had to change site in the middle of the night

[albasmom]

We had to change dd site last night because the old one got pulled out. I don't know how it happend. She sleeps with her pump in a shirt with a pump pocket. Did this ever happen to any of you?
We did it without waking her up and we didn't have time to numb with emla. Her bg was 18.5 (333) and we didn't know how long it had been disconnected. She woke up when we inserted it and I just felt so cruel. Do you think it would have been better to wake her up? She's scared of site changes unless we use emla and we didn't have time for that. I know i'm rambling i just hate this disease right now. :(

[StillMamamia]

Anne-Sofie,

Don't have much advice for you I'm afraid, as we've never done a night site-change. I can, however, recommend using a cold-spray to numb the area a bit (ask at the pharmacy) or even an ice-cube or ice-pak (you know, those bags filled with a blueish/greenish liquid (if you used Avent baby bottles, you've seen a small version of these paks). The cold-spray numbs it in about 5-10mins, and the ice-cub/pak I would say in the same amounf of time.
Then, you can use Tegaderm over the site to keep it in place. Hope this helps.
Also, you can check if the site is away from any clothes potentially rubbing it out (like the waist).
Personally, I'd wake my son up, but I know how he is...he hates not being an active participant in screamin and yelling during site changes...LOL...

[albasmom]

I didn't think of using ice because she usually hates it, but I will try that next time. We did use tegaderm at one point but her skin gets so irritated. She was wearing a nightgown so not really anything to rub on. She had gotten the tubing between her legs and I would love to know how she did that :confused: She usually doesn't move much at night

[StillMamamia]

Where are you putting the site, on the thighs?
Maybe consider getting her a pump pouch for sleeping only.
Ask your endo if there's another adhesive she can use which is more 'skin-friendly'.
Also, there are different tubing lenghts. Try a shorter one if possible.
There's also Tubeguard, you wrap the dangling tubing around it.
Oh, I've heard also about using a cold spoon, like putting it in the freezer first. I do wonder how you make sure it's hygienic before though...maybe cleaning it with alcoprep?
This is going to sound silly, but one of my first fears when Ian was first wearing his pump clip onto his pjs pants, was having the pump 'unclip' itself and the tubing wrap around him so tightly he couldn't breathe:eek::o Yeah, slight paranoia there...

[albasmom]

We put her sites on her bottom and we use invicible/liqiud band aid under it. Tegaderm is the most skinfriendly i have heard of but I will asked at our next endo visit. I had never heard of a Tubeguard but I will definitely look into it. Thanks so much for your advice.
This is going to sound silly, but one of my first fears when Ian was first wearing his pump clip onto his pjs pants, was having the pump 'unclip' itself and the tubing wrap around him so tightly he couldn't breathe Yeah, slight paranoia there...
I hadn't thought of that. Funny :D

[staciebco]

We only change Caleb's sites at night. He HATES to have his site changed, and likes the EMLA even less. We don't wake him. Sometimes, he does wake up, but typically he sleeps right through it.

[saxmaniac]

Alex likes us to changes them at night since he doesn't feel it. But I don't like doing it at night because he tends to go high afterwards, and I'd rather be awake for that.

[jendean]

Nah... I think it is OK to do that, but heres my advice:
1. ask her if she remembers you coming in to do a site change in the middle of the night...
2. ask her if it bothered her.
3. ask her if she would prefer that you do it that way from now on, or if she would like you to try it again when she is asleep.
Then, let her know that you respect her wishes, and of course, then respect her wishes.
(unless she says no way, and pulls a site out again, and let her know that in that case, you dont have a choice, but that you will try to remember to check the site before bed every night as a safeguard...

Some kids like that better, less ancicpation.... less prep time... they wake up, whimper, scowl, yell, or whatever, and go back to sleep. Takes a load off for them.

Other kids hate it. Freaks them out...

Sorry for the long answer... I am just a really firm believer in US letting our D kids know that we respect their wishes on thier treatment... in as many aspects as possible. :cwds:

[hawkeyegirl]

When I've had that situation arise, I always (1) correct with a syringe to give me time to (2) use the EMLA. I wouldn't change his site without it - I'd be afraid he'd wake up and punch me in the nose!

Jack is 4, and if I asked him if he wanted me to change his site at night, he'd say no. But he doesn't particularly want me to change it anytime, and he sleeps through night changes, so that's when I've been doing it lately. He's honestly not old enough to make rational choices yet, so I do my best to decide what he'd actually prefer if he WAS being rational, and I do that.

[albasmom]

Thanks for all your advice. We asked her, and she did remember and did not like it, so we told her that we wouldn't do it again unless the site was pulled out. We try as hard as we can to avoid correcting with a syringe because she hates that and will scream, kick and yell. One of the reasons we got a pump. She fine with site changes as long as we use emla ( we call it magic cream :D) Thanks for all your answers. I love this place :)