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In 1993 Terri Hopkins was diagnosed with diabetes and placed on insulin. Until only recently, Terri was miserable. Not only was she trying to accept her diabetes (a process that took about two years), but she gained weight. Her blood glucose levels averaged 260 mg/dl, and with an A1c of 9.8, she realized that she would never feel comfortable about having a baby.
"It got to be psychologically terrible," she says. "There were bruises all over my arms and legs, and my belly hurt."
Despite her struggle, Terri has nothing but praise for her physician, Michael Greenfield, MD, of Mountain View, Calif. Since her diagnosis, she says, "Dr. Greenfield has been a constant source of encouragement and support. Even when my diabetes seemed completely uncontrollable, he never gave up."
In mid-1995, Greenfield suggested Terri try the insulin pump. She was at the emotional breaking point, but Terri agreed that going on the pump could be "part of the healing process."
To be sure that Terri was ready to become a pumper, Greenfield gave her an empty demo pump which she had to keep attached to her body 24-hours a day. In August of 1995, she was ready for the real pump, and except for a short adjustment period, it has been smooth-sailing ever since.
"I feel tons better. I feel like I'm finally in control of my diabetes and that I can now lead a completely normal life free of complications."
Today, her blood glucose levels average around 130 mg/dl and her most recent A1c was at 7.4. Some of the many benefits of being on the pump are easier food management and the ability to sleep in.
"The pump allows for so much flexibility in a constantly changing and often hectic schedule. With the pump, I don't ever have to wonder when the NPH will peak or if I need to eat now. I don't have to worry about taking an injection and then getting delayed in a meeting, or planning to exercise, adjusting my insulin accordingly, and then not exercising.
"Being on the MiniMed 506 pump has made the answers to these questions much simpler."
The pump uses velosulin regular insulin and is programmed to deliver a set basal rate 24-hours a day (a process that took about six weeks to perfect). In Terri's case, the bolus rate for breakfast is one unit for every 12g of carbohydrates; for lunch, one unit for every five grams of carbohydrates; and dinner, one unit for every six grams of carbohydrates. For example, if Terri ate a serving of lasagne with 65 grams of carbohydrates for dinner, she would take 11 units of insulin.
"This is a commitment well-worth making. The decision to go on the pump was the best decision I have ever made in my life."
When Terri started the pump, her husband Nick had just been offered a job that would send him to Italy. Nick was extremely excited about the job prospect, but he was hesitant to accept the position because of Terri's diabetes.
After doing some research, Terri learned that diabetes care is managed much differently in Italy where there is socialized medicine. As long as the Hopkinses reside there, they are considered 'legal residents' entitled to medical care as well as diabetes supplies free of charge.
Nick stayed with her as she made the initial adjustments to pump therapy, and then, in October 1995, he left for Florence. Once Terri and Dr. Greenfield felt that she could manage her new lifestyle, Terri was able to join Nick in Florence.
The Hopkinses expect to live in Italy for two years. Terri plans to form a diabetes support group for English-speaking people living abroad.
"My goal is to work actively in diabetes counseling. When I was first diagnosed, I found that the answers and support I received were very generic. I want to provide for somebody else what nobody could or would provide for me."
Another one of Terri's dreams is to adopt a child, possibly from the former Yugoslavia. The war-torn nation is right across the Adriatic Sea from Italy, and Terri knows there are many children there in need of a home.
"I want children," she says, "But I'm not willing to risk damaging a baby. Even though I'm doing much, much better than I was on insulin injections, my blood sugar can still swing up to 200-250 mg/dl for no reason. That isn't good for a baby. I really have no problem with the idea of adoption."
On her last visit to Dr. Greenfield, however, he encouraged her not to discount the idea of pregnancy. He believes that since her diabetes has improved so dramatically in such a short period, a healthy pregnancy is not out of the question.
Terri's only regret about traveling abroad is that she is leaving her doctor behind. Luckily, she will be able to return to the United States every six months for a check-up with him. And thanks to computer software available from LifeScan, Terri will be able to download her meter and e-mail the results to Dr. Greenfield who will then be able to give her advice via the internet.
"Thanks to advancements in technology, and thanks to my husband and my doctor, I am not afraid of being a diabetic in a foreign country."
With her passport, meter, and pump in hand, Terri says happily, "My life is mine again."
Those interested in contacting Terri can write her at: Via Palestro #3, 50123 Florence, Italy, or e-mail her at firstname.lastname@example.org.
Multiple studies have shown that people on insulin pumps have an improved quality of life. Often success with pump therapy can be accomplished via an enthusiastic physician and a motivated patient.
1 comment - Apr 1, 1996
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