where do you put your cannulas?

Nomi

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Hi guys,

So recently I've been told to stop putting my cannulas in my stomach and sides (love handles!) area because the sites have broken down and don't absorb properly.

I was wondering what other places people use? I have the insight pump with tubing, but I am happy to stick the cannula wherever if I can just get the insulin to go in reasonably well.

I have tried my legs in the past but didn't get on with it, tried again today and my blood sugar is just creeping up as if I never bothered to take anything at all. I tend to have the same issue with my lower back/ bum.

Is there anywhere else I can try?

My DSN basically told me there is nothing I can do and I just have to keep trying. But I'm really fed up of feeling like and like I'm gonna fall asleep at any second.

Any tips and trick would be really helpful!


Thanks

Nomi
 

Juicyj

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Hi Nomi - I use a clock rotation method on my stomach so I don't over work any one particular area, so if one day the cannula goes in at 12 then it goes in at 6 on the next positioning and I keep going round clockwise in this way, each area get's time to heal then. I have heard some use backs of their arms, I haven't tried this as i've got the tubing and not sure how I could cope with tops, exercise and getting changed, I did try an experiment on my bum but couldn't sleep well with it there, as it kept waking me up, back of love handles could be an idea as long as you can see what you're doing and are happy it's definitely stuck on and in your skin. Can your DSN get the pump rep in to see what other options are available to you ?
 

azure

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Hi @Nomi I can't use my tummy either.

I've found the trick with other areas is to get the right cannula type and length, so you'll need to,try a few.

I use my thighs, top and outer side, and my bum just above the top of my pants. Placement is everything, especially with the bum, as I find there's only a narrow strip that works properly. I also find I need a slightly increased basal rate in my bum.

Edited to add that I find steel sets work best in my bum.
 
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I will watch this thread with interest as I have struggled to find good places for my cannula apart from my stomach and love handles.
It was suggested to me to use my backside. The bottom of my bottom is not possible because I sit on it. But I have occasionally used the top of my bottom (or what I like to refer to as my "lower back shelf"). This area is limited, not only because it is not easy to insert the cannula myself, but because, if I put it too high, I keep catching it on the waist band of my jeans.
 

Nomi

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Hi Nomi - I use a clock rotation method on my stomach so I don't over work any one particular area, so if one day the cannula goes in at 12 then it goes in at 6 on the next positioning and I keep going round clockwise in this way, each area get's time to heal then. I have heard some use backs of their arms, I haven't tried this as i've got the tubing and not sure how I could cope with tops, exercise and getting changed, I did try an experiment on my bum but couldn't sleep well with it there, as it kept waking me up, back of love handles could be an idea as long as you can see what you're doing and are happy it's definitely stuck on and in your skin. Can your DSN get the pump rep in to see what other options are available to you ?

Thanks for replying!

My DSN has basically told me that 'there is nothing I can do about it. Children manage ok with these cannulas and they're skinnier than you. I don't know why you're having problems. '

She told me that my sites on my stomach and sides just collect the insulin and that's why I get erratic doses and it's hard to manage. I tried the Omnipod pump as it has a different type of cannula but they caused the same issue.

I switched to the pump because I wasn't getting proper absorption via my pens and the idea was that I could give my sites a rest. I've been on the pump for two years and my sites are still screwed up.

The problem I have is i either hit a lumpy site that doesn't absorb properly or it bleeds and causes the cannula to block up. Probably one in three cannulas go in ok, and then I'm reluctant to change sites again because of the issues.

The pump does have tubing but I'm at a total loss of what to do now, so even if I have to tape it across half my body I will do that!

Nomi
 

noblehead

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Is there anywhere else I can try?

You can infuse insulin where you'd normally inject on MDI, so stomach, arms, legs and bum.

Much like yourself @Nomi I've tried my legs with no success, haven't used my bum yet and don't fancy using the site at all, just can't see how it would be comfortable.

Unconventional and don't advise it but I'm currently using my chest area at the moment, the absorption rate has been really good.
 

Nomi

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Hi @Nomi I can't use my tummy either.

I've found the trick with other areas is to get the right cannula type and length, so you'll need to,try a few.

I use my thighs, top and outer side, and my bum just above the top of my pants. Placement is everything, especially with the bum, as I find there's only a narrow strip that works properly. I also find I need a slightly increased basal rate in my bum.

Edited to add that I find steel sets work best in my bum.

Can I ask what pump you have?

I have spoken to accuchek and at the moment the only cannulas I can get are the flexlink teflon ones that go in at 90 degrees. They don't have any others available and the clinic won't switch my pump out cos my service contract still has 18 months on.

I have tried both the 8's and the 6's and whilst the 6's were a bit better it's still not great.
 

Nomi

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But I have occasionally used the top of my bottom (or what I like to refer to as my "lower back shelf"). This area is limited, not only because it is not easy to insert the cannula myself, but because, if I put it too high, I keep catching it on the waist band of my jeans.


Lower back shelf had me chuckling there! That's kind of where I am trying now, but I have the same issues with stapling it on and it does catch on my jeans :(

Hopefully we can find a way!
 
