Tuesday, April 1, 2014

Getting A "Leg Up" On Scar Tissue & Trying New Insulin Pump Infusion Sites ~

 I have an affinity for wearing my insulin pump infusion sets on my abdomen and for several reasons. Infusion sites on my belly are easy to access, easy to see, easy to change out  - Just easy in all dimensions - At least for me.
Except of course for scar tissue and the development of deadspots on my belly - As in areas on my abdomen that no longer syphon insulin properly. 
I don't like deadspots, who does? 
So with the being said, I've decided to get a "leg up" re: insulin pump infusion set sites and I've committed to alternate sites for the month of April. 
This rotation started on Saturday March 29th, on my right thigh. Now, I've used leg sites before - it's not a new location for me, but it is a tried and true location. I'm still using my right thigh, but will rotate to the left midweek. 
I'm considering trying out other locations, but I have some questions  -And I figured if I had questions, so did other people. I/we could REALLY, REALLY use your advice regarding the following: 

1. Leg Sites: 
Do you place infusion sites on the backs of your thighs? Also, do you find yourself changing out the sites more on your legs than on your  belly? 
I do, always have. I change my leg sites every 24 to 30 hours, mostly because of the workout that area gets re:clothing - As in pulling pants on and off, up and down, bathroom breaks and  tubing getting caught in underwear.  
2. Arms: Who out there puts insulin infusion sites on your arms and how does the whole subcutaneous syphoning of insulin work for you in that location? 
How long do arm sites usually last and what issues do I need to be aware of with arm sites? Like what happens when I take my shirt off? Will my tubing get all tangled?  
3. Boob: Since I'm being all honest, I'm not really interested in trying that particular area of my anatomy - I'm scared - Like REALLY scared - But let's just say I might be considering it. 
Any thoughts or advice re: infusion boob sites out there? 
Sidebar: C over at "C's Life With D" wrote a great post on this very subject! Click HERE . READ IT. 
4. Calf: Someone posted an infusion site on their daughter's calf recently ( And for the life of me, I can't remember who,) and I was like: WOW, I never thought to try that! Has anyone out there used their calf for an infusion site and if so, how'd it go? 
5. Butt: Believe it or not - I've never tried putting an infusion site in my gluteus maximus
in all my years of pumping for several reasons. My rotator cuff issues and the fact that my culo lacks cushioning.  
 Any and all advice re: arse infusion sites would be greatly appreciated!
6. OTHERS: Are there any other infusion site areas I haven't listed? If that's the case, where are they and how do they work for you? 

Change can be hard in life - And life with diabetes, so thanks in advance for any help in this area - Or should I say areas? Either or, I really appreciate your input, advice and help on this this subject!


Unknown said...

My kid rotates between arms and her bum exclusively. She loves those spots for her pump sites!

A long time ago (before she wore a pump...so, like, at least 7 years ago), I was sitting in one of those mall play areas and she came over feeling low. I checked her, gave her a juice, and she ran off.

The mama next to me was just sitting there, nursing her newborn and asked when she had been diagnosed...we got to talking a little, and then she lifted up the long skirt she was wearing to reveal a pump site in her calf!! She had her MM pump rigged up around her ankle (think vertical against her leg in a garter-type thing, not horizontal) -- said it was the easiest way to manage breastfeeding and not have to worry about the pump/tubing getting in her way.

It was the first "diabetes in the wild" encounter I ever had, and I've never forgotten it!

Good luck!!!

Alanna said...

I am squicked out by using my abdomen-always have.

My arms are my best/favourite sites. They have the fastest absorption, I use all of my upper arms between my elbow and shoulder and have never had an issue.

My legs I use only the upper outer thighs. I don't get the best absorption regularly on them, but when I do I can have a site last almost a week! my CGM works best in my thighs

I use my butt a lot too. The only issue I have is forgetting my site there and ripping it out when I go to the bathroom. It is a slower start for absorption for me as it is my most muscular area, but it works great for me.

Good luck exploring. My tatas are, and will always be infusion set free....I am too scared ;)

Anonymous said...

I recently tried my upper abs, just under the bra line. I get the best absorption there. The outer edge, just before it curves around to my side is the best.
If you do arm sites, think about how to angle your set so the tubing is the least annoying. I use MM silhouettes. It's easier to get it into my arm with the needle pointing up toward my shoulder but then the tubing slinks around funny. If I put in an arm site with the needle facing down toward my elbow, its harder to put in but the tubing is less annoying. For arm sites, I tend to tuck the tubing under my bra strap to help keep it in place. Changing shirts is best done unplugged.


Melissa E said...

I used to just use my belly exclusively, but then I started running out of real estate too!

My favorite spot is usually my butt and lower back. It is a little troublesome when you get dressed/go to the bathroom, to make sure you don't get it caught in your pants or the tubing in the toilet! You just have to be slow when getting undressed...which is sometimes a pain if you really have to "go"!

I don't find that the butt sites have to be changed any more often than the belly sites. Although I have to be careful about the placement so that it doesn't hit right at waistlines, etc.

Lately, I have ventured to using my hips and my outer thigh. I like the outer thigh too and the hips work great.

I don't think I could ever use my boob! I do use the backside of my arm for my dexcom, but not the pump, I think it would constantly get it caught on stuff up there!

Good luck with your experimenting!

Kristin said...

I just started pumping in mid-November and have always used my stomach -- for both my pump and CGM. The legs intrigue me but I'm worried about the tubing. Same with the arms. How do you navigate the tubing?

