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Re: [IPp] Cooking Insulin, Extended Boluses & Fasting Basals [long]

In a message dated 4/10/2002 10:49:36 AM Mountain Daylight Time, 
email @ redacted writes:

> Which type of
>  infusion set is Katie using?  We are using the sils for Josh and we are
>  on the new paridagm pump.  We switched from the sils to the quickset and
>  then back to the sils.  How do you prepare her site?  What is Mastisol. 
>  Is that something that will help the infusion set stay on better.  I gave
>  Josh a bath the other night and his set came out because it got wet. How
>  can I avoid this?  I am now using ELMA cream to numb the area and also
>  using the IV3000 tape to help the set stay on better.   When you take the
>  old site out, what to you clean it with?  How often are you changing the
>  site?  

Katie uses the MM Quick-Set (with her Animas pump) -- it's the same type of 
set MM makes for the Paradigm except that the end of the sets that connects 
to the insulin cartridge made specifically for the Paradigm pumps have 
special connector (and the regular sets' connectors have a standard "leur 
lock" connector which works on any pump: Animas, Diestronic, Minimed, or even 
the new Dana).

Mastisol is a liquid adhesive.  It works really well for Katie to keep her 
sets stuck -- even when she spends lots of time in the water (we change her 
sets every three days).   A bottle of Mastisol costs about $30.  We've been 
using it for almost 10 months and it's not even 1/2 empty.  

Before Mastisol, we tried inserting the set through a couple different types 
of dressings (like Tegaderm and Opsite IV 3000) and then sticking the set's 
adhesive tape to the dressing.   This technique of inserting through the 
dressing seems to work well for a lot of pumpers.  Some also add a second 
layer of dressing over the top of the set (called the "sandwich method") -- 
sometimes also cutting a hole in the top layer of the dressing if needed to 
allow for disconnecting the set .  . . Unfortunately, these great ideas 
didn't work for us.  All of the dressings really irritated her skin, leaving 
red marks that took weeks to go away. If you're having set adhesion problems 
(a VERY common problem for new pumpers), call Minimed's customer service.  
They can send you samples (including Mastisol) for you to try.  Everybody is 
different -- so you just have to experiment to figure out what works for your 
child without irritating his skin.

When changeing her set, Katie cleans the new site with IV Prep (we're going 
to try Skin Prep next time I order stuff -- our CDE says it's stickier).  
Then we paint on Mastisol using a Q-tip in the shape of a bullseye (with no 
adhesive in the center where we're going to insert the cannula).  We fan the 
Mastisol for a few seconds until it's tacky (it goes on wet -- and you don't 
want it to be too dry either), Then she inserts the Quick-set using the 
Quick-serter.  To remove the old site, she uses a Unisolve pad (comes in an 
individual towelette packet like the IV Prep.  First she wipes it all over 
the top of the sets round adhesive tape and around the edges.  She usually 
lets this soak in while she's prepping the new site -- by the time she comes 
back to the old site, the Unisolve has deactivated most of the adhesive and 
it's very easy to peel up the tape all the way around and just lift the set 
off her skin (with a sil, you'd want to slide the cannula out before lifting, 
of course) -- the nice thing is that there's no pulling on her skin . . . she 
even uses unisolve to take off regular band-aids now . . . anyways, after the 
set has been lifted off she uses the same unisolve pad to wipe away any 
remaining adhesive thats on her skin . . . then she dabs a little antibiotic 
ointment (like polysporin) on the little hole where the cannula was.

Katie used EMLA cream for her first couple of insertions when she started 
pumping and then decided they weren't necessary with the Quick-sets.  I've 
inserted a couple of the Sils on myself and they truly don't hurt at all, but 
BOY does that needle look LONG!  One thing I did learn with using the EMLA is 
that you really need to make sure that it gets cleaned off really well if you 
want your set to stick . . . what I did was wipe of all the emla with a 
couple paper towels or kleenex before we even started with the IP prep and 
stuff . . .

Pumpmama to Katie
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