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To the Editor. —
A 50-year-old physician with diabetes mellitus recently traveled deep into the Ecuadorian Amazon rain forest. This physician had controlled his diabetes with an insulin pump for the past 9 years. Although he was well accustomed to temporarily removing his pump to protect it from water exposure in showers and baths and during swimming, he was concerned about travel to an environment that was oppressively humid, where intense rainfall occurred without warning, and that was approachable only via a narrow canoe navigating the broad, turbulent Rio Napo.Desiring to protect his battery-operated insulin pump at all costs, the physician requested help of an enterostomal therapist. She devised a protective apparatus normally used for collecting colostomy or ileostomy effluents and adapted it for maintaining the pump within a watertight seal. A Hollister Two-Piece Ostomy System with a 10-cm flange was adapted to the job by cutting out a
Stillman AE, Muir J. Protection of an Insulin Pump in the Amazonian Jungle. JAMA. 1989;262(11):1470. doi:10.1001/jama.1989.03430110060019
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