Trying the silhouettes.

[Subby]

Got some sils to try out... exciting. I've been on the quick sets 3 months now and I suspect 1 in 3 has not performed well for me, as far as absorption goes. Dunno if the sils will be better but worth trying hey?

Stuck my first sil in 3 hours ago, no pain, needle was intimidating but I told myself don't be silly, you've injected yourself up in the teens of thousands, this is nothing, and I was right. :) So far, comfortable.

I guessed the angle... visually got a fix on 90 degrees then tried for halfway. (In fatty areas, for the moment). Is this an ok approach? How much added absorption variation might I be getting myself into due to insertion angle discrepancies doing it by hand?

I just pulled out the last quick-set that I put in 10 hours ago, that just hasn't seemed to perform. Stupidly it's the first time I've looked in detail at the canula post-useage. I notice the end looks a bit chewed and mangled. Could this be the issue that's been going on? Is this a "crimping" of the canula? Or do I expect this look, regardless?

[Funnygrl]

A variable angle is ok. As long as it's in the subq tissue you should have similar absorption.

[Subby]

One other thing, the sillhouettes seem to have a much bigger range of motion, being more a "flap". I've been used to the much firmer grip that the quick sets have on the skin as far as not worrying about little tugs and pressures on the set etc, which seem occur quite frequently for me one way or another!

Should I look into anchoring the set down more securely to the skin to avoid canula movement in bed etc?

[Funnygrl]

I've never had to use anything but the included adhesive.

[Subby]

OK thanks Funnygrl.

[shabbie]

subby,
i had a problem with the angled sets making me a bit sore because they seem more mobile than the others. i insert it through Tegaderm/IV3000 now and it does the trick ;)

[RLK]

Ditto what Sharon said. Inserting through Tegaderm or similar works great for me!

[Mich]

I use the 17mm and I use only the adhesive that comes with the set. No problem with cannula movement that I've noticed. I do notice it gets a bit sore if I get hit (dog being friendly, etc) directly on the site.

[Subby]

Thanks for the words of wisdom. I'm been on my first sil 3 days, here is my impression:

Definitely noticed more stability. Felt better and blood sugars bear this out. Today was excellent - things (boluses, basals) actually worked pretty much how they are supposed to! Much reduced spikes after meals and good returns! Wow! :)

It's always possible this was not the sil contributing (I tend to get mild sicknesses for example) but suffice it to say I lean towards thinking it helped. Appeared to start working much faster than the quick set (which would take up to 6 hours to start being effective)

Now to the negative... whether it's the extra flexibility of the canulla or another reason, this first one only lasted 2 days before I felt it was looking sore enough to pull it. It's quite a bit worse than my quickset wounds. I think I need to work out a way to anchor it better.

I also found it a bit fiddlier to deal with. The low profile is good but the flappy nature worries me. The connector click is good but it's harder to get on.

However, all these negatives are minor compared to the insulin delivery. I'm onto my next and trying out my first upper rump site. Yay :)

[Subby]

Sharon, do you mean to say you put the tegaderm on your skin then put the set over it (hole for the cannula I assume?)

Do you cut the tegaderm down or leave it whole?

I'm hoping tegaderm isn't the one I come up with a rash with.

I understand this will help adhesion... but does this help the problem of actual cannula movement? I am thinking I need something to hold the top of the set more steady to prevent the cannula "grinding" in it's hole. Sorry if I'm being thick here and not seeing something...

[shabbie]

the best way i can describe how it works...

my skin is very sensitive to anything rubbing and causing soreness anywear...new shoes for instance!

the cannula seemed to be able to wriggle around causing the actual hole at the skins surface to appear red and swollen whilst not infected.

i place a patch of tegaderm on the clean skin then insert my set right there through the tape.

2 things are better for me here....the tape seems to anchor the cannula in one place so no more wrigglers and no more soreness then much quicker healing time. also....the tape was making me sore after removal so the tegaderm puts a neat barrier under the set to reduce that too.
i dont cut it down. just use the size 6x7 and your set will fit nicely even if your shooting isnt too straight when you insert the new set ;)

trust me this really works (i had doubts until i tried it) thanks to notme ~ nancy!

