Infusion Sets Issue

[Rokaab]

So, I've now had my pump for about two weeks, and trying to work out whether I'm doing something stupid or whether these infusion sets just don't like me.

The pump,infusion info:
Medtronic 670g pump using Medtronic Mio Adance infusion sets - using Fiasp, been putting the infusion sets on my stomach (which has never been used as an injection site before - ever)

What has happened:
Applied first infusion set - under the instruction of the Medtronic trainer (over a webex so she could see what I was doing) - worked perfectly fine, when I removed it (after 3 days) it left a small lump and was a bit tender til the next day but I put that down to me not being used the them and the next day it was fine, the 2nd set was perfectly fine, the 3rd set was perfectly fine.

The 4th one however, went on fine, connected it all up, all seemed to be working (I changed sets between breakfast and lunch), but when I took my first bolus (lunchtime) it stung/itched intensely, any basal amounts seemed to be going through fine without me noticing, I thought ok, leave it a bit longer I'm sure it'll be fine, so at dinner time it again stung/itched when the bolus was going through, decided not to change it as I remembered having been told its best not to change it in the evening unless you're going to need another bolus to check its working (cos you don't want it not working for the basal overnight), so left it til breakfast the next morning and yet again it stung, anyways, at some point much later after talking to the diabetes nurses at the hospital I changed it for a new one - it seemed fine and didn't sting - however the next day it also started to sting when bolusing, now, not wanting to change it again I thought it'll be fine I'll perservere (in hindsight I shouldn't have done) - when I took it off (yesterday morning), there was a bruise and a lump and it was quite painful (and its still tender now!), put on a new infusion set - but yet again the next bolus was stinging, thus followed some amount of swearing, so replaced the set (again) and this one has been fine so far (ie no stinging yet).

Anyways, after this malarky I'm wondering if I'm doing something wrong, or if it could be that my body is objecting to the cannulas (I have read some people do react badly to them), so if anyone has any useful thoughts or has had this happen please let me know how you got past it - if it had only been one that stung/itched I'd have just ignored it, but 3 in a row (from two different boxes - but the same batch) makes you think it's not just an iffy set.

PS. the pump is awesome, so I really need to get along with the infusion sets as I'm loving said pump.

 

[Hopeful34]

You could try inputting your bolus over a slightly longer time, especially if it's a larger amount. Although I seem to remember Medtronic pumps don't do it over 15 minutes, which is what I use on Combo. I find that helps with Fiasp if boluses sting. Not all of them do for me either, some are fine, but others can be very ouch!! However, you shouldn't be getting a lump underneath. Maybe ask if you can try a different length cannula.
Hope you can get sorted out, as it's very frustrating when some cannulas work fine, but not others.
Are your blood sugars rising with the cannulas that have got a hard lump underneath?

 

[Rokaab]

You could try inputting your bolus over a slightly longer time, especially if it's a larger amount. Although I seem to remember Medtronic pumps don't do it over 15 minutes,

Don't think I can do that, least not that I've found - but yeah really small amounts I don't notice, anything over about 2-3 units I definitely notice (which I need for most things), and I've been using Fiasp for the last two years or so and it never stung on MDI

Are your blood sugars rising with the cannulas that have got a hard lump underneath?

No, my sugars have been perfectly fine, which is at least one thing

 

[NicoleC1971]

I do occasionally get bruised feeling or stinging where the auto insertion device has been placed over a previous lump or bruise (as used to happen with the pen). I have made myself bleed too. But only once or twice in 8 years!
Its a good point about quantities going in but hopefully you are generally on less now anyway..other than the boluses!
Assuming your tech is the same you have fine filament being driven in by the metal insertion device which then comes out (mine is a Roche pump).
I'd advise rotating sites around quite a bit but mainly to check in with the pump nurses on the helpline who may be able to suggest a different filament or other practical suggestions.

 

[Rokaab]

I'd advise rotating sites around quite a bit but mainly to check in with the pump nurses on the helpline who may be able to suggest a different filament or other practical suggestions.

