position of cannula?

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heasandford

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Relationship to Diabetes
Type 1
Does anyone have a way of deciding where to put the cannula at each change? I change mine every 3 days, but have a really bad memory for these sort of things so don't remember where it was before the last time! I also have very little fat on my tummy, so only a relatively small area to work with. Do you move it up from down, or side to side or clockwise or...??
 
I tend to work clockwise with 6- 8 different sets on my left thigh, same on right thigh, left and right buttock and stomach. By the time I get bcack to my left thigh a few months have passed so there's plenty of time for recovery.
 
I wish I could reach round to connect the tube to the cannula in my buttock!:(
 
We alternate sides, and then try to avoid anywhere that it's been recently (the marks take a couple of weeks to fade). Daughter doesn't like the idea of having anything in her buttocks but we might have to use them if we start getting lumps in the belly! We try to use a wide area but it's hard sometimes, she doesn't have loads of fat either.
 
I found it most uncomfy using buttocks/back of hips. I go up and down in lines either side of my navel, alternating sides and moving outwards when I have done bottom to top of that "line".
 
I start below ribs and work along the one side then go down to the next row until I reach the end of that side. Then start on the opposite side doing exactly the same thing.
 
Pattidevans said:
I found it most uncomfy using buttocks/back of hips. I go up and down in lines either side of my navel, alternating sides and moving outwards when I have done bottom to top of that "line".
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Pumper_Sue said:
I start below ribs and work along the one side then go down to the next row until I reach the end of that side. Then start on the opposite side doing exactly the same thing.
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I'm another that uses lines.

I've tried buttocks as a site a few times, but found it a bit lumpy when I was slouching back on the sofa - well more that I worried I would squash it/pull it out really.

I'm still using sides-round-to-back and to three lines on each side in a zig-zag pattern. Starting at the front just above waistband, moving around to about 2-3 inches from spine then back round to front again with a final return round to the back. I get 4 or 5 sites in a line so that's around a month before I return to the other side.

I probably should start looking for other sites too. But I've just kinda got into the habit. 🙄

I have a much bigger area to aim at since I started using angled sets. The 90-degree ones seemed to need quite a bit of 'coverage' to avoid discomfort/set kinks.
 
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I need to get myself into a routine of some kind, so some thoughts to have a go at here, thanks!
I once did a 'round the back' cannula which pulled out, so I'm not doing that again! Before pumping I found everywhere except my tummy was much slower to take effect, and since that's one of my problems I'm not using those areas at all any more
 
do you all get 4-5 sites per 'line'? I think I only manage 3 or so. Maybe I am afraid of them being too close together
 
heasandford said:
do you all get 4-5 sites per 'line'? I think I only manage 3 or so. Maybe I am afraid of them being too close together
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I make sure the sticky pads don't overlap... but apart from that I try to pack em in!
 
I use my stomach and thighs and generally move round clockwise......

I always try to have my next canulla on the opposite side and stomach/thigh site as the one being changed...
 
I used to be methodical and go clockwise around my stomach in ever decreasing circles in towards my navel but since using cgm I try and keep my cannula on the opposite side of my stomach to my sensor. This leaves me looking for any bit of me that isn't bruised or red and isn't at waistband level as I have pulled a few cannulas out catching on my clothes.
 
thanks everyone! I am trying to get the best out of being a pumper, some things not quite as I thought.
 
Flower, have you tried wearing your cgm in your lower back? Mine lives there almost permanently, in various spots, always on the same side as my cannula which might be in my thigh, stomach or bum.
 
Good topic and useful replies! I'm nowhere near as methodical about site rotation as I know I ought to be. I'm not terribly keen on angled sets as I feel they leave a greater entry scar, but I can use them in leaner areas which wouldn't otherwise be used.

