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PODsitively Perfect

Monday, October 10, 2011

Site changes.

They've been a source of frustration around here for... well, forever.

Way back when Sweets was doing MDI (multiple daily injections), we couldn't wait to start pumping.  She cried and fussed and kicked and screamed with almost every shot.  It was finally starting to get a LITTLE better around the five month mark when we started pumping.  Ugh.

We were so glad to switch to inserting the site every 3 days instead of doing 5 or more shots a day!  We were ecstatic!

But that didn't mean that site changes were a piece of cake.

When Sweets first started pumping, our CDE recommended that we use the angled manual inserter on her because she was so small.  That was find - except that she was scared.  She would not hold still.  She still cried.  She still fussed.  She still kicked.  She was only 3 and half.

Still... it was better than 5 times a day.  But... frustration.  I was new at the inserting and trying to get that done a crying, wiggling munchkin was next to impossible.

At our pump start follow up, the CDE suggested we try the automatic inserter.  It was not angled and went straight in and she thought that might present a problem on a little person but thought we should try it.

So we did.

It WAS better.  It did not come out easily like she had feared.  And it was much easier to insert on a wiggling and crying little person.  She, however, did not like the "click" it made when it went in.

One night as we were getting ready for a site change, Sweets fell asleep on the couch.  There we were with all the stuff ready to go.  And there she was sleeping peacefully.  What to do?

Do we wake her up - knowing that she will get upset and fight and cry?  Or do we try the change while she's sleeping?  I'd talked with a friend who's daughter had been pumping for years and she had suggested trying the night time site change.  She said her daughter never woke up and it was so very easy.  I seriously didn't think it would go over well for us... but that night- since she was already asleep - we tried it.

And she didn't wake up.  She didn't even flinch.  The next day she was so thrilled that it had happened and she hadn't known it!  She said, "Oh wow!  I didn't even have to worry about it!"

The other benefit to this was the issue with bent cannulas.  We were getting bent cannulas.  Because she was so afraid, she would clench her butt muscles.  Because she has practically ZERO body fat, the cannula would hit muscle and bend.  We didn't know what to do.

I talked with our endo about it and she said she thought it was fine for us to do the site changes at night.  She knew that we checked her closely all night long.  She knew that we didn't just put her to bed and not think about it until the morning.  She said that due to her incredible anxiety about site changes and the fact that we were so on top on things, we were fine to do the changes at night.  She also thought this would help solve the bent cannula problem.

Now, I'm not saying that you should do this.  It's technically against the pumping "rules".  It can be dangerous.  I'm just telling you OUR story.  And what worked for us.

Except it didn't really totally work for us.  It helped in the sense that she was no longer fighting and crying and getting all worked up over site changes.

It didn't work so well in sense that we were still having issues with site changes.  Specifically, we were STILL getting LOTS of bent cannulas.  Like 2-3 a time during some changes.  We even ended up in the ER last November on World Diabetes Day because a bent cannula had led to high blood sugar and large ketones and vomiting.  Even though we had checked her all night long.  Her numbers had not really gone high until HOURS after the site change...  it was really weird.

So we met with the CDE again.  We tried different types on sites.  We tried different locations.  We originally had only used her tush because she didn't have enough fat anywhere else.  Belly is STILL - to this day - off limits because she has no extra skin there.  The kid has a six pack.  It's soooo wrong...  But I digress...

Arms worked well for a time.  We were all happy with that location.  But at our next appointment, our endo thought we should go back to her tush because she didn't like the way her arms were looking.  She thought she was building up scar tissue there.

So... we kept on keeping on.  And then some other things happened that led us to start thinking about the Omnipod.  I had read in their literature that Omnipod was recommended for people who were afraid of needles.  Because you can't see it.  Not at all.

And this proved true for Sweets.  For some reason - maybe due in part to the fact that you can't see the needle - the Omnipod did not scare her.  She was not afraid of it.

Now, there's lots of reasons we are loving the Omnipod! But that's a post for another day...  Because THIS post is about site changes.

Sweets was find doing pod changes... at first.  But then she would get all worked up over it.  It's really the anxiety about what's going to happen.  She can tell you that it doesn't hurt.  She knows it logically.  But she still freaks out.  And I didn't know how to help her.

We decided that we needed to do pod changes while she was awake.  She did not love this.  But... we just thought it was better due to reasons that I'll go into later.

She liked the fact that we could put the pod on and then all you had to do was push a button.  What she DIDN'T like was the loud "pop" it makes when it goes in.

So, we tried different things.  Distraction.  Yelling (don't ask... it masked the click sound and she thought it was funny).  Going to Gaga's house.

I had her watch this awesome video made by Noah, The Diabetes Dude.

And... guess what?

It helped.

Time.  Praise.  Love.  Letting her go at her own pace.  Reassurance.  Love.  Praise.

And watching someone else do it on his own.

The last couple of weeks of pod changes have been.... amazing.

No fighting.  No fussing.  No tears.

As Sweets said, "Not one single tear, Mom!"

She's getting so grown up.

It's bittersweet.  I wish she didn't have to be so brave.  But I'm so very proud her.

She's PODsitively Perfect
By the way....
She rocked that arm draw on Saturday, too!



  1. That's great. When my daughter first started pumping this summer, she would watch Caleb's video. She would be laughing so hard at Caleb that she would forget all about the click of the pod.

  2. That is wonderful! Nate still gets worked up some days and some days not. I've shown him a ton of videos. I'm going to post them all on my blog someday when I get a free moment to do so! :)

    We do a lot of pod and Dex changes at night. I don't really follow any rules. I mean really ---- who made these so called rules? I'm going to go ahead and guess it was NOT a mom with a little one with T1. Just my guess.

    I commend you for doing site changes at night and making things easy for Sweets. That is what we do as parents. Help them until they are ready ---- let them take it on at their own pace. Great job, mama!!


  3. The picture of her showing off her pod is adorable! I'm glad that site changes are way better with the pod. Also, I got a laugh imagining the two of you yelling to cover up the clicky noise :)

  4. I love that through it all you listened to your daughter, even if you kept to doing the changes during the day you let her voice her concerns without telling her they were invalid. I appreciate these posts as they are how we handle things here, Isaac doesn't like site changes, and we let him loudly voice his dislike of them, but still we do them during the day.
    The last pic of her is priceless, too. I was wondering - is she bothered by carrying the dexcom around at all?

  5. I am laughing about the yelling too! When we tried the omnipod and I got to wear it (as well as the animas site) I was amazed at how little pain there was when it was inserted. I am afraid of needles too and I was SWEATING the animas insertion but was not as nervous about the pod . I loved that I didn't have to see the needle on the pod. I am glad it is going better for you guys! Sweets is so freaking cute btw!

    And we don't follow the rules either..

  6. Hooray for Sweets! She looks so proud-- not to mention darling -- in the bottom pic!

  7. Love her ROCKIN' the POD Pic!!!!

    And, Joe tummy sites still (and he is 8!). He has a 6 pack...sometimes I swear they two peas in a pod.


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