Site changes becoming difficult

[Jacob's Mommy]

Jacob has been on the pump for over a year now with no problems on doing his site changes (in the fatty part of his rear). Just in the past month though, he has fought me so hard. I threaten to get rid of the pump (which of course I wouldn't) if he doesn't lay still. He screams, kicks, shakes his rear so I can get a good grip to put the site in. It took me 20 minutes to do a site change last night. But when I finally do stick him, he says it doesn't hurt.

It is almost like he has developed a phobia of it. I am trying to get his Endo to prescribe some Emla cream and I have ordered this new inserter from Animas that is a one click insertion. But the insertion device is back ordered and I am waiting on the Emla cream.

Any one out there have this issue all of a sudden? Any thoughts? He doesn't have enough fat on his tummy to do them there. I threaten to put him back on shots and that justs puts him in a meltdown.

I am at a loss!

[WestinsMom]

Are you on a MM? You could use a Sure T...then you just need to stick them and it is done. They just have to stay still enough to hit your target. No needle to pull out :)

[Sarah Maddie's Mom]

With a 5 year old I think you need to find ways to stay calm and listen, to reassure but remain firm that this "needs to be done" and is not negotiable. Easier said than done, i know:rolleyes:
Can you
1. Give him the chance, when it's not site change time to talk about his fears?
2. Help him think through ways to make site changes easier - can he watch TV, or listen to music?
3. Can you give him some measure of control during the change? can he cue you when to insert? Our daughter waits till I have the new site ready to go in and she lets out a little yelp to cue me, it's all drama and distraction and gets the job done every time.
Good luck - it's probably an age thing and something that will pass but no doubt stressful for now.

[Val]

I know your son is a little older, but we ran into the same problem. We went about 8 months with no problems. Then all of a sudden, Simon started kicking & struggling every time it was time for a site change. After we changed it he was fine, it was just all of the time leading up to it & during the change that was the problem!

The good news - We ordered emla & an inserter then the problem disappeared! (we are using silhouettes) I think it only takes one or two painful site changes to freak them out. Maybe it hit a nerve or something. We call the emla his "magic potion". It takes a while & some pre-planning, but WELL worth the emotionless site changes! :D Simon says the emla itches sometimes, but that stops after about 5 minutes. Now I give him one sugarless peppermint when he puts on the emla & 2 more (they are teeny-tiny) after the site change for sitting still. We can even do them "out & about now", so the wait isn't that big of a deal. We just bring the stuff & change it out in the car. He has even recently let me rotate the sites to arms, legs & belly too! He really doesn't have much fat, so this has been a huge milestone for us!

I really think the emla & serter will make a big diffence for you, but keep us posted!

[hrermgr]

I suspect Jacobs is trying to exert some control over the process. Maybe prizes will help?? And allowing him more control. Our daughter, T, is almost 3(been pumping since last Feb). She has never really enjoyed set changes. But we do allow her to "pick" her spot and we rotate between the arms (upper), thighs and behind. She never has liked the behind, even when on MDI so it doesn't surprise us that we have the most problems here for set changes. We also let her "push the blue button" (to prime it) after the site is inserted. She likes button pushing!

The emla cream doesn't work for us. The emla prolongs the experience for us all which is not always good. We have also iced the area (arm and thigh) for set and CGMS changes with good results--a little bit of numbing.

Good luck! Challenging site changes are one of the worse things to deal with.

[Mom2rh]

Try to give him as much choice as possible...who changes the site, the location of the site and the site change...even a window on when it is time to do it. Try to have something for him to look forward to after the change too.

Hope the phase passes.

[Gwyn]

Maybe he is still too young, but we have been using the "quarter, dime, nickel" approach that Becky suggested in a recent thread.

You ask them once and they do what you say--they get a quarter. Ask them twice and they do it, they get a dime, three times, a nickel.

We used it to have Devin come in from outside and test and then for having a snack if she is low. She hates to come in, but her meter doesn't work when it is below freezing so it has to be done.

