New to pumping - question about infusion sites

[jwhit26]

Hello, all.  I am new to the whole pumping world and have been doing TONS of research and am currently reading 'Pumping Insulin' to prepare for my daughter to start in July of this year (2011). 

She seems super excited, mostly to do away with MDI, but I was curious how it goes for the other parents out there inserting the cannula, changing it every 3 days etc. 

Do your children have issues with it being painful, do they complain about it, is it difficult?  I know it seems kind if like a basic question, but I haven't found much info/feedback much on this and I am just trying to gain as much knowledge as possible before beginning.

Also, I welcome any tips, tricks, suggestions you may have regarding, choosing a pump (doing lots of research on that too), bumps in the road you may have had or any helpful information you have as an experienced parent of a pumper.

Thanks so much for any info you can give!

Mom to sweet Rylee, age 7, dx January 5, 2011 with Type 1,
Kaylin Claire, age 5, non-diabetic and
Levi (still in utero) 

[mariedee7]

My 9 year old son has been on the pump since April 2011. So we are semi newbies but so far so good. He prefers his stomach for sites. We are working in a rotation that was recommended to us by Kaiser for the sites. He uses the One Touch Ping. We had to have the carb ratio adjusted for afternoon because he was starting to run low in the afternoon but once we got the ratios on par it's been great. Loves that he only has to get a poke every 3 days now and can go to bed without another shot. I would highly recommend them we very rarely have numbers that go much higher than 200 now. The pump has been great on keeping him within range on the BG.

[cathya35]

Welcome to the world of pumping Your daughter will love it. "Pumping Insulin" is an excellent resource. My son Cole is 8 and has been pumping for 5 years now. He has a One Touch Ping. His first pump was an Animas as well, and they have been wonderful! His pump broke last year and they were very quick to overnight us a new one. We chose the Animas because it has the lowest basal/bolus increments. Cole is very sensitive to insulin and having the smaller increments helps a lot with control. The Animas pumps also use a standard luer lock connection for the sites, so you have a wider variety than other companies (like Medtronic where you can only use their sites). Cole uses the Comfort short infusion sites. These are the 30-degree angled sites that you insert by hand. I thought they would be hard to do, but it's not bad once you get used to it. We use EMLA cream before changing the site and he usually doesn't even feel it. You can also use an ice cube to numb the area before inserting the site. Cole has to change his site every 2 days or it tends to get red and his numbers start going higher. Cole was 3 when he first started pumping and they sent the 90-degree straight infusion sites. Those were too long for him (he didn't have enough fat in the area) and they were hitting muscle, which caused his boluses to burn and his BGs to go higher. Luckily, we exchanged those sites for the smaller 30-degree angled ones and the problem was quickly solved. I would ask your daugher's doctor for recommendations on sites.  As for other recommendations on pumping, don't be afraid to ask your doctor or pump company for help when you need it and look for support groups, like JDRF or Sugar-Free Gang, etc. Many pump copmpanies have free classes on pumping to help with basic information and more advanced pumping skills. I know your daughter will love pumping--it is so much easier than shots! Good luck as you get started

[greenan]

You won't be disappointed by the opportunities the pump will give your daughter! My 4 yo daughter has been pumping since Oct 2010 and she LOVES it!  She gets timid with every infusion site change but she'll just hug a teddy bear or Daddy and grin and bear it because she knows it is only once every three days now. 
We are pumping with the Medtronic Minimed Paradigm as well as using their CGM.  We use the Lidocaine cream for the sensor installs on CGM but she doesn't need it for the infusion sets.  We use the Mio infusion sets with a 23" line at 90 degree angle.  I can't install in her belly or it kinks at a 90 degree angle, likely because of what another poster just mentioned about it the muscle getting in the way.  Instead, we use the top of the thigh, the top of her bottom, and the back of her arms. 
I have an entire list of pro's and con's I send to local parents that ask me about it but more recently, my FAVORITE part, is the reduced lows while active during the summer months.  When they are disconnect, they are completely free of insulin.  So, when I disconnect for her to swim, we get to go an hour without it and then reconnect, test and correct.  Lately, there are many times that we don't even have to test and correct because it is staying so stable.  In fact, after two hours of swimming this week, my daughter went from 157 after first hour, to 120 at the second hour.  I was so happy!  She felt great and she got to be a kid!
Here's my list!
Pros:
It has helped me feel like I can feed her like a normal toddler again and not have to wait until mealtime for a good snack.  They still ask that you stick to the three hour rule so snacks would be about three hours from a meal but I’ve gotten a little less strict with that over time as I get used to how the active insulin affects her.   Because I have her on the CGM as well, I just feel like I can relax knowing that I can keep up with what her sugar is at all times, and adjust easily with the pump (suspending it if she’s low, and bolus when she’s high) without an extra shot. 
Also, sometimes with a toddler you don’t know how much they’ll eat in one meal so a lot of times I start her off on 25g carbs and then if she eats more than I anticipated, then I just bolus a little more to cover the entire meal.  Before the pump, I would have had to do two shots to do something like that, or calculate and hope that she eats all of her food.
I used to carry around a calculator, carb book, and notebook to make sure I had all of the carbs and calculations done correctly.  But the pump does the bolus wizard so that allows me to just enter the blood sugar, then carbs, and it automatically calculates the insulin for the meal.  It is so helpful!!  By the way, if you have a smartphone, I use the “GoMeals” app to look up carbs for restaurants or grocery or generic food. 
Also, if she’s really active like jumping on the trampoline or playing at the playground, I just take it off when I think she might get low.  So, her body can go without any insulin at all and it prevents a lot of unnecessary lows.
I’ve also bought her a whole set of pump belts and she doesn’t even notice wearing it.  It isn’t an inconvenience for her and no one even sees it under her shirts. www.toosweetboutique.net.  I think most of the patterns are girly but she has some options for the boys. 
I also really like the nighttime basal rates.  I rarely have to wake her up for a snack.  Before the pump, I had to get her up at least once a night to eat something so she would make it through the night. Now, if she is starting on a trend downward, I can do a temporary basal change (like for 1.5 hours only give 0.05 insulin rather than 0.20) and we make it through without getting up for a snack.
Overall, it just seems to match the insulin to her carbs better. 
Cons:
It stinks to have to do the pump change every three days, but it is still way better than 4 shots a day.  Look on youtube to get an idea of what it is like to do a pump change.   
She’s on a tether with tubing that is 23”.  For some kids this is super inconvenient, but again, the pump belt has helped eliminate that problem.  She wears her infusion set on her arm.
Some kids look at her funny for having something attached to her arm but my daughter doesn't really care about that too much.
I’ve heard you can get infections at the site but that hasn’t happened to us yet. Just with her CGM site.
I’ve also heard you can get scar tissue at the site areas but that hasn’t been a problem for us yet either.