I Hate Set Change Days…

QuicksetI am very regular about changing my infusion sets. Every three days, usually in the morning – unless some emergency dictates otherwise.

I believe that it is important for me to not leave my infusion set in too long. I feel that it creates more scar tissue when it’s left in too long. While I’ve never had a set in for so long that it created control problems (that I noticed anyway), I have gone longer than recommended in times past. If I remember correctly, my longest infusion set was left in for 5 days. Could be a lot worse.

Now I have been pumping for what I consider to be a long time. I don’t know exactly when I started, but I’m thinking that it was somewhere around 8-10 years ago. After all those years, I do know that I have areas of my abdomen that have more scar tissue than others. Those tend to be former “favorite” site spots. Places that I used perhaps more often than I should have, and didn’t give enough time to heal between re-use.

I was on shots for a long time before pumping, and I would bet that many shot users can attest to funny pockets or lumps that form when a spot is used too often. For me, I had overuse lumps on my thighs and the back of my left arm (because I’m right handed, so I used it to inject into the left arm). Nothing majorly huge and gross, but they were there. After 8-10 years pumping, they have healed and are back to normal. No, it didn’t take all 8-10 years, but I’m just saying that at some point they healed up to where I didn’t notice those shot lumps anymore.

So, experiencing the healing of those spots (the body is magnificent isn’t it?), I trust that given appropriate rest, any scar tissue in my abdomen will probably heal up pretty good too. Not sure if it’s possible to heal it 100% and make it go away, but I think you can get pretty close.

Back on topic – I’m very regular about changing my sets.

What I hate about the days I change my sets, is that I always seem to have trouble with the morning of the set change, and especially the very first meal on that set. I’ve talked about it a couple times, once back in January of 2005 , and most recently on this post. Kevin made an interesting suggestion, and that was to leave the old site in until the end of the day. Not connected to it, but leaving it in to avoid the little bit of “leakage” that happens when it’s removed. Basically allowing time for any insulin infused there to be absorbed. I have heard that before, but haven’t experimented with it in many years – so Kevin, thank you for reminding me, and I’m playing around with it again.

This morning is an example of why I get frustrated with this. I woke up and tested at 71. On the upper fringe of being low. I didn’t have any symptoms of being low (which I made note of – always on the lookout for hypoglycemic unawareness!). I did my set change (and leaving the old site in) and then had breakfast. I had what I consider to be a very responsible breakfast. I had one slice of white bread (15g), with peanut butter (7g), 2 cups of skim milk (26g) and two servings of Nestle Quick Chocolate Milk (powder, no sugar added) (14g). I bolused for 60g and did not correct for the 71 blood sugar. This was all right around 7:00am.

At 8:45am I checked my blood sugar, and it was on a lunar rocket ship to the moon. 334. WTF?!? Arg. Now I’m lethargically sleepy, moody, pissed off and concerned about a problem with the new infusion set (which, by the way, has never happened in all my years pumping). As hours move on, I keep checking and correcting, and sure enough my BG is coming down (which wouldn’t happen if there was a problem with my set).

Now, I can understand if I go and have a huge breakfast (like my Burger King special), throwing on a couple hundred grams of fast acting simple carbs into the fire. But don’t beat me up when I’m being good!

Is it possible that I somehow rebound from almost being low this morning? Is it possible that some jerk cut me off on my way to work and pissed me off (though I don’t remember)? Is it possible that I thought too hard about some sweet treat, and the mere idea of it spiked my BG? Who knows. Anything is possible.

I would like to try to understand if there is some pattern to this. Are there set changes that go fine, or are they all like this? Is there any other thing that happens consistently? Is it something I’m doing (yes, I do remember to fill the cannula)?

It’s a real job to eliminate the variables, and it takes a lot of time and patience. Hopefully in three whole days, when it’s time to change again, I’ll remember that I’m supposed to pay attention.

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Scott K. Johnson

Patient voice, speaker, writer, advocate, and Senior Community Manager at Blue Circle Health. Living life with diabetes and telling my story. All opinions expressed are my own and do not necessarily represent my employer’s position. Read more…

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