Pump - changing sets and getting highs

[ann34+]

I recently found out that long term pumpers like myself may have to change sets everyday due to various issues, i think what was meant was that the skin, and underlying tissue, has had so many cannulas in it is damaged . not sure if this is relevant to other people's issues

 

[donnellysdogs]

Thanks for replies.....

Even with 6.8 units through pump for 5 hours and 200% for 6 hours does not work in my stomach. Have to resort to pen when I am 20! Pen is brilliant but trouble is when get the lower after 5 hours... For the next 12 hours will have lows.

This morning was horrendous in some aspect but proof of all the occlusions if I do not add in extra, extra!!

Got up after highs last night (set change at 5pm and 20.5 by 11pm) and the pain from set in my stomach was bad from the set I had put in when I was moving around. It had not been painful all night. It was no different to the other cannula changes.

Was in a desperate hurry this morning as was running late for cancer therapy. Pain forced me to change set before going. Changed, put new set in my bum as knew no discomfort ever there. Was in such a rush forgot to put on 200% for 6 hours and forgot to do start of the (non working) corrections. Also have to do a 1 unit correction on old set normally before attaching new set and leaving old set in for up to 6 hours.
This was 8.30am.

10.30am with just normal set and no extras and I was 11.4 and the occlusion alarm started.

So proof of needing extra bolus's and basals.

Have tried less time and less TBR, No bolus etc.... All being logged daily and sent to hospital team.

They have no answers and literally say I have to judge, other cannot help regarding doses or TBR's. I have devised my own action plan to show them everything that is being tried.

My consultant off sick and the consultant taking over his patients is too busy and booked up to see me.

Set changes daily were tried previously. It's only now that I have discovered that it's the actual set changes that are the trouble.

No answers, just despair to be honest now.

 

[donnellysdogs]

Have tried sideways, 6mm and 8mm teflon.. with machine, without machine and everyone has occluded.

The steel ones have occluded twice this week.

Eg just tried set change before tea... sideways, occluded, 6mm occluded, 8mm occluded, steel occluded!!

Don't know how much (if any) of the insulin went through on any set

For all. Plastics ...Put 2 unit through to prime and pre empt bolus and ok. Turned on 200% ok. Bolused 4 units and every one alarmed.

Changed tubes to go back to rapid d... 1 unit pre empt and 200% and do bolus and occlusion.

Now on 5th set and tea bolus went thru ok but can slightly feel 6mm
needle in me so doubt it will continue well.

For me this is tortuous... i now don't know if any of those sets did release any insulin, and going to have hell to play now for at least 21 hours..

I prefer teatime set changes otherwise I can't risk doing anything like driving orgoing out or anything in examples like this one. Tuesday morning when I tried a morning change jyst occluded whilst out...

This for me us not good pumping....

 

[iHs]

If every set more or less causes an occlusion, then the cause of the problem may well be the way that the cartridges are filled and air is being trapped until it is released by removing the set and priming insulin through the tube until the build up of air occurs again and the occlusion alarm sounds again.
Get the Accuchek rep to come to your home or clinic and supervise yr technique. ....take a new vial kept at body temp, a new set and new cartridge...

 

[donnellysdogs]

Once past the first 21 hours of the cannula change my levels are brilliant if the sets not occluded!

I checked the steel ones before going in and when I took them out- they still dripped 5 units lovely...

Its my body...

I have one last place to try and thats my legs.... only ever injected in them after trying sets and get big bleeds from them.

It wasn't just this pump though / cartridges... it all started on the Insught with prefilled.... cartridges are always filled to 315 and piston always wound up to 295.

I am positive it is my body. Absolutely positive.

How many people actually feel the steel 6mm cannulas in their stomachs?
Mine I genuinely feel discomfort or genuine pain when they are totally hitting something and then problems occur...

Hopefully consultant on Monday will say wnough is enough and we can agree to MDI until my consultant comes back. But I do not want to go tgrough all of this again just because he was off sick and I'll
Be back to ground zero again....

 

[iHs]

Don't fill the cartridges with so much insulin as I think that might be the problem. Try filling 200u instead and put cartridge in pump after expelling air bubble up the tube first. Then advance the piston upwards to reach the bottom of the cartridge so that priming makes insulin travel up the tube to the end.

 

[f1_Debs]

View attachment 20968
Bloody great!! Will be A&E again soon!!

Hi, I used to have similar issues - did some research and now keep old cannula in place for 2 hours after inserting new and 'fill canula' with 1 unit at time of change - works much better. I use Medtronic 640G and steel Quickset. I've also learned that if the set hurts/stings going in then it won't work effectively so I immediately change the set and move site. Good Luck .

 

[donnellysdogs]

I kept the old set in tonight the whole time.

Yea, I am fully aware that painful sets don't work. I always used to advocate taking them out. I've had two extremely painful ones this week that were removed. The others I can just feel in me...

11pm this last set has just occluded.

I have removed pump totally. Supposedly I have had 23 units of insulin through the 5 different cannulas tonight. That is double my daily dosage of basal rate in 6 hours.

Levels raised now to 21.3.

Was also running at 250%.

Now I got 3 units from my pen and hourly scanning libre.

Will go back to pen tomorrow and phone my non existant pump educator who is off work till Tuesdsy again or my non existant consultant that is off sick....

If I cannot get any help tomorrow or their opinion then I can only go back to mdi again.

 

[donnellysdogs]

@admin
Why has 1/2 this posting n reponses disappeared?

 

[richyb]

I am a new pumper of only 2 weeks. Reading my litrature on the pump it advises changing sets prior to a meal. I had one fail yesterday due to leakage.(lesson learnt). my levels went to 19.8. so used pen to get down.
Though thinking about how it all works, the skin is like a pad of flexible rubber that can self heal.. ie. once punctured it closes the gap and seals. So we put the canula in and soon after, pump insulin in. Just seems strange not to give it time to heal and seal before pressurising the body. probably not relevant sorry for that.

 

[donnellysdogs]

Think my body is doing that too quickly!!
Reminds me of when I had ears pierced 40 years ago.. and having to turn them everyday... I did religously and my piercings still got infected despite the salt water in those days that we used.
Even a year ago I never went for reconstruction after boob amputation as I have so large intolerations to artificial food ingredients.

The trouble is if you don't do a bolus for food aftter a set change then it will take a ling time to occlude.

I tried 4 cannulas on Friday.. all occluded... when trying to give food boluses.

Finall cannula appeared to be ok. Food bolus done but occluded 3 hours later.

I'm back to MDI now...