I hate my pump!

[RuthieG]

Just a little extra, I regularly clip mine to the centre of my bra and it is well hidden there (although I worry a bit about temperature but apparently for 2 days the insulin will be fine).

I have found this to be the least obtrusive place for it as it felt quite vulnerable on my waste band.

It might not work for everyone though but maybe..!

 

[Ellie Jones]

BS
I am surprised that you were told by the DSN and Rouche Rep to use metal as this isn’t correct..

The steel cannulas are more likely to kink than the Teflon!

Teflon is a much more flexible material so doesn’t kink very easy at all, I use Teflon for this reason as I really don’t have a fat layer, so metal is likely to hit my underlying muscle causing the cannula to kink.. I use the Tenderlink angle as a 90 degree angle set would again hit muscle underneath the fat layer causing problems..

In the 4 years I’ve been pumping I’ve only had one kink, and I’m sure that happened when I took my cannula out, as had no indicators of raised BG’s before I changed my cannula which was standard change at the end of my 72 hours of use..
I’ve only ever used my thighs for injection during pregnancy, because this was the only place available but suffered greatly due to lack of fat on my thighs… I ended up black and blue and control was achieved by 2 jabs a day and a very strict regime of timing and carb consumption but I did manage to control my diabetes, even though with my youngest daughter if my BG hit 8mmol/l I would start going DKA and up going into hospital on a sliding scale for a couple of weeks at a time.

 

[Twitchy]

I wonder if the DSN / Roche came to that conclusion re the steel vs teflon when there was a problem with the flex-link plus? It's been withdrawn from use now, there had been a problem with not enough cannula protruding from the insertion needles & therefore the cannulas were kinking on insertion - I can see how a steel cannula would be stronger in this situation than a teflon one, but I don't know if they had the steel cannula with the flex-link plus??

I've always been on teflon cannulas (the insertion needle's steel) & so far apart from a bit of a nightmare patch when I had a dodgy batch of the flexlink-plus cannulas that were as described above, any problems have been due to clipping a blood vessel or the sticky backing washing off. Hmm, interesting one to ponder!

 

[Ellie Jones]

The flexi-plus did have a design fault, where the cannula caught the casing when it was fired causing the kinking..

When I started pumping I had quite a discussions about the pro's and con's of Steel V Teflon and length of cannula as we debated which would probably suit me best due to my sheer lack of a fat layer, to give you an indication of how skinny I am, my BMI is 18 on a good day, on a bad day 17😱 It was hoped that going on my pump would help me improve my weight which it hasn't

But going from observation over the years, more people complain about kinks issues in the metal cannula's than Teflon which every pump they've got... And more people change from metal to Teflon than Teflon to metal. The main reason for changing from Teflon to Metal I've seen given is the deterioration of adsorption over a 72 hours stint, followed by their bodies starting to protest with having an foreign object inserted in the body!

But I due to see my team at the beginning of April, so I shall ask them to double check

 

[everydayupsanddowns]

Interestingly this blog post from US blogger and all-round good egg Jess specifically mentions lack of kinking (or "bending into weird pretzelly shapes") as a benefit of Sure-T.

http://jess-meandd.blogspot.co.uk/2012/03/geeking-out-about-infusion-sets.html

I've had 3 teflon cannulas kink at 90-degrees (both Quicksets so not related to a Roche cannula design issue). In my case the seemed to go in OK, but then kink after the insertion needle is removed (I and surmising here). - a bit like this: http://instagr.am/p/JfHZAAq6Jn/

1 was immediately obvious (hurt like stink) but the other two (a 9mm one in my saline week that doesn't really count) were only really evident when pulling the set out and finding it bent at 90-degrees 3-4mm from the end. Seemingly where the layer of flesh over muscle was a but thin.

Mostly 6mm ones are absolutely fine with me. And the can't 'go in' like that cos the inserter needle is longer than the teflon cannula so the bend must happen sometime later.

Only one of those involved subbornly rising BGs over 4-6 hours suggesting the site might be a bit suspect - but just goes to show (again!) that YDMV 🙂

 

[Ellie Jones]

Mike

I don't use an inserter to fire my cannula's in, I self insert which I reckon cuts down the kinking problems, With a inserter is fires the cannula in, if you haven't got the inserted position right on the skin or it hits underlying muscle the pressure behind the firing will cause the cannula to buckle or kink..

Injecting has always been a problem with me due to lack of a reasonable fat layer, even with a 6mm needle I had to inject at a 45 degree angle otherwise I was likely to hit muscle underneath, I can't use my thighs for injecting or with a cannula as I don't even have enough fat to raise with a pinch...

But if you look at how and compare how the metal and Teflon kink there is a lot of difference in them..

With metal, if it buckles or kinks it stays buckled or kinked, if its kinked this is a lot shaper which either drastically cuts insulin delivery or totally blocks it. And once you've buckled or kinked it they don't come out.. So when you fired your inserter, if it hits the skin at the wrong angle is can buckle or kink, if you hit muscle underneath it kinks, if you place it where the your movement can exert enough pressure one point of the cannula it will either buckle or kink staying like it. In certain position on the body where there a lot of movement, because the ridgediness of the metal the movement can cause it to wiggle out..

