Hi all, I'm new to this site, hoping for some quick advice. We started my daughter (who will be 4 next month) on the pod a week ago Friday, so we are only 8 days into this and REALLY want to make it work, but we have had issues with our last 2 pods with the cannula coming out.
The first two pods were fine (we put them on her arms). The one we put on her arm Thursday evening either never went in or immediately came out b/c she was over 500 at bedtime check. I had heard about people having highs after a pod change, so at first I thought that was the issue and bolused her for the HIGH. But by 2 am when she was still in the upper 400s after another 2 boluses, I decided that the cannula must not have gone in and I gave her a shot of Novolog. When I took the pod off yesterday, the cannula was bent. I put a new one on - this time on her leg - and it was fine until this afternoon.
At dinner check, she was once again over 500. I looked and could see the cannula was not in. It must have come out in the pool while she was swimming. I did put an XL waterproof band-aid over the pump to keep it secure - could that have caused the cannula to pop out? Has anyone else had similar experiences or issues with a small child? Any advice on how to ensure the cannula stays in? I really don't want to go to a pump with tubing, but we can't keep going through this either.
I don't have any experience with children but I don't think I've ever had a cannula come out. I have never had good results using my legs or arms. I know some love it but I prefer my stomach or back hip area, it's protected and it's softer and I think takes the cannula better than my more muscular arms and legs. I do have highs when changing but not into the 400 and 500's. Usually it goes into the 200's. Try some different areas. Good luck, give it a bit more time to work out the glitches.
My son started the Omnipod when he was 18 months old. The first few weeks were a nightmare because we realized that the initial calculated doses weren't aggressive enough so he kept going HIGH. I told someone that if I got asked one more time if the pump was working I was going to go insane. Going forward, the way we determined if it was the pump or his blood sugar was by taking ketones - if he had ketones meant pump not working or not delivering, if no ketones just had a high BG. With moisture problems, I have a sweaty kid plus the pump can become loose with water - which is why they suggest a bath or shower before pump change to loosen it up. I have to put the pump on with skin tac and cover with tegaderm to keep it on normally. When he goes swimming, I have to put an additional layer of vetrap on it to keep it attached.
We have been on omnipod for 1yr now my daughter is 11 and plays high level soccer 5 days a week and none have come out. When we put a pod on her arm we make sure the cannula part is pointing down.I went to the soccer store and bought these thin nylon covers you put over shin pads and we wear them slipped over the pod. They really help them stay on. The highs you are getting after pod changes are normal for us . We have better luck with morning pod changes or after exercise.I will give her .50units before taking off the pod and 1.00units after changing. If it is before bed I will increase the basal rate from .30 to.35 but still check her avery couple of hours. The activity of the day seems to work the best though and then i don't have to do as many bed time checks. I agree with the last post. I would only take a pod off if we had high ketones.
When we started with our saline test run, we put the pod on her upper bum, but by that night, the pod itself had come loose from the adhesive. She likes her arms and legs best. She's too lean for the stomach and doesn't care for the bum, although I might can coax her into trying it there again. Thanks for the input!
Wow - 18 months old! When was he diagnosed? How old is he now? Thanks so much for your feedback. I have been checking for ketones with a ketone meter, and so far all have been negative, except for a single reading of 0.3 the other night. I sometimes find it difficult to tell through the window whether the cannula is inserted, although given the circumstances (she was 197 at 3:30 pm then > 600 at 7 pm), I looked and could tell it was not in anymore.
I haven't tried tegaderm yet. When it's on her arm, I've been wrapping coban around the pod and her arm (and it stays on in the water!), although I just ordered an arm band from bandsforlife.net. But the coban doesn't work on her leg b/c it rolls up when she pulls her pants up and down. What size tegaderm do you use?
Thanks for the quick reply! I'll have to try cannula down on her arm - we've put it up each time so far, although I've been told you can do it both ways. As we speak, she is down to 351, after almost 4 units of Novolog and 3 units of NPH to get her (and me) through the night. We'll try another pod in the morning. It seems many people push down at the window during insertion, so I'm going to try that too. Maybe the cannula will go in deeper.
Jack was diagnosed right after he turned one, and he turned three in June. We use the vetrap because it's intended for animals and therefore cheaper. Anything intended for humans is three times more expensive. I use the 4" tegaderm on his pump, and 2" tegaderm for his Dexcom sensor.
I am surprised your daughter didn't have ketones if the cannula popped out. BTW it's impossible to see anything in the cannula window. People have been trying to get Omnipod to change the color of the cannula for years so you can see it better, but apparently the FDA wants people to be able to see blood in it. I don't know - blood in the cannula has never stopped insulin delivery for us - a popped cannula obviously will.
He usually goes high after a pump change (but not always), because of insulin absorption issues at the new site. However, sometimes it works for a few hours and then he goes high. Anyway, I figure any high within 12 hours of a pump change is an absorption problem unless I've got ketones.
If you have a skinny little kid like us with no fat, it does help to pinch up the skin and also press down on top of the window during insertion. I am surprised you can use the arms - good for you - if I put a pod on Jack's arm the cannula might shoot through to the other side. LOL. However, we have found (and have seen others) that you can put a pod anywhere you can find fat, no matter where it exists.
