Occlusions


#21

I have been pumping since 1990 and been through many different infusion sets over the years. In the beginning, I used metal and found them very painful. So soon switched to different Teflon cannulas. I have always been a manual inserted. I have to have control so I do all the insertions.
Spent 20 years with Minimed/Medtronic and only had a few occlusion due to cannula issues.
I switched to Tandem 5 years ago and had a few occlusion alarms which is something I didn’t have with Medtronic and was kinda worried I had made the wrong choice. But it was suggested to try the metal type. I was worried about the pain but was told the current infusion sets are much different than the old ones. So I did, and haven’t looked back. I don’t feel them, they are super easy to put in, just a quick push and done. And once when I pulled it out, unlike Teflon, I just put it back in and retaped it. I use then all over, arms(back and undersides), hips, upper and lower abdomen, thighs. Anywhere is up for grabs.
My biggest frustration with the Tandem ones, is the tubing length no longer comes in a 42 inch length. Makes it very hard sometimes when I do those harder to reach areas.
Hope your issues are an easy fix. Good luck!


#22

Just what kind of metal sets did u use? I tried one or two angled sets and those were THE worst sets in the world for me. They would become inflamed and the opening around the needle was always enlarged. There would be leakage of body fluids. It would hurt so bad after about a day I’d have to remove them. They were far worse (for pain, swelling, redness) than the Quick Sets (or Sof Sets). Those 3 sets were all more irritating than a Sure-T, for me. I still scratch my head trying to understand how anyone could find those old angled metal sets comfortable! :slight_smile: Also, the insertion was kinda scary for me, due to the size of the needle and I can easily tolerate picking my fingertips and inserting other sets. What was the name of those angled sets, anyone?


#23

Back in 1987, this is the first infusion set I used. It was called the MiniMed Polyfin Bent Steel infusion set. It was painful to wear and I wouldn’t have continued pump therapy if the SoftSets (teflon cannula) were not available.

20%20AM


#24

that is it! What a horrible set (IMO).


#25

So, success! Yes, Dave, I mentioned to my trainer that your experience showed not pinching was more effective than pinching so I followed your advice exactly while she watched and we were both impressed with how easy it all was. I definitely did not even feel the insertion - I have a 6mm needle since I am pretty lean and she was thinking the needle looked so small, until I reminded her my cannulas are also 6 mm. So, I have it on behind my hip with the tail part near the front of the hip, and my pump happily doing its job. So far so good - and thank you! I think this is going to work!


#26

So glad it went well, Kathryn! I knew if you tried the Sure-T the odds that you’d like it would be overwhelming. I’ve turned on lots of people to them over the years and only a handful didn’t like them, so the odds were in our favor. :slight_smile: You are most welcome!


#27

oh, I cover mine with an IV3000 so that there is little chance of accidentally pulling it out (I’m an active guy). I had one or two come out (w/o the IV3000) when I had something brush really hard across the set, at a shallow angle to my body. That sort of contact can lift an edge and rip it out. Other than that, they are very secure. And I love how low-profile they are. I don’t use the included cover for the set-connector when showering, but if u are afraid u might get soap caked into the port, u might want to use the cover for showering.


#28

Thanks. Yes, I put an IV3000 over the needle and I have some Simpatch I can use over the adhesive edge of the tail. I generally am pretty aware of where the inset is so that I am careful putting on or taking off clothing over those sites. After the first few times of pulling it out from my leg when I first started using that site I have been pretty good at keeping sites in place. I also tape down the excess tubing so that accidentally catching tubing was lessened, and if it did catch then it would probably hit the tape before the site. I really like how low profile the Sure-T is as well and that makes it even more unlikely to be pulled out accidentally - and if it does come out, it can just be re-inserted - extra bonus!

I actually keep my pump on while showering since it is waterproof, but yes, I have the connector cover available if I do take it off. The trainer said it shouldn’t be a problem while showering but if I went swimming without the pump or took a bath without the pump using the cover would probably be a good idea.