It's a bribe, but it is working for us.

[Mary Lou]

I've noticed that Andrew, who is the same age as Jacob, really craves the routine around the set change. We generally do it at night, and he is distressed when we try to do it any other time of day. We have a whole process -- icing the area until he (or his brother) says he is ready. We count down 1, 2, 3..insert. And then they have ice-cream or some other "set change treat".

I think that for some kids, knowing what to expect and having this routine is helpful. Brian, who is 9, can do it anywhere, anytime, no problem.

Do you feel stressed around set change time? I think that sometimes kids pick up on our vibes. Maybe a glass of wine for Mommy would help? :D

We let the boys get a book to read and sometimes even let the dog lay beside them if they are having a rough time of it.

Good luck.

[Kirsten]

I've noticed that Andrew, who is the same age as Jacob, really craves the routine around the set change.
Good luck.

Yes, we have a set routine for pod change.

1. Bath
2. Griffin gets choice of four sites (if he takes too long, we pick - this usually gets him to maake up his mind in a hurry.;))
3. Apply adhesive.
4. Apply pod and wait for Griffin to tell us to start insertion (again, if he stalls for too long, we go forward.)
5. He hugs his stuffed dog and howls playfully during the insertion (the pod clicks for several seconds before inserting).

GL!

Kirsten

[Thoover]

Do you use the numbing cream?? Ladicaine I believe what I use on my daughter. I put a quarter size amount, put the IVprep over it wait and hour and change the site. She doesn't feel a thing. However we have had to move to her behind since her belly was getting some scar tissue problems.

[MrsBadshoe]

We use animas and my dd dx at 7 had issues with set changes from the beginning. She is now 10 and it isn't a problem any more. We used Emla cream on each and every set change and the issue became mute.

[coni]

We are MDI, so I can not speak to your specific issue. However, I have learned not to threaten my child with something I am not willing to do. Please do not take offense as I am speaking from my own personal experience and offering this advice in an effort to assist you.

I hope you are able to reach a resolution. It sounds stressful for all involved.

[Jacob's Mommy]

Thank you everyone for your advice. I have tried to respond a couple of times but my computer shuts down everytime I post the reply, so I guess the third time is a charm!

I got the emla cream so hopefully it will work. I will let you know how it goes.

[MamaChrissa]

We have a ritual, like others have mentioned. After his shower we go into his room and he just hugs his "Gary the cat" and I count to 3. We started with the Insets from Animas a few months ago...and he likes them far better than the Comfort Shorts we were using before. Of course, they are green... that does help! LOL Gotta love 5 year olds! ;)

[Momof4gr8kids]

You can buy OTC numbing cream that people use for leg waxing, or there is some antibiotic type stuff for sunburns. These are oily though so they need to be washed off well.

Did he have a site that hit a nerve? Have there been any major changes in his life? Maybe he got older and became more aware?

What type of infusion set are you using? Maybe see if there is a kind that is less intimidating? What about a prize, or a chart?

Does he get to pick the spot? I find that if I pick two good areas and let Julia pick here, or there she is more willing. Have you tried the leg area? Even though he is thin you may still want to try the tummy. Julia can't pinch an inch, but her sites work really well there. We use a 6mm. Her dad is also thin and uses his tummy. He couldn't do injections there, but the pain with the infusion set isn't bad. Even though he is an adult he uses a 6mm infusion set. The bum and the leg are horrible for both of them, as there is a lot of muscle. If your DS has built muscle and lost baby fat you could be pinching muscle and putting the site into muscle. I'd honestly ask him a body part and try another area to see if it has the same effect. Try talking to him on a non site change day and see what he thinks about it, and why it is so scary. You might get better clues from that. Try not to threaten him, but give him choices instead. Good luck. I know this is hard. Jamie

[Jacob's Mommy]

We are using the comfort short, but are getting the insets in 3 months from Animas (have to wait on my 3 months for insurance).

I'll let you know tomorrow night how it goes!