Ugh - I have to do my first site change - at 11pm!

[Nancy in VA]

Emma has been in the 300s since dinner. :eek: We weren't TOO worried since the CDE expected the numbers to be wonky since pump start. But, when she didn't come down at the 3 hour mark (she always used to), I tested her ketones and I got a 1.0 (I've never gotten more than .2) :eek:

Its been 2 1/2 days with this site (I was going to change it after breakfast) but I think I need to change it now. I just was really ready to get my act together in the morning and go through the entire procedure for the first time and now here I am changing the site on a 2 year old who is sleeping at 11pm at night. Ugh!!

[zeb'smom]

Oh well that just stinks. We also had a bad site in the first days of pumping and our first site change was not the calm well planed event I had intended. It all turned out alright and we really haven't had a bad site since.

I hope it goes as smoothly as possible and you are able to get rid of those ketones. Good luck.

Robyn

[jeep_bluetj]

You'll only do a few hundred more... You need the practice. :)

Actually, sleeping is pretty good.
It'll go fine, if not, the next one will.

[Amy C.]

It is a breeze to change a site when the child is sleeping -- especially when in a deep sleep.

Haven't you done a shot when she was asleep?

These are the only site changes I have done. My son does all the others.

[LJS118]

that stinks :(
but actually my son has slept through many of site changes in the middle of the night...he wakes up in the morning and doesn't understand how come his pumpsite is in his leg instead of his arm or vice versa :D

[Nancy in VA]

Well, that was a miserable experience.

I gave her the correction by syringe, per the CDE instructions, but that woke her up enough to know that I was doing something and she started crying. It took 3 sets to get it right - the first one fell off because of the baby oil from taking off the old one (the CDE said to stay on the same side of the body and there just wasn't enough room for 2 on at once - she's only 2). The 2nd one I ripped the site right off the needle trying to take off the paper cover from the adhesive.

We have a tough time getting them in because she sucks her belly way in (she looks deathly when she does that) and there is nothing to stick it in. So we have to make her puff her belly out, but by now she was crying so much that she was "wimpering" and that was making her belly go in and out.

But, ugh - its back in. She didn't even want to sit with us on the bed - she wanted to go back to her bed.

And hubby and I are about to kill each other. He only half pays attention in training and when I try to explain things to him and so it takes 2 or 3 times to get something done right. He yelled at me for not having it all ready before I even walked into her room so that she wouldn't have woken up and noticed. I said "well, she's wearing her pump" and he said I should have taken it off and left the room to switch out the tubing and priming and all - well, fine, maybe I'll think about that next time when its not 11:30pm at night and I'm not prepared. I asked for baby oil to remove the old site - he brought a bottle. I said, duh, I need it on cotton balls, so I get a cotton ball with one drop. I said "it needs to be wet - I need to feel it and drip it on the adhesive". So finally I get that right.

Then when the first set fell off BECAUSE of the baby oil - again proximity to old side - I sent him downstairs to get a new one. It took him like 2 minutes because he decided to wash the baby oil off his hands while I'm sitting here half done with a fussing baby. He kept yelling at me "its coming off" while I'm trying to remove the inserter and all along Emma is fussing and her belly is going in and out -which is tough when you're trying to get adhesive to stick. And then I couldn't get the pump to prime right and that took 3 times.

So, there we are - first site change was miserable. I was all ready to do it after breakfast and go through my whole checklist calmly and carefully. So much for that plan. We'll see if the correction by syringe and the new site brings her #s and her ketones down.

[yeswe'rebothD]

Sorry that went so un-smoothly. I would be thankful if dh would try helping at all. He has yet to do a site change....... I keep asking what he'll do if I die, and he won't discuss it. Your dh sounds like at least he'd be willing to figure it out if the need arose.

[Isabelle's Mom]

Sorry you're having such a rough start. We also had to do a couple of set changes at night in the early days ...

[swimmom]

I feel so badly for you. We did our first couple of changes with our diabetes educator on the phone and were still sweating buckets.

Instead of baby oil, you might try Uni-solve. I learned about it from this site. I order it from Bruce Medical. It's not greasy, but I still remove it with alcohol after using it.

We always switch sides with a site change. There is no reason not to do this. Makes it a lot easier because you can clean up the old site when you have time and everyone is calm.

You might try the insertion in her bottom. My daughter finds this much more comfortable (she is very thin), but of course, she doesn't wear a diaper :->. Is that why you are using tummy space?

We also use Emla cream (covered with IV 3000 tape for 20-30 minutes) to numb the area. Some people hate this idea because it makes changes "on the run" harder. We just don't use it in those instances. I think anything I can do to make it easier and more comfortable for Lauren is worth it.

