Quicksets? Silhouettes?

[Purple]

I have to agree with Mand, just by the unbelievable improvement in my control in such a short space of time is enough for me to not lose faith in the pump. My average blood sugar has come down from ~11 to 8.0 in six weeks! I am really looking forward to my next hba1c which I'm getting done in a few weeks!

Patricia: I do the sils manually and the quicksets i use the inserter. I think the only reason I use it is because I have it to be honest.

 

[Sugarbum]

Good luck Purleshadz!

I am having dreadful trouble with marking still. Perhaps I shouldnt whinge- the quickset is soooo sticky, it really doses the job (I guess if it were anythign less I would complain about that!) but it makes my skin sore after peeling off. The onle I have removed this morning is itchy on the hole where it was sited- anyone find this? I used the lifter spray recommended by Adrienne this time though to lift it off as my skin is falling apart!

I am glad none of this is putting anyone off pumps, Heidi! 🙂 The insulin pump has been the best thing to happen to me since I was diagnosed- you would have to prize ot off my dead body I love it so much! 🙂

 

[Patricia]

Hello all!

Have zero minutes in which to try to record our clinic visit -- just home -- but I'll try!

Generally very successful. We have a great clinic. And a certain DSN -- T1 herself -- is just absolutely straight-talking, understanding, and full of ideas. We are SO lucky to have her.

It *does* seem clear that the quicksets are troubling E because of his build. This is common and esp more so at growth or puberty. We looked quite closely (poor thing) and all came to the conclusion that there ain't much fat there. She agreed with Medtronic that a) painful insertion b) bent cannulas and c) no delivery messages were all clear signs that what is probably happening is that the sets are either running into muscle (eg bending the cannula or making it less efficient by swinging it off to the side) or nicking muscle (causing considerable pain and being less efficient).

She had two options ready for us. First, silhouettes: we did everything right EXCEPT pinch up whatever fat is there. Psychologically this makes a HUGE difference -- it's going into *something* then rather than feeling like it's going to skim across the top! -- and it guarantees going into the slim layer of fat. After watching it all happen on a cushion, E gathered his considerable nerve and did it to himself right off the bat. I cannot stress the difference that pinching made. Everything seemed much more stable (the inserter is sort of 'held' in by the pinch too). He was immediately impressed that it didn't hurt. At all. Except for the expected pinprick of the needle at first. So he is now on a sil for a couple of days.

She also had another option, which I think also may work: adding a little 'donut' (as she called it) to the cannula of the quickset, a little 'cushion', to make the cannula not go in as deeply. It's hard to explain, and it's wonderfully heath robinson/blue peter, but basically it involves scissors and a hole punch: you take high quality dressing (only available from GP), punch hole, cut to size, repeat another time or two to build up the thickness of the cushion, then remove the adhesive on the back to connect it to the cannula set, and insert as usual, with the added cushion just keeping the cannula from going in as deeply.

I need to say though that this method is simply one tried and tested by this hospital, and they particularly use it for babies, who are exclusively on quicksets -- because the needle for the sils is much longer and sites are harder to locate in little ones 🙂(). This is not a method you will find anywhere official, I reckon! BUT -- they use it. If anyone is thinking of doing it, this is one I'd discuss with your DSN before trying, just to make sure you have the right materials, and think it through.

In any case, we will try this too in time and see what happens. Finally, there is another set which is only doable by hand and involves a little needle under the skin. Off-putting, BUT works well as a last resort. The great thing here is she has tried EVERY SINGLE ONE OF THESE, with inserters and by hand, at some length.

We left feeling that we will get there. She was so positive about the pump that I think E felt rallied up too. He *is* positive about it, just a bit tired of the hassles, understandably. There was *no* discussion of the pump being faulty. She congratulated him over and over, complimented his growth and successes, and acknowledged his feelings completely: sometimes you want to throw it against the wall, she said. I do. Hear hear!

Anyway, must run. Feeling positive. We have more options than we thought, and E was open to them all.

As for the traffic -- pah! Don't get me started.

