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[IP] inserting sils

Carole asks:
terrified of needles after 6 years of shots--go figure). Every time we use
the soft set, we have a problem with the cannula getting kinked when he is
very active & playing. When we use the sil we don't get that problem, we just
hate inserting those because they never seem to go in right. Sometimes it
feels like we hit a blockage and sometimes I'm afraid that they are too
shallow. Has anyone else had this problem? Or do you have any helpful hints
on inserting the sil better? Thanks.
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i Was taught to put them in like you are landing a plane on a runway. very 
good, but I don't fly with my hands or anything else. generally I clean the 
skin with iv prep and put down a polyskin dressing. I pinch an inch or so 
of skin and stick the inserter needle into the end of the little flesh roll 
thru the polyskin. i don't angle it up or down. if you let go of the flesh 
and the sill you'll see that it goes in at about 15 degrees. keep pushing 
to advance the sil, do not stop or slowdown or it will start to hurt. aim 
the sil point up towards the surface. keep pushing until it is in up to the 
hilt. then remove the introducer needle, peel off the backing and fasten it 
on place front and back. generally I do not put any dressing over it but I 
do insert it thru a polyskin which I put down first. generally it does tend 
to ache a bit as you push thru the skin but once in the subdermis it moves 
along without pain. I would use ice rather than emla since emla can cause 
an allergic reaction. If you notice the needle point getting close to the 
skin surface during insertion angle a little less up as you push the sil 
home as you don't want to buttonhole your hide.  The sil is the most 
comfortable set to wear and seems to cause fewer problems than the micro 
soft sets.
There are probably 60000 more ways to do this I'm not saying its the best 
or only way but it works for me. if you have had diabeasties for more than 
a few years it really doesn't hurt but you cant tell that to a little kid. 
just have them look at how fast it goes in and how it doesn't really hurt 
so much, yes kids do get apprehensive but when you tell em, once its in it 
wont hurt anymore until we have to change it again. they generally don't 
raise too much sam about it. Ice does help a lot with kididdles.  i used to 
use it for kiddie spinal taps. Spot. Hope this helps Carole.
A Bender, M. D.
email @ redacted
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