I hope you have a stable night. I'm sure you won't be getting much sleep until everything is ok (and maybe not then). I can only imagine how difficult it is to go through this with a baby.

[Carrie]

Ugh! Those kinds of experiences can literally make your heart ache and your gut feel like it's going to vomit. :( Rough. Until we started using EMLA, site changes were two-men jobs.

It could of been the site, but this early in pumping (in hind-sight) I would of tried correcting through the pump and re-checking. I've saved all of my logs since day one. Our second full day of numbers when we started pumping went like this...356, 335, 315, 375, 332, 401, 439, 419, 212. We got up to .5 ketones that day but I don't show that we changed the site. Her first number under 200 came on the third day. :( It ended up that she required some serious basal and carb to insulin changes. One other thing to check is the tubing. Unscrew the reservoir and check that and the tubing for air bubbles. You could try bumping up the basal by 10% for an hour or so. If that helps, she might need a bump in basal.

[Tori's Mom]

Ugghh, sorry that went so badly. The pump start itself is unnerving, then when you have to do an "emergency" site change right off it makes it worse!!

We were lucky and did not have our first bad site for several weeks after pumping.
I was busy patting ourselves on the back because "we" didn't have those site problems that I was always reading about on here!!:D

Well, we've had our share since.... Once not getting a good site until the 3rd set change, one right after another.:eek: Talk about a LONG night!!

Hope her ketones are quickly gone and good numbers on the way.

[Amy C.]

Wow, that wasn't very good. You learn a lot in hinesight.

The next one can only be better.

I won't offer what I might have done -- you have already learned a lot from this experience.

I just offer my symphathies. We have had our share of bad site changes. Fortunately, these haven't happened recently. Philip always knows he can go on shots at a moment's notice. That has never lasted longer than 4-5 hours.

[Nancy in VA]

Well, Emma came down overnight - too far. I tried to email the CDE last night because she's often online around that time - ask me how I know!! Anyway, when we did MDI, we actually reduced her corrections when she was over 300 because she seemed more sensitive to insulin. I didn't do that last night - I did the exact correction that the pump would have done - just through a syringe (the CDE says to correct with a syringe when you have moderate to high ketones)

So, 1 hour later she was 280 and Ketones were down from 1.0 to .9 so we were headed in the right direction. 2 hours after that, she was at 138 so we were happy and back in range.

7:30am wake - she is 58. ugh. Even worse - 1.7 Ketones!! So, I have paged the CDE to see what's going on. I'm having trouble understanding how she could have gotten down that low WITHOUT her basal but the Ketones would make me think that she isn't getting her Basal.

So, now I'm waiting for a call back from the CDE to figure out what to do.

BTW: We were trying to do the site on the same side because that's what the CDE told us to do. She said its too easy go back to the same site when you switch back again.

[caspi]

Wow Nancy, what a night you had! Your hubby sounds like mine! :rolleyes:

Hopefully you can get things back on track today!!! Like everything else with this disease, every new thing is something we learn from, good and bad.....

Here's hoping for better #'s today!!! :)

{{HUGS****

[BrendaK]

Yuck -- what a horrible night for you. It almost sound like she's getting sick??? Sometimes low blood sugars with ketones indicate an illness is coming on. I hope not. I just can't image her site wasn't working with a blood sugar at 58.

One more tip with site changes -- I always leave the old one on until I get the new one in. That way you won't have the baby oil problem. (And we switch sides every time, too. Left tummy, right tummy, then left butt, right butt.) I don't like getting adhesive remover everywhere before that new site is stuck on good.

What did the CDE say?

[Kaylee's Mommy]

I'm sorry you had such a tough time on the first site change.. Notsure why your CDE wants you to stay on the same side of the body, with such a tiny body to work with. We started w/ Kaylee's belly too.. but its so much easier to grab an inch of bum than it is to grab an inch of belly LOL.. it WILL get easier.. butI remember those site changes in the beginning being hectic... I played a game with kaylee.. I'd tell her to make her belly as big as she could.. it is still hard to grab an inch of her belly.. she loves her sites on her belly.. that use to be my fav. place too (except for insertion..) because it doesn't get in the way of going potty and change clothes... but I rarely use that spot anymore just because I've found other spots that are so much easier to insert.. bum, 'love handles' Not that she really has these, and the back of her arms (my new fav spot.. get awesome numbers and doesn't get in the way of potty and changing pants:) )

It will get better, it does get easier.. we've never used baby oil to remove and old site, most of the time I just pull it off, like a bandaid.. but we do have some remover too.. that works well.. regular alcohol may work better for you, won't leave it smooth and oily like the baby oil.. so the new one will stick betteR:)

hope you got some sleep last night!

