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Any ideas to help with our Pumping Frustrations?

Discussion in 'Parents of Children with Type 1' started by KylesMom, Feb 28, 2013.

  1. KylesMom

    KylesMom Approved members

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    I would love some input to an issue we are having with infustion set sites. My son has been on the pump for 5 months now and we have been having a reoccuring problem the whole time with what seems to be the infusion set getting partially or fully blocked when inserted. We insert them in either his arms or the backside. These are really the best options we have because of his body type. Kyle is very lean and muscular (lean muscle, not bulky, but hardly any fat), and his legs and stomach are very tight, and all we feel is muscle in those areas. To make a long 5 month story short we have had prolems with a lot of his sets not working mostly during boluses. The basal seems to absorb well but the boluses are hit or miss. If we have a "good" site inserted his BG are great staying around 100 for the most part. But other times we have consistently high BG after boluses or corrections (250-350) where a shot immediately lowers the Blood sugar, and the basal seems to maintain him, but we have to either keep giving a shot for the bolus or change the set. For this reason we have been changing sets much more than we should have to be, sometimes once a day because they just aren't working.

    It has been determined that even in his bottom and arms, the site is hitting muscle tissue (or maybe scar tissue) and partially blocking the flow of insulin. This isn't just once in a while, this is probably close to half the time. We have tried the Sure T and the Mio sets. The Mio gave us No Delivery alarms, but when I pull the site it is not bent or kinked and I can easily see insulin coming through it. (We only tried a couple of Mios though) The sure T's don't give us alarms just consistent High BG when they aren't working.

    The nurse educator we are working with said the Sillhouette might be best for his body type, but Kyle will NOT try those...he doesn't like the look of it. He said the needle that inserts it looks too long a scary, and that he would go back to shots before using those. The other day we had a No Delivery alarm at breakfast, forcing us to unexpectidly change the site and making him late for school. He refused to put another set in him and I ended up giving him Lantus and doing shots for a couple of days. So that is how frustrated he is getting. He loves the pump though and asked if we could give in another try.

    I am looking for ideas that might help reduce the amount of problem sites we have to go through so he doesn't end up giving up on the pump. I know failed sites are a part of pumping, and I can't eliminate them, but this is a VERY regular problem, not just every once in a while. And Kyle's body type can't be that uncommon...lots of kids are lean like him so I don't understand why we are having such a problem. Or am I expecting too much and this is just a typical experience?

    I don't post much but I know this is the best place to come for ideas, and I always appreciate all the help I get from everyone here!
     
  2. hawkeyegirl

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    Well, I was going to suggest Silhouettes, which are insanely reliable for us. (In 5 years, we've had about two sites fail.) Would he let you try a Sil with numbing creme?
     
  3. Megnyc

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    Hi there,

    I would guess the silhouettes would work really well for you. Is he willing to try if you use an insertion device? I tend to have less pain inserting a silhouette then any other sort of site. PM me if your medtronic rep can't get you one. I should have a few floating around and could stick it in the mail.

    http://my.medtronicdiabetes.com/insertion-devices/sil-serter

    Also, a more complicated solution (but what I personally would try first) would be using the inset 30 infusion sites with a 3rd party reservoir. They are just like the silhouettes but insert automatically with an attached inserter. They are almost the same as the mios just an angled insertion.

    http://www.infusion-set.com/index.asp?pageid=H2312

    You would need to use the 50-50 reservoir with them.

    http://www.fifty50pharmacy.com/Merc...duct_Code=IADR332A&Category_Code=PumpSupplies
     
  4. chrissy92972

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    Ryan has been using his pump since December 2008. He was started on Sure t's 6mm and up until a few months ago they worked fine. Then we tried the mio's because he seemed to be running high way to often. The mio's were a disaster with kinked sites, ketones, etc. So we switched back tot he sure t's but he is using the 8mm size. Mainly his sites are in the hip/side area since his cgm is in his rear.

    Maybe changing the size of the sure t's will help?

