulin pump, my advice: Take your time; ask lots of questions, know what you'll be getting into, and then if and when you decide to become a pumper, you'll be completely comfortable with your decision.

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Dr. Bill Quick began writing at HealthCentral's diabetes website in November, 2006. These essays are reproduced at D-is-for-Diabetes with the permission of HealthCentral.

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