#29

Yes, if swimming in less than pristine water it would be advisable to cover the port. I wouldn’t shower with a pump even if 100% waterproof, because the tiny amount of basal I would have gotten during the 20 minutes my pump is off is less than negligble. Think about it. If I get 15 U/day of basal and leave my pump disconnected for say, 30 minutes, (presuming just one rate per day) I’d be getting about 14.7 U instead of the full 15U. Put another way, I’d lose 1/48th of the day’s total insulin. A most inconsequential amount. Besides which, I tend to drop from the warm water cascading over my site, as I’m presuming is the cause of dropping from my showers. Having a pump attached would therefore be counterproductive. :slight_smile:


#30

I always bolus 15 minutes worth of my active basal rate when I disconnect for showers (or swimming for 15 minutes).

I.E. If basal rate is 0.400units/hr, I bolus 0.100units just prior to disconnect

Seems to work


#31

My bg tends to rise when I take a shower. I used to disconnect and then bolus for the missed basal but it would go even higher and take longer to come down. If I keep the pump attached, then it still goes up but not as high as when I disconnected. I inspect the pump each time to ensure it has no cracks but this was one of the features that was important to me since I have to give up the other one that I loved about my Animas - being able to bolus fully through my meter and never actually having to touch the pump - much more convenient when one wears it on one’s bra.

I did have another quick question - the two ‘leaves’ that fold up and you use to hold the infusion set prior to its insertion - I notice that they still are not 100% flush with the skin after I have used them. The adhesive and needle are down but I wonder if the leaves ever ‘catch’ and pull out the needle, even when it is well secured. Did you ever consider taping the needle in place with the leave secured under tape? Don’t know if that is a good idea or not.


#32

I’m not following, Jim. Even if you say “it works”. 15 minutes is 1/96th of the day. How much can that matter?? I’m not arguing the point, but simply trying to understand how it is possible that your bg’s require that much precision. Generally regarded “wisdom” from sources FAR, FAR more credible than yours truly state that it is fine to have one’s pump removed for an hour. Over the course of pumping since 1996, I’d say that wisdom is indeed very credible. 1/96th or 1% of a day…


#33

That is why I said to place an IV3000 over the Sure-T. Just in case something drags across your body, lifting a wing. The IV3000 will keep those wings from being lifted up. Perhaps I wasn’t clear the last time I mentioned using an IV3000, but I think you have the idea!

Oh, I do NOT use those wings for insertion! You must have been told that by the trainer. Grabbing those wings can be awkward and is totally pointless. Just hold the set by the tubing and tap the set in with a smart tap of a finger, with the needle just touching or just above the skin.


#34

Dave, I have an IV3000 over it but the opening in the center is much larger than the needle site and covers only about half of the adhesive center. Yes, it would be more difficult but I can see that wing catching and pulling up even with the IV3000 on it. I was just asking if you had ever taped over the wings so they do not catch.:-).


#35

There should be no opening in the IV3000. Perhaps you have a different IV3000 style than I expected you to have. Mine are just rectangles. Part no #4007 2-3/8" x 2/3/4"


#36

ok - these are ones I got from my trainer - they are for use with insulin pumps. https://diabetesexpress.ca/products/medtronic-iv3000-infusion-set-dressing-hms-66800786


#37

WOW. Useless for covering a Sure-T. sigh. Maybe u can find some use for them, but not for covering a Sure-T.


#38

Dave - you think of 15 minutes as 1/96th of a day, while I consider it 1/4 of an hour. For my metabolic rate and insulin needs, that 0.1 unit means the difference between staying flatlined or having my BG rise 20mg/dl (1.0 mmol/L).

Does it make that much of a difference or does it matter? Is it “fine” or “OK”? For me, fine and ok aren’t satisfactory when taking 5 seconds for a small bolus keeps things near-perfect.

Different strokes for different folks :smiley:


#39

I hear you Jim. I don’t just understand how a lack of 15 minutes of basal, no matter if it were 2.0U/hr, or .2U/hr of basal, can make a demonstrable difference. I believe you–I just don’t “get it”. If my bg is 80, or 100, or 130, I’m happy, for example (unless I were about to embark on a strenuous hike or long walk, or heavy yard work–then I’d want to be higher than that, but for around the house, I don’t feel compelled to be exactly 100. Some wiggle room is fine.


#40

Yes it was. There multiple factors but no occlusion message. There can be other problems with the inset site etc too which there is no pump warning for. I hope you like them. I def prefer the steel insets.