Blood from my cannula!

Hi Mike

I am assuming that you put a new infusion set in…

I’ve yet to experience the gusher, but understand that it is something that can occasional occurs with sets… You’ve caught one of the very find capillary veins that lay under the skin, with injections you tend not to notice that you’ve caught one of these, unless you see the bruise that is left behind…

The normal procedure pumpers use is, put pressure on the site, using cotton wool or tissues hold this down for a about 5 -10 minutes to stop the bleeding…

I use the Accu-check Spirit pump, and as yet never managed to pull out one of the infusions set, at work one of the dogs standing and basically swinging on the tube hasn’t pulled mine out… If this is becomes a problem, then perhaps a change of infusion sets…

This has happened to me once (in coming up for 3 years of 'pumping'). It was quite frightening as I didn't know what on earth I'd done!! It was fine though and when I asked my DSN about it, she said it can happen occasionally. It's nothing to worry about though. As for the kit coming out in the night, this has also happened to me on a couple of occasions. No explainable reason that I can see but it's not happening often at all. Hope you get on well with the pump

Marie xxx

Mike,

I have had a cannula come out a few times, but that was more to do with too much sun tan lotion. Soon learnt to use soap and water....

I do get blood from the cannula site when I remove a cannula. Yes it can be scary. If I am away from home and need to change the set, I do not remove the old cannula until I can deal with a bleed.

Don't let the scare restrict you. I regularly travel overseas. I have changed an infusion set in the most obscure places. These include a loo in Munich airport, a tent in the Samburu game reserve in Kenya and in the car on the eurotunnel whilst under the channel.

I just make sure that when I remove the old set, I have access to tissues in case there is a bleed.

Hi Mike,

I too use the Accu chek spirit (since may 07). I have on occassion had the uncormfortable cannula and then when I removed it had blood - but not to the same extent as you describe - NASTY!
What cannula's do you use?
I use the Flex Link (Roche Accu chek ones) and I also use the link assist - which is a device to help insert the cannula. It's great, just like a stapler!
I haven't experienced a hypo or low whilst eating my meal so soon after a good blood reading but I know different insulin work at different speeds - had you done a correction bolus earlier that was now just catching up with you?
I use Novorapid which I believe takes some time to work so over correcting is often my biggest problem.
Have you had an HBA1C check since the pump? Is it going down?

Best Wishes

Nash

Hi mike

Have you tried the extended or the mulit-wave bolus’s yet with your meals, as these can be very usefull indeed…

I find when eating high fat content meals, that I need the mulit-wave bolus, which I normally have a bout ½ of the dose at the beginning of the meal, and then time the rest for around the ½ to 2 hours delivery… this does really help with stopping the hypo followed by a high of your BG’s… It takes a bit of tweaking to get the best split and timed delivery to match different meals… I also use it at breakfast has I require a 2 units – 10g of carbs, but finding that if I did a straight bolus I would have trouble, so I mulit-wave it as standard practice, with the timed split set to ¼ of hour works well.

The extended bolus I find very useful when I’m going to eat a low carb meal and my BG’s a very good around the 4 mmol/l mark, I usually have my dose delivered again over a ¼ of hour I find this helps prevent a hypo before the carbs adsorb fully.

And another thing that I use as well is the Temporary Basal Rate, if I’ve got good BG’s and decide that I want a little snack I quite often rather than a straight bolus I will use the TBR for around ¼ to ½ hour at around the 110-120% to keep things even as I find with a small snack that if I bolus then it starts to work before the carbs start to adsorb..

I found with my first 3 months of using the pump, there wasn’t a huge improvement with my HbA1c’s but with saying that, they had actually improved as they were more representative to what was actually going on, as there were no hypos to undercut ad drop the HbA1c’s to a masked lower level… But every 3 months my HbA1c has continued to drop as my control improves and becomes more stable and tighter … I know what my latest is on Friday if I can get into see my DSN, other wise I have to wait until next week for it when I see my consultant…

Hi mike and Jopar,

Good to read your stories seeing as you on same pump and experiencing same issues.
I've never been able to get on with Multiwave or Extended, despite roche rep saying about it every time - I can never get it right!
Mind you today is a nightmare day....got a slight cold and blood in late teens. Running at 200% and corrected loads but i can't get it down....ideally need to go for run but looking after kids!
I've got HBA1C next week- hoping for in the 7's but not going to get hopes up too high.
Don't think hormones help too much either...hey ho such is life!
Nash

Mike,

First gusher I got was a bit scary, second just a bit tiresome. You tend to know (i.e. on insertion) which sites have struck a blood vessel - kind of a localised dull ache for the few days its in use. Nothing to worry about as long as they heal OK and there's no infection. Sometimes needs a hefty plaster and a bit of pressure at first...

And on topic 2, I couldn't live without the multi-wave, square-wave whatever you want to call it bolus on my pump. I can now eat pasta without fear of hypo or bg in the high teens

Jo

I've been using the extended bolus feature for heavy carb meals and high fat meals.... Im not sure the Animas has a multi-wave bolus feature on it?? I've not seen it...

Mike,

Could have been several things going on, I assume that you ruled out, tube/infusion set delivery problems!

Some people find that above a certain mmol/l that they need to increase there correction ratio’s as they become insulin resistant so take more insulin to correct… Also above 14mmol/l using a standard injection instead of the pump quite often works better, as this can rule out a blip caused by air bubble that’s caused the high..

Other things is that you under estimated the carb count of the slice of cake you eat, and/or the cake had a higher fat content that raised the bg’s later in the morning..

Another reason could have been because you missed your dinner, and exercised if your levels were higher, then you might have needed a bit of extra insulin to get the body to utilise it better…


Stuboy

I think animas calls there a dual-wave, there should be different bolus of a pump,

1, standard = just like an injection delivers the whole lot in one go
2, extended = you set the amount, and the time you want it to be deliverd, i.e. 15 mins, 30mins, 45 min etc, it then delivers the insulin equally over that period.
3, multi-wave = you set the amount to be delivered it splits the amount, the first part is delivered straight away, then the second part is delivered over a timed period… Both the first delivery amount can be alter to suit, and so can the time period to suite…

Some manufacturers have slightly different names for the extend and multi-wave bolus, i.e, square wave = extended, and dual wave = multi-wave…

p.s stu the 2nd paragraph onwards is for general information of all!