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Total number of sites

Discussion in 'Parents of Children with Type 1' started by GChick, Oct 1, 2014.

  1. GChick

    GChick Approved members

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    Being slightly new to pumping myself, the previous post on sites made me wonder what others regimen is like...

    On average, how many sites (not necessarily areas) do you or your child use for pumping?

    While it may vary from time to time, I have a total of about 24 sites that I use regularly (on 6 "areas").

    6 on left side of tummy, 6 on left,
    5 on right lower back, 5 on left,
    and one on each thigh.

    I admittedly put them fairly close to each other in the areas, so am slightly concerned with over usage, but have a tone of real estate (and go a long time between using each area) that I don't use at all (particularly on stomach and thighs) moreso because they are currently "inconvenient" than anything else, so at least I know I have somewhere else to go if I have absorption problems with my current ones eventually.

    So, if you don't mind, how many site do you generally use?
     
  2. rgcainmd

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    An estimate:

    2 - 3 per thigh (4 - 6 total)
    about 2 per tummy side (4 total; we could probably map out DD's tummy better and get about 3 sites per side)
    2 per back of arms (4 total)
    (We rotate Dexcom from arm to arm. Arms seem to give us the most accurate readings.)

    So that's approximately 12 to 14 different sites on three body parts, give or take.

    IMO, something you mentioned is key in order to avoid potential liopdystrophy: giving each body part as long a rest as possible before using it again. For example, we don't rotate like this: left thigh upper, right thigh upper, left thigh middle, right thigh middle, left thigh lower, right thigh lower, then on to tummy. Instead, we do something like this: left thigh upper, right thigh upper, left tummy upper, right tummy upper, left or right arm upper (only one arm per body pass is possible, as the Dexcom sensor is always on one arm or the other), then left thigh middle, right thigh middle, left tummy middle, right tummy middle, etc.
     
  3. GChick

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    Hmmm bin mostly flying by the seat of my pants on this one. Got info from the doc on various pumps and then thought about it for awhile, figgered I was ready and started the process without even having the chance to talk to my doc. Taught myself how to use the pump, then only had Skype training about a month or two later, so not everything I do is exactly "by the book".

    I generally do upper-right tummy, lower-right tummy, upper-left tummy, lower-left tummy and so on and use up all my "areas" before touching the first area again. Beyond being easy to just keep track of, I figured that way at least my entire right tummy (and so on) doesn't get touched at all for at least a month an a half, if not two months sometimes... but maybe I need to rethink that theory.
     
  4. rgcainmd

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    If you're giving your sites 1.5 to 2 months rest, I would think that would be more than sufficient! I need to keep a list or a chart to make sure that my daughter doesn't use the same area as the time before when we rotate back to a particular body part. She and I both bruise very easily but heal extremely quickly (kind of like vampires), so it's impossible for us to see where the last site was when we return to a body part.

    Regarding starting the pump before talking to your doc, I'm pretty sure that you didn't miss out on anything there. IMO, the best endos know infinitely less about how to operate a pump than a parent who's been at it for a month. I'd estimate that 10% of everything I know about pumping (which is definitely not everything I need to know about pumping) we learned from our CDE, 50% from Pumping Insulin and the remaining 40% I learned right here on this Forum. I suspect that the remainder of what I need to learn will also come from this Forum.
     
  5. GChick

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    Oddly enough I have only seena CDE for the first time this year. I remember visiting here on occasion and seeing the abbreviation and had to go searching to find out what a CDE even was.

    The beginnings of my diabetes "career" were interesting to say the least. Was on a very antiquated system of a single shot a day for the first 13 years of being diabetic, but oddly enough, I think I was quite well controlled for the first 11 years of using that system.... all things considered anyway (once preteen/teenage years hit, it all went downhill though, but we didn't know any better). Nearly cried when I was 16 and in the hospital in the US for something else and they "forced" me to switch to two shots/day. Then they came in just talking about "the pump" which just terrified me, 'cus I thought they were gonna force me to do that too. Kinda swore then that I'd never pump :-D

    Had since switched to three shots/day and then the Lantus/Humalog combo which ended up being a minimum of 5 shots a day, since it didn't ~quite~ last 24 hours and I still never figured I'd be pumping... but, here I am. Even now with the whole thing with CGMs, I do at least KNOW that I will eventually start wanting to use one.... I just know I wont be ready for that step for a long time.

    Pointless ramble over.
     
  6. rgcainmd

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    Not one bit pointless!
     
  7. Brensdad

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    I have almost no fat on my behind, legs or arms, and anytime I've ever tried one in either of those places it doesn't usually go well. I am pretty much limited to belly sites, so what I do is rotate around there pretty well and then will periodically go off the pump for long stretches and go MDI so I can use other injection sites.

    Emma has her tummy, behind, and thighs so I guess that makes 6.
     
  8. mmgirls

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    OK I will try to answer this using my oldest as a "specimen" 9.5, 64lbs and "fit"

    each arm I have atleast 4-6 places to put a site.

    Booty the same.

    Thighs, those are not as easy, you see the blood vessels and of course try to avoid. So maybe 2-3 spot I feel comfortable with.

    so 30 total.

    That's a lot when I come to thing of it.

    Tummy she feels them "all the time" and small of her back they just do not stick for more than a day.
     
  9. GChick

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    Yes, 30 is a fair number of sites for a lil kiddo. Not too much chance of overuse for her I figger. I have more that I can use on my upper stomach, upper back (high end of the "love handle" type area) and a lot on my thighs, but choose not to use them because:

    a.) even if everything was done by the book (which for me it never is), Id still worry (probably needlessly) about "where to go" if the ones I got (if I used every good spot at my disposal that is) stopped absorbing.... and
    b.) I just HATE thigh sites. They work well mind you, I'm just constantly worried about ripping them out when going to the bathroom etc (which oddly enough, actually happened for the first time this morning)... and
    c.) I have to disconnect a few times a week to exercise and I'd rather not be rummaging around under my shirt (imagine the looks I'd get) to find the connection point (particularly when they are up high) nor go to the restroom to get the thigh ones.

    So I got other ones at my disposal, but I'm quite happy to not start using them at this time... maybe I'll never have to
     

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