Two years ago when I started to have regular fun and games (see also: swearing and rage) with kinked cannulas, I made the decision to try out the Medtronic steel cannulas. Rather than being most people's nightmare because of the idea that you might feel them under the skin (you can't), it took just a couple of weeks of before I made the switch on a permanent basis.
I loved the fact that as they are removed after just two days and were so much more narrow than the Teflon needles, there was always much less scar tissue left after it was removed. And the purple marks people talked about seeing after removing the Teflon needles seemed like a thing of the distant past, to me.
Perhaps the issue is just that in order to use my steels I have been using my abdomen for every cannula, but I feel like I'm starting to resemble the Olympic rings. Right?
With an inkling over the last few weeks that burnout may be approaching (**rips off own pump and goes to hide in garden shed for a day with a pint of ice cream**), I've put in a sharpish order for some inset IIs (Teflon needles that could park themselves on my back or arm).
Why? Because as PWDs who have choice (even if that choice is limited) over the tools we use to manage our diabetes, and it is my prerogative (and sometimes a survival technique) to shake things up and change my form of attack.
For a long time I didn't mind using my abdomen for cannulas. It worked for me and the lack of kinky (oo-er) issues kept me kicking the crap out of diabetes without a second thought. But it's OK to reach an impasse and say, "This isn't working out, anymore" and make changes that will help you feel ready to take on another day with diabetes. Diabetes paraphernalia is something unavoidable that we have to live with as PWDs, so we might as well make that paraphernalia work for us.
Have you changed your paraphernalia to make it work for you?
Hi Anna, love this post cos it's meee tooooo...well, not the Olympic Rings (which was the best bit hehe - try baby or other body oil to wipe them off...there is a spray called 'Lift Plus' someone was given by their Roche rep but I find oil works fine).
ReplyDeleteI've been experimenting a lot with different sets as I think it's really important you're as satisfied as is possible with what's available re : reliability, practicality/ease of use, tolerance etc. and can make a big difference to how you feel about your pump, we just don't need too many frustrations or failures with sets, we have enough of those with diabetes in general thank you very much!! And we gotta keep loving our pumps :)
Yes, so I really hated the auto inserter devices and their loaded actions and initially was determined to find a set which I could successfully manually insert. I use a Vibe and have been trying some of the luer lock sets from different co.s (I thought Medtronic pumps had a different patented Paradigm connection i.e. Inset IIs won't connect as they're luer lock??) - overall the straight teflons were a real struggle, they just fail too often with manual insertion whatever make. The angled Teflon sets hardly failed (and Roche doesn't even make an auto inserter for their angled sets like Medtronic do) and could be inserted in much less fleshy areas i.e. bits of me I wouldn't otherwise have used like closer to hip-bone/ribs/lower knicker line etc. BUT I def found they left a bigger scar on entry so was not happy with their long term use! (not everyone finds this though) And eventually I was persuaded to try steel - thought they'd interfere and hurt in yoga postures and twists but actually have been fine :) :) and very easy to (manually) insert, no failures. Still don't really like the extra dangly bit which I know means you can insert them in harder to reach places as the disconnection is more accessible, and cannula not so easily yanked out if you occasionally drop pump or get tubing caught as the taped down bit takes the pressure. Ah well, I'll get used to the dangly bit eventually! Oh, and I love that if you insert and hit a nerve or muscle oucheroonie, you can just whip out the cannula and re-insert elsewhere, no wasted cannula or having to prep another one!
I searched (and asked reps, DSN, message boards) high and low to find out why the recommendation for set change with steel is 24-48 hours compared with up to 72 hours for Teflon to no avail. Eventually found a 2012 paper http://dst.sagepub.com/content/8/2/199 about Insulin Infusion Sets which in its Steel vs Teflon section reports that they also could not find any data pointing to why the steel need to be changed more frequently than the Teflon. So I stick to an average of every 3 days for steel. I can understand if people have absorption issues sooner, but I figure if you were ok with 3 days for Teflon, why change more frequently if it's not necessary, or until someone can point me towards a good reason/research data that indicates otherwise. If anything, steel seems to be much better tolerated, the cannula is thinner too.
ReplyDeleteHave to say I hated the Inset IIs for many reasons not least the faff in doing a set change, a lot more complicated and time-consuming than all the others I tried. Also a lot more plastic waste. And the vicious spring-loaded action :P lol Only thing I miss about them is the vibrant pink colour of the clips!!!! Well, you know, these things matter...
My hospital did not ever offer me or even know about experimenting with different sets. Animas don't even list steel sets on their website and when I phoned to order them, the agents didn't know anything about them except that hardly anyone uses them! (no surprise) Shame. They're cheaper to the NHS too!! And my lovely consultant from 20+ years' ago (who moved to a different hospital boohoo but I have luckily had another fab one since then), apparently now heartily recommends steel sets, especially for children, particularly because of their reliability.
Oooops didn't mean to write an essay. It's nice to come across someone else who is trying out different sets as most pumpers stick with what they started with, even if they have not infrequent 'issues' with failures/occlusions/accessibility of sites....and maybe like me were a bit scared of the steel sets causing pain during activity or even just bending down.
Here's for British Steel!!! (prob isn't British though..) Ok, here's for Steel Cannulas! Hmm doesn't have quite the same ring to it. Whatever. Wish I wasn't diabetic. Wish I didn't have to take insulin, use a pump etc. but at least I've found a set which ticks all the boxes for me. Gold medal for steel sets ;-)