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Where do you put your cannula?

Discussion in 'Insulin Pump Forum' started by Nomi, Dec 19, 2018.

  1. Nomi

    Nomi · Well-Known Member

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    hi guys,

    I’ve been having fun with my infusion sets recently and found i’m having to change them every day or so. On top of that the new box seems to have extra strong adhesive so i’m covered in red welts when I take them off.

    My stomach is a no go area now for infusion sets whilst it all heals, but i’m struggling to know where else to put my cannula.

    Legs or bum aren’t great as the insulin gets sucked in as soon as I walk, so I run high for ages and then plummet into hypo-ville. I do use my arms, but I can’t keep doing that with a new set every day.

    Is there anywhere else people put them that I could try?

    Thanks for your help

    Nomi
     
  2. Jaylee

    Jaylee Type 1 · Moderator
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  3. Juicyj

    Juicyj Type 1 · Moderator
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    Hi @Nomi

    Out of interest are you just getting red welts and no lumps on your tum ? Have you tried using something like Cavlon spray to protect your skin, it's a barrier application. From time to time I get lumps and in certain areas on my tum I get absorption issues, so for a brief rest I move to my chest area, I can't use legs, bum or arms as have tubing and it's also uncomfortable when I sleep, although if I really had to I'd try using my lower back.
     
  4. LooperCat

    LooperCat Type 1 · Expert

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    I usually use my legs... currently my left calf.
     
  5. Chickenboy

    Chickenboy Type 1 · Active Member

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    @Mel dCP do you find putting it into your calf affects absorbtion by going straight into muscle?
     
  6. LooperCat

    LooperCat Type 1 · Expert

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    No, makes no difference to me. But I’m quite fat, so I doubt it’s going into muscle.
     
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  7. Engineer88

    Engineer88 Type 1 · Well-Known Member

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    I find using my back (love handle ish area) is amazing and really comfy.
     
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  8. Chickenboy

    Chickenboy Type 1 · Active Member

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    Thanks @Mel dCP I'll give it a try on the calf next month when I start. Just glad to be giving my thighs a rest after 30 years of MDIs! thnaks @Engineer88 - I'm wearing the demo version of the omnipod on my lower back and i've hardly noticed it. that will defo be a fav spot i think!
     
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  9. Chowie

    Chowie Type 1 · Well-Known Member

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    Why do you need to change every day, I quite new to pumping almost 11 months, so I’m still on the learning curve and very interested as to know why people do different, things, so if I see a problem coming I will have a possible solution.
    My pump nurse said rubbing the area with olive oil will help get the adhesive off your skin so less agrivation. I have found slowly peeling it off leaves a slightly pink area and hurts more.
     
  10. Jollymon

    Jollymon Type 1 · Well-Known Member

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    I can place them into the back of my arms, if I use a little longer tubing length.
     
  11. kitedoc

    kitedoc Type 1 · Well-Known Member

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    Hi @Nomi, whilst my tummy is my usual site I have 'expanded" to the side of my tummy, and my back .
    Part of the issue is how much or little subcutaneous tissue (below the skin, above the muscle ) one has. And I have developed a bit of a hate of plastic cannulas. Too many bending and not reliably delivering insulin. 6 mm 90 degrees has been my preferred type of cannula* as I found even the shortest 30 to 45 degree cannulas bent at the tips, presumably at the junction of subcutaneous tissue and muscle.
    Whilst I now use metal cannulas* for under the skin, I was very recently having trouble even with them but after talking with my DSN and pump rep there is the possibility, after 7 years on a pump and 52 years all up on insulin, that scar tissue may be extensive where I have been placing my cannulas.
    So the strategy is moving the sites around to the side of my stomach, to nearer the back if I can avoid muscle (and prevent my rucksack dislodging the cannulas) and also trying a 8 mm metal cannulas as this might missed the scar tissue (so far so good).
    I avoid my legs and arms as the muscle is close to the skin (serves me right for all those years of walking, kayaking, swimming and running) !! But on the very rare occasions when the BSLs shoot up and ketones appear, some judicious use of intramuscular insulin (with my DSN calling 'the shots') has saved me from hospital.
    Best Wishes, fellow pumper ! :):):)
     
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  12. Nomi

    Nomi · Well-Known Member

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    Hi,
    My sets stop working properly for me due to placement and scar tissue from repeatedly using the same areas causing the insulin to not go through properly. Or I find I sometimes hit blood vessels and it will be ok for a bit and then blocks up.
    I used to be fine using them for several days, it’s just wear and tear. I have found zoff wipes are really good for getting rid of the adhesive and i’ve Started using a barrier spray too to stop them taking my skin off when I peel them off.
    X
     
  13. Nomi

    Nomi · Well-Known Member

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    Hi, thanks for replying! It sounds like I have similar issues with scar tissue.
    Have you found the longer cannulas made a difference? I switched from 90 degree to angled and that has made a bit of difference but not a lot.
    How do you find the metal cannulas? I was considering trying those out but am a bit nervous. Are you aware of them more than the plastic ones?

    Nomi
    X
     
  14. Nomi

    Nomi · Well-Known Member

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    I never even thought to try my calves. I find with my thighs I get lots of lows when I walk, do you get that with calves as well?

    X
     
  15. LooperCat

    LooperCat Type 1 · Expert

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    Nope :) I don’t get many lows at all, and certainly no pattern to do with where I’ve plonked my pod. But I do take very small amounts of insulin, 18-30u a day in total, depending on the time of the month.
     
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  16. kitedoc

    kitedoc Type 1 · Well-Known Member

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    Hi @Nomi, the first 8 mm metal cannula worked very well, comparable to the 6 mm metal cannula at its best.
    The second 8 mm one placed yesterday somehow managed to be pushed out a bit when I checked this morning and was leaking with a BSL of 16.8 to boot. So either the cannula tip was resting on the top of the muscle layer and got pushed out a bit or the tubing between the metal cannula and the connection caused a twisting and lifting of the metal cannula.
    Had I been using a plastic cannula I would likely have had a bending of the tip of the cannula where it met the muscle layer and some pushing out or bending of the cannula at the plastic base just below the skin and so obstruction and leaking would have happened sooner.
    Of course the plastic cannulas and tubing do not have a connection partway along the tubing. I think the different design with the metal cannulas is that any drag on the tubing only bends the plastic cannula whereas if there was direct or more direct tugging on the metal one it would cause more damage under the skin. Please see photo. apologies for the lack of focus - difficult to do selfie of this !! The white tape is to try and prevent any twist in the tubing between cannu a site and connection from lifting the cannula up but it has partly taped the connection bit so if I need to remove the tubing to charge up the pump I shall need to untape and re-tape that part !!
    Having only used the metal cannulas for 2 weeks I am still making my mind up but I am leaning towards the metal ones as they do not seem to obstruct/bend as readily as the plastic ones.
    IMG_3839.jpg
     
  17. Nomi

    Nomi · Well-Known Member

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    Ooh that’s a different set up to what i’m used to. Thank you for providing the picture it’s so much easier to weigh things up when you can see them!
    I might see if my nurse will let me try them instead of the plastic ones to see if it makes any difference.

    Thank you so much for sharing your experiences, really appreciated:)
     
  18. kitedoc

    kitedoc Type 1 · Well-Known Member

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    As they say @Nomi, a picture is worth a thousand words !! Given my experience I think I shall not 'coil' the tubing but leave the tubing between cannula and second sticky patch straighter. As long as that will leave attaching the pump to my belt or to place it in a pocket wallet around my neck without causing the tubing to be stretched!!
     
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