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Re: [IPp] Thanks for the support

On Monday, November 24, 2003, at 09:06 AM, pop-digest wrote:

> Date: Sun, 23 Nov 2003 20:24:28 EST
> From: email @ redacted
> Subject: [IPp] Thanks for the support
> Thanks all of you who took the time to send me encouraging words, It 
> is so
> hard somedays,and it is nice to know someone understands, we are not 
> getting
>  alot of support for the Dr's office(too busy) and we are having 
> trouble with
> the
> Cannula , my son is thin and muscular (5-3,and 105 lbs) and is using 
> the 6mm
> Quick-set ,but we are having to change the site everyday, because of 
> highs and
> when we used his upper buttocks, his underwear pulled it out! Are 
> silouettes
> what we need? and he is eating more but covering with bolus, but they 
> say to
>  change the site if he is over 240,and the bolus doesn't bring his BS 
> down in an
> hour and a half,we have changed it everyday so Far! I'm listening,so 
> send me
> any thing you think would help!
>                                                    Thanks,
> Kayla

Kayla - sounds to me like maybe  you need stronger adhesive  (not 
necessarily a different type of site).

(1) I have found that, if you use Ella-max to numb before inserting the 
site, that the site doesn't stick well - unless you wash off the 
Ela-max before putting the site in.  Don't know if this might be 
contributing to your problem.  I suspect that EMLA cream for numbing 
might also interfere with site adhesion.

(2) We use "SkinPrep" wipes on the skin, and let dry till tacky, before 
putting the (Quickset) site in.  This adheres remarkably well, on our 
daughter.  Doesn't come off in the bath, or anything, even with some 
serious tugs.  The wipes were sent to us by the medical equipment 
distributor who sent the original pump and supplies.  There are other 
brands of similar stuff (wipes to both clean the skin, and to help 
infusion sites stick to skin)

(3) There is a stronger adhesive called "Mastisol".  If you use this, 
make SURE you have "Detachol" to take it off with for the next site 

(4) I'm not sure how well the site would stick by itself- we haven't 
tried that.

(5) Note that there have been a LOT of reports on this listserve of 
quick-sets crimping when used in the stomach - but I don't recall 
reading about this problem when the site was used in the buttocks, or 
thigh.  Upper arm you could use too, theoretically, but I think it 
would be inconvenient with the tubing.  (Anywhere you used for a shot - 
you could use to place an infusion site.)  Our daughter has used the 6 
mm quick-sets for over 6 months now, (usually buttock, sometimes thigh) 
and I think we've only had one or two crimps, ever.

(6) When are you testing that you get a 240?  On our daughter, we 
*must* wait 2-1/2 to 3 hours after a meal to test, or she is invariably 
"high" (>250).  However, if we try to tell our pump (Cozmo) to correct, 
it says "no, she'll go to low", which turns out to be true if we force 
the issue.  We've noticed lately (now that we're paying attention) that 
her biggest drop after a meal bolus is in the 2 to 3-1/2 hour time 
frame.  This is probably an insulin absorption issue.  Perhaps you are 
dealing with the same thing.

(7) Finally, how old is this kid?  He may be starting puberty which is 
gonna screw up the system just wonderfully (so I'm told).
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