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Priming the (Insulin) Pump (Part 3)
October 4, 2007
This week, Eric continues with Part 3 in an ongoing series of entries about his recent transition to using an insulin pump (click here for his first and second entries). He’s trying to be somewhat comprehensive about his insulin pumping experience, and that’s why, thus far in his blog, he hasn’t even received his pump yet.
By the end of my diabetes education class in April of this year, I knew I wanted an insulin pump. And, as I said at the conclusion of last week’s entry, I discovered that obtaining a pump entailed jumping over some hurdles. Here’s a truncated, edited, mostly e-mail simulation of how I finally got ahold of the pump. Join me, now, as I relive a rather tedious few months of going through the pump-getting process.
Kathryn and I have discussed moving to a pump and we think it’s the right thing for me. I spoke with Dr. Kumagai about it yesterday as well, and he agrees. Four weeks ago, when I was diagnosed, my C-peptides were at the low end of the normal range (I think they were at 2.0), so if they’re still there, then we’ll probably have to wait until they drop to file the insurance work.
My HbA1c is down to 11.0%, which, after only four weeks, is pretty good (given that I was at 14.5% when I was diagnosed). In fact, Dr. K said something to the effect that if he had to define the ideal way for how a newly diagnosed Type 1 would handle his first month, I’ve gone beyond even that scenario.
Anyway, in your experience, what can I begin doing to facilitate the move to a pump when my C-pep levels are pumpworthy? I’m pretty sure I’ll do the CozMore pump. I’m also waiting for Amazon.com to deliver Pumping Insulin by John Walsh.
Hi Eric, I think you’ll do fabulously on an insulin pump. The first step toward getting the pump is to do a seven-day food/glucose/insulin record (forms attached). It is important that it be seven consecutive days. After you’re done with it, call me to set an appointment. We’ll get all the pump paperwork completed and get you on your way to a pump. Thanks, Glee.
Hi Eric, I received the pump application forms you sent. Your C-peptide on May 23 was 2.2, which is still too high for M-CARE [my insurance provider] to cover the cost of the pump. I am going to ask Dr. Kumagai to write a special letter, though, and see if we can get it through. Linda
Eric, I ordered your pump today. Dr. Kumagai gave me the letter he wrote yesterday and hopefully it will help! Linda
Hi Eric. We are the insulin pump company that Dr. Kumagai referred you to for your Cozmo pump. We received a denial letter from M-CARE for the insulin pump. La Neta
La Neta, does M-CARE give any reasons for the denial, and if so, are you allowed to share those with me? I was under the impression that because my endocrinologist wrote a letter that I would have a pretty good chance of acceptance. Eric
From: La Neta
Good Morning, Eric. The reason M-CARE gave is that there was no six-month regimen of insulin therapy and six-month follow-up. Your insurance provider requires six months of intensive insulin therapy. La Neta
So, Linda, is the next step to simply wait a few months, test my C-peptides again, and see where they are? Eric
Eric, I have a call in to M-CARE to discuss this first, and then we can appeal if necessary. I’m sure Dr. Kumagai will be glad to do it. I am also giving Dr. Kumagai M-CARE’s medical director’s number to call directly. That may help. Knowing him, he will call this week! Don’t give up! Linda
Good news! I just got off the phone with the medical director of M-CARE, who approved Eric’s starting the pump as an exceptional case. I told him that your (Eric’s) physical activity and professional schedule put you at risk for hypoglycemia, and that in my nine years as the director of the Intensive Insulin Therapy program, you are the first patient I’ve felt confident in transitioning to pump therapy within such a short time. Congratulations!
La Neta, my CDE told me she would be contacting you guys today to let you know that M-CARE has authorized a pump for me. Thank you very much for your correspondence throughout all of this. It’s nice to be kept in the loop about something so critical to my health. Best, Eric
Eric, Thanks for your e-mail. I can feel your excitement and that is what makes my job so rewarding. I sent an e-mail to the M-CARE case manager on the 21st to fax over the approval # for the pump and supplies. I also phoned her today requesting the same information and even told her you were inquiring as well. Will keep you posted when I hear back from her. Just can’t wait to be able to send your pump out, Eric. Have a wonderful day.
Hi Eric, I have your Cozmo pump ready to ship to you. Once you have been trained, please call me with the infusion set choice that you have chosen and I will then ship out the remainder of all supplies that M-CARE approved.
Linda! They’re shipping my pump out next week. I should get it after the holiday. Have a happy Fourth!
Congrats! We will schedule your training. I have an opening on 7/16 at 1:30 PM. Would that work for you? Linda
Works for me. See you then! Eric
Next week, I’ll go through what it is like to become familiar with the pump—the experience of receiving it and playing with it before training, and the training itself.
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