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Hi guys, I've been pumping (Paradigm 522) since Mar/07, and am having a hell of a time getting consistent results. I'm muscular, mostly in my legs and have found a few bent/crimped cannulas after removal (and whopping sugar levels). Mostly though, I find no such evidence - I bolus for a meal and find my sugar levels inexplicably soaring two hours after. Medtronic's call centre insists I have scar tissue, but I don't feel it, and doc doesn't agree either, although he didn't examine me so we don't know for sure at this point. I've tried Quicksets (6mm AND 9mm), Silhouettes, Sure-T's (twice)...found that 6mm Quick Sets work in my legs, but not in my abdomen. Silhouettes work in my abdomen (sometimes) but not in my legs. NOTHING works in my upper butt (too muscular apparently). What's the deal? I keep reading about people who have never had a bad site, which only drives me crazier than I am now. Anybody had these problems? Doc/pump company/nobody seems to have answers for me as to why I've been chosen to be the "poster boy for infusion set problems." |
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| | | From: Julie | Sent: 7/15/2007 2:04 AM |
Mark, Did you have consistent results on shots? I'm also a Type 1, been using the paradigm for 5 years now. I have inconsistent results alot - my doc says that I am not alone and that is just the name of the game for Type 1. One thing that did help me with the 2 hour after meal spike was Symlin. But I had the post-prandial spike with shots as well as with pumping, so I needed Symlin. Julie |
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Have you tried Humalog vs. Novolog? That can make a difference. Also, as I think Julie was saying, different things absorb differently. I think for myself, carbs are no longer acting like they used to, and if there is any fat in the meal my meal hits way later. Just some ideas. Probably not the sets, but, I have hardly ever had one bad set since I went from straight in sets, to angled ones. I never get a crimp, ever, and it made all the difference to keep trying till I found the right deal. |
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To answer comments... Julie: When injecting with syringes, I inject and always know that the insulin will bring my sugar down. NO chance of sky-high sugars two hours after a meal, unlike pumping where I always wonder. Gelsey: Trying Humalog vs Novolog (Novorapid, my insulin in Canada) is something I wonder about to try and "think outside the box" to find a solution, but I can't seem to find any comments on this to support a change. I don't use very much insulin and I'm aware that Humalog has a "crystalizing" issue, but my mind isn't closed to this insulin change yet. I'm hoping for replies over message boards like this one, to hear of people that have had experience with this.... My doc, who you'd be surprised to learn is a supposed top pump-wearing doc himself (which was the selling point for me to get referred to him), is busy 99% of the time, and said once via email (yes, isn't that what good docs do, lol) that "I don't think scar tissue is an issue for you". That was it. The nurse CDE I end up dealing with is a text-regurgitating idiot, so no point trying to start a conversation....I mentioned Humalog, and she simply offers "NovoRapid is what we recommend". I asked for samples of the Sure-T, and she said only that "we don't have any as they're not widely used." No "why don't you try...or try this person..." etc...She's going on leave shortly, thank god. If I didn't need the doc for prescriptions/taxation purposes (I need him to sign forms for income tax credits), I would be on my own in a second! |
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| | | From: Julie | Sent: 7/15/2007 12:12 PM |
Mark, I use Novolog too - my doc (who I love) asked me to try it just before I started pumping because he said it holds up better for pumping next to the heat of your body, and also because it has a longer tail, it gives better results with the pump. As far as scarring, I was told my abdomen was badly damaged from shots when I started pumping and I should avoid putting sets there for 6 months. After 5 years of pumping, I have rarely put sites in the abdomen. I have pretty good layer of fat in many places (although I am only 125 pounds now at 66 inches tall after a year of using Symlin) and I will put the sets in lots of places, which has cut down on further damage. The other suggestion is using your Minimed representative if you have one in Toronto to get you sample sets to try. My rep is wonderful about getting me samples of things. I use the Silhouettes - I have never found anything I like better. I tried the 13mm ones but they have less tape than the 17mm ones and did not stay on as well. So when I re-order I am going to get the 17mm ones again. Julie |
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As far as scarring, I was told my abdomen was badly damaged from shots when I started pumping and I should avoid putting sets there for 6 months. --> How did your doc determine this? Just from touch? Or is there some proven way to find out if you have scar tissue? Note: I used syringes for 21 years, but my stomach was not a preferred location - I used my legs and behind a ton, and no issues there except my behind which is now too muscular from cycling. My doc said (via email, no less) that he didn't think scar tissue was the cause of my problems. Then again, he doesn't think that caffeine in coffee could POSSIBLY raise my sugar (it can, and does, at least for me). After 5 years of pumping, I have rarely put sites in the abdomen. I have pretty good layer of fat in many places (although I am only 125 pounds now at 66 inches tall after a year of using Symlin) and I will put the sets in lots of places, which has cut down on further damage. --> I would avoid my abdomen if I could, but the problem is that I can't use my arms/behind as alternatives. Even my legs provide a select few sites. The other suggestion is using your Minimed representative if you have one in Toronto to get you sample sets to try. My rep is wonderful about getting me samples of things. I use the Silhouettes - I have never found anything I like better. I tried the 13mm ones but they have less tape than the 17mm ones and did not stay on as well. So when I re-order I am going to get the 17mm ones again. --> Yes, I have a contact from Medtronic I was referred to (after hospital nurse CDE didn't know any solutions to help with adhesive problems). I already contacted her to get some samples of the metal needle Sure-T (to avoid any crimped/bent cannulas). I just got some 17mm Sils, but am trying to give my stomach a rest after changing many times last week (my stomach looks like somebody did a drive-by shooting!!) Mark |
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| | | From: Julie | Sent: 7/15/2007 9:49 PM |
Mark, It was my pump CDE that told me to give my abdomen a rest. She could see the damage by looking at it - it was very lumpy and bumpy. That does go away after you give the area a break. It looks and feels smooth now. I think women may have more areas for sites than men. I have LOTS of spots on my hips. Another place I really like is my chest above my breasts. I used to use all parts of the breasts too until I got a scary infection there and had to take antibiotics.  And I use all parts of my thighs and they have lots of spaces too! Julie |
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