Can canulas bend once inserted??..why didn't pump catch it?

[luvmytwins02]

We had another issue with Hannah's canula being bent yesterday and no messages from the pump telling me that there was no insulin delivery.

My question is....does the canula get bent when you insert it, or can it get bent by laying on it funny (like yesterday hannah was climbing in and out of our deck box...and I was wondering if it could have bent then.)

My second question is....why didn't the pump tell us it was not getting insulin through the canula. I have had one message before (when the canula was bent) that said "No Delivery". But the last three times this has happened...no warning from the pump at all! Is that normal?

We did end up changing her site, but she was high all afternoon and developed ketones. By bedtime she was back to 250 with ketones of .3

She has only been pumping two months, and this has happened a few times now. Should I try a different insertion set? People on this site keep talking about the SURE T. What is that and does it go with the Medtronic 522?

Thanks!

[Kaylee's Mommy]

HI, bent cannulas can happen at anytime.. we had ALOT in the beginning and now, almost a year later, its very rare that we have a bad site.. every once in a while it'll get bent or fall out, but it definitely itsn't the norm now.. actually we can leave a site in for a good 4 days now and not have a problem..

when we were having issues in the beginning our CDE said it was probably part us putting it in.. having the right motions and stuff.. are you using the mushroom inserter? We definitely have better luck using this than doing it by hand.. Kaylee likes it done better by hand becasue she doesn't hear the 'click' from the 'mushroom' but it definitely goes in a lot smoother with the mushroom....

on the pump giving you a no-delivery message.. we don't get this often with Kaylee's pump, even if the cannula is bent and thats because the pump needs so many units NOT delievered before it goes off.. Kaylee insulin requirements are much lower than most because she's so little.. so it takes longer for the pump to be aware of a problem.. also we've had cannulars that we bent at the tip but insulin was still getting through, not all of it, but she was still getting some so it never alarmed..

I don't think you can use the t-sure with minimed.. minimed has their own sets.. you can't use the same sets that animas and cozmo use... theirs are interchangeable.. but minimed has their 'own'.. i'm not sure if they have anything like the t-sure because we are happy with the quick sets.. once the first few months were over it got so much better.. we did try the silloutte at one point but she got on infection and that was the end of that, wouldn't let me try it again.. those are longer cannulas (13mm, I think, quick set is a 6mm) that go in at a 45 degree angle, and kinda hook in.. they have a little window so you can see better if the cannula is in their.. but the needle was very intimitating for Kaylee and there was no serter that we could use because they wanted it at the different angle than what the older kids would use because its so long it would have gone to deep (I think it goes in at a 45degree angle and they wanted it at a 30 or something.. I don't remember it was months ago, so I"m not to positive on the angles..)

you are doing an awesome job pumping.. its a lot to get use to.. playing on the playground Iworry about K's sites.. but we very rarely have issues now..

:)

[EmmasMom]

The sure-T is actually made by MM and has a steel cannula. You can order them on the MM web-site. It looks like a little thumb tack.

We've never had kinking issues with the QS unless the cannula was in a bad spot that didn't have enough fat, (on Emma it's her tummy that gives us problems), but she's not as active as an older child yet. We always use the inserter.
If they're kinking that often you may need to try a completely different location, (like her bottom instead of her tummy), and if that doesn't fix it hopefully the Sure T will! Call your rep and see if they have a sample you can try, that way you'll know if you like it before you invest in a box.

Good Luck!

[Kaylee's Mommy]

Thank you Amy, i was totally confused by the t sure.. I looked on the mm website.. is it called something else as well?

does the metal actually stay in? is that safe? :)

thanks for straighten me out before I confused more people LOL:)

[jpb286]

Thank you Amy, i was totally confused by the t sure.. I looked on the mm website.. is it called something else as well?

does the metal actually stay in? is that safe? :)

thanks for straighten me out before I confused more people LOL:)


The MM Sure-T, and the Accu-Chek Rapid-D are the same infusion set with different connectors. Yes, it is a metal needle that goes in and stays in. It is safe because its completely covered by the tape and adhesive dressing. It works great for some, for others it causes pain and discomfort because there is ALWAYS the needle under the skin. But the needle is much smaller (~26-27g) because it doesnt have to pass a catheter over top of it.

[Noel]

Oh, we have had such a problem with bent cannulas!!! The only site we can insert on Aidan is his tush! There is barely enough fat to do it there. Sliding boards are a sure bet on a bent cannula!

I haven't found a solution to this but if you do please let me know.....I have seen the steel cannulas but I am not to keen on them!