With the Teflon which is flexible, it's very difficult to actually kink it unless a lot of pressure is exerted on it.. Even if it is kinked it's rare for the kink to stop insulin delivery, just a drastic reduction of supply..

I've just changed my sets, so did try to kink the cannula and the only way I could do it what to almost double itself back on it, by squeezing the tips of the cannula towards themselves, until I'd almost closed my thumb and fore finger together before it kinked, before the stage was reached releasing the pressure the cannula spring back flat..

Yesterday I had an occlusion, caused by clean jeans meant my waistband was sitting over the set.. So when I bolused it alarmed. The pressure of my waistband had either kinked or bent the cannula enough to interfere with the insulin delivery, so repositioned my waistband taking the pressure off the set and no problems with delivery, today I checked my cannula has I always do, not sign of a kink or bend... The cannula had sprung back flat again. Metal cannula's don't do this..

 

[Babysaurus]

I had a very quick Google and found this: One disadvantage of the soft cannula, however, is that its flexibility can potentially lead to kinking, which disrupts the flow of insulin into the body. If a disruption is not detected, it can lead to dangerously high blood glucose levels. Users of soft cannulas, therefore, need to know how to troubleshoot and immediately change their infusion sets if kinking occurs. from this site - http://www.diabetesselfmanagement.c...ing_and_using_an_insulin_pump_infusion_set/1/ so it can't be completely wrong.

Mike, what happened to you re your cannula's and kinking is precisely why I was recommended the metal one's. I have been assured I am more than welcome to try the other kinds once it's not so imperative that I keep such tight control.

 

[Phil65]

I have found metal cannulas work much better for me, I had real absorbtion problems with teflon...no kinks though. Or maybe it was because I was an inexperienced pumper with teflon initially....they might be worth another try now!

 

[everydayupsanddowns]

I'm glad that you like Teflon, Ellie. I'm happy with teflon too, and have no desire to change - you don't have to convince me that one is better than the other... I have no issue with teflon cannulas.

However... I have seen them kink, bend at 90 degrees and stay bent after having been inserted 'straight' with a solid metal needle run through the middle of them and out the other end (which also came out straight after insertion - that's how Quicksets work).

I don't use an inserter to fire my cannula's in, I self insert which I reckon cuts down the kinking problems, With a inserter is fires the cannula in, if you haven't got the inserted position right on the skin or it hits underlying muscle the pressure behind the firing will cause the cannula to buckle or kink.

This was not what happened in my case. It went in straight. but at some point after insertion some pressure was put on the flexible teflon tube (I fully expect this was my rock hard six-pack abdominal muscles flexing and rippling ). The teflon tube then bent and stayed bent.

Some insulin still got through when delivered as a bolus, but I think less so as far as basal trickle was concerned. I know the supply was not completely shut off because I did not get a 'no delivery' alarm.

You clearly have no desire to try metal cannulas, but I can't help thinking they must be a little better than you suggest here:

With metal, if it buckles or kinks it stays buckled or kinked, if its kinked this is a lot shaper which either drastically cuts insulin delivery or totally blocks it. And once you've buckled or kinked it they don't come out.. So when you fired your inserter, if it hits the skin at the wrong angle is can buckle or kink, if you hit muscle underneath it kinks, if you place it where the your movement can exert enough pressure one point of the cannula it will either buckle or kink staying like it. In certain position on the body where there a lot of movement, because the ridgediness of the metal the movement can cause it to wiggle out.

otherwise metal cannulas could not possibly be offered to people, and anyone using one would be constantly beset with non-delivery problems.

I'm not trying to convince you to change your mind - you dont like them and that is fine... But I do recognise that they work better for some people, they like them, they work well for them and that's fine too.

 

[Northerner]

This thread seems to have wandered off at a bit of a tangent, so I will close it.

 

[Lauren]

BS
I am surprised that you were told by the DSN and Rouche Rep to use metal as this isn?t correct..

The steel cannulas are more likely to kink than the Teflon!

Teflon is a much more flexible material so doesn?t kink very easy at all, I use Teflon for this reason as I really don?t have a fat layer, so metal is likely to hit my underlying muscle causing the cannula to kink.. I use the Tenderlink angle as a 90 degree angle set would again hit muscle underneath the fat layer causing problems..

In the 4 years I?ve been pumping I?ve only had one kink, and I?m sure that happened when I took my cannula out, as had no indicators of raised BG?s before I changed my cannula which was standard change at the end of my 72 hours of use..
I?ve only ever used my thighs for injection during pregnancy, because this was the only place available but suffered greatly due to lack of fat on my thighs? I ended up black and blue and control was achieved by 2 jabs a day and a very strict regime of timing and carb consumption but I did manage to control my diabetes, even though with my youngest daughter if my BG hit 8mmol/l I would start going DKA and up going into hospital on a sliding scale for a couple of weeks at a time.

My teflon ones kink all the time so it has been suggested that I go on the steel cannulas. The Medtronic Rep herself told me the steel ones are extremely unlikely to kink.