On a grey Saturday afternoon back in July, I was out painting. The rain was pouring down outside. I remember checking my blood sugar level after a perfectly carb counted and pre bolused lunch to find an unexplained high. After I gave an insulin correction with no effect, I lifted up my shirt to find my 6 hour old infusion site bleeding. In addition to those feelings of failure and guilt, my supplies were all the way back at home. I was doubly devastated. Diabetes had ruined my afternoon. I hesitated for a moment, unable to find the words to explain to my brother that I had to take off.
As I drove home in the pouring rain that afternoon, I was on the verge of tears. Once again, I felt failed by my diabetes.
Infusion sites were one of the most overwhelming issues I faced during my first three months of insulin pumping. I spent ages obsessing over where on my stomach my site would be least likely to fail. After every site change, I was left in suspense for hours on end, almost waiting for a site failure. Wondering if the cannula had “clicked” in smoothly underneath my skin, or whether it had kinked. Checking the skin underneath my infusion sites like a hawk, looking for any signs of bruising or occlusions. Worrying about the rapid loss of usable real estate on my stomach, and how much longer I would be able to continue using my beloved insulin pump. I actually felt guilty for the amount of insulin I was using, because more insulin meant quicker onset of site failures.
I was using a 90 degree infusion set with an insertion device at the time. Others had suggested I try a different type of infusion set. I knew that there were different kinds of infusion sets on the market. Ones that went in on an angle, rather than straight in. I don’t really know why it took me so long to look into it. I guess I just thought this was normal. I thought that the site failures were simply a side effect of six years worth of insulin injections. I thought that my body simply couldn’t handle 3 days worth of insulin infusions into the same spot. Besides, it was daunting to try something new.
When I woke up one morning to a bleeding infusion site that I was yet to actually begin using, I knew I had nothing to lose. I grabbed the box of Animas Comfort infusion sets that had been sitting in my wardrobe for a week, and I haven’t looked back since.
This cannula goes into my stomach on an angle, rather than straight in. For starters, I don’t feel it “digging in” when I’m laying on the couch or in bed. On the angle, it doesn’t hit blood vessels and nerves which likely caused the bleeding and site failures so easily. Not having a lot of fat on me probably didn’t help, either…
Yeah, I have to stick a big long needle into my stomach with every site change, but it virtually eliminates the possibility of the cannula kinking on the way in. It’s so much less wasteful, too. If for some reason my infusion set feels uncomfortable after insertion, I can stick the needle back into the infusion set and re apply. Previously, infusion sets were pretty much useless once they came unstuck from the insertion device.
Since I began using the comfort infusion sets a month ago, I’ve had one failed site. The first one. The rest of them have been a breeze. And did I mention that I can actually get them to last the whole three days? Even four? Possibly five…
I keep thinking back to a comment Laddie left me several weeks ago. She mentioned that she couldn’t find a 90 degree infusion set that worked for her. Looking back on my experience, I’m very much inclined to agree.
I feel so much more comfortable with site changes today. I can change a site and actually get on with my afternoon, rather than stress about it for hours. My stomach is actually starting to look like a stomach and not like some blood stained wasteland. I finally have an explanation for all of the site-related issues I went through, which I can take great comfort in. All those feelings of guilt and failure are gone.
Today I can finally close that book of doubts and confidently call myself an insulin pumper.
Massive thanks to all of you who suggested trialling a different kind of infusion set. I do read and appreciate all of your comments of encouragement. I apologise for being so hesitant to give it a go. I owe you all coffees some day…
Sidenote: I’ve been nominated for a Wego Health Activist Award. If you enjoy reading my blog, I’d really appreciate your endorsement which you can do by clicking here.
Bobbie
Wow Frank that’s exactly what I wrote you about last time. I started with the angle sets and switched to the T-90s thinking it was easier to put on. But you are right they kink and bleed more times then not. I just received my 3 month order and will call to exchange them to the angle comfort set. Thanks for your input. Hope they work for you
Bobbie in very hot Arizona.
Laddie
I am glad to hear that angled sets are working for you, Frank. Every time a new 90-degree set comes to market, I give it a try. And then go back to angled sets.
Congrats on your Wego nomination!
Rick Phillips
Frank, I am glad you have found something that works. I think int he 14 years or so I have been pumping I have perhaps 5-7 infusion site failures and i have only used 90 degree sets. Like we say on TUDiabetes, YDMV (your Diabetes May Vary). It is a great way of thinking about diabetes (tech and otherwise)
Bobbie
Frank and Steve, I must admit after using the 90 for months I decided to read the instructions again. All 15steps! I was pulling up the trigger wrong causing it to bend after it went in. I was twisting it instead of pulling straight up. So the one in now is working well. We Wil see.
Bobbie
Sorry I meant Rick
Caroline
This used to happen to me too! It stopped when I switched to the Sure-T infusion sets (Medtronic). They consist of a small metal needle that sits under the skin. Very comfortable with no worry of kinking. Also, no scaring which was a big issue for me with the other infusion sets.
The feelings of failure….wow can I relate. Last weekend I opened a new box of reservoirs only to discover that the company had sent me the wrong size! I went into complete panic mode because it was a Friday night and so everything was closed. Luckily once I stopped panicking, I realized I could just reuse the old reservoir. Amazing how when you don’t panic, a solution is easily found!
Tip: if you’re going to be away from home (day trip, work, etc…). Carry extra supplies with you 🙂
Well wishes
Bobbie
Well so much for the 90 degree infusion set. I am back to the comfort short angled ones. I kept trying to use the 90 degree thinking it was me screwing up. Went to bed with BG at 135,woke with 250!. It kinked somehow during the night. So furious and depressed. Was all set to go back to MDI. My doc talked me out of that and went back to the angled sets. Very happy for now. Hope it lasts. What a roller coaster!
Frank
I hear you. Here’s my story of a kinked Cannula on a 90 degree set. Scary stuff.
http://www.type1writes.com/2016/07/07/a-tumultuous-night/
I haven’t had that issue since switching to the Comforts. The manual insertion almost guarantees it won’t kink on the way in. Glad to hear you’ve got it sorted.
Bobbie
Frank that is some story! I will never use the 90s again. Thanks for sharing. I have had probably 5 or 6 bend. But I was lucky to catch it and change quickly. I am retired so I have plenty of time to waste checking my blood sugar !
Ashleigh Ricardo
Its so good when you try something new that works! Glad you like the angled infusion sets. Ive never tried one, but I did resist metal canulas for a very long time. Then when I did do them I realised that if one came out, I could simply push it back in & tape over the top if I needed to.