In general, you have to find what works for *your* kid. Everyone is different. Getting used to a new pump is very frustrating, and will be a constant learning process. The first few weeks are the toughest, and after that everyone's lives will be easier. Just keep at it and you'll figure it out, and you'll be very glad you did. I know though - easier said than done.
so sorry you are struggling so, i agree with some of the other posters, if you can see the canula no blood or anything ( blood can be a sign of impending occlusion) and no ketones i would keep trying. we always do a .5 bolus before a pod change and 1-5 U post depending on his bs with no food for a bit. the tegaderm or any type of wrap helps with arms, we have had the most success with belly just over his hip but if she is really lean it might be uncomfortable all you really need is a little pinch up and the pinch is important at start up. it really is a big adjustment switching to a pump so hang in there. another thought sometimes when endos switch to a pump they are conservative with basal do you think she is getting as much as on MDI maybe she needs more? keep the fluids going and keep her active as long as there are no ketones! best of luck i will be thinking of you! amy
My 7-year old son has been on the OmniPod since March and we've had the most success on his thighs. We put a piece of Hypafix Adhesive Tape on every time as well. I don't think the brand matters; it's just important to put some form of adhesive/protection over it, especially because kids are so active. My son plays every sport imaginable, rough-houses with his friends and little brother, and while we certainly do have some issues with the cannula coming out, I'd say for the most part it stays in. We also purchased a thigh-band from Bands4Life which we have him wear whenever he has a soccer game, goes swimming, or anything where we know the pod could get hit. I am a big fan of the thigh band (they make one for the arm too FYI).
Hi Scott, we seem to be having the most success on her arms, and that is where she prefers it. I ordered an arm band from bands4life and it should be here any day now, but they have discontinued the thigh band - I was going to order one the other day, but no luck! Hopefully my mother-in-law can look at the arm one and make something similar for us for the leg.
Yes, Liz is very lean, but she definitely seems to prefer the arms. The first time I put it on her arm, I noticed a lot of "gappage" between the pod and the adhesive and it looked like it could easily snag on something, so I first put Nexcare waterproof tape around her arm and the pod to keep it snug, then I switched to coban. We just inserted a new pod yesterday at lunch and I used the pinch up/press down technique. She had 3 little friends over yesterday and they were swimming and very active all afternoon and the cannula stayed in! Thanks for the reassurance that we are doing the right thing at the right time. I know my daughter appreciates being injection-free and having more freedom with meals, snacks, etc. so we will stick it out (no pun intended)! I'm just looking forward to the new, smaller pods!
Oh so young. It's not fair. I'm surprised you went with the pod for him so soon. It seems so big on my almost 4 year old, I can't imagine how big and bulky it must have seemed on an 18 m/o.
I'm surprised she didn't have ketones either. I just felt so terrible that I didn't take action sooner and allowed her BG to be so high for so long. I have heard the the new, smaller pod IS supposed to have a colored cannula, but not sure how that could be if it's an FDA issue. I just wish the pod could sense and alarm when the cannula pops out. I'm surprised the FDA didn't make THAT a requirement!
How do you like the Dexcom? I'm definitely on board with that in the near future.
My daughter got the Omnipod right before she turned 3 (she is now almost 6). It took us one month to get the basal rates correct. We replaced many pods during that first month thinking that were not working - once we got the proper basal rates the problems almost disappeared. The doctors are generally conservative (especially in these little kids) - I think we ended up doubling what the doctors originally suggested. We have had some cannulas come out but usually that is when the pod is starting to come off. Flexifix tape has been wonderful for us - especially at summer camp! Taping it also seems to cut down on the kinks - that was more of a problem for us that the cannula coming out.
I would recommend staying with it for a month if you can - it does take that long to get comfortable and hammer out the insulin rates. We used the bum exclusively when she started but now we use arms and legs.
The pump actually turned out to be a no-brainer. My son was on a 1:100 carb ratio when we came home from the hospital, so I would have to give him over 50 carbs - per meal - to do a half unit on a syringe. Plus lantus was making him go low at his nap because he just didn't need a lot of insulin. Even after stuffing him full, he was only on 6 units total (humalog+lantus) each day. We are on novolog now because we found it works better in the pump. Just avoid DKA for now and know that we have all been through the impossible highs when going to a pump, trying to figure out what is going on. And know that no pump will alarm when the cannula comes out.
LOVE LOVE LOVE the Dexcom. It's a lot of data and keeps you on your toes, and is overwhelming the first few weeks like a pump, but it's cut down on the BG pricks by more than half and I don't do a BG at night now unless he's going low or high. It allows anyone around him to feel more comfortable taking care of him (babysitters, teachers, grandma, new nurses), and I am definitely more confident in my pump dosing with it.
Hmmm, we were on Novolog and NPH until the pump, which meant we didn't deal with carb and correction factors. We just limited her to 38 g of carbs at meals and 22 g at snacks. So she only got 2 shots a day unless she was > 200 at lunch and she would get a shot then too. Our injections were based on a sliding scale. NPH was definitely NOT the best insulin for stable BGs, ESPECIALLY during sick days. But it was certainly convenient.
Yes, definitely want to avoid DKA. That's how she was diagnosed and it was scary. I'm using our ketone meter a lot more now that I ever did with injections, at least until we get her rates dialed in. Thanks again for the encouragement!
Hi Amy, as you can see, I'm an Aimee, too! Thanks for the feedback. Liz's basal rate is definitely conservative. I've got to email reports to our CDE and endo so we can adjust. She woke up low then was high (200s and 300s) the rest of the day - but no ketones. We got our arm band today from bands4life and Liz likes it - yea!
