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Re: [IP] highs after infusion set changes

In a message dated 98-06-06 16:47:36 EDT, you write:

<< 1) prior to placing the syringe in the pump prime 20 - 25 units to clear 
 the infusion line of all air and allow insulin to drip out of end.
 2) place syringe in pump and prime with a bolus of at least 5 units or 
 until a droplet of insulin forms at the end.
 3) bolus 0.7 units to fill catheter after removing insertion needle.
 Make sure you are not going to deep with the catheter, the angle should 
 be very shallow.
 If you're already doing all that, your are doing every thing right and it 
 may simply be the stress involved with doing the insertion. See if you 
 can get her to do it or help. This will involve her more in the process 
 and she should be more comfortable.  Are you using some ice cubes or emla 
 cream to numb the site? >>


We are doing steps one and two as you wrote, and step 3 we were told to do a
.5 unit bolus.  That's where I think we may be going wrong.  We are also
inserting very shallowly (30% angle) because she is so small and a skinny-
minny.  WE use the emla cream and Kayla admits she doesn't feel the insertion,
but she does get stressed out over it.  I had no idea short periods of stress
could affect her blood sugar that much and for so long.  Ah, live and learn!!

Next set change (tomorrow) we'll try a .7 unit bolus if her blood sugar is
good.  If she's a little low, I think I'll follow Bob's suggestion and stick
with .5 or .6.  He mentioned with her 1:140 HBG ratio her sensitivity to
insulin is high and too much priming may cause her to drop too much.

We'll get it straight one day!!  Actually, I'm enjoying the problem solving
involved!  Two years out of the work force has had a numbing effect on my mind
- glad to be involved in math and thinking again!!!

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