[RLK]

Just put the set directly through the Tegaderm (or similar). The insertion needle will pierce a hole in the tape with no problems, and the Teg will stabilize your skin so the cannula doesn't "chafe", causing soreness.

I was a bit dubious about this when Sharon and Nancy were discussing it here on DF, but it has removed almost all of my set irritation issues.

[Jan B]

I use IV3000 on clean skin, insert the set, then I put another IV3000 on top (but with a hole cut in it) to anchor, for extra security. Works great . . . I haven't had even a little bruise.

[Subby]

gotcha. I will try this.

[fgummett]

Haven't tried these myself but wondered if they might be used instead of the top layer of IV3000... more of fashion statement I guess ;)

Welcome to Groovy Patches (http://www.groovypatches.com/)
http://www.groovypatches.com/images/pump2/normal/Groovy3.jpg

[shabbie]

i'm lovin those groovy patches!!!

[Subby]

10 days on and in my mind it is official: the sillhouettes afford me substantially faster and more consistent insulin absorption. Every one has worked almost immediately or within 2 hours on putting them in (Quicksets took 3 to 5 hours), and worked through to the time I take them off.

My pre meal bolus requirements have gone from 1 to 3 hours to around 30 minutes with good results.

The pump is again offering me real improvement and progress over mdi and I no longer have a sinking feeling that I need to talk myself into being positive about it - instead of waiting around for my insulin to absorb or waiting out hours to see if it's a bad set, instead I'm being pleasantly suprised with responsive insulin response, regularly.

I have tried tegaderm and it helps, thanks for the suggestion. The whole set is still more fragile and fiddly than I would like, the sites are still quite sore, and I am still changing mostly every 2 days. However these things are small prices in my book and I will keep trying methods to improve this.

[Funnygrl]

Yay! Glad to hear they're working well for you.

[Gary_W]

So with the Sillhouettes, are you all putting them in 'by hand'?

I'm sure when I went to my pump info session, the nurse mentioned a device called a Silserter (sorry for the dodgy spelling, that's how it sounded) which just fired the canula into you. That sounds more attractive for me. Whilst no longer scared of the pen needles, I was needle phobic when diagnosed all those years back and I still struggle with arm-based blood tests and bigger needles. The idea of a fire and forget device appeals to me.

Again, moot point at the moment as I don't have a pump but just getting as much info as possible up front.

Gary

[Subby]

Thanks for mentioning that Gary. I don't have a sil-serter. So far, manual insertion seems to work ok for me - it's easy and the absorption rate has been consistent so I can't fault the method there. As far as being scary - just like injections, the novelty of being afraid/wary of them wore off in a couple of days, for me.

I have had problems with sites becoming sore, the biggest reason that I can see being that the line tends to "drag" on the cannula, and I tend to put a bit of demand on the line day-to-day. Of course there may be other issues. I'm "cleaning" the needle with a swab, to avoid the lubricant irritant issue others have reported. I am not sure if auto insertion may decrease irritated sites? Anyone?

I have been wondering if some of my issues with the quick set was because I used a quickserter. If I ever find myself trying them again I will try manual insertion.

[shabbie]

hi gary, i know some users have tried the sil serters, it does sound like it fires it right in there at 30 degrees.
many said they preferred to insert by hand as you have greater control over it. YMMV.

i have only inserted mine in by hand, and i find it works better and less discomfort during insertion if i go deeper at 45 degrees.

still keeping my fingers crossed for you there gary ;)

[shabbie]

subby thats great news that you are getting on better with the sils now.
the issue with the quicksets might have been something to do with the type of tissue they were going in to.
my issue was that the cannula was hitting muscle and causing me pain, now with the angled sets i dont have any issues whatsoever.

[fgummett]

I'm "cleaning" the needle with a swab, to avoid the lubricant irritant issue others have reported. I am not sure if auto insertion may decrease irritated sites?Can't say as I have ever had to do this and I wonder if cleaning the needle ( I assume with alcohol) is in your case causing irritation... you might try without. I also prefer to insert by hand. I usually get a good three days (sometimes more) with each sil. I'm so glad that they are working out for you... what's the point of fast acting insulin if you are having to wait a couple of hours before it kicks in :cool:

[Funnygrl]

So with the Sillhouettes, are you all putting them in 'by hand'?