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azure

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@Nomi I have the Animas Vibe :) How long have you had the Insight? I got mine swapped to a Vibe because I hated it. I had it a few weeks before they swapped me over. My clinic now no longer gives people the Insight.

If you've already asked to,swap and been refused, it's worth asking again, giving your reasons and citing the ongoing issues and warning notices with the Insight.

Having a choice of sets and cannulas is crucial, in my opinion, especially if you're having absorption issues.

I use an angled Teflon cannula in my thighs and a 6mm steel in my bum. I insert them all manually as I feel I get better placement that way.
 

Nomi

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@Nomi I have the Animas Vibe :) How long have you had the Insight? I got mine swapped to a Vibe because I hated it. I had it a few weeks before they swapped me over. My clinic now no longer gives people the Insight.

If you've already asked to,swap and been refused, it's worth asking again, giving your reasons and citing the ongoing issues and warning notices with the Insight.

Having a choice of sets and cannulas is crucial, in my opinion, especially if you're having absorption issues.

I use an angled Teflon cannula in my thighs and a 6mm steel in my bum. I insert them all manually as I feel I get better placement that way.

Ok, I will go back to them.

I feel like they've just run out of ideas and they rejected my request to change pump for financial reasons. But they did trial me on the omnipod, so I guess they're trying. Bolusing by the omnipod was agony and had me in tears each time, so I'm not changing to that one. When I told them that they told me my only other option was to go back on injections. :/

I will see if I can speak to the animas rep and find out if I can trial that one instead.

Thanks for your advice, it has made me feel a bit better about the whole situation :)
 
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Nomi

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Ok, I will go back to them.

I feel like they've just run out of ideas and they rejected my request to change pump for financial reasons. But they did trial me on the omnipod, so I guess they're trying. Bolusing by the omnipod was agony and had me in tears each time, so I'm not changing to that one. When I told them that they told me my only other option was to go back on injections. :/

I will see if I can speak to the animas rep and find out if I can trial that one instead.

Thanks for your advice, it has made me feel a bit better about the whole situation :)

@azure oh, and I've had the insight for two years. First and only pump.
 

Nomi

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You can infuse insulin where you'd normally inject on MDI, so stomach, arms, legs and bum.

Much like yourself @Nomi I've tried my legs with no success, haven't used my bum yet and don't fancy using the site at all, just can't see how it would be comfortable.

Unconventional and don't advise it but I'm currently using my chest area at the moment, the absorption rate has been really good.

@noblehead i did wonder about chest. My next plan was arms if I can work out where to put the pump unit and the tubing!
 

noblehead

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My next plan was arms if I can work out where to put the pump unit and the tubing!

Can see that the tubing might be an issue, I also use my arms but being on the Omnipod Pump there's no tubing to worry about.

Maybe have a look on Youtube for suggestions on how to use your arms when using a tubed pump, there really is some some great vids on there.
 

iHs

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See if you can change from the Insight to the Spirit Combo. The Combo uses standard luer lock tubes whereas the Insight uses tubes with a black snap on connection. The Animas uses standard luer lock tubes and has much nicer sets than Accuchek luer and are compatible with both pumps.
 

Nomi

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See if you can change from the Insight to the Spirit Combo. The Combo uses standard luer lock tubes whereas the Insight uses tubes with a black snap on connection. The Animas uses standard luer lock tubes and has much nicer sets than Accuchek luer and are compatible with both pumps.

Oooh good advice.

The combo pump was what I wanted originally when I asked to change.

I'm going to go back to them again and see what I can get!
 
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azure

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I tried my arms but found the absorption very variable. I'd have thought they'd have been ok as I'd used them for injections a few times, but the cannula was often uncomfortable and my BS was usually high.

If you want to try, you need to choose a position for the cannula that allows the tubing to go up your arm. I had my tubing going up my arm then down my side to my pump which was clipped to my waist band. Be careful putting tops on.

I never used my ar a again after that failed experimemt. It might depend on your body composition. It didn't work for me.
 

iHs

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Oooh good advice.

The combo pump was what I wanted originally when I asked to change.

I'm going to go back to them again and see what I can get!
The Combo is still available so need for the Insight if the sets are no good
 
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MushyPeaBrain

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I can't use my stomach but I use my love handles all the way round to my back and next to my spine - although not close enough to risk a home epidural! The area on my back is above the waistline so no issues with my jeans rubbing. I also use the area just above my waistline at the front between my ribs. I get about 4-5 sites in a row here and it's very comfy.

Rotation is key but so is care of sites. As advised on this forum when I have finished in one area I make sure I massage bio oil very firmly into it for several days to help healing and reduce the chance of new scar tissue build up.
 

Snapsy

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Same here, @MushyPeaBrain !

I have an Insight too, @Nomi , and I don't like using my tummy (one side is screwed up from 29 years of injections, and the other side, well, I find having cannulas round the front just means they get in my way. I use my love handles on my back and sides, and even just on my waist (not where my trouser waistband is, but much higher, i.e. the bit where if I was an hourglass it would be the bit that goes in. Except I'm built like a stick of rhubarb rather than an hourglass.

I'm slim but there's still plenty of flesh for a 6mm Flex all the way round. Came a cropper with the 8mm ones - messy to the point of horror-movie gore, sugars in the 20s........

:)