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4 year old hates inserting infusion set.

Discussion in 'Parents of Children with Type 1' started by apples, Dec 25, 2014.

  1. apples

    apples Approved members

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    Hi everyone,
    I have an amazing 4 year old who was diagnosed with T1D at 16 months old. Needless to say it's been a bit of a bumpy ride and we had been holding out hope that the insulin pump would bring the stability to her sugars that we had been looking for. Her sugars are much better for the most part however, when she had to change her infusion set she experiences a great deal of anxiety and panics at the thought. Ive tried to take the approach of getting it over and done with as quickly as possible but, she fights it and it very difficult for both of us. I find that she is less playful than she used to be and she has asked several times if we can just go back to injections.

    I have 2 questions really.
    1) have any other parents of young children experienced this and could you offer some advice on making things easier on her?
    2) she has only been on the pump for about a month, is this rejection a normal pat of the adjustment process?


    Right now this doesn't feel great, sure her sugars are better but, the child matters too. My diabetes team has been really great about medical support bur, they haven't much to offer in the way of emotional support. I could use some supportive advice.
     
  2. Sarah Maddie's Mom

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    A couple of thoughts. You should practice inserting them on yourself and SO. Your technique could be less than perfect and you should know what it feels like in any case. When my kid was younger she'd get to lay on the bed in our room, watch her choice of TV. I would prep the site and count down from 3 and she'd scream , yell, as loud as she wanted to on "1" and then it would be over. The screaming part was just a distraction. She did it for a while and them just outgrew the need.

    On the big question of her not wanting a pump, have you asked her what she doesn't like? I believe in listening and taking their concerns seriously, but I would not switch back to shots if I felt that pumping gave her better "control". I think it helped our daughter that I let her do sites on me, or watch me do them to myself.

    Good luck.
     
  3. dpr

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    My daughter is just a few weeks from 9. We've been pumping for 3 years and it has just been the last 6 months she has let me get a site change done in a couple minutes. She is very strong willed.
    What infusion set are you using? Some are definitely less pain full than others. We use Sure T's and find then pretty painless. When we tried Silhouettes' she found inserting them very painful. Have you tried lidocane cream? It makes a big difference but takes 45min to an hour to get really numb. With a child that young I would give it a try.
     
  4. apples

    apples Approved members

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    These are awesome suggestions and I have already practiced on myself, let her watch me do it and even offered to let her in set one into my stomach be a use it is pretty hard to tell someone "it wont hurt" and have them take you seriously when you've never done it. I've let her have her choice of distraction but, the poor kid can't get it out of her mind. She doesn't seem to mind the pump and recovers quickly I'm concerned that she works herself up so much that there will be mental damage. She's having what I would consider severe emotional outbursts and I just don't feel like this is normal.

    Thanks for your help.
     
  5. apples

    apples Approved members

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    We have in fact tried emla cream but, it wasn't a success in this case as the near hour it takes to take effect was just an extra hour for her to worry about it. I don't feel like the pain is the problem because as soon as it's in she recovers in moments. I feel the issue is psychological. Really helpful suggestions though. I appreciate your time.
     
  6. hawkeyegirl

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    When my son was little we'd use EMLA and insert while he was sleeping.
     
  7. Charliesmom

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    How many times have you used Emla? It really did help my son with his anxiety about site changes.
     
  8. StacyMM

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    We tried pumping with my daughter when she was 4 and it was about as unsuccessful as an attempt could be. We did MDI for another two years and tried again. At 6, we were able to get her pumping for about two years. After two years, she was done. We agreed to go back to MDI when she hit eight. She's 11 now and has been pumping since 9 this time. She is one of those kids that doesn't mind shots and is perfectly content with MDI. Honestly, she would probably be very content to be MDI forever because site changes are still an emotionally chanllenging thing...but the idea of getting 60 units of basal a day is more intimidating so the pump wins. My son, on the other hand, never wants to go without a pump. Ever. Those 2-3 months while we chose a pump and waited for training were horrible - I don't think he will ever, ever go MDI again.

    Every kid is different. Don't feel that pumping is a *must* when it's really just an option. And don't forget that kids change and their preferences will, too - pumping may be traumatic now but great in a year. You just don't know.

    You are the one that knows where that line is between the benefits and difficulties of pumping. Just chiming in as someone who has done the pump break thing a few times and has had success with it. Just do what is right for you and your daughter :)
     
  9. bamaboyd82

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    My son is also 4. We have only been pumping for a few months, but what has helped him to agree to "just get it over with" is me getting everything ready, including wiping the site with alcohol, and then I start counting (slowly). I wait for him to say "Ready, Set, Go" before I push the set in and tape it down. If we get the change done before my count reaches 60, he gets to put five stickers in his sticker book. We've been doing it this way for a couple of months now, and most of the time, he doesn't even actually ever collect on his stickers. He seems to just like the idea of both a deadline and a reward, regardless of whether he redeems it.
     
  10. apples

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    Just 4 he one time and she flatly refused to do it again. It really was just an extra hour of worry and the actual act if inserting was much worse. I totally understand her fear as I have an irrational fear of needles. I understand from my own experiences that it's not the pain that worries me as much as I am unsettled by the invasive object. I believe hers is the same sort of "I don't want that in me" reaction.
     
  11. apples

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    This is interesting but, I'm concerned it would cause trust issues. My kiddo is sensitive.
     
  12. apples

    apples Approved members

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    Thank you Stacy, a little support goes a long way. Did your children ever stop reacting negatively to insertion time?
     
  13. KHS22

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    My kiddo is super sensitive too - and we have the same anxiety over lead up to site change etc. She is also 4.

    We have tears most site changes. I take the no non-sense get 'er done approach. I change the cartridge and everything after, because if she sees me doing that she knows a site change is coming. No emla or other freezing here, same thing - draws out the process.

    I do let her chose a distraction. For us, she almost never watches TV , so it is usually watching a show.

    BUT, if I can, I do it while she is asleep. She thinks its hilarious. She wakes up with a new site (or dexcom) and is THRILLED she didn't feel it... You know your kid though - if they sleep sound enough for this?

    AND - if I 'm going to do a change at night, I usually do a 90 degree - tend to be quicker and hurt less. So less chance of waking her up.

    Good luck.
     
  14. Lori_Gaines

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    My 4 year old throws a mini fit too, but we get through it quickly without too much of an issue. She has been on a pump since shortly after diagnosis though, so she doesn't know any different. I have to say, I concur with those who suggest a change while sleeping. I have had to do that a couple of times, and it is so much easier. No drama while sleeping! :)
     

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