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[IP] "Do it to me one more time"

Gabe is pumping; site is in his butt; it is a Quickset, as he didn't like the 
Sil and one of our criteria is that he be able to change the set himself.  
The tape has mastisol and an extra tape (hyapfix) covering the tape (hole in 
the tape)  with masitsol on that.  He has a safety loop held in place with an 
ordinary bandaid.  He was uncomfortable covering the site with a pad or large 
bandaid and if he is uncomfortable with that, no sense in doing it.  He has 
the pump in a holder and hooked to his pocket so it cannot fall and tug.  He 
will not leave it "Free" in bed.  He knows he has to check every 2-3 hours 
and has to carry a meter and an insulin pen.  He had his LAST SHOT of 
ultralente this morning as I am getting mixed messages about that issue; at 
least, some are telling me that he needs at least .3 basal per hour to keep 
pump running well, so there is no point to Ultralente.  Also, he has to get 
used to the pump fully meaning learning the beauty of NO shots and the 
inconvenience when you have to stop and change a site.  We are going to 
change the site in 48 hours whether it goes bad or not, as least for now.  
When he has experienced the pros and cons (and we have too), then he can make 
a better decision.

These are all the variables I have been able to identify by reading all your 
helpful comments, talking to the CDE a number of times and harassing Mini Med 
Clinical Support:
1) no tugging at the tubing meaning no "dropping" the pump; make a safety loop
2) masitsol or other adhesive to hold site in place
3) Stop Ultralente and let minimum of .3 basal through the pump all the time.
4) Prime after every disconnect to shower
5) Change site when bad and don't go back to injections so easily
6) Change site every 48 hours for now, even if it is working.

If there is anything I have left off, PLEASE let me know.  I cannot cover the 
site with a Scholls or large bandage; it was too uncomfortable for Gabe.

My instructions are:

1) one high sugar, bolus, check in an hour
2) second high sugar, bolus and check in an hour or if rising, inject and 
change the site.

Is that correct?   Meter and pen are required at all times out of the house.  
Gabe's sisters and brothers have volunteered to help me check him through the 
night and Gabe knows it is every two hours checking for a couple of days.

That's about it; we will try til we simply cannot find any reason for site 
failures that we can correct or until the correction factor (like wearing a 
large pad over the site) becomes so cumbersome that it is not worth it to 
Gabe.  An example would be if the site really only lasts 24 hours then Gabe 
will have to decide if he wants to pump under those conditions.

I guess that is it; thank you for all your help and support these last 2 


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