2 site failures in first month of pumping?

[Liongirl4]

Samantha is pumping with mm522, using quick set sites. We have had 2 caths bent in less then a month..she had a delivery failure which was a bent cath, but tonight she just was running high so we did a site change and the cathetor was bent.
I am going to order some sure T's tomorrow to try..(steel needle) But was wondering if this is the norm?? How often on average is site failure an issue?
Rose

[momtojess]

we used to use comforts and we would get several bent sites..

We now use the inset and we rarely have site problems.

[twodoor2]

You know, I'm supposed to start pump training in January, and all the "pumper - parents" keep reassuring me that this is rare, but I keep reading about it over and over again in the forum the same thing, "the site failed", "her tubes are clogged", "is the insulin bad??"

No wonder I want to go to the untethered method with Lantus. I really like the idea of the pump, but the site failures really bug me. Maybe they are rare and I'm just blowing it out of proportion, I only know I seem to read about it all too often right here in CWD.

Everyone can jump on me if I'm wrong!!

[funnygrl]

Bad luck with Quick-sets here. Much better luck with Silhouettes.

[ErictheFerret]

Same here.

[Liongirl4]

Can I ask why those who choose silhouettes over sure t's do so? How do you know the angle to insert and how far??
R.

[bz'smom]

Brandon has been pumping since April of this year. He uses the quick-sets, and we only had 1 bad site. That was my fault, too. He was tired, so he was in a weird position (curled up on the recliner) when I inserted the site. It is a big step to start pumping, and a VERY scary step, but I think it is soooo worth it. It's hard to make that big step when you are comfortable doing injections, and having to learn a whole new process to care for you child. Hang in there, maybe Sure-T's will work better for for her body type.

[Amy C.]

You know, I'm supposed to start pump training in January, and all the "pumper - parents" keep reassuring me that this is rare, but I keep reading about it over and over again in the forum the same thing, "the site failed", "her tubes are clogged", "is the insulin bad??"

No wonder I want to go to the untethered method with Lantus. I really like the idea of the pump, but the site failures really bug me. Maybe they are rare and I'm just blowing it out of proportion, I only know I seem to read about it all too often right here in CWD.

Everyone can jump on me if I'm wrong!!

All the problems never happen to one person. There may be hundreds of folks on this site who go for weeks with a problem -- they just don't speak up. This site is a forum to vent frustrations. If things are going well, folks usually don't say anything.

If you test as often as you currently do, you will catch the site problem before problems develop.

Philip has never had a bent canula. When he gets two consecutive readings over 240 without a good explanation, the site is changed (usually). Most of the time, he runs out of insulin around 2.5 days and the site has to be changed.

[Lee]

3 bad sites in 7 months...sometimes on the skinny ones, site angles make a big difference and it just takes getting used to. We can't use metal and are happy with the silhouettes, and other than the three bad sites, we have had no problems.

And problems happen with injections all the time also, it is just that there are less variables to guess about. You see the needle every time, but the insulin can go bad, the injection can go just under the skin and not into the actual system (happened to us 3 times!!!! UGH!), draw up the wrong insulin, etc.

I still say try the pump for what it is worth, then, if you still miss Lantus, try untethered.

[momtojess]

IMO, it isnt really a huge issue. We've pumped for almost 5 yrs (it will be 5 yrs in feb). At the beginning we had some sites bend, comeout, etc.. partly due to inexperience and part was probably the set we used. Once you find the one that works for you, it isnt much of a problem.

Even the times when we have had to trouble shoot (is it the site, the tubing, the insulin, etc) it was an easy fix issue. Obviously if you are check bgs and working to find the problem, giving insulin with a syringe (which btw, we have done only 1 time since we started pumping) then the chances of dka are slim.

Anything new is scary, and takes practice and perfecting before it gets right.

[kel4han]

Most bent cannulas happen from insertion in a site that is too thin, not enough fatty tissue, so it hits a muscle. We have had 3 bad sites in 7 months, all in the too skinny tummy using quicksets. They have never been a problem for us anywhere else except the too skinny tummy. For tummy now we just use a steel set, the Sure T.

I questioned this is the beginning as well before pumping. It is far worth it, and you know quickly when BS rises after a site change. ;)

[Jensmami]

we only had one bad site, and that was my fault, we use quick sets and so far are happy with them. WE LOVE OUR PUMP:cwds:

[Nancy in VA]

Since Sept, I can think of only one time that we had a "bad" site - and by bad site I mean basically bad from the beginning. We've had some that haven't lasted 3 days but that is mostly due to some locations being better than others and still figuring it out. I just watch trends and timing of the site changes and decide whether I should go ahead and change a site.