Well it was only my 4th ever infusion set that was the first to do that so it wasn't an issue with reusing the same spot , I could still see the small marks from all the previous ones for a start
I did try asking my diabetic nurses at the hospital and when they eventually got back to me they said just to change the set.

Have you latest cannulas been put somewhere different to the first few? Maybe somewhere with less fat?
I have found if mine don't go into fat, I can feel the insulin going in.

They all had about the same amount of fat, I've never been overweight but at the mo I'm at my heaviest ever and there is definitely an 'inch to pinch' there

 

[NicoleC1971]

Well it was only my 4th ever infusion set that was the first to do that so it wasn't an issue with reusing the same spot , I could still see the small marks from all the previous ones for a start
I did try asking my diabetic nurses at the hospital and when they eventually got back to me they said just to change the set.


They all had about the same amount of fat, I've never been overweight but at the mo I'm at my heaviest ever and there is definitely an 'inch to pinch' there

Have you tried contacting the manufacturer's helpline? I find they are run by helpful pump nurses if you get through to the right person... Diabetic nurses aren't always very experienced in the practicalities.

 

[Rokaab]

Have you tried contacting the manufacturer's helpline? I find they are run by helpful pump nurses if you get through to the right person... Diabetic nurses aren't always very experienced in the practicalities.

I haven't talked to them yet and I have an afternoon of work meetings starting soon (that I'd rather not go to but had better) so can't ring them this afternoon anyway. And yes I don't have the greatest confidence in the nurses at the hospital about dealing with this kind of stuff, but the current infusion set seems to be fine for the mo, need to change it tomorrow morning.
I've got a catchup-meeting with the Medtronic trainer on Tuesday anyway so I think if they're all fine til then I'll ask her then, if not I'll ring up the helpline as soon as the next issue occurs.

 

[porl69]

@Rokaab I have had a few "stingers" on the sides of my stomach BUT they usually are of after a few hours. Give the tops of your legs a try AND do try to rotate your sites. I try each side of stomach then top of each leg on a rotation. Its a possibility that you could be having a reaction to the teflon cannula? Fingers crossed you can get this sorted ASAP

 

[Rokaab]

Well I just put a new set on a few hours ago( after breakfast) , and just had a snack to check it and gawd it stings worse than the other ones, it is further round the side, I am wondering if its a reaction to the teflon - as now its happened on the last 4 out of 5, I'm fine with whatever the libre uses for its thing but don't know what its made from.
I'll wait til lunchtime to see if it calms down, if not I see what Medtronic suggest

I suspect my legs are unfortunately a no-go area after many years (about 30 ish) of vast overuse and not enough site rotation
Not sure where I'd put it on my legs to not get constantly pulled and yanked on when moving around or trying to my take trousers off

 

[porl69]

I use the top front of my legs. The Mio Advance has a fairly long tubing

 

[Rokaab]

I use the top front of my legs. The Mio Advance has a fairly long tubing

Cool thanks.
Might try there then, as I never injected on the front of my legs when I was younger, was always the side, and at least at the mo with working from home, I can wear baggy-er shorts whilst I try and work out where it will get in the way
I also have a lot more fat there - my legs are the chunkiest bit of me (makes it awful tricky trying to find trousers that fit lol)

 

[Rokaab]

Well as a quick update, I tried that one yesterday at lunchtime again and gawd it made me yelp, so I gave medtronic a ring and mostly what I got was 'well you'll have to talk to your diabetes nurses about it and work out if you need a different set or not, and of course from the diabetes nurses I got 'you need to talk to Medtronic about it cos they know about their stuff, awesome huh!

