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[IPp] Re: Sils needle

After years of those teeny tiny insulin needles, that long needle on the
Sils/Comforts/Tenders may seem scary, but remember, it isn't pushed deeply
into your child's flesh the way the shorter needles of the soft-set are.
It slides in just under the skin and you don't have to push it in its
entire length, just until you've got plenty of cannula under the skin and
can see where it comes out of the skin in its little viewing window (to
watch for signs of redness, etc.).

If you are considering trying the Tender on your child, I have a
suggestion: I know the 12 mm needle/cannula on the Sils/Comfort/Tender is
daunting, but try inserting one on yourself, into some of that nice tummy
skin most moms (and dads) have plenty of.  Think of "landing an airplane"
as you put it in, inserting at a very shallow angle.  Use a numbing agent
first if you're afraid of the pain, though I didn't think it hurt much at

We've tried the sof-set and the newer QR version of one from Disetronic
with the short needle and cannula which still go straight in at a 90 degree
angle, and neither has worked on Annie.  Since losing her baby fat (which
we think was more a result of feeding the insulin) she has very little body
fat and she hates to use the front abdomen anymore after years of getting
her shots there, so we primarily use rear "hips," from high up on her
buttocks (below the beltline) to just above the point where she'd be
sitting on it, and sometimes over to upper outer thighs, just below a panty
leg line, always pointing the needle toward her back, not pointing up,
down, or outward.  She is a swimmer, very athletic, and I think any set
that goes in at a 90 degree angle must hit muscle on Annie no matter how
short the needle is.

She has pretty sensitive skin (Emla used to leave a red welt when left on
for an hour or more), so we try to get by with as few foreign materials in
or on her skin as possible.  We have had great success with the Tender from
Disetronic, without needing any tape or sandwiches of any material other
than the sticky gauze it is mounted upon, along with an IV prep swab and a
swipe of Tincture of Benzoin, dried to a tacky state, for extra glue.  We
sometimes use the faster form of Emla cream, ELA-Max, under a piece of
tegaderm for 20 minutes prior to insertion, just to numb the area a bit,
but more often than not, we're in a big hurry so we just grab a coke or
beer from the nearest fridge and hold it in place about 2-3 minutes to
chill the area into numbness.

As I reported earlier, we are lucky that we get nice long lives from each
set, unless it gets kinked.  If we are changing just to be sure we've got a
good fresh set in for a week of school (and not because her old one seems
to be failing), then I always leave the old one in for a while, not just to
keep from interfering with absorption of earlier boluses or basal, but so
that we have a back-up in case the new one goes wrong somehow.  We
sometimes forget to remove the old one for a day or more, which can be a
problem when neither of us remembers which one we were using after we
disconnect for a shower.  I was embarrassed to realize that Annie arrived
at diabetes camp last summer with one set in each cheek--had to ask the
nurses to be sure to remove the old one for us!

BTW--Annie objects to REMOVING sets more than she does inserting new ones.
(she's always hated taking off bandaids and tapes.)  We use a packet of
Unisolve, soak the entire set completely, and it slides out and off with no
problem--making her giggle sheepishly after she's put up a fuss about it.
Then we use the same unisolve wipe to rub off any old sticky stuff, clean
up with an alcohol wipe, and rub in a bit of triple antibiotic ointment.
So far (knocking on wood as I type) no site infections in nearly two years.

Hope someone finds this useful,
Pump mama to Annie, diagnosed Christmas 97, pumping since March 2000 and
loving it!
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