Pain on inserting and how to avoid bent cannulas

[donnellysdogs]

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

Blimey!

 

[CarbsRok]

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

You say the cannula is coming out? So the obvious question is why? Are you pulling on the tubing in your sleep, if so simple solution is to put a bit of tape over the tubing so it can't be pulled out.

 

[dancer]

I use 9mm Mios and discovered that many use 6mm cannulas.

At the training for my new 640G pump, the Medtronic nurse presumed we were all on 6mm cannulas. I asked my DSN if I should change to 6mm Mios as I'd recently changed from 8mm pen needles to 4mm ones (for my emergency kit). She said that many DSNs think that 6mm cannulas are long enough but she believes there is more chance of them coming out.

I move around a lot in my sleep and do a lot of dancing so I decided to take her advice and stick to 9mm.

 

[tigger]

@CarbsRok - one came out when I was awake part way through the morning and the other while I was asleep. I asked them to send me a longer canula and if I can work up the nerve I'll try again. I'm feeling a bit pin cushion like at the moment and my stomach is quite sore.

 

[donnellysdogs]

Why use stomach as a pin cushion when ur bum prob has more fat?

 

[dancer]

Why use stomach as a pin cushion when ur bum prob has more fat?

Yes, but don't use the bit you sit on!

You can also use the midriff and the the bit round at the back of it (unless you're really skinny unlike me!)

 

[-Artemis-]

I only use my tum... The absorption in my bum is awful... :-(

 

[donnellysdogs]

How do you know absorption in your bum is awful when only been on pump a week?

 

[-Artemis-]

How do you know absorption in your bum is awful when only been on pump a week?

I've been on the pump for three weeks and I change my sets every two days - with a couple of blips, that's nearly a dozen sets... I've tried different spots around the top of my buttocks 3 or 4 sets -- so about a weeks worth of data.... I eat three meals a day so that's 20+ meals I can look at the data for whilst the sets are in my bum -- and every time I eat with them there I have high numbers (double figures -- not like me at all) for 4 hours, then a sudden drop into a hypo at about the 4hr mark. This had happened every single time, no matter what I eat or what I'm doing.... (I'm active -- the activity seems to make no difference)

In my stomach that just doesn't happen.... the insulin behaves as I would expect it to with no extended highs and no sudden hypo hours later.... to me thats clearly an absorption issue?

 

[azure]

I replied on your other thread, but I just wanted to add that I stick with a site area for a few months and don't swap from one to another. Other people might do different, but that works for me.

I do approx six months in my legs, then six in my bum. I have a slightly different basal for each area (bum needs more). I find this gives me more consistency.

I'd also say that it takes a while to get the knack of sets and cannulas and to see how you personally need to use them. We're all different.

Finally, I use a different set in my bum than in my legs - Tenderlink for legs. Rapid D for bum. That change to Rapid D sorted out the absorption problems I was having.

 

[-Artemis-]

Ah.... again, interesting @azure! I have the medtronic version of both those sets, so worth a play around....

 

[ann34+]

@CarbsRok - one came out when I was awake part way through the morning and the other while I was asleep. I asked them to send me a longer canula and if I can work up the nerve I'll try again. I'm feeling a bit pin cushion like at the moment and my stomach is quite sore.

Hi, tigger, as CarbsRok says, the tape is a simple solution, and it works well. I used it a lot when learning, hardly need to now - it is microporous tape, costs less than £2.00 from any chemist, 2.5cm x 5m is a good size.
Re the soreness, it may be you are setting up minor infections, esp if you have any bleeds. Just use antibacterial silver plasters when you change sets - especially while learning - i have said elsewhere i found it took a while to learn good insertion, years later i am still learning. These silver backed plasters are perfect, I still keep a stock of them. Agree with others, why not persevere with other areas - i never use the stomach, never have, not enough fat there, too painful

 

[ann34+]

This thread has made me think. i looked to see if there was recent research out there - not sure if anyone's posted it before, but i thought this from 2012 very interesting - http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3440169/ - "The insulin infusion set - the Achilles Heel of Continuous Subcutaneous Insulin Infusion" Ann

 

[victry77]

I had to change my steel sets THREE times on Monday!

Was due my usual set change which I did in the morning. Waking BG was 4.9. 2hrs after set change and my usual breakfast they'd shot up to 16.6. No pain from the cannula, also wasn't bent when I removed it. I checked the tubing and think I saw some air bubbles, so possible culprit maybe.