[Ali]

I also have this issue. I rarely get the no delivery alarm. I did not reaize the reason why till Kaylee's Mommy posted below. The problem I have is that once I pull the site and redo I never know how much to correct because I do not know how long the problem has been going on and how much insulin is in my system even with the high numbers. I am probably going to switch to the Sure-T's for this reason just to avoid the random problem (probably once a month or so). I have tried them and they are very tiny and very easy to insert-easier than the Quick-Set. I prefer the disconnect at the set but after spending six hours two days ago dealing with highs and then getting corrected I think I may go ahead and change. Ali.





We had another issue with Hannah's canula being bent yesterday and no messages from the pump telling me that there was no insulin delivery.

My question is....does the canula get bent when you insert it, or can it get bent by laying on it funny (like yesterday hannah was climbing in and out of our deck box...and I was wondering if it could have bent then.)

My second question is....why didn't the pump tell us it was not getting insulin through the canula. I have had one message before (when the canula was bent) that said "No Delivery". But the last three times this has happened...no warning from the pump at all! Is that normal?

We did end up changing her site, but she was high all afternoon and developed ketones. By bedtime she was back to 250 with ketones of .3

She has only been pumping two months, and this has happened a few times now. Should I try a different insertion set? People on this site keep talking about the SURE T. What is that and does it go with the Medtronic 522?

Thanks!

[Budapest]

We use the inset (and now for the first time the inset II) and the canula is basically ALWAYS bent at the tip. We put it in his stomach and the general conclusion was that it gets bent because it reaches slightly past the fat under his skin and reaches the muscle. The movement between the tissues bends it.

Although initially we thought there must have been a site problem when we saw the bent canula, we learned that it is no problem. Insulin passes through no problem. Over the past six months we thought a dozen times that there must be a site problem only to realize later that there was something else. True problems short of actually falling out happened maybe 2-3 times, towards the very end of day 3 or into day 4.

[WestinsMom]

On the issue of no alarm...just recently, as Westin has started pushing larger amounts of insulin at meals, have we had "No Delivery" alarms. I think it is definetely due to the size of the bolus being so small.

[EmmasMom]

I just tried using Emma's tummy again yesterday,(she finally has a tiny amount of fat there so I was hoping for a new place to rotate), and we had very erratic numbers for 24 hours. She would shoot up for no obvious reason and it would take several boluses to bring her back down, so I knew it must be a site issue. When I pulled it out it was bent in half. :rolleyes:

I think if you're having a lot of bent cannulas you should try another location, and if that doesn't work a new infusion set. Cannula's really shouldn't bend if they're in a good spot w/ enough fat, and once they do bend they are not reliable.
We have had exactly 3 bent cannulas in 17 months of pumping and all 3 were on Emma's tummy, no further investigation needed... ;)

[sam1nat2]

We get these all the time!! We've only had 1 no delivery alarm, but ds is on such a small amount of insulin.
If his numbers are high and don't come down as expected, we pull the set and there is usually a bend at the tip.

I do think activity makes a difference. Last week he was rolling down a hill at recess and sure enough, later that day was higher than expected. We had written it off to a growth spurt since he was coming down with corrections. Sure enough, 2 days later and a huge bend in the set!!

With us, i think he is getting the corrections, but not the basal. We are waiting for samples of the sure-t, which does work with minimed.

[Chase's mom]

We use the Quick set 6mm and we have to put it in his butt, It wouldn't work in his stomach had all kinds of issues and even had to stop pumping for a week after starting. No canula will work in the muscle is what we were told. Since we started using the bottom no more problems.It's hard to find a fatty spot on their tiny bodies.

[Budapest]

We use the inset (and now for the first time the inset II) and the canula is basically ALWAYS bent at the tip. We put it in his stomach and the general conclusion was that it gets bent because it reaches slightly past the fat under his skin and reaches the muscle. The movement between the tissues bends it.


Attached is a small picture showing how removed canulas always look for us.

[beckybuckley]

Our quicksets bent every time, usually within 14-18 hours. So we switched to Silhouettes, they go in at an angle. I really wasn't comfortable with the insertion of those at all and now we use the Sure T. The medal cannula really bothered me at first, but we've had no issues with it going bad.

The pump doesn't always catch it because if it's a really small amount that it's trying to push through (which was the case with Alyssa) - it's not enough to trigger the alarm. But I have had 2 different scenarios where I got the no delivery and minimed techs said it was either bad tubing or bad reservoire. They were really good about letting me send in the items that we were using when we got the no delivery -- and sending us replacements (sometimes double for our trouble).

Good luck!