[Nancy in VA]

Well, I'm glad that some of you switch back and forth from side to side each time. I didn't because the CDE said not to, but after the 2nd one wouldn't stick, of course I switched. She still had the little mark from when I removed the site on Tuesday, so I could tell where the one before one.

I finally reached the CDE. They had changed numbers for the ENTIRE HOSPITAL this week and I had the wrong pager #. Finally reached a friend who is also there and got me the right number.

She was a bit surprised by the #s. Thought that she was maybe a bit dehydrated, which I find hard to believe because she goes to sleep with a full cup of water every night and had more in the middle of the night when we did the site change. But, she had us pump her full of fast-acting to get her about 200 and then do a bolus + 20% (she had already eaten breakfast) to clear the ketones. She agrees the new site must be fine if she was 58 too - so at least we all agree about that. She said she might not have assumed last night that the site was bad, but Emma's never had Ketones over .2 so when she gets to 1.0 on the pump and staying high (even with a new lower c:i ratio), I think it had to be the 2 1/2 day old site.

Ugh. I'm supposed to be heading out for the weekend later today to a scrapbook retreat but there is no way hubby can do this by himself. I am the primary care since she's home with me all day - he can handle the routine but not the out of the ordinary!

[momofsingingdiabetic]

Oh, I'm sorry you are going to miss your weekend. I love my times away (haven't gotten to do a scrapbook retreat yet though....just a local two day event). I would be soooo tempted to put her back on MDI for the weekend so I could get away. Well, maybe not really, but that thought would probably float around in my head.

Now watch, everything will be fine and normal for the weekend....it always happens that way.

[cadesmom]

We did our first 2 site changes at 2 am, with our son screaming you lied to me it hasnt been 3 days, Its ruff in the begining. I know they tell you to give an injection then do the site change but I like to change site then deliver the cor. bolus that way the pump stays on track, check 30 min later to see if bg is coming down, if so you know that site is working, also to avoid waking her up dont pull the old site out until you put new site in, That works for us, Ive even waited until the next mornig to pull it out.
Hope tonight goes better.

[MamaChrissa]

Man, I am so sorry! When Jason went on the pump his first insertion was when he was sleeping, so when I had to do it for the first time it was a complete disaster. :( It gets easier.

I would also recommend doing the behind. It was strongly recommended for us, because J is so scrawny. We just hop from cheek to cheek for each site change so it makes it easier to keep it rotated.

Sorry about the weekend and hope she feels better soon!

[MissouriMom]

I'm feeling for you! We have only been pumping a month .. with a 2 year old. I've not changed in the middle of the night. Just three days ago, I had changed his site every day because of high numbers. The last time I changed the site, it was over 400. I'm still trying to figure out which infusion set works best (had 2 kinks with the quickset). I called the doctor in tears! :( Needless to say, they told me to stop changing the site, and to work on the numbers. We've made some adjustments to his ratios, and it seems to be going much better.

I also use his butt, and switch sides each time. I have been using the Sure-T sets with the IV-3000 to cover, and only cleaning with alcohol wipes.

Also, I think our husbands must be members of the same club!!!

Hope things get better.

:)

[Nate'sMom]

Ugg, at least you got the really bad one over with at the beginning. The rest will be a breeze (HA!) The very first site we did I was all worked up and Nate was screaming and I forgot to take the plastic cover off the needle and tried to insert it with the guard on. (Needless to say the screaming level increased considerably) Anyway, hang in there, it does get easier. We had alot of trouble with the insets we started out with, and switched to Cleo 90 insets (they work with Animas and Cozmo for sure, not sure about Medtronic) They are such a breeze to insert. (If you go to the Deltec Cozmore website you can get a couple free samples to try). Now, when she goes down for her nap today, you should lay down with her and get yourself a little rest!! Good luck with it all

[Cyndi]

I hope things get better for you. I know exactly how nervous those first site changes can make you. I still hate changing sites in the middle of the night even after 2 years of her pumping.

Which infusion sites are you using? We use Insets and we have always used Mackenzie's bottom for her sites. There is more fat here and less pain. I have tried her belly two times and it didn't work out. Also, we don't use anything to take the old site off. We just pull it off and that is it. We also have switched from side to side but since we are using the CGMS now we stay on one side for a few changes and than switch. Both ways are fine as long as you rotate. You can tell where the old sites are even after a few days.

A few things we have found that help tremendously with site changes is to distract her. We give her a popcicle EVERY time we change her site. We also put on cartoons for her. Sometimes her dad or one of her brothers hold her hand. Now these won't work for night time changes, of course. For those I just try to do it as fast as possible. Sometimes she wakes up and sometimes she doesn't.

It will get easier. You will be a pro at it in no time.