I was at a pumpers educational afternoon at the hosp today (well...mutter, mutter...yesterday) and as I was the only Viber there, had a whole session with the Animas rep, as well as a little time with Roche rep (as I use their sets) and was informed that skinny children successfully use the steel cannulas in their sides/backs, so I'm reconsidering giving them a go for harder to access areas like butt. My previous attempts in bottom have all kinked! My reluctance is based on less flexibility of cannula when doing yoga, backed up with Patti's pain experience when first trying the steel ones!! But I keep being advised to give them a try. I suppose anything which increases available sites and/or set failures.

Thanks for posting this topic 🙂
 
and thanks all for your useful replies!

I am still resistant to cannulas other than the one I started with, which is teflon and has an 'inserter' gadget. I really struggled putting in either of the angled or steel ones, drew blood, and haven't tried them since. Maybe I will have to, and will ask for help how to do it without closing my eyes!
 
You may have seen this... but here are a few I tried...
http://www.everydayupsanddowns.co.uk/2012/09/set-changes.html

I found steel painless to insert, but a bit of a faff changing more frequently and with the double-sticky.

The silhouette kerplunker (angled sets for Veo) is a bit 'assertive' at times but I've got used to it and make sure I don't hold it too tight to the body when inserting.

Were there no inserters for the angled sets you tried?
 
ingrid said:
Good topic and useful replies! I'm nowhere near as methodical about site rotation as I know I ought to be. I'm not terribly keen on angled sets as I feel they leave a greater entry scar, but I can use them in leaner areas which wouldn't otherwise be used.

I was at a pumpers educational afternoon at the hosp today (well...mutter, mutter...yesterday) and as I was the only Viber there, had a whole session with the Animas rep, as well as a little time with Roche rep (as I use their sets) and was informed that skinny children successfully use the steel cannulas in their sides/backs, so I'm reconsidering giving them a go for harder to access areas like butt. My previous attempts in bottom have all kinked! My reluctance is based on less flexibility of cannula when doing yoga, backed up with Patti's pain experience when first trying the steel ones!! But I keep being advised to give them a try. I suppose anything which increases available sites and/or set failures.

Thanks for posting this topic 🙂
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Hi Ingrid, we use the steel cannulas on my young daughter (back and buttocks) and there is no signs of any pain - she is comfortable bouncing around as usual and have been using these successfully from her being about 2 1/2yrs, she would definitely let me know believe me!!!! We had problems with Teflon kinking and have peace of mind with these. They are much quicker to administer (well for me doing it to her, may be different faffing around and twisting if you need to get it onto your bot and back) I believe this is the choice treatment for babies too. Worth a try. My only issue is you have to be extra careful on removal for reasons obvious. 🙂
 
heasandford - if you're happy with the sets you use, you don't need to change or even experiment, from what I've read on various lists the majority of pumpers do just stick with whatever they were first given and it works for them. In fact, when I requested to try some different ones, and even *gasp* sets from a different co. to my pump's co., my DSN was very surprised and didn't know about luer lock connections being the same on all pumps/sets except some Medtronic, and so interchangeable. I wasn't happy about various aspects of the Inset IIs (Animas) so needed to look to other co.s for what I was after (mostly manual insertion). Interestingly, there is only the option of manual insertion of angled sets with Roche and Animas. Medtronic are the only ones to offer a kerplunker (like that word, better than Sil-serter or whatever they call it!) for their angled sets.

Thanks Mike for your blog ref. I'd forgotten about the double tape business...hmmm. And more frequent changing needed, though I might experiment stretching to every 3 days. I should still give them a try I think, and I'm very reassured now by your daughter's experiences Hanmillmum, thanks for that.
 
Pumper_Sue said:
I start below ribs and work along the one side then go down to the next row until I reach the end of that side. Then start on the opposite side doing exactly the same thing.
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I do this too. After both side of my front, I go round the back and fit a couple of rows on both sides, then upper buttocks but I find them difficult due to underwear waistband, belt on work trousers.

Despite having more than sufficiently fat legs, thighs are tricky due to bending cannulas but I've had some success keeping towards the back of my legs.
 
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