Since my daughter started pumping insulin 8 years ago, we've used the same territory for her pump sites. It was chosen when she was 3, because for her it was out of sight, and less tempting to mess with. Now, to her, it's just where her site goes. The endocrinologist agrees this general vicinity may be best, since she's on the thin side and some of the other possible spots (belly, arm) 'don't have much meat on them.' Yet he's offered ideas for expansion.
Sites could be put lower or higher, over to the hip, or down to the thigh. In the past this suggestion has been more theoretical. We weren't seeing blood sugar issues, or scar tissue, or infections. It's something we'd try once in a blue moon when she was feeling very brave and I was feeling very patient.
I'm thinking we're now going to have to get more brave and more patient. Failed sites used to be scarce around here. Yet recently, there have been a few stubborn highs which have quickly resolved themselves with a new site. Nobody here is going to be happy about the change. My daughter is familiar with how the sites feel going into her favorite spots, and how they feel under her clothes. I've become confident inserting the sites in these locations too. Those new angles and new topographies make me nervous.
So how do we move forward with this?
I started here, writing about it, to sell the idea to myself. I need to be positive and convinced it's what we have to do. Then I need to sell it to my daughter. What route to choose?
There's the laying out the facts route: You're having high blood sugars. They're not healthy. We need to try some new spots and see if that helps. You know - the ones the doctor always suggests as alternatives? When he talks about scar tissue? We need to start using them.
There's the buy-in route: We have to chose some new spots. I will allow you to choose what new spots. I will make sure we have plenty of time for each site change so that you can take your time choosing, and so that there is no hurry to insert it before you feel ready.
Lastly, there's the reward route: Currently, she gets a 'prize' for every 3 site changes without excessive drama. Perhaps now there's something in it for her every site successfully inserted in a new spot. Or maybe a bigger reward for a week or two of success. Or both.
It will need to be a combination of all three, I'm sure. She needs to know why: the facts part. She needs to have some control over the situation. Getting to choose which fresh spot gets the jab seems like the least I can offer. Upping the ante on the reward part will hopefully be the bit that closes the deal. I'll stock up on tic-tacs and hair accessories to be doled out for each success, and probably throw in a mother-daughter frozen yogurt outing if (when) we make it through 3 or 4 rounds of this. I'll deserve a reward too, after all.
Sites could be put lower or higher, over to the hip, or down to the thigh. In the past this suggestion has been more theoretical. We weren't seeing blood sugar issues, or scar tissue, or infections. It's something we'd try once in a blue moon when she was feeling very brave and I was feeling very patient.
I'm thinking we're now going to have to get more brave and more patient. Failed sites used to be scarce around here. Yet recently, there have been a few stubborn highs which have quickly resolved themselves with a new site. Nobody here is going to be happy about the change. My daughter is familiar with how the sites feel going into her favorite spots, and how they feel under her clothes. I've become confident inserting the sites in these locations too. Those new angles and new topographies make me nervous.
So how do we move forward with this?
I started here, writing about it, to sell the idea to myself. I need to be positive and convinced it's what we have to do. Then I need to sell it to my daughter. What route to choose?
There's the laying out the facts route: You're having high blood sugars. They're not healthy. We need to try some new spots and see if that helps. You know - the ones the doctor always suggests as alternatives? When he talks about scar tissue? We need to start using them.
There's the buy-in route: We have to chose some new spots. I will allow you to choose what new spots. I will make sure we have plenty of time for each site change so that you can take your time choosing, and so that there is no hurry to insert it before you feel ready.
Lastly, there's the reward route: Currently, she gets a 'prize' for every 3 site changes without excessive drama. Perhaps now there's something in it for her every site successfully inserted in a new spot. Or maybe a bigger reward for a week or two of success. Or both.
It will need to be a combination of all three, I'm sure. She needs to know why: the facts part. She needs to have some control over the situation. Getting to choose which fresh spot gets the jab seems like the least I can offer. Upping the ante on the reward part will hopefully be the bit that closes the deal. I'll stock up on tic-tacs and hair accessories to be doled out for each success, and probably throw in a mother-daughter frozen yogurt outing if (when) we make it through 3 or 4 rounds of this. I'll deserve a reward too, after all.
I'm much (much!) older than your daughter but - trying an inset on my leg was wonderful, once I got over the fear...
ReplyDeleteI like it there (a lot!) but it does require a little more thought when dressing, etc...
One idea - maybe varying "points" for different sites with the newer ones worth more points.
Points! That's an origional idea. We may just implement that one! Yes...I think the leg apprehension has a lot to do with clothes. She likes her jeans and is afraid of dislodging it or having the clothes rub the site.
DeleteI am so glad I read this. I am amazed you've been at this for EIGHT YEARS of what I am assuming are bum-only sites. We have been pumping for about 9 months, and I keep thinking the scar tissue is going to become an issue--not I'm hopeful it won't for a good, long while.
ReplyDeleteWhat a well-rounded approach. You thought of everything.
I'm like you: "new angles and new topographies make me nervous." It has taken me months to really angle the Inset 30 correctly, instead of aiming more toward skimming the surface. We have had maybe five (?) tummy sites, zero arm or leg. I have told my guy "It's important that we move the sites around so your bum doesn't get worn out," and he agrees half-heartedly, and then feels sort of tender and uncomfortable the whole time it's in the belly.
You are very wise to include a reward for yourself in the plan. I love it! I am going to copy your strategy.
I guess it's just like anything else--we just gotta do what we gotta do. Preferably with generous rewards for all involved.
Stay tuned...I'll eventually post about how this all shakes out. Then you'll really know whether to copy my strategy or not!
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