[Previous Months][Date Index][Thread Index][Join - Register][Login]
  [Message Prev][Message Next][Thread Prev][Thread Next]

Re: [IPk] Re: Melissa's site infection

[--Warning: this post is long and detailed! You have been warned.... --]
Hi Barbara,

In the first few years of pumping, it was common for me to have a site be a 
little sensitive for a day or so after taking out an old set. I have just 
realized that I haven't noticed such tenderness in a long time; whether 
that's a matter of just being used to it and so not noticing it anymore 
(when's the last time I actually flinched when I tested my bg...?) or using 
only Tender sets for the past few years, I don't know. I will say that I 
blame that bad infection on the design of the Sof-set. I could not see the 
actual point of entrance for the cannula because, at least 5 years ago (I 
have not looked at a Sof-set in years!) there was a little plastic knobby 
bit directly on top of the cannula. It stuck up less than a sixth of an inch 
or something from the skin when the set was inserted, but it made it 
impossible to see exactly where the cannula was going in. Being unable to 
_see_ the site, and expecting that it would be a little sore by the last day 
I had it in, I didn't know that it was getting rather red and angry looking 
until I removed the set on the 4th day. Also, at least 5 years ago, I found 
that the Sof-set adhesive pretty weak, at least on my skin (body chemistry 
can affect how sticky adhesive feels). I imagine that some nasty germies got 
into the site because the set adhesive was not sticking to me well and the 
site was therefore not kept as sterile as it might have been.

Anyway, back to the long, involved story: the tenderness that I'd expected 
after taking out the set didn't go away after two days, which rather 
surprised me. By the third day after I'd taken out the set, sitting down 
with jeans on was uncomfortable. Because, at least in those days, the 
needles for Sof-set insertion and the Teflon cannulae they inserted were 
pretty thick, at least in comparison to any Tender needles/cannulae I've 
seen, I used to dab a little antibiotic cream on a site I'd just finished 
with in order to prevent infection while a site healed. So I dutifully 
applied antibiotic cream to the painful site and it started looking a lot 
better. By the sixth day after I'd taken out the set, I thought I might have 
been imagining the pain because the surface of my skin looked fine, except 
for a tiny scab where I'd had the set (also, I used to get tiny scabs from 
Sof-sets. I have never had  a scab from a Tender set).

After convincing myself that it was real, I got worried about the pain and 
thought I should see a doctor. I went to my college physician and, having 
seen a pump about three times in his life (in magazines, I believe), he 
referred me to a pediatrician in the town who had my medical records on file 
(my own doctor was 2.5 hours away, in my hometown, but as the college doctor 
had limited hours it made sense to have my records held by a local doctor as 
well). When I went to the pediatrician's office, a woman who had just 
qualified several previously was sent to examine me (my doctor was on 
holiday). The doctor I saw was very sweet, but remembered only little things 
about the pump from a lecture she'd heard the year before. I had to explain 
to her how it worked and show her an unused set so she could picture how 
deep the cannula had gone in. She diagnosed then infection, but not having 
any idea how bad it might have been, prescribed me a dose of Amoxicillin 
that probably wouldn't have cured a five year-old's ear infection. (I was 15 
and about 9.5 stone.)

So I took the medication for...mmm, 4 days, I think, and there was no 
improvement; in fact things were getting worse. I couldn't even find a 
comfortable sleeping position and my bgs were running high. On a Friday 
morning, almost two weeks since I'd removed the offending set, I phoned home 
in tears and asked my dad to pick me up that night so I could see a doctor 
who might be able to fix things. When we got back to Fredericksburg I went 
to a night emergency pediatric clinic (not an A&E room, though) at the 
hospital. An elderly English doctor who'd been practicing in America for 
something like 20 years was on duty. 'Oh no,' I thought, 'if a doctor in her 
late twenties who just finished med school didn't know what to do, surely 
this guy will have no clue!' I think I recall that he had been a military 
doctor at some point in his career, though. He had seen a lot of bad 
internal infections in his time. He felt my stomach carefully and determined 
the size of the abcess (pretty big). He prescribed some heavy-duty 
antibiotics, lots of water, rest, and hot, moist compresses every two hours 
until the abcess burst. So I went home and followed his instructions. The 
antibiotic kept things from getting worse and the heat and moisture drew the 
abcess out until I had a noticeable (to me) lump on my side. I stayed home 
from uni for a few days past the weekend because I wanted to be at home when 
the thing finally burst. On (I think) the fourth day of compresses, it went 
while I was in the shower. Hallelujah! I was so happy. I stayed in the 
shower for a while to let a lot of the yucky stuff drain, and then I applied 
hot more hot compresses for the rest of the day to get the last of it out. I 
went back to college the next morning. The next time I ordered sets I got 
Tenders (called Silhouettes in the US) and I have never looked back.

I know plenty of people who have never had problems with Sof-sets, so I am 
not trying to slag them off completely. Still, I avoid them to this day 
because I just don't like them.

IDDM 8+ years; MiniMed pumper 6+ years; ONE bad infection out of *over _six 
hundred_* set changes! (Not a terribly high incidence, I say!)

[--Hey, I warned you that this would be a long, detailed post!--]

Surf the Web without missing calls! Get MSN Broadband. 
for HELP or to subscribe/unsubscribe, contact: HELP@insulin-pumpers.org
help SUPPORT Insulin Pumpers http://www.insulin-pumpers.org/donate.shtml