    Chrissy
    Ryan diagnosed 5/08 Revel, CGM, MySentry age 10
     
  5. KylesMom

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    That's encouraging to hear how reliable the Silhouettes are for you. Are they easy to insert? I don't know what it is but it looked complicated to me when I watched the demo on the website. Good thought about the numbing creme, we've never used any before so I didn't think about suggesting that.
     
  6. MomofSweetOne

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    We used the Silhouettes with good luck for 18 months. We've just started using Mios. We like the smaller hole and easier insertion, but I'm noticing they also kink and pull out easier. (Two pull-outs today!)
     
  7. Lee

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    Sihl's are really the best for muscle. I might try numbing cream - either RX or some from Sally's Beauty used for eyebrow waxing to convince him to try. Plus $5.00 always for my kid. Minimed will send you samples, so ask them to send a couple to you and see if they work.
     
  8. hawkeyegirl

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    We insert them manually. It's very easy, once you overcome the natural hesitation to plunge a 13mm length needle into your kid. ;) I can send you a few if you want. It's probably good to practice on yourself or your husband first, just so you're comfortable with them. We actually have an inserter that we've never used, and I could send you that too if you wanted to try it. I think it's less "violent" to insert them manually, but it's personal preference.

    Numbing creme works like a charm. We put a small bit on under a regular band-aid. It's at full effect in an hour, but it's pretty numb in 30 minutes. I'd suggest putting some on your son and after an hour letting him poke at the spot with a paper clip or pencil or whatever. That way he'd "trust" that the site wasn't going to hurt.
     
  9. TheLegoRef

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    My very skinny 14 yr old uses the silhouettes. He likes them better than the Quicksets. Although we're going to get some Mio's for on the go. We used to use the Quicksets, then started having a lot of bad numbers / sites. Someone at D camp suggested silhouettes, and we haven't regretted making the switch. The site changes are faster and easier, too.

    Maybe you could have your son read this thread, or a few others on this site, to show him how many kids like the silhouettes.
     
  10. Sari

    Sari Approved members

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    When my son was first diagnosed we were on the Silhouettes. Have to say, HATED them. For us they kinked all the time. Plus with the inserter we got, I felt like I was harpooning him. To be honest, it was very traumatic for ME! I cried every time inserting it on him.
    We use the Sure T's as well and we love them. My son is lean as well and we only insert on the butt cheek.
    Good luck with what you chose. I know everyone reacts differently.
     
  11. KylesMom

    KylesMom Approved members

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    After reading the replies it sounds like we should at least give the Silhouettes a try. The nurse we are working with had said she can give us some to try. I just need to convince my son to be open to trying them (a little bribery never hurt!) I like the idea of numbing creme. And I will share with him the success many of you have with the sillhouettes. If he does try them and they don't work we are no worse off than we are now. I'm just glad the other day he asked if we could give the pump another try. Even with the frustrations we are having, the pump has so many benefits we would miss if he went back to shots. Thank you all for the replies!
     
  12. MomofSweetOne

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    If you talk to your pump rep, you might be able to get a box of them to give them a good trial before switching completely from another options. If we'd only been given 2 Mios, we wouldn't have switched. Those attempts were disaster.
     
  13. Yellow Tulip

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    I agree with hawkeyegirl. We have used Sillhouettes since starting the pump 2.5 years ago, and have had maybe 1 or 2 failures. The insertion isn't the easiest with the inserter. It takes time to get used to it. It's hard to get the angle right, some sites are deep, some barely graze the surface. My son refuses to try a manual insertion, though. At first we used numbing cream to get the sites in, but after a few months he is ok with just an ice pack beforehand.
     
  14. MilesForMiles

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    I just wanted to second (or third) the numbing cream idea. My 18 month old gets set changes without even flenching. The only drawback is it takes about 30 minutes to get things numb. A great tip I received was to use the Glad Press & Seal wrap to cover the cream while it absorbs. It sticks to the skin and peels off easily. Good luck!
     

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