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[IP] Re: sites for lean pumpers (and children!)

Thanks for your input Michael and Bob and Lori.

  One question for Bob:  What are the indications that a site is not
"working"?  Or better, what makes you change a site?
I've taken shots for 40 years, and have been pumping Humalog for less than
2 weeks.  The first set (Silhouette) I left in for 3 days (according the
the package and trainer recommendations) and it worked great.  Ditto for
the others.  I was pretty good about rotating needle sites (with about a
month between returns to a site) so maybe the hypertrophy you experienced
didn't occur with me.

Lori, I also thought the bent needle might work for me, but it was not
supposed to last as long in one site.  But it seems for you that you get
around that by just taking one "shot" per day (like the good old days!).  I
may give it a try if I run out of Silhouette spots.

Michael, is Minimed planning make a children's softset, i.e., one with a
shorter needle and cannula?  This would also be useful for us fat-free

<<<From: "Bob Burnett" <email @ redacted>
Subject: RE: [IP] Re:Advice from lean pumpers

Let a "lean pumper" chip in here :-)

Michael, I agree with most of what you said, but I think there may be some
additional issues if the "lean" pumper has used injections for many years
prior to pumping.

Years of injections can lead to hypertrophy of the injection sites prior to
pump therapy. If the sites used for injections over the years have
hypertrophied at all and then are used for infusion sites, they may not have
a chance to properly "heal". If the site is not a good one to start with,
working it into a rotation scheme may not produce ideal results, though it
may have more of a chance to "rest" than it did with injections. This
problem may be exacerbated some with lean pumpers, since there is less real
estate to work with overall.

Some might consider this a minor point, but if you are "lean" and looking
for sites, you may need to avoid those sites which have worked so well with
injections over the years until they get some well deserved rest. Alternate
sites which you have not considered in the past may be the "norm" until the
favorites return to good condition.

FWIW, this is one lean pumper who has successfully restored several of his
previously unusable sites to good shape by discontinuing Humalog and
returning to Velosulin. I am now on the fourth day at the same site, going
on the fifth. No site deterioration at all, absorption is good. Note that
immediately prior to switching back, I was getting (on average) no more than
1 1/2 days per site with Humalog. >>>>

<<<<From: "LBE FSD" <email @ redacted>
Subject: Re: [IP] Re:Advice from lean pumpers

I know that I am in the minority here, but I use the bent needle, and change
sites (not sets) daily.  Since I only move an inch at a time, and need
almost no tissue, I have yet to repeat a site in 3 months -- granted I'm
tall so there are lots of inches above my waist, but there is very little
subq.  I do wonder why I am among the few that still use this set.  Will I
start to dislike it?  What are the disadvantages?  In any case, if the
number of sites becomes a problem, try this set, and learn to insert it
shallowly.  I insert right over my ribs with NO problems.  I also use the
area above my navel that the site map says not to -- a little like you're
being split down the midline until you become accustomed, but no biggy.  The
CDE claimed that my first incident with pain was due to inadequate depth.  I
called MM after the second one and they said that it was more probably the
opposite, so now I use a very shallow angle, and life is grand.
Take care,

Wayne Mitzner
Department of Environmental Health Sciences
The Johns Hopkins School of Hygiene and Public Health
615 N. Wolfe St.
Baltimore, MD 21205
Tel. 410 614 5446
Fax 410 955 0299

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