I'm sure when I went to my pump info session, the nurse mentioned a device called a Silserter (sorry for the dodgy spelling, that's how it sounded) which just fired the canula into you. That sounds more attractive for me. Whilst no longer scared of the pen needles, I was needle phobic when diagnosed all those years back and I still struggle with arm-based blood tests and bigger needles. The idea of a fire and forget device appeals to me.

Again, moot point at the moment as I don't have a pump but just getting as much info as possible up front.

Gary
You spelled it correctly. I do it by hand.

[RLK]

Can't say as I have ever had to do this and I wonder if cleaning the needle ( I assume with alcohol) is in your case causing irritation... you might try without. I also prefer to insert by hand. I usually get a good three days (sometimes more) with each sil. I'm so glad that they are working out for you... what's the point of fast acting insulin if you are having to wait a couple of hours before it kicks in :cool:

I was doing the alcohol cleaning thing for awhile, and it definitely helped my irritation issues. I started inserting through Tegaderm as others have recommended and that has helped enough that I'm not cleaning the cannulas anymore. I do still believe that there's something on those cannulas that irritates my skin, but the tegaderm trick is easier and seems to help my sites heal faster too.

FWIW, I insert by hand in my abdomen, and with a Silserter in my tush, and notice no difference in which is more comfortable, longer-lasting, etc.

[Subby]

I am lucky I can stretch around to do my backside manually, so far! I think it was the practise of injecting my Lantus back there for years with a syringe.

I had one that I thought was going great, I was thinking this is it, it's going to go three days... then I visually checked it, it was looking terrible. I think your suggestion is very good Fgummett, perhaps the alcohol is creating it's own problems, I shall definitely try without it to double check.

Unfortunately tegaderm is causing redness and itchiness, looks like I have some allergies there. I tried putting my current one into Mefix, It feels very secure so far. No waterproofing though... havn't thought as far as my next shower. ;)

[birds_eye]

Have been reading the comments and they're interesting, would definitely like to try the Tegaderm or IV3000 to stabilize sites.

I've been using the Silhoettes for about 2 months now after using the Quick sets also by Minimed, which were giving me problems on insertion and led to many "No Delivery" alerts.

I am glad to say I have had no problems with the Silhoettes save for struggling to spell the name!! ;) I do find them to be a bit "out there" but have had no problems, save for when I''m playing my sport underwater which involves tackling. Only once has my set been ripped out and thats why I'm looking for some water proof plaster to cover the set during practice - any suggestions?

But overall I have good comments for the Silhoettes - after looking for an infusion set for my more muscular build (not being ego or anything, but i'm low on the fat areas) which the Silhoettes have worked great, and it's been painless on inserting (i'm using a sil-serter) and also had no problems with absorption and delivery. Changing sites every 3-4 days though the sites do seem to take a little long to heal - nybody had any similar experience?

Looking forward to your comments. Thanks for all the active participation in this site - our comments and support is our best cure so far!

Mark

[shabbie]

birds-eye

i noticed my old sites heal much better now i use the tegaderm patches.

my belly is now a patch work of little light purplish dots as they all heal. its quite handy actually because i never use the same spot as long as there is evidence of previous sites. so scar tissue should by right s not ever be and issue with absorption...hopefully ;)

i never leave mine in longer than 3 days btw ;)

[Subby]

In finding a good fixing solution for my silhouettes, I found out something about tegaderm I'm not sure was mentioned around here.

I was trying the normal tegaderm and finding it was still a bit disappointing for me. It could start rolling off me as little as a few hours later. By the end of the second day the cannula was ripping out of the cover of the (dual layer) tegaderm.

I noticed in a pharmacy a very similar product but called "tegaderm HP". It seems very similar but the assistant said it stands for "high performance". It does indeed stick a whole lot better: with a tegaderm HP sandwich my silhouettes are finally not the fragile headache they were before, and sites are a lot better. This stuff sticks brilliantly for days on end. My skin doesn't seem to react badly to it either.

Thanks again for your invaluable help in working all this out, it's been a really big improvement to have that faster more consistent absorption.