Bleed at a cannula site.

[johnpol]

Hi everyone, now I have been on my Medtronic 640g for a few years and am about to get a renewal as the funding is still in place, but my question is, has anyone ever had a large bleed from the cannula site?? And I don't mean the usual bleed when you inadvertently catch a small vessel whilst putting one in or removing it. On Christmas day I had done a usual set change, with no issues, no swelling, bleeding or bruising and sat down to relax. After a short period my wife noticed a large swelling appear at the cannula site and commented on it, on investigation I had developed a hand sized lump which was solid to the touch and felt quite alarming. I immediately removed the cannula and re-sited it on my upper thigh with no issues. I did feel quite unwell and massaged the lump but I have a big solid lump now and I came out in the largest bruise I have ever had (other than when I have ruptured a muscle) it took up all of the cannula site and spread to over twice the size of my hand. I have never experienced anything like this before, I have consulted a nurse at the hospital about it and was told that it was a subcutaneous haemorrhage and should have went to hospital (for what I don't know, unless I may have had a build up if my insulin and it released it all at once I assume).
Has anyone who uses a pump experienced this ?? I have a Consultant review on Tuesday and will be discussing it then and making sure that I speak with my pump nurse too. sorry for the long winded explanation for clarity I use the silhouette 13mm cannula, as I cant tolerate the steel ones.

Thanks in advance for any advice.

 

[Shiba Park]

Hi everyone, now I have been on my Medtronic 640g for a few years and am about to get a renewal as the funding is still in place, but my question is, has anyone ever had a large bleed from the cannula site?? And I don't mean the usual bleed when you inadvertently catch a small vessel whilst putting one in or removing it. On Christmas day I had done a usual set change, with no issues, no swelling, bleeding or bruising and sat down to relax. After a short period my wife noticed a large swelling appear at the cannula site and commented on it, on investigation I had developed a hand sized lump which was solid to the touch and felt quite alarming. I immediately removed the cannula and re-sited it on my upper thigh with no issues. I did feel quite unwell and massaged the lump but I have a big solid lump now and I came out in the largest bruise I have ever had (other than when I have ruptured a muscle) it took up all of the cannula site and spread to over twice the size of my hand. I have never experienced anything like this before, I have consulted a nurse at the hospital about it and was told that it was a subcutaneous haemorrhage and should have went to hospital (for what I don't know, unless I may have had a build up if my insulin and it released it all at once I assume).
Has anyone who uses a pump experienced this ?? I have a Consultant review on Tuesday and will be discussing it then and making sure that I speak with my pump nurse too. sorry for the long winded explanation for clarity I use the silhouette 13mm cannula, as I cant tolerate the steel ones.

Thanks in advance for any advice.

Strange you should ask this question; I've not had anything like you describe, but when I removed my cannula yesterday morning I had a quite impressive blood fountain that didn't want to stop... a first for me.

Shiba.

 

[kitedoc]

Hi @johnpol and @Shiba Park, As a pumper for 7 years, (out of 52 years on insulin, not as professional advice or opinion:
I have had small bruises with slight swelling after some cannula insertions or removal and small blood leaks. I have also had bruising after accidentally bumping or scraping a cannula port against a hard surface.
Also this was more likely on the few occasions when I tried my outer thigh for the cannula rather than my stomach ? more blood vessels there ??
All I can think of is that there is always a small risk that one could pierce a larger than usual blood vessel during insertion or removal of the cannula. And maybe a cannula finds its way partly into a blood vessel or close by and on removal the 'flood gates' open. And without a way of directly seeing what is happening it is only after the event that one knows.
In theory an ultrasound scanning might see how close the cannula is to a blood vessel under the skin as well as if the cannula had gone deep enough to pierce the barrier between under-the-skin tissue (called subcutaneous) and muscle. I understand that muscle has lots of blood vessels.
As an aside I have once inserted a 90 degree cannula with the firing device that pushes the cannula through into and through the skin. Because of the design the tubing is attached. I then removed the tubing to fill it via the pump and found it would not fill. The poor pump kept working away but no drops appeared at the end of the tubing. It turned out that a small amount of blood had come up the cannula and into the connecting device. I had missed seeing it in the small window there. By the time I had detached the tubing from the cannula site to fill it the blood had clotted and stopped the tubing being fulled.
They say that cannula problems are the most frequent problems in insulin pumps. Hopefully things can be improved over time and with feedback to the manufacturer!!