Sarah said...

Hey Kelly! Great questions, great info, and great to have in one place!
Leg Sites. I never did direct back of thigh (was worried about sitting/sliding in and out of chairs). I changed them more often than on tummy, often because I wasn't happy with the absorption.

Arm Sites. LIKE! These lasted longest and felt out of the way. How quickly the insulin seemed to work differed here from other places. I did't have too many tubing issues. Biggest problem was getting tangled in my bra. But, bra also helped keep the tubing all tucked in. Also, I'm a swimmer and had a few issues catching the site on lane lines.

Boob Site. LOVED IT! It took multiple reads of C's post plus a self-motivational talk, but after the first insertion, I was hugely surprised - it hurt less than pretty much any other site. I don't even have big boobs, but could find a few different places to use. Make sure to check where your bra sits first. Possibly a weird site if you're intimate with someone new.

Calf Site. I liked that it was out of the way, but didn't like the absorption. Insertion slightly more painful than other sites.

Butt Site. Most common site for me. Depends on your infusion set I guess - but yeah if you can't twist around too easily, butt sites might not be great. I think of butt as everything from hip to cheek :) Test with your pants first - I had a few pant line rubbing problems.

Other sites - inside thigh, and if you've got enough cushion, side upper back.

Good luck!!

Lynnette said...

Starting at the top:
Arms -- tried it once, but wasn't good with the tubing arrangement. Will probably try it again sometime.
Belly -- my belly sites seem to fade the fastest. I don't like the rib area, just belly.
Love handles -- work well for me. Except sometimes with jeans.
Bottom -- works fine, but I don't use the sitting part (does that make sense?).
Thighs -- work pretty well. Fast absorption when doing a lot of walking/running. Can't go too far to the inside; they don't hold well there and have gotten irritated. Haven't tried the backs of them, but I might. Used to only do the upper half b/c I was wearing my pump mid-bra, but I'm back to pants pockets now, so I can use the lower areas. That lets me put the pump in my sock, too, though I haven't done that much yet.
Calves and breasts -- haven't tried either. Never considered the former, and haven't wanted to try the latter.
Good luck!

Sarah Spiller said...

I started using my arms as sites after I saw a lot of the campers/ counselors wearing their sites on their arms at Camp Kudzu (my diabetes camp.) Ever since I tried them out a camp, I've loved using my arms for sites- they're my favorite place and I almost never have issues with weirdness on my arms.

I also use hip sites sometimes and my only issue with those is that the adhesive stuff starts peeling off really quickly because of stuff rubbing against it so much.

Arm sites = the best and you should totally try them out!

Have fun experimenting with new sites!

Andrea said...

Love this post and all the comments. I can certainly relate after 14 years if pumping! My poor belly still absorbs ok but is full of little white scars. I still use it but also use love handles, lower back, upper abdomen and arms.

I don't use butt sites as every single time I have tried, I've ended up ripping them out as I hook my thumbs in my underwear to pull it down. I also don't use thighs because back in the days of MDI I could not inject in the thigh without bleeding. I've never tried boob sites but know some who have and have loved them. I absolutely love arm sites. They can be a little awkward with the tubing but have great absorption for me, presumably because of the scar-free tissue. However, I've taken to wearing my dexcom on the arm so currently am not using them for infusion sets.

I think all the sites you mentioned are worth giving a try. Thanks for the reminder to rotate as much as possible!

k2 said...

Guys -
THANK YOU all so much for helping me!
I just put in a side thigh site last night and it worked!
Switching to the left leg next and then the left arm.

BBird said...

I find this discussion fascinating. I've only been pumping a few months so I haven't created much scar tissue or dead spots yet. My endocrinologist, however, told me I should stick to the belly as much as possible because of the variable rates of absorption that come from thighs and arms. Doesn't anyone find that? Or maybe he's expecting it'll hit me more because I lift?

Kelly said...

Love handles! Thats my thickest body part, just remember to not place it along the waist line where clothing goes!

Jenn said...

(Yes I realize this post is nearly a month old, but life has been hectic and I'm slowly catching up on my blog reading.)
Arms: I really like using my arms during the winter when I have long sleeves on. I find that I catch the tubing less that way. The most annoying bit about using my arm is if you don't angle the tubing right it can literally tickle your underarm all day. The absorption seems to be a lot better, but I'm not sure if it is just because I move my arms more than my belly, or something else.
Upper butt: If you put your hands in your back jean pockets it's the area right under your palms. I find that that is the safest place on the backside to avoid my waistband.
Thighs: I like to save my outer thighs for my CGM, but sometimes they need a break from that much tape. I do find that I have a higher tendency to rip out sites on my thighs than other places.
Boobs: This one is one of my favourites. My endo first suggested it to me, and I was like, "Are you CRAZY?!" However, I have NEVER ripped a site out from there. My bra totally prevents that from happening. My husband chuckled the first time and asked if I was going to refill the other side too. (Needless to say, he got a pillow thrown at him. *grin*) The biggest issue with this site is tubing length. If you clip your pump to your waistband, you need the longer tubing, otherwise going to the restroom can make you look like a hunchback.

I've been pumping for a little over three years and try to rotate a lot. When I got my pump, my endo suggested that I find 10 different spots to use as sites. This would allow a full month's worth of healing time between each insertion. I haven't kept up with using all 10 in a regular pattern, but I do still use all of them.