[funnygrl]

Can I ask why those who choose silhouettes over sure t's do so? How do you know the angle to insert and how far??
R.
I had one Sure-T fall out in my sleep once. I woke up with a high bg. The worst part though, was that the needle had been scrapping against my leg all night, so my leg was all cut up and my sheets were bloody to boot. Never. Again.

[clb1968]

I am an adult , so my experiences are a little different.
I have been pumping 3 months and using quick sets the whole time, the 9mm and so far only in my stomach.
I have not had a bad set (knock on wood, since I probably just jinxed myself), the only problem I have had was the other night, I got caught on a kitchen chair when I walked by and it pulled out my set.

[Twinklet]

When Emily first started pumping she was high a lot due to figuring out basal and ratios. I often thought it was a bad site so I changed it.

Then we didn't fully realize just how badly fat affects our daughter (she skyrockets 6-8 hours later if we don't do a combo/dual wave bolus) and we'd think it was a bad site and change it.

As far as TRUE bad sites, I'm not so sure we've really had any in 14 months. :confused: We did have a clogged tube once, but that wasn't a site issue and hasn't happened since. We've had a couple of "iffy" times where she was running high but it could have been attributed to several things. We just change the site anyway.

I think the first 6 weeks of pumping are a lot of trial and error with sites and setting rates. It's a LOT of work! Hang in there!

[Mama Belle]

We never had site issues at first. But then about 2 months ago out of the blue we started having major issues with the sets (Cleos). The infusion set itself was fine, it was the tubing that was the problem. Thanks to Marisa (MWAH!) we tried out the insets and absolutely love them! The other day my daughter accidentally forgot to do a set change at her dad's house and she went 5 days on the same set with absolutely no climb in numbers. We could never go more than 2.5 days on the Cleos. Since starting the insets we have hod no bad sets, but she's only been on those for a couple weeks.

[miss_behave]

You know, I'm supposed to start pump training in January, and all the "pumper - parents" keep reassuring me that this is rare, but I keep reading about it over and over again in the forum the same thing, "the site failed", "her tubes are clogged", "is the insulin bad??"


You can completely eliminate concern of bent cannulas by using a needle set like the Sure-T. There is no canulla to get crimped, just a tiny skinny needle left in place. Many people on this forum swear by them.

[thebestnest5]

We've had some questionable sites and some bad sites...we just pull them. We've had 2 bad Sure T's due to bleeding about 4-6 hours after insertion.:confused: I thought Lantus was worse--we had leak back after injection at times. Sometimes it didn't seem to last 24 hours and other times it had a slight peak. It stings...

[Boo]

When Emily first started pumping she was high a lot due to figuring out basal and ratios. I often thought it was a bad site so I changed it.

Then we didn't fully realize just how badly fat affects our daughter (she skyrockets 6-8 hours later if we don't do a combo/dual wave bolus) and we'd think it was a bad site and change it.

As far as TRUE bad sites, I'm not so sure we've really had any in 14 months. :confused: We did have a clogged tube once, but that wasn't a site issue and hasn't happened since. We've had a couple of "iffy" times where she was running high but it could have been attributed to several things. We just change the site anyway.

I think the first 6 weeks of pumping are a lot of trial and error with sites and setting rates. It's a LOT of work! Hang in there!

This describes my son exactly (except that the first 6 weeks wre actually pretty easy for us). Fortunately we figured out pretty early on that the sites weren't bad..it was a delayed reaction to the high fat/high protein food. We've gotten better at dealing with those meals, but if I assumed it was a bad site every time, he'd been changing that thing quite often. We've only had one site that was bad from the get-go (which we changed out within 1/2 hour of insertion...it was painful, and bled when it came out). There have been 2 others that seem to have failed after a day or two for no obvious reason. He's been pumping now for about 9 months.

[twodoor2]

And problems happen with injections all the time also, it is just that there are less variables to guess about. You see the needle every time, but the insulin can go bad, the injection can go just under the skin and not into the actual system (happened to us 3 times!!!! UGH!), draw up the wrong insulin, etc.

I still say try the pump for what it is worth, then, if you still miss Lantus, try untethered.

That's precisely why I like injections - I see the needle everytime. I am the one giving the insulin, not a machine. Machines can fail more than we would like to admit. I sometimes fail as well, but I always know if it's me. You cannot always tell when and if the machine fails.

[Nancy in VA]

That's precisely why I like injections - I see the needle everytime. I am the one giving the insulin, not a machine. Machines can fail more than we would like to admit. I sometimes fail as well, but I always know if it's me. You cannot always tell when and if the machine fails.

