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[IP] Site Changes

Hi Robin,
My heart goes out to you.  As I wrote to you before, Erica and I had it
relatively easy going into this pumping business and although we had
some glitches, the anxiety that comes with just starting and having to
overcome problems wasn't there.  However, we didn't sleep well the first
few weeks, testing, testing and more testing.  I was so sensitized for
the first week but with a lot of Luck, we got off easy.  We have had the
odd set go in that Erica felt much more than the others, even with Emla,
but they were fine after a little bit.  Whenever I ask Erica if it feels
okay she says.....I think so.  She never seems to be sure if it hurts or
not!  Dealing with their indecision and our own is difficult.  When our
children are upset, it upsets us......one of the joys of motherhood I

Hang in there !! <<<<<<<<<<HUG>>>>>>>>>>
#1 you are not a failure.  It will come in time   #2 I felt like crying
a few times too when things were not going right, that is normal,
especially when your children are looking to you for the answer and you
aren't sure what it is  #3 If you are wondering if pumping is the right
thing  YES!!
We are not experts at this yet, but here is how we do Erica's site
insertion.  I know everyone is different, and we may even change as
times goes on, but for now this seems to be working just fine.  The only
change I plan to make is to get some Hibiclens (today) now that I know
what the active ingredient in it is.  Remember, this works for
US...everyone is different.
1.  I find it much more relaxing to have the syringe ready to go, awhile
before a site change.  I take a long time working on getting those dang
bubbles out but we are getting better and have tried lots of tips.  It
sits for a while, and if I notice bubbles I can give them a bang and get
them to the top.
2.  We put the emla on
3.  40 mins later we take off the Emla, I wipe with a warm wet cloth and
follow with a swipe of alcohol.  Allow it to dry all the way. We have
Erica stand up for all her insertions..they have been more consistent
that way.
4.  Once the Emla is removed we have a nice circle showing on Erica's
skin.  When inserting, I pinch up the skin, and insert the introducer
needle at about the 3 o'clock position of the circle, in from the edge
about  1/4" or so.  If I start right at the outside edge of the Emla,
Erica is much more apt to feel it.  We insert at a very shallow angle.
We aim for 10-15 degrees but sometimes it seems to have a mind of its
own and just takes off.  Use a steady constant push.  Sometimes it
doesn't seem to go in as much as it should, but if it seems to stop on
its own...we leave it.  There always seems to be plenty of the cannula
left under the skin.  Her skin directly around the insertion site always
takes on a slight pink tinge...we used to worry about that but looks
like it is common.
5.  Erica's most consistent spot is on the backside.  below the
beltline, not too close to her side, and not too close to the
middle...if you know what I mean :-)  We use her belly successfully too,
but she is very muscular there, we have to be much more accurate with
inserting, and her skin is like alligator skin for some reason.  Just
one of those YMMV things.  We have used her back, but I need more
practise on that one.  The one I put in was too close to her waist and I
think it was getting too bent with all the motion....someone might have
some better ideas on that one.
6.  Once the introducer needle is out, the tubing in, we do a .8 bolus
(that one works great for Erica).  We make sure, of course, wiith
priming, that there is drop of insulin showing at the connector.  We
always follow an insertion with a snack or meal so that there is a nice
sized bolus going through to clean out the end of the cannula.  Then we
hold our breath for an hour and wait for the first post-insertion blood
test.  Whew!  What a relief!  Over for 3 more days :-)...usually.

As far as the bleeding when the cannula was taken out, I have read here
about people who have had gushers.  I was so glad to know about them
before actually encountering them.  We haven't had that problem, but
once when Erica had been using a hot tub we had difficulties with a new
site insertion because her circulation was causing her cannulas to
IMMEDIATELY fill with blood...twice.  After waiting a few more hours for
her body to cool down, we did have a successful insertion 3rd try :-(.
It was scary though, and even though I downplayed things, Erica was
afraid that she would have to go off the pump, that there was something
wrong with her.  Poor thing.  We were pumping successfully for over a
month, and when I encountered that I mumbled and grumbled and got upset
(not in front of her though).  But...once she was off and pumping
successfully again...we were all happy.  Her happiness directly affects
the whole family and of course the opposite holds true.  Unfortunately
for you now, things are not going well and it sometimes is hard to see
past the negative.

Hang in there, we still have lot of learning to do too, but regardless
of what we as parents might have to go through to get this thing close
to perfection (perfection is not someting we are expecting to attain)
Erica would be so upset if she had to go back to the idea of schedules,
food exhanges and needles.  90% of the time everything is Terrific and
that makes up for the glitches we have to overcome.
Sorry for the book, hope it helps.  I would have sent it to you
directly, but I thought putting it on the digest, some people might be
able to add to it or put their own two cents worth in.  We are still
learning too and are always open to suggestion.

Barb...Erica's mom.

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