@wkrebs59 Thanks for the additional onfo.

@wkrebs59 I have had my pump for more than 2 years. I can verify that all Wendy says is consistent with my experience I only have to chanage my pump meds once a day. It absolutely is important to do it in a timely fashion, though., and I can see how it would be challenging to rely on someone to come once a day to do it, becaus some days you need to change it earlier than others. For example, normally I have my pump set on LOW just before I go to bed and ideallly, turn it back to BASE when I wake up in the morning. But if I have an active day, I may take an extra dose or two during the day. (Think of the extra dose as a cup of coffee ;If it's 5 pm and you are dead on your feet at work but have 1 more hour to go, you might grab a cup of coffee to make it that last hour).This is an amount you can take as much as 5 times a day. if your'e having a taxing day. Another way to deal with a higher-than- normal day is to turn the pump up to HIGH for a couple of hours. This, of coiurse, will affect the time when you need to refill the pump. And while you have some wiggle-room, there are certain parameters that you have to think about. While the trial of the pump prior to its release noted that Pill People averaged 2 hours a day more OFF time than Pump People, my experience is that the ONLY time I've ever had to endure an OFF time is completely due to USER ERROR - for example, If I take a shower, I have to turn the pump off. a A shower takes aat least 30 minutes. Once or twice I may have forotten to turn my pump back on. I never (at least not yet ) forget to put my pump back on .but I have forgotten to turn it back on. If that happens, within an hour of no pump meds, I start feeling tired and getting cold. If I go for 2 hours, I go COMPLETELY into OFF- LAND. and it's a bugger! It takes at least 4 hours to get back to normal. While I have a general impression that some medical folk don't realize the challenges that are involved with useing the pump. And why should they It's early in the game and we're all just learning how to deal with our parts of it. One nurse in the hospital where I got my pump tried putting the cannula in to herself just to find out what the patients were experiencing. That type of dedication to her patients brings tears to my eyes;; It's clear that she really wants to have an idea of what her patienes are expereincing. However, there are some things that others can't emulate. In my case, my husband is capable of dealing with all of the things required by the pump. If I didn't have him, I know that I wouldn't be able to do all thsi myself.We are both 81 and while he is healthy, he's still 81 and is finally starting to get tired, something he never experienced in his first 70-years. For one thing, I don't have the strength in my hands to remove the cover of the vial the medicine comes in. I also have vision issues and trying to connect the teenny weeny hose to the syringe is beyond my capabilities because both parts are small and they are both made of translucent plasstic.(I would suggest making one part colored. ) It's like trying to connect two invisible things. Then the device that connects the syring to your body -- the cannula requires some strength. BUT now that we have been doing it for 2 years, we've gotten it down to a reasonable routine. After 2 years, I LOVE my pump!! Here's what it does for me. 1. When you take pills, you have to fast 2 hours beforer and 1 hour after taking a pill. So each pill-taking involves 3 hours. I was taking pills 8 times a day. so If you do something 8 times a day and it takes 3 hours fasting per pill, you're fasting 24 hours a day. This is because when you take pills: (a) the meds have to go through your digesstive system, which lessens their efficacy so you must take higher doses of l-dopa than you do with the pump. The pump not only evades your stomach, but it also allows you to take lower doses of l-dopa which hcan have long term benefits o (B) When you take the pills, the l-dopa in your body is constantly in flux. As the pills go through the digstsive proess and into the blood sstream the delivery of l-dop rises sslowly and then it falls slowly. In my own case, the pills wore off after 2 hours so I had to spend 2 hours in OFF-time between pills. In healthy folks, the body maintains a constant level of l-dopa. The pump emulates that constant flow, making the adaptions to going lower when you're sleeping and getting higher when you're active,;(C) You don't have that fasting 24 hours a day t hing. You may still have to do it later in the day for one meal but I can do that standing on my head and spitting wooden nickles. AND it means you can socialize with your friends and go out to dinner. Finally, the lower doses of l-dopa that you can take have a long term benefit. The nature of Parkinsons is that over the years, you will need to take increasingly larger doses of l-dopa to have the same effect. ,The increased levels of l-dopa required to have the same effect as you got earlier from loeer doses won't happen. You'll start having side effects of these larger doses of l-dopa. At some point on the Yellow L-dopa Brick Road you will have to make a decision: Which is worse: (1) the side efffects of high levels of l-dopa; or (2) UntreatedParkinsons. By using the pump, you can take smaller leels of l--dopa and you can push that date of making this nasty choice a bit farther out and with any luck, you will stand a chance of dying from something else before you reach that point. Because most of us would do absolutely anything to avoid giving up l-dopa. Is the pump demanding YES. Is it worth it: my answer is YES for me. I know a care worker coming by every day may not be the answer, but If you are capable of changing a cannula once a day, you will have a much more normal, comfortable life for a longer period of time than taking the pills. It may take awhile to get into the groove. I was one of the first people to get the pump when it was released in the EU; my neurologist was on theboard that evaluated the pup but I also board that evaluated it for approvalin the EU, which not only means I have the most knowlegable Nerurologist on the planet and I got an early place in line for gettng one of these marvelous machines. If you try it and it's beyond your ability, then it is what it is. But if you dond't try it, you may wonder what these last years of your lives could have been diferent if you had tried it.