Personally, I think that don't fail as often as you think. There are concerns with every treatment regimen. I think you are loving Lantus right now because of its comparison to NPH. But I can honestly say to you that most (and I know not all but most) feel the same way about the transition from Lantus/MDI to the pump - the differences are unbelievable and most people would not go back. I just encourage you to go into the pump and give it a try - and don't try to look for reasons for it to fail - give it a chance to work and I think you might be surprised. If not, you can always back off to the untethered method but I think if you don't give it a try, you just won't know.

[Boo]

The pumps have SO many built in checks and balances and security type features that I don't worry about the "machine failing". Sure, a site, or even a pump can go bad or stop working (it hapens), but when you're checking BG regularly, you can usually catch those things before it becomes a nightmare.

If the shots are working for you, then I wouldn't stress about feeling pressured to use a pump. The method of insulin delivery that you choose to use should be based SOLELY on the patient, and what works best for them and their family. A pump isn't the right answer for everyone, and MDI is certainly not a wrong or worse choice. What works for one stage of life may not be the most practical for the same person 10 years down the road.

It is nice that we have options these days with regards to how the insulin is delievered. For our family, who is very busy with 3 young active kids, the freedom that the pump allows us is a godsend! However, sometimes I *wish* that I was more routine and regimented with my son's schedule...I am certain that would help in his BG control. I'm just not that way, so this is what works for US. YDMV :D

[D-Dad]

We started with comforts, an angled set and thought they were evil. Tried a rapid-d but the metal cannula caused some bruising. Went to Insets and never looked back. When we switched to minimed we went to their version but did not like the inserter. So we got the res with the luer-lock and went back to insets. I think we had one issue with insets over 2 years.

[Momof4gr8kids]

To answer the original question first, during the first month of pump you are still working on technique and learning the best spots. Chances are you're going to have more failed sites during that month then the year.

As far as not pumping because of site worries, like I said above, site issues happen, mostly in the beginning. You get your technique down, learn what's what, and you find the set that works for you, and you are fine. My DH was used to inserting infusion sets, he had his technique down. He didn't have one failed site, and still hasn't. It's almost been 2 months. Last night he chose to pull his set early because he hit a nerve and it hurt to bolus. He didn't see any higher, or lower numbers, it was totally a comfort thing.

Go for the untethered method if that is what you want. A lot of people here are concerned though because going untethered while it has it's benefits also cancels out a big portion of the benefits of pumping. We can't tell you what to do, it's your choice. But like Nancy said, you'll never even have an idea of what we are talking about as far as the benefits go until you try it. Most people know it will be good, and they also know that to start it will be hard, but they don't have the exact idea of why/how/what it's like until they are there themselves. If you're not up to it, return your pump while you can and stay on lantus until you are ready.

[twodoor2]

To answer the original question first, during the first month of pump you are still working on technique and learning the best spots. Chances are you're going to have more failed sites during that month then the year.

As far as not pumping because of site worries, like I said above, site issues happen, mostly in the beginning. You get your technique down, learn what's what, and you find the set that works for you, and you are fine. My DH was used to inserting infusion sets, he had his technique down. He didn't have one failed site, and still hasn't. It's almost been 2 months. Last night he chose to pull his set early because he hit a nerve and it hurt to bolus. He didn't see any higher, or lower numbers, it was totally a comfort thing.

Go for the untethered method if that is what you want. A lot of people here are concerned though because going untethered while it has it's benefits also cancels out a big portion of the benefits of pumping. We can't tell you what to do, it's your choice. But like Nancy said, you'll never even have an idea of what we are talking about as far as the benefits go until you try it. Most people know it will be good, and they also know that to start it will be hard, but they don't have the exact idea of why/how/what it's like until they are there themselves. If you're not up to it, return your pump while you can and stay on lantus until you are ready.

I'm definitely going to do the pump next year, I'm just debating tethered vs untethered. I need to do the pump because she will be starting school next year, and the injections, although we're good with them, are very cumbersome and inconvenient. We don't have much freedom, and I like the automated calculations and bolusing, although knowing me, I will probably double check them each time. We got the pump early this year because with our insurance, it's cheaper for us than doing it next year. We still have to pay a portion out of pocket for it.

I didn't know you could return a pump. Is that possible??

Stupid me, didn't even think about that.

We have the MM552, and I don't hear a lot about it breaking down, so that's why we chose it. I also have our pump "purse" that she picked out, so she can wear it, and I'm reading "pumping insulin" and I took the online MM course, so we're on our way. Notice no mention of dear hubby doing these things :mad:

The untethered method just seems very attractive to us right now. I think that would be better as far as keeping her in control and not starting from scratch. It's a huge learning curve doing the pump and at the same time, trying to get the numbers in control. We have all of our carb ratios, ISF, DIA, corr factor, lantus dose, all figured out pretty well. I think it would be an easier transistion to go from injections to untethered, and then from maybe untethered to 100% fast acting.

