Occlusion errors increase overnight

[mliszews]

I recently switched to an Animas 2020 pump. I am using the Silhouette Infusion Set inserted in my abdomen. I seem to be getting a lot of occlusion errors overnight. Every time I get them there doesn't actually seem to be an occlusion in the line as I am able to prime and resume normal pumping. It seems like my pump thinks it is totall ocluded at night as I get 3-4 errors a night with a basal of 1.3 u/hr. I have never got an occlusion error during the day with the same infusion set that cause multiple errors the nigth before. I am not laying on the tubing or on the infusion site so they should be free and clear. I have also tried inserting in my buttocks and had the same behvior. As a side note, I recently lost a good amount of weight (~20 lbs) and was experiencing increased occlusion problems with my old pump (Paradigm 712) before I switched but they were not isolated to overnight only and did not occur almost every night as these have been. Has anyone out there experienced similar issues with occlusion errors overnight or have any otehr advice on what I could try to reduce these errors.

[xMenace]

What insulin are you using?

Anecdotal evidence suggest Humalog occludes easier than Novolog/Novarapid.

[mliszews]

I am using Apidra. I have been using it for about a year now and had no occlusion issues prior to the weigth loss.

[fgummett]

How and where do you wear your pump at night?

Did the way you inserts the Sils change after you lost weight?

[xMenace]

Does this help?

Common Pump Problems and Solutions, Clogs. (http://www.diabetesnet.com/diabetes_technology/insulinpumps_problems8.php)

[mliszews]

fgummett, I keep my pump in my pocket of my shorts I sleep in. As I said in my original post I have been careful to make sure that I am not lating on it or the tubing at all sicne I have been experiencing teh problem. Also I did not change the way I inserted the sils sicne losing the weight. I have always inserted them by hand. I slightly pinch my skin and then push it in. I have been using a pump for nearly 10 years and I have not had any consistent problems with occlusions until recently and it seems to have coincided with the weight loss. It almost seems like the cannula is fine during the day when I am either sitting down or stading up but when I lay down it gets occluded.

xMenace, thanks for the link but the causes listed do not really apply to my situation as I have experienced the problem with brand new inserted sites and I replace my infusion sets every 3 days at most and usually every 2.

I have mainly inserted into my stomach though I have tried to experiment with insertign into my buttocks recently to see if it helps. Any idea if a different are might be better for avioding occlusions?

[notme]

You might just try using a different set for awhile and see if that helps. Call and get a sample of Quicksets 6mm (since you lost weight) and see if that helps. Also, try putting a piece of IV3000 or some other tape down before you insert. For some reason this helps your skin from getting sucked in around the canula and causes less trauma to your skin.

Give it a try, it REALLY helped me.

[mliszews]

thanks for the advice. I was kind of leaning towards trying a different set as I have always used sils and I had seen that piece of advice in numerous places.

Regarding the IV3000, do you put that down and then insert through that? I have a supply of those so this is defintiely something that would be easy for me to try.

[Subby]

Yep, put it down first then punch straight through. I use tegaderm (normal, or tegaderm "HP" is VERY sticky, an excellent waterproof hold).

As suggested by some friendly person around here, I then put another tegaderm on top, with hole cut for set, but sure to cover the actual cannula: this eradicated all the problems I had with sillhouette cannula moving round in the hole and causing pain/sore sites/more variable absorption. Never had the repeated occlusion problem though, myself.

I was started on the quicksets and found them to be much more secure, but lousy absorption for my body. Perhaps they will work well for you, worth a shot. Good luck, what an annoyance and worry overnight.

[notme]

Yes. put down the IV3000 and insert right through it. I know it sounds like an odd piece of advice, but it definitely works. I have told several people about this trick and all of them have said that it worked for them. Can't hurt to try it. :)

[fgummett]

Only on DF can you give advice about sticking a needle into your belly and finish with, "Can't hurt to try it"..! :D

[Subby]

lol frank, too true :)

[mliszews]

Thanks for all of your advice. I will definitely try the trick with the IV3000 as well as explore some different set options.

[notme]

Hehehehe......... never thought of it that way. Ok. Let me rephrase.

Could hurt like he&% when you try it, but it probably will help. :T

[HollyB]

Are you by any chance using the long Sils? If you've lost significant weight, you might need to switch to the shorter ones.

Though I confess I'm baffled. My son is using an Animas, and I don't believe we've ever had an occlusion error alarm.

[mliszews]

According to Animas website they only have the 17mm sils so i'm assuming that's what I'm using. I just got off the phone with them and they are sendign me out a sample of their inset 30 (looks similar to silhouette but with 13mm cannula) and the 6mm Quick-Sets