Where do you put your infusion set for it to be the least painful to insert and the least obtrusive to wear?
So far, my son only wants to do his abdomen. He doesn’t have a lot of fluff there (or anywhere, really), so he doesn’t have a huge area to move sites around on his tummy without getting too close to his belly button or getting close to hip bone on the outside.
He’s concerned about having his site anywhere on his backside because he thinks it will get in is way, catch on things, or hurt when he sits at his school desk or works out (sit-ups, bench press, etc.). He also thinks it will hurt (both to insert and to wear) if he puts it anywhere else. His arms or legs wouldn’t be ideal because he’s very active in sports and running. Do you find having your site on your backside (including love handles) is painful or bothersome for exercise, sitting, pulling pants up & down, etc.?
I’ve thought about having him insert an infusion set into his backside but not hook it to his pump and just try the site itself for a few days to see if it’s as bothersome as he’s convinced it will be.
Why would a bolus hurt?
A couple of times, my son has said a bolus hurts. At first we thought it was larger boluses that hurt (3-4 units or more), but last night a 1 unit bolus hurt. A subsequent 1 unit bolus a few minutes later didn’t hurt him at all.
What kind of infusion sets do you use? Consider changing, if possible, to a set with shorter cannula. Also, some sets (e.g. Minimed Sof-sets) have angled cannulas and you can vary the angle when you insert. This would allow insertion at almost any of the usual sites: you would use more of an angle on sites without fat, and less of an angle on fattier locations.
Sometimes it hurts when I bolus if I’m in or close to a vein. It hurts sometimes and sometimes it doesn’t. The arm is alright for an infusion site, but it can get in the way during sports. I have plenty of ‘fluff’ as you put it, and I still mostly use my abdomen. I go above the belly button as well. The sides are alright and the backside, upper or lower, worked for me. They do hurt more sometimes because the nerves and tissue hasn’t been abused yet. I also set my infusion site by hand. I find I have more problems with the inserter. The sticky part tends to get caught on the plastic inserter and the needle gets half in with half stuck to the inserter.
Like your son, I primarily use my abdomen. I am a woman so I have probably a bit more fat than he does, but I’m lean enough that I have to stay away from bony areas (hip/pelvis bones in particular!) I primarily use my abdomen because those sites are easy to put in, don’t get in the way when I work out or play sports (which I do often), and aren’t visible.
I do not use my arms or legs. I tried an upper-leg site once and found the absorbtion was too fast (probably because I’m very muscular). I have found that “fatty” sites get more even/consistent absorbtion.
I also use my lower back and upper butt area. If he uses his upper butt it will not hurt (I find it actually hurts less than my abdomen) and won’t get in the way when he sits. He just has to be careful when pulling up his pants. Also, the side butt area works well too.
He definitely should experiment with different sites because the tummy sites really need time to heal. If we use any one area too much, absorbtion will slow down over time.
Sometimes a bolus can hurt if the site is not good. This does not happen very often for me, but when it has happened, it was usually due to a vampire canula. If a site hurts consistently with each bolus, it should be removed. But if it just hurts once or twice and BGs are ok, I leave it in.
My 10 yr old is very active in cheerleading and gymnastics and she hasn’t had any problem with the abdomen, love handles, upper buttocks/lower back, front of thigh. We just make sure to put either above or below where her waistband usually sits.
When she was first went on the pump she only wanted to use her abdomen. I went on Youtube and pulled up videos of other diabetics her age putting in their infusion set. It really helped her to see other kids putting it in other areas and not experiencing pain.
The only time she mentions any discomfort from bolusing is immediately after putting in the set. It seems to be best to let the nerves settle down for a few minutes before bolusing.
A quick update: my son finally agreed to try the love handle area and likes it. The insertion was less painful than on his abdomen, he complained of the site hurting/stinging for about 5-10 minutes, but since then, there isn’t any pain. It’s a bit harder for him to disconnect (which he does many times a day due to changing for school sports practices, gym class, etc.). He won’t do his upper butt area. He says he thinks it would be weird to be sticking his hand down his underwear in the locker room multiple times a day - can’t really argue with him on that one! I may get him to try it when we have a long weekend and frequent clothing changes and locker rooms aren’t an issue.
I used to use the 6mm Insets too, but usually the bolus would hurt. A switched a couple of things around and it helped a TON!
I switched to the 9mm insets. It went deeper, and it hurt less.
I slowed down the speed at which my bolus was delivered. If he uses the Animas Ping, this can be done under the Setup function, under the “Advanced” screen 2. You have two options, normal and slow. I used slow now and it helps a lot.
Also, like someone else mentioned, if my site is sitting next to or in a vein (even if it’s small), it will hurt every time I bolus. I can usually tell if I’ve hit a vein right away, as it will feel sort of “pinched” when I move certain ways or if I press on the insertion site. When that happens, I just usually change out the inset right away, because I know it will just hurt constantly, probably get infected, and not absorb well. It’s annoying to waste the inset, but it’s better than being in pain all the time.
I had painful boluses for a year using an Animas even with the slow feature enabled. Once I went back to Minimed with the .1 unit pre second (guessing) delivery rate it went away. I talked with my Animas DE several times about the pain and she never could explain it. When I jumped to Minimed the DE for them explained that their super slow rate alleviates the bolus issue. Not sure what causes it and prior to using the pump I don’t recall injections hurting but in any case I did experience the pain with pump boluses after 14 years of pumping.
Not knocking Animas in any way, just mentioning what helped me.
Good luck and glad to hear he finds relief with the "love handles."
Rob
