infusion set site

[nynca]

we are struggling with my 3 year old's set site when he gets wet for a bath or the pool.  it always comes out.  we already sandwich the set between two transparent dressings.  that keeps it intact for day to day life, however as mentioned it comes out when he bathes.  our endo suggested benzoin, however i worry then about removal for site change.  any other suggestions would be helpful and appreciated.  thank you

[JDRF-Team-gg]

Hi nynca,

My name is Gale and I am a Mom of a 16 year old who has had diabetes since the age of 21 months.  I am not a medical professional, so any information that I pass on to you should be verified with your son's healthcare team.  

My daughter is on the Medtronic MiniMed Paradigm pump and she uses the silhouette infusion sets.  She has not had a problem with water causing the adhesive to fail.  I called the MiniMed 24 hour help line and asked their representative your question.  You didn't mention what type of site you are using so I will go over some of the possibilities that Lee from MiniMed and I came up with. The type of set could be causing this.  The silhouette has the longest needle and therefore could be the reason why my daughter has not experienced this problem.  The other two sets that they manufacturer have shorter needles.  Using the benzoin was suggested by Lee also.  I expressed your concern about removal, and he said to try using 4 dabs on the corners of the set, and experiment with the amount if that is not enough.  Another thing that we came up with is perhaps there is some type of oil in the soap that you use that is causing this to happen.  Try using soaps that do not have any type of mineral oil or moisturizers in it. That might be another cause.  We use a liquid cleanser by Arbonne that doesn't contain any animal fats or mineral oil. This is all I could come up with.  Perhaps others who have experienced this problem will have more possibilities for you.  I hope this helps!  Good luck with the little one!

[JDRF-Team-LRS]

nynca,
I'm a pumper, too -- and also not a physician.

In addition to Gale's recommendations, I wonder about some other things at the simpler end of questioning ;-)  

Do you disconnect your son before his bath/swimming?  If not, do try that; if your sets don't allow for a quick disconnect, check with your son's endo about trying that type.  

My infusion sets almost never come out, but 100% of the time so far (9 years), it's been when I've pulled (YANKED!) on the pump inadvertently.  It's just too much force for even reasonable adhesive to sustain.

Might it be feasible to apply an extra layer of Hypafix tape just for bathing/swimming.  Here's what I picture, bear with me as I try to describe it in words.  The basic idea is to put an additional protective layer on for water activities -- ensuring the new layer does NOT stick to the infusion site itself, but rather to the skin all around it ... Two "ingredients" needed: Hypafix tape (rolls are availalbe from med supply stores; last I bought it .. maybe $15.  Lots of tape on the rool; it's the same kind of stuff that's used for our infusion sets) and sterile gauze.

Cut a length of Hypafix tape that's longer & wider than the infusion set taping.  Cut a cotton gauze pad to comletely cover the infusion site (so the tape will stick to the gauze and not to the infusion set).  Make sure that the gauze fully covers the set, but is also smaller than the Hypafix.  Layer the Hypafix on top of the gauze.  

An example for me:
My infusion sites are round, with about 1.5" diameter for the tape.  I'd cut the gauze to match the shape of my site but probably 1.6" to be sure it's covered.  Then, my Hypafix layer would be maybe 3" diameter or else two 3" long stips crossing each other to ensure the gauze & the infusion set are covered.  

It took more words to describe this than to do it, but I hope it helps.