February 22, 2005

Change Is Bad, or, I Destroy Many Infusion Sets, with Blood

Have I mentioned lately that I’m not so good with the physical world? Yes? Good. Allow me to illustrate.

Set change this morning before work. I put out the supplies, try to fill the reservoir, rewatch training video, fill the reservoir, try to prepare the infusion set, rewatch training video, prepare the infusion set, ponder my abdomen (pumping gives a new twist to the term “navel-gazing”), swab. I am good to go. It’s a little complex because I want to use a 6-mm set, but the only one I have left has 43-inch tubing, and I need the 23-inch tubing, which is attached only to my 9-mm set. So I must attach the 23-inch tubing to the reservoir, attach the 6-mm set to myself, then swap the one for the other.

If you followed that, you have my empathy, as you must have diabetes.

Infusion set count: Two.

Quick-Sets can be used with a handy spring-loaded insertion device (called a serter in aren’t-we-cool-NOT diabetic lingo) that spares the user the terror of driving that thick creepy needle directly into the body. You plop the set into ther serter, remove the sticky tabs, pull down on the spring-loadie part, and off you go. Only something goes wrong. When I pull down the spring-loadie part, the sticky part of the set gets stuck to the serter. In my attempt to free it without impaling myself on the needle I make the problem worse. Soon the set is stuck to itself as well as the serter. I rip the whole thing apart and start over.

Set count: Three.

The serter has a button on each side. You have to press the buttons simultaneously to get the set to go in properly. If you don’t, the cannula might bend, which would be Very Bad. No insulin for you, clumsy diabetic! As a longtime video game addict, I ought to be very good at this button pushing. Not so. I seem to lock up and do it wrong every time. This time, for example, I feel myself pushing the buttons a millisecond apart. But the set goes in fine, and upon removal of the leftover parts I see that the needle is not bent, a good sign according to my trainer. I pat myself on the head and trot off to therapy (ahem, no wonder).

Two hours after changing the set, you are supposed to check your BG. I do so while sitting opposite my therapist, who has learned quite a lot about diabetes since October. 150, seems reasonable. I trot off to work.

Lunchtime. I am chatting with my friend Vicki, to whom I have proudly showed off my pump. I check the BG—163, hmm, that’s a smidge high, but isn’t it cool how Charlotte will calculate the correction I need—punch in the numbers, and sit back while she delivers my bolus. Ah, pumping. So much easier than injections.


Charlotte has never spoken to me this way before. I take a look. (Good thing the pump isn’t in the thigh thing today. Ahem.)


Uh-oh. I remember the unmatched button pushing. But I am prepared. I can change the set right here at work. Vicki makes a graceful exit. I place do-not-disturb sign on office door. Suspend. Disconnect. Pull out cannula. It’s a bit liquidy, eww. And the needle is bent at a 90-degree angle. Ah, clumsy diabetic. Not Charlotte’s fault at all.

Set count: Four.

I put my backup set in the serter, ponder abdomen, swab. I am thinking, push the buttons at the same time. Push the buttons at the same time. I push the buttons, not at the same time. The needle goes in. I start to pull the serter off, but something is wrong. It’s not pulling off the set like it’s supposed to.

Oh. I forgot to remove the sticky tabs, so the set is not attached to me. Moron.

It is impossible to remove the sticky tabs when the set is on top of a needle which is already in my belly. I am a little fuzzy on the next details, but I manage to remove the set—along the way it separates from the needle—and then the needle, upon which a veritable river of blood gushes forth. I do mean a river. And I do mean gushes. Much more blood than ought to ever gush from such a tiny hole.

I and my skirt sop up the blood. (At least I wore dark denim.) This was the only set I had at work. I guess I could switch back to injections for the rest of the day. Bah.

Then again, the cannula isn’t bent. Nor is the needle, though it is now stained a charming scarlet. This is probably Very Bad Behavior, but I reassemble the set, grit my teeth, remember to remove the sticky tabs, ponder abdomen, swab. I am thinking: Push the buttons at the same time. Push the buttons at the same time. I push the buttons, not at the same time…


  1. (Snicker). Sorry to laugh, but you have such a funny way of writing. I'm really sorry you had such a bad time of it. I've been feeling guilty about how many sets I've gone through due to my own malfunctions. Maybe we'll get better at it with enough practice.

  2. I have to agree with Lori, your sense of humor with this stuff is great.

    While it sounds like a bit of an ordeal, you made it through just fine. The routing things such as set changes will not be so routine yet - just because it's still a new thing.

    With the blood, it's what pumpers call "a gusher". Sometimes you may nick a capulary or something, which is fine until you actually remove the set - then it just starts streaming (or gushing) like crazy. I would say, in all my pumping, it's probably only happened a few times. Nothing really to worry about (at least medically).

    You did just fine with all that stuff being thrown at you. Trust me, it will get better and easier as time goes on.