Pain on inserting and how to avoid bent cannulas

[tigger]

I did a set change last night and had to take it out after the pump told me that it wasn't working and I found the canula was bent. So I put another in quite quickly and firmly on the other side of my stomach. It really hurt when it went in, was painful at night (I can't lie on that side) or be touched anywhere near the site or I get a sharp pain and I can feel it more during the day now although it's bearable. I only have one set left so didn't want to risk trying again until I have more in the house (delivery today). Insulin delivery seems to be fine though.

Has anyone had this experience and if so what is it caused by and how do I avoid it again? All the other sets I've used have been virtually painless. I use a minimed quick sert.

I've only been using the pump for just over a week and this was a completely new site so scar tissue is unlikely. I don't usually inject in this area (I stick to thighs).

This is my second bent canula as well. I thought the first one was caused by me being slightly hesitant on inserting (it was my first time unsupervised), but I managed it fine the 2nd time and last night was the third time and I know I did it confidently. Does anyone have any tips on this as well?

 

[-Artemis-]

Oh hello! I just PM'd you about this

.... which sets do you use....?

 

[-Artemis-]

... I just saw -- quicksets!

It could be that the length is wrong with them for you (they come in two lengths) or it could be that the set type just doesn't suit you... I tried quicksets and didn't get on with them; they were painful like you describe and I couldn't lay on the side they were on. I don't get that with Silhouettes.

Also Silhouettes I think are less prone to bending, and steel sets even less.... but it also kinda depends whether sets at a 90 degree angle or variable 30-60 degree angle suit your body shape/activity etc better.... maybe ask your DSN if you could try both?

 

[victry77]

I was plagued with quick-set problems and could not see anything that I could do to avoid a dodgy insertion. I started on 9mm, which were far too big for me, then went to 6mm but still had problems. I'm now using the steel ones to see if I fare better on them. Must admit, though, if a cannula was causing me quite a bit of pain, like yours has been doing, I would have changed it, but I understand that you were low on sets so had to put up with it.

Might just be a bit of a blip, but yes, quick-sets did cause me issues.

 

[MushyPeaBrain]

The Mio is supposed to be much better than the quickset so I would ask for some of those to try. The painful one you probably hit a small vein and that happens to us all at some point. Also make sure you don't push down as you insert as this increases chance of kinking.

 

[Riri]

Sometimes, as I use the inserter device with silouhettes, it fires in quite hard and it's painful and I found out that the pain comes from a bit of brushing aroudn the entry site as it goes in quite forcefully. This only happens occasionally and I don't find it affects my blood sugars but it does feel tender and, as you say, painful to touch it.

 

[tigger]

The new supplies came today and I've changed the set and pain has gone. There was nothing wrong with the site, no infection, blood etc so I think it was probably a muscle or a nerve. I'll ask the DSN for some different models to try and see if they're better. Thanks for all the advice.

 

[ann34+]

The new supplies came today and I've changed the set and pain has gone. There was nothing wrong with the site, no infection, blood etc so I think it was probably a muscle or a nerve. I'll ask the DSN for some different models to try and see if they're better. Thanks for all the advice.

Hopefully things will now be ok , but it can be difficult finding a suitable infusion set. I could not get on with all the type of sets i was offered at the start and gave up pumping completely. It was months later that i found out that there were steel sets with a short straight needle, i was hesitant to re-start, but was having hypo problems again, so went back and tried with these steel sets, and found they worked. Delivery was fine - it often was not with all the other types of set - and i did not get severe soreness at the infusion site.

 

[victry77]

What's interesting with the steel is that you tend to know when there is a problem. It was DonnellyDogs who told me that you will feel pain if a steel cannula bends and that is your little alarm signal to change your set.

This came true this morning. I changed my steel cannula and it's about my fourth set change using them. I felt a little bit of soreness on insertion (which I hadn't previously) and then within about 20 mins realised I couldn't sit down at all on the side where the insertion was, it was pretty sore. I took it out and the tip was bent!

Obviously I changed set but as I'd already had my breakfast and bolused with the other set, I was left with no idea whether that bolus actually worked or not. Anyway, decided to give myself another bolus and will just keep an extra check on my levels. If I hypo I can easily deal with that over a hyper.

 

[ann34+]

What's interesting with the steel is that you tend to know when there is a problem. It was DonnellyDogs who told me that you will feel pain if a steel cannula bends and that is your little alarm signal to change your set.

