Pump visit number two : infusion sets

We drove down to Children's Hospital, incident free, for an early morning appointment. M was really excited to try the infusion sets today. This is part of our months-long plan to get her on the pump.

An infusion set is the part of the insulin pump that actually is attached to your body, and is the device through which insulin is administered. It is removed and changed every two to three days. For those of you who are having trouble visualizing this, think of it as a teeny, tiny IV. It is held in place with a strong adhesive. You can detach the tubing from it when you shower, swim, or are doing other things during which tubing might be (ahem) inconvenient.When the tubing is detached from the infusion set, the pump may be put away as well. The pump is usually clipped to a belt or something, and although it is meant to be worn continuously, may be removed when necessary.

So, apparently testing infusion sets requires an hour-long appointment. We used 30 minutes of it.

First off, M had to share which pump she decided she would like to purchase. She had spoken to her friends from diabetes camp and decided on the "Minimed" the Medtronic infusion pump. This narrowed M's infusion set choices to four: the Sure-T, the Silhouette, the Mio, and the Quick-Set.

Our DNE quickly dismissed the Sure-T as an option. She pointed out that it had two parts. The design was created for small children to prevent them from pulling the tubing out easily.

The Sure-T

M mentioned that a friend of hers had the Quick Set. M liked the Quick set, because in order to remove the tubing, one needed only to turn the knob on the set and pull out the tubing. The others require squeezing the set on both sides, which M found less attractive. The DNE said that there had been some problems with the Quick Set lately, but if M wanted to try it, it was fine. After all, her own son uses the Quick Set and has never had a problem.

 

The Quickset

The one that the the DNE clearly preferred was the mio. This is the first sample she pulled out the box. It was in a hard, plastic case. First the plastic seal had to be removed. Then we had to remove the paper/foil seal from the bottom. Then we had to remove the adhesive and the cannula cover. After that we had to flip open the top of the hard, plastic case, and pull back on the knob to set a spring, because this device would insert the cannula for you, by launching it into your skin. This one was M's least favorite option. Her first comment was, "That's a lot of trash", referring to the amount of waste generated by opening the device. Her second was, "That's really loud", referring to the loud popping noise the device made when it released the cannula for insertion.

The mio

The last one we saw was the Silhouette. The DNE pointed out that this one took a little coordination. It is inserted at an angle, after you peel back half of the adhesive. After insertion, you remove the back part of the adhesive, which means trying not to wiggle the needle around in you while you remove the backing.

The Silhouette - the needle looks bigger than it actually is.

M was only interested in trying the Quick Set. The mio looked complicated and the Silhouette's needle looked scary.

That's when the DNE said, "Who's going first?"

I thought, "Yippee, I get to insert stuff into myself. Time to man up."

But what I said was, "M goes first!"

M tried the Quick Set, and it went in without a hitch.

Then it was my turn. I tried the mio. Now, before I can truly judge how well or accurately the mio works, one must remember that the flesh around the belly of a forty-something mother of two is not as resilient as that of the 13-year-old mother of zero.

After a loud "pop", the cannula had only inserted itself part way into my abdomen. I imagine it's like the proverbial "nailing jello to a wall."

When I finally got the cannula inserted, it drew a little blood. I know this happens sometimes when M gives herself her shots, but it was not the smoothest introduction to the new device.

It was now M's turn again, but she decided she didn't want to try another set.

I put my foot down. Firmly, but sympathetically. "You really need to try another set, so that you will have two experiences to compare." To her credit, she gave me an exasperated look, but did not roll her eyes or give me an unpleasant comeback or remark. She  saw the wisdom of what I was saying, relented and chose the Silhouette. The instertion was a little fumbly, but she got it in, and said that it felt comfortable.

So here we were, all hooked up and ready for insulin. But not today. Not yet.

We were instructed to wear our infusion sets for a couple of days, so that M could choose which one she would like to use. Once she chose the set, we could go ahead and contact the pump company representative.

M and I left the office, M gleeful, I a tad aware that there was a little stinging item in my abdomen.

We are off on a new adventure. One that will lead M to better bg control, and one that will teach me more new things that I never expected to, or wanted to, know about diabetes.