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Re: [IPk] Archives

Hi Denise,

The lumps from injections are scar tissue. Putting a set into scar tissue is 
like putting it into a wall: you have to be very lucky for it not to kink. 
Ryan's not the only prospective pumper I've heard of not to be assessed for 
scar tissue before having an infusion set plunked in. Why do they not do 
that over here?!?! Advice on where's best for an individual to put a set 
would save a lot of people a lot of worry. ARgh!

Putting a Quick-set in with the Quick-serter causes several times the amount 
of tissue trauma as one injection by pen or syringe. The 'wham!' of the 
spring drives the needle through tissue so fast it can't help but think it's 
been injured badly. With Ryan being so thin, the 6mm cannula may still be 
too long, or it may be that he's got enough pockets of scar tissue that it's 
tough not to hit one. Yes, the Silhouette can be used with a 'serter', but 
it is still quite possible to hit muscle with the introducer needle if 
you're putting it in with a serter, in addition to the tissue trauma thing. 
With a serter you can't stop pushing when you hit the wall of scar tissue, 
but you can stop if you're doing it manually. The serter tries to bang the 
needle into the scar tissue anyway. You wind up with an 'owie' and a wasted 
set (the needle may come out bent and the cannula is likely to kink 
visibly--scar tissue don't mess around). If the Sil-serter does result in 
kinked sets and poor absorption, it may be worthwhile just doing the set 
changes manually yourself until Ryan wants to do them by himself. If you do 
them without a serter, he will probably not become afraid to do them by 
himself, without the serter, in due time. But if he starts using the serter 
now, he may wind up wasting a lot of sets, getting higher blood sugars 
because the insulin is being put into non-absorptive tissue until the alarm 
goes off (about 2-3 units of non-delivery--on a .5u/hr basal rate, 4+ hours 
without insulin), and continuing to build up scar tissue (albeit less than 
he would get from injections) from the trauma the serter entails.

Good luck,


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