Later in the evening I was walking over to my yoga class when I started to feel slight pain. In two minds whether to turn back home. Carried on with class and when I got back my levels had shot up AGAIN! So, yet another blinkin' set change!

Starting to lose the will now...

 

[-Artemis-]

This thread has made me think. i looked to see if there was recent research out there - not sure if anyone's posted it before, but i thought this from 2012 very interesting - http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3440169/ - "The insulin infusion set - the Achilles Heel of Continuous Subcutaneous Insulin Infusion" Ann

--- completely fascinating! Thank you for posting!

 

[tigger]

Thanks for all the replies. That's really interesting about different basal rates in different places but makes sense. @ann34+ that is sort of reassuring that it takes a while to learn. Bit depressing too though...

I had an airbubble experience yesterday which wasn't much fun and thought I'd try a silhouette instead (45 degree insertion one). The DSN had suggested I do it manually as it's less painful. It was rather a large needle and quite daunting and quite uncomfy for quite a few hours after but then it "settled" and is now painless. Delivery seems (cross fingers) to be fine. Has anyone else had this experience with the 45degree sets?

I've received the longer needles for the steel ones to try now but I'm wondering if I should try another site. My stomach (aside from all the issues) only has a certain life as by the time I get to my next scan in 6 weeks I'll need to have the canula somewhere else so it won't interfere with the ultrasound.

 

[tigger]

So after some advice from people in RL I decided to try bottom last night with a quick set. Not very comfy despite all the fat and then today my sugars really started to go up. I thought it was what @-Artemis- was saying about basal rate so upped this to 150% on a temporal rate but it still didn't seem wonderful. When I got home I decided to try a different set. The one I took out had not only bent but was bent in an exact L shape. No wonder it was so painful. I'm now trying an 8mm steel canula in my stomach. It feels quite comfy so far (except when I banged into the side) so fingers crossed if I get through the night with all ok maybe this is the one for me.

The silhouette worked ok and was painless after about 4 hours of pain but left a nasty mark too.

 

[-Artemis-]

Ouch!! ... I found the same with silhouettes -- better than quick sets but still could feel them and left nasty marks afterwards... The steel ones seem to be the ones I'm doing best with too... Plus when I take them out there's just a teeny mark which seems to be the quickest to heal for me too. Fingers crossed for you; keep us updated!

 

[tigger]

And my latest - I put a sure-t in my thigh on tues afternoon and it seemed to be working well and I did a basal test yesterday which helped. This morning just as I was about to go to work I pulled up a pair of knickers (sorry for tmi) and the set came out completely! There was hardly any adhesive left on the back. That was my last 6mm. I tried an 8mm in my thigh but ouch was definitely the word. So in the end I tried a silhouette again in my stomach and actually managed to get it in painlessly and touch wood it's been working well this morning. Kind of upset my great basal test plans for doing the 6-12 stretch today.

Does anyone else have this issue with the sure-t? I think the issues I had with them coming out may be more to do with this than the needle length.

 

[ann34+]

And my latest - I put a sure-t in my thigh on tues afternoon and it seemed to be working well and I did a basal test yesterday which helped. This morning just as I was about to go to work I pulled up a pair of knickers (sorry for tmi) and the set came out completely! There was hardly any adhesive left on the back. That was my last 6mm. I tried an 8mm in my thigh but ouch was definitely the word. So in the end I tried a silhouette again in my stomach and actually managed to get it in painlessly and touch wood it's been working well this morning. Kind of upset my great basal test plans for doing the 6-12 stretch today.

Does anyone else have this issue with the sure-t? I think the issues I had with them coming out may be more to do with this than the needle length.

Hi, tigger, did you try the tape solution? see CarbsRok above and my suggestion re type (micropore) of tape? If a taped sure t still comes out , 1.do you use body lotion or cream? the tape and sure t cant adhere properly if you do. 2. technique - one way i learnt is to take longer - first take each piece of backing off and move it over so a lot of the sticky bit either side is still covered, then manually put the needle in, pat the needle down gently nearly to the skin, lift off/slide out the backing gently from one side ( easy once you have had practice but difficult at first, as the needle must stay in), and press down, then do the same with the backing from the other half, and, before you stick it down, make sure the needle is fully in, and the sticky is flat on the skin, not pulling the skin anywhere. If i do not do this i still have failures sometimes - did yesterday when had to remove the whole thing for a medical apptment, and put in a new sure t in the loo, in a hurry, in my midriff, an area i never use due to more movement in that area. Hope you sort this, or find a suitable set. Ann