Anyways, I've now got one on my leg and its seems to be fine so far, but when I removed the offending one omg there was blood everywhere - ok maybe not everywhere but there was a lot and I had to be quick to stop getting my nice shorts blood covered - anyway it now looks rather unhappy there, looks like an angry purple spot now (although it was quite funny at the time cos I got the new one sorted and was then just talking to some gaming friends online at the time I removed the old cannula (expecting no problems) and what they mostly heard was 'aggh, back in a minute, blood everywhere!!!' from me - their follow up question to my comment was 'did you murder someone?' )

I have however just chatted to the trainer that did the training for me when I started and shes sending me a couple of Mio Advances from a different batch (just in case it was the batch) and a couple of Mio 30's to see if that helps (if the different batch Advances have the same issue) - so fingers crossed I find an infusion set soon that doesn't disagree with me (for a start my stomach looks like a warzone currently)

 

[Hopeful34]

Hope you find some cannulas that work well for you. Horrible when you get one that is a real bleeder when you remove it. Not had many, but yes blood all over I can identify with. Hope legs work for you, as I know they do for many. I tried the Omnipod on my legs a few times, but blood sugars went through the roof, so gave up, but it may just have been the Omnipod as I had problems elsewhere after 1 day or 2 days with most pods, and eventually went back to my Combo.
It takes time to get things sorted out, but great when you find what suits you (with the odd hiccup here and there as madam diabetes gets up to her tricks!!!)

 

[Ann48]

Hi Rokaab, I’ve been using a pump for 7 years, I use the Medtronic 640g and like you found using my stomach painful and a bit hit and miss, often found my BG rising after a set change.I use the Quick set but have also used the Mios original sets. I have for some while now been using the top of my legs. I rarely feel pain and my BG is much better than it was using my stomach. Give it a go.

 

[johnpol]

Hi @Rokaab the blood when removing the cannula is where you have clipped a blood capillary and bleeds what looks like a pint, have you thought about a metal cannula? I am on a Medtronic 640G and the MIO infusion set, 8mm cannula if memory serves me right, and had a spell of it stinging but changed to a longer cannula and the problem subsided, as with the rest of the suggestions the top/front thigh region works well for me and I no longer get a stinging sensation when Bolusing. I do put quite a lot of insulin through for a meal (big insulin resistance going on, but that's another story) hope you get sorted.

 

[Hopeful34]

Well, after posting 2 days ago about not having had many cannulas that were real bleeders, have had 3 in a row, 2 of them the blood came out the hole in the top of the cannula when I took the inserter needle out. Not had this before, think there is a problem with this box of cannulas, as they were extremely painful immediately I'd inserted them. Present one not bleeding, but very sore. Will ring Roche later.

 

[xenomorph2020]

Old thread but I have had nothing but trouble with Mio advanced over last year. I used teflon on accu check without problems but with this the insertion device I think is badly designed. Very painful 8/0 time's and I go through 3 to 5 sets before finding one that works. My body don't like the metal needless either. I'm trying to get hospital to change my pump but they keep saying I cannot until warranty runs out. Pump is much better then combo but combo had better infusion sets.

 

[Hopeful34]

Sorry you're having such a hard time with the Mio advance sets. Hope the hospital will change their minds, and let you have a different pump.

 

[xenomorph2020]

Sorry you're having such a hard time with the Mio advance sets. Hope the hospital will change their minds, and let you have a different pump.

Thanks
Has it improved for you?
Out of interest if it has what batch number you using at moment of Mio advanced?

 

[Rokaab]

Since I'd totally forgotten about this thread I made, a quick update from me, I just cant use the Advances on my stomach, it itches burns or stings when I bolus more than about one unit, but the Mio 30's do seem to work fine, I think its cos I don't have much fat there, they do leave a red mark for a day of so which may be the cannula, but given the metal one is the same size (ie 6mm at 90 degrees) I'm not convinced that'd work, cos I think its the depth and angle that is causing the stinging/burning/itching

However I find using the Mio Advances on my backside works better than the Mio 30's, due to the ahem, the roundness of the area the Mio 30's at a diagonal insert leave lumps (not just redness) for a day or so but the Mio advances don't and well I have more fat there so they work there - and well the Mio 30's are more effort to insert which can be trickier when twisting round to try and see what you're doing

As for my legs, I cant seem to get anything comfortable there anymore so that plan is out of the window so I'm still trying to find other spots to use (my stomach is not very big and I have to change the cannulas every 2.5 days instead of 2 for it to not leave redder marks for longer, so yeah trying to find other spots