Will add more later!

xxoo

 

[Mand]

Great news, Patricia!!! Look forward to hearing how he gets on over the coming days. Sounds like you have a great dsn and clinic! I like the sound of the extra padding so needle doesnt go in so far. I will run that by my sons dsn if we continue to have problems.

My son getting on ok with new site so far. We have to insert it for him but he says it doesnt really hurt and so far we have not had a 'no delivery'. But his levels are a bit up and down at moment. Probably we just need to do some basal or bolus tweaks but we need to have the insulin going in properly before we can make these tweaks.

It has been a difficult couple of months, especially due to the night testing.
We have been totally exhausted so we really hope we can have a smooth run soon.

Good luck for your next hba1c, Purpleshadez! 🙂

 

[Purple]

Wow, I love the padding idea! Genius! Glad you had such a positive outcome 🙂 Thanks for the luck, I have to say its the first time I've actually looked forward to finding out

Mand: Fingers crossed that things settle down for you and your lil man now.

All the best, Martin.

 

[tracey w]

Wow incredibly useful stuff, thank you all. Like everyone is saying, in some ways jury still out...

We are off Wednesday to clinic to try the silhouettes and also talk in general about the quicksets. Since starting this thread we have had ANOTHER no delivery message. Feeling a bit like jumping off a cliff, and poor E -- he gets over it, but it literally makes him tear his hair out, and no wonder. When we took this one out: no bent cannula, and insulin actually coming out the end (was in the middle of a bolus).

Medtronic say that insulin 'builds up' in the tubing if the site is not right. But I confess I am now wondering about whether the actual pump could be malfunctioning? Medtronic say no, and actually nothing else has caused us the slightest worry...

Oh lord! It's such a huge pain!

E is not particularly muscular (sorry E!), but he IS very slim, and more slim even than a few months ago it's true, because he is just shooting up. I took a good look today at set change and did think he actually had considerably less of ANY kind of fat on his tummy, anywhere, than a few months ago. And he has nothing anywhere else. It's just his build at the minute. At this age, until about 30, to be honest, his father was exactly the same.

I'm really interested in the hand insertion Tracey, as some of what is troubling us just from the outset with the sils is the inserter, which is like some kind of shot gun. It's very hard so far for him to manage with one hand, while holding a shirt up for instance, and the silly button to push down is right at the end, and requires a push virtually *past* the end of the pen, concave like, if that makes sense. It's fairly daft, and a little scary looking.

Purpleshadez, I'm interested too in your switching around... So you have found that they hurt more when wrong? Some of what we've found with quicksets is actually quite a lot of pain, almost every time...and this too, say Medtronic, is a sign it's going into muscle?

We had No Delivery messages about 6-8 weeks ago -- every other one or so for a week or two. Then, like Mand, Medtronic sent out a new few boxes to try. Seemed okay for a while. But now, last two weeks, nightmare. Two bent cannulas and four No Delivery messages. Up until 8 weeks ago, we'd had two bent cannulas ONLY, since last June. Even then, now that I think about it, it's quite a few?

Tracey et al: do you think 45 degrees scars less? What does attract me about them is that you can actually *see* what's happening with the cannula. With quicksets it's all out of sight, and you never know what the heck is going on...

Sorry if its been answered, just catching up. I dont know if they scar less as I only tried the other type the once and yowser😱 too much pain for me.
I do have scarring but nothing that i worry too much about and they do seem to disappear after a while.

I too like the fact that i can see what is happening with the canula. I always check to see for example no blood in it (so far not), and i definately like the fact i can insert by hand at 45 degrees. Its not too painful apart from the occasional one like on injections you do get the odd one that makes your toes curl for a second. But mostly no problem.

I hope you have resolved the problem now, I do think the sils are definately worth a try.

 

[Mand]

Just a quick update to say that now my son using a new site, the quicksets are working fine again. Phew! (though I hope i have not spoken too soon 😱)

It has been a difficult couple of months but, fingers crossed, problem solved.

So we are now making some tweaks here and there to get his levels steady again. So far so good! 🙂