In fact, I know the DIA is something that may change when we go on the pump, so I'm going to start a new thread on that.

[Nancy in VA]

Marsha:

Just so you know - all of our I:C ratios changed on the pump. We started with the same as injections - and even the nurse thought they were going to be the same, but the ended up being different. So I wouldn't count on anything staying the same - I think your body reacts differently in some cases to the way in which you are getting your insulin - especially if you are going to run basal through as well. Just to let you know

[twodoor2]

I definitely think they would change if you're using 100% fast acting, but I don't know if they would change as much if you're untethered, maybe slightly, but not dramatically. :confused:

[Kaylee's Mommy]

Samantha is pumping with mm522, using quick set sites. We have had 2 caths bent in less then a month..she had a delivery failure which was a bent cath, but tonight she just was running high so we did a site change and the cathetor was bent.
I am going to order some sure T's tomorrow to try..(steel needle) But was wondering if this is the norm?? How often on average is site failure an issue?
Rose


Kaylee is using the MM 522 and quick sets.. the first FEW months we delt with A LOT of bad sites, bent cannula.. I think a lot has to do with getting use to doing it.. 1.5 years into pumping and we now hardly ever have a bad site.... do you use the serter? if you don't, you should.. my DH use to put them in mannually and I'd have to change it every single time using the serter (he didn't like it..) now, he's band from doing site changes without it ;)

we haven't tried the sure-Ts.. a lot of people like them though:)

[twodoor2]

I'm definitely doing the Sure-T's - they seem to most favored for small children. After reading several posts on your children's ages and weights, I've come to realize I have a giant 4 year old. She's 54 pounds, 45 inches tall, and has a large stomach and tush (but she's not fat, just squeezable;)). I know a lot of people have problems because of lean and petite children, I hope it will be easier with us.

[Kaylee's Mommy]

I definitely think they would change if you're using 100% fast acting, but I don't know if they would change as much if you're untethered, maybe slightly, but not dramatically. :confused:


if you go to the untethered method and use lantus and then the fast acting.. not much will change, but once you start using the fast acting for basal too it'll all change.. we asked about staying on lantus and doing fast acting (novalog for us) through the pump and Kaylee's cde basically said there is no point going to tohe pump then.. getting those basals individualized is one of the biggest bennifits to the pump.. I do know there are those that use lantus and then the pump and have great success with it...

I think you have 30days to return a pump:)

[Kaylee's Mommy]

keeping her on lantus and using the pump for fast acting and having apump site issue is going to be the same if you are completely on fast acting and having an issue.. that insulin still isn't going to get through the cannula.. The fact of the matter is that pump site problems happen, they happen far more in the beginning than any other time.. you could have perfect technique but hit a muscle.. you won't know on insertion that you've hit a muscle.. you won't know until she goes high.. its not something that you did wrong during insertion, its just something that happens.. I would take the once in a blue moon site issues over having to do MDI again anyday.. thats just me..we definitely had our fair share of site issues in the beginning, even through all that I could see the definite bennifits of pumping.. and now I could never see going back..

[Momof4gr8kids]

Marsha, One thing you might want to consider is doing a lower lantus dose, like 50-75% lantus, and do the rest through the pump. That may help you to still be able to reduce basal if she ever gets the stomach flu, or has a low that you just can't bring up, plays really hard, or tries something new.

Most pump companies you can return the pump up to 30 days of purchase. I thought you bought it and were starting to worry so badly that you were considering not doing it.

[twodoor2]

Marsha, One thing you might want to consider is doing a lower lantus dose, like 50-75% lantus, and do the rest through the pump. That may help you to still be able to reduce basal if she ever gets the stomach flu, or has a low that you just can't bring up, plays really hard, or tries something new.


That's exactly what one of my questions was in your first paragraph, but I didn't get a precise answer on that one, everyone in this forum seems to 100% lantus or 100% fast acting in their pumps. I wanted to do 75% lantus and 25% fast acting, as recommended by the endo that first developed the tethered method (I forget his name). I will ask about it at the CDE. Thanks!!

[Momof4gr8kids]

That's exactly what one of my questions was in your first paragraph, but I didn't get a precise answer on that one, everyone in this forum seems to 100% lantus or 100% fast acting in their pumps. I wanted to do 75% lantus and 25% fast acting, as recommended by the endo that first developed the tethered method (I forget his name). I will ask about it at the CDE. Thanks!!
I've seen a few people that do it that way for sports. They want some, but not all basal because they know that they will need to reduce the basal during and after play. You might want to look at insulinpumpers.org
I've only been on there a few times but there is a lot of pump info there.