This came true this morning. I changed my steel cannula and it's about my fourth set change using them. I felt a little bit of soreness on insertion (which I hadn't previously) and then within about 20 mins realised I couldn't sit down at all on the side where the insertion was, it was pretty sore. I took it out and the tip was bent!

Obviously I changed set but as I'd already had my breakfast and bolused with the other set, I was left with no idea whether that bolus actually worked or not. Anyway, decided to give myself another bolus and will just keep an extra check on my levels. If I hypo I can easily deal with that over a hyper.

I hope things worked out ok. ....the thing about the steel sets is if they are uncomfortable at the start they wont settle - it is just learning how to put them in ok which takes a long while. I have never noticed mine bending, though . Also, the other thing about them - this was not the advice i was given some years ago - is that my pump company says i should to change them every 2 days, not three, as with the flexible cannulas. Not sure whether this is individual advice because i had problems, and i don't what others have been advised? My experience is that this, for me, is good advice, though i often forget it - as i did today, and now i have had a small bleed. In my case, at least, the steel sets appear to set up a tiny infection if they are left in. I have worked this out because when i have to be on an antibiotic course for something else, i can keep the sets in with no problem at all, for much longer. Ann

 

[donnellysdogs]

Steel sets have always been 2 days to change.

Victry77 you did exactly what I would have done. Bolused again.

 

[victry77]

Steel sets have always been 2 days to change.

Victry77 you did exactly what I would have done. Bolused again.

Yes, it seemed like the right thing to do. I was at a perfect number 2hrs later. Went down to 3.8 about an hour and a half after that, but I just figured that maybe a bit of the original bolus had worked but certainly not all of it, and a 3.8 is remedied in a couple of minutes as opposed to having been stuck somewhere 14+ and waiting for correction doses to kick in.

Also, yes, ann34, 2 days for steels, although I started to change the plastic ones after 2 days also, as I only seemed to get 1 and half - 2 days use out of them.

 

[tigger]

Hospital have given me silhouette and sure-t (steel needle) to try. I did another quicksert last night and it completely failed and I couldn't work out why as the canula was not bent so I tried the steel and so far it's fine and levels are good. I can sort of psychologically feel it but not physically if that makes sense. I think it's the idea I've got steel in me all the time.

 

[tigger]

Aah!!!! Now I have a high reading and I think the needle may have come out as when I pulled it out it looked like there was liquid on the adhesive. I've now reinserted it elsewhere and put surgical tape around to keep it in place. Hopefully that will work.....

Why does everything with a pump feel like 2 steps backward, 1 step forward????

 

[Mrsass]

Hi @tigger I changed from quickset to Sure-T as I had similar problems to you, been using sure t for about a year now with no problems, I know what you mean about the psychological feeling it, I didn't dare bend over or touch my stomach when I first started using them, obviously you can't actually feel it at all and you do soon get used to it hope it works better for you x

 

[donnellysdogs]

If you can feel the steel they won't work and you will immediately know to change them.

 

[victry77]

I did another quicksert last night and it completely failed and I couldn't work out why as the canula was not bent

This was the case with me, also. Most of the time they would come out straight but yet they clearly weren't working.

I appear to have had better luck so far with the Sure-T. I've only had two blips, that one I already mentioned further up the thread, but then in the early hours of the following morning (4 am) I rolled over in bed and OUCH!!! Couldn't move for 5 mins! Knew I had to change set right away and when I got up, there was blood running through the tubing

At that point, I really was thinking that I just might not be able to have a pump anymore, but I carried on and so far things have been fine. I always seem to have difficulty if I wear it on my right side (hip/bum area) as opposed to my left.

 

[tigger]

Interesting. I've put in a new needle and it feels ok. I'm wondering if i need a longer needle. We'll see what happens with this one. When you all insert it do you pinch the skin? I wasn't told to do this but the minined video has pinching technique. I like the fact you can reinsert in an emergency. I find that a lot more reassuring than thecanulas.

 

[donnellysdogs]

Ooooh.. Longer?? Won't that just hurt more??
Depends upon body fat really. Everybody I know uses 6mm.
Why do you think you need longer?

 

[tigger]

Because of coming out and guidance on the chart re bmi (i'm definitelyat least average ). It came out again in the night and i was 16 at 5am i injected to correct and at 8 decided to inject for the day but put the quicksert in at 5 and touch wood seems to be working. I'll call their technical line on Monday to discuss and see if i can get some more samples and i'll give the silhouette a go. All rather dispiriting and my stomach feels like it's a mess of scabs and rather sores