When I started using my insulin pump, I stuck to midriff area sites exclusively and it was quite rare for me to have an issue with a site leaking or bleeding. I was advised to start rotating through more sites so I started using my upper thigh and have noticed a huge increase in the number of issues I'm having. On a regular basis, I am able to detect small amounts of blood through the clear window on the site itself. I am also noticing that those sites are way more likely to leak.

Leaks scare me. I'm never sure how to deal with it when I've noticed that some of the insulin hasn't been delivered. I usually end up waiting to see how my BG levels do and adjusting from there but it often leads to some instability and spiking.

Have other people noticed this and what, if anything, can be done to avoid the problem? I work in IT and am often very active and mobile all day long - including frequently crawling under desks and lifting decent amounts of weight - is this what is causing the bleeding and leaking? Is there a "perfect" infusion site that people tend to favour over others?

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Replies to This Discussion

Perfect infusion set - not really. If you use IV3000 dressings over your insertion set, try taking a piece of the tape off of the IV3000 backing paper and put it at the disconnect part of the set to keep the tubing from stressing the adhesive and allowing the adhesive disk to lift.

I just had a site failure and my BGs went over 400 before coming back down. So this was my fix to keep the set in place.

Blood in the window - I have seen it when I nick a large capillary near the surface. Watch BGs closely for the next 6 hours. If BG is OK then cannula is in place, if BG is even slightly higher "TREND-WISE" triple check the site. Be ready to change it because it may be flawed.

Jay
i always have problems in my thighs, more bleeding and very frequent absorption problems... my dr. recommended avoiding the thighs as much as possible, and just stick to the stomach, sides, back, and upper buttocks to ensure there's enough site rotation.
I've never used my thighs - just over a year of pumping, so I'll be interested to read the replies.
i'm changing a failed site right now actually. perfect site? only if you have a spot on your body that never ever comes into contact with anything else ever and there's nothing on the planet to catch your tubing on.
things that have knocked my sites loose: cats, dogs, dishes, laundry, wearing clothes, not wearing clothes, doorways, seatbelts, my elbow, dropping a book while reading in bed.
which explains why i have a whole box of infusion sets, IV3000, a bottle of skin tac, little scissors and q tips at my desk at work, another set in my car and both bathrooms at home.
usually it's a cleo 90 with half a piece of IV3000 on it. i cut a hole in the IV3000 for the infusion port to slip through. if it wasn't for the fact that this one was through a blood vessel and slowly failed all day, this would be a perfect example of my sites

http://www.flickr.com/photos/catastrophegirl/4207179680/
Thanks for the replies. I think after reading these and doing a bit of other online research, the verdict will simply be "avoid thighs". I've never had too much trouble on the stomach and will start trying my lower back too.
I started pumping last month, and have been experimenting with different sites and sets. I've used straight and angled sets in my stomach and thighs.

I'm not sure that I have any advice to give, since I'm new at this, but I do have a story...

The only configuration I've had a problem with so far was the angled set in my thigh. I had it in for about a day and a half when my pants brushed up against it and the whole site started to sting really badly. I changed everything out, and when I told my CDE what happened, she said that she doesn't recommend using angled sets in the legs. I forget the reasons she gave, but I think it was something she read, or stories she's heard from patients.

I figured I'd mention this in case you're using angled sets, and because my problem began when I was moving around, which you said that you do a lot of.
My theory is that there's just not enough "meat" and too much muscle on the thighs. The only time I really use this area is when I go to the beach. I wear river shorts and a top, so I attach on the outer portion of the thigh, just under my shorts, for quick release to go in the water.
I run in to similar issues on my back, but if I lower it to the top of my butt, I have enough fat there to support the set.
Everybody is different. I use my thighs all the time. For me, I can't use the sides or the back of my thighs, cause I have lots more muscle there. The fattier the area the butter, that is the key. Even for multiple injections, it's always been the fatty area of the body for injection.

In terms of securing the infusion set, I like to put on an IV3000 BEFORE I put on the infusion. I know that most pump trainers and CDE's are against that, but it works for me very well; and most importantly, it beets using messy Skin Tacs.. and it also keeps the adhesive a little cleaner longer, because the adhesive doesn't have direct contact with my skin. I've also noticed that my wounds heal a lot faster when I do it that way...


Good Luck..
I have no problems with thigh sites - I actually prefer them over most others. There are a bunch of factors that will go into a site working/not working for you - clothing tightness over the area, amount of fat/proximity to the muscle, etc - everyone will be different so it's best to try a bunch, see what works for you and avoid what doesn't. I also really like arm sites - I buy a box of infusion sets with the longer tubing and use those for arm sites so I have a little more room to maneuver the pump. Maybe that's one more place for you to try to find somethings that work for you? Good luck!

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