I’m sure many of you have heard this throughout your time with diabetes-
“Make sure you rotate your sites.” I’ve been hearing that since my days on NPH and regular- from checking my blood sugar to shots to pumpsites to the CGM. From my younger years, I remember the warning of “they don’t work as well” or “scar tissue can become a problem.”
For this post- I’m going to focus on pumpsites.
A little back story for reference
But I didn’t retain any of that, and at some point- my parents pretty much gave up trying to push me to rotate them all of the time- because it’s hard to convince and force a stubborn and defensive child who is still terrified of needles and only liked her butt and legs for pumpsites.
In my mind, I didn’t like any of the other pumpsite options I had. I basically lost my stomach at one point because of an intense allergic reaction- and I still have insane scar tissue- 10 plus years later. My legs were my favorite spot-Followed by my butt. I didn’t want people to see them or for a chance for them to come out easily. All the other places also felt too close to my line of sight- making the process all the more scarier.
My first much needed pump vacation
Fast forward a few years- to teenage me- pumpsites are starting not to work as well. I bleed into them often, etc etc- all of the signs of scar tissue. I was more frustrated with my diabetes and angry at the pump.
So after my senior year in high school, I took my first pump vacation since going on the pump about 10 years before that.
It was an amazing break.
Things seemed better- each summer after that I went on a pump vacation. (I still preferred my butt and my legs with the occasional arm).
Trying something new
My junior year, I began paying attention to site rotations, and I started POLI full time. (It was part of me trying to get through diabetes burnout). I then embraced the idea of using my hips and my arms on a regular basis. I still cannot use most of my stomach, and now my legs really don’t work at all.
I started putting it on one area then moving to the next- for example- right arm, left arm, right hip, left hip, etc.
But it was hard to remember what spots in those areas I used when I returned to an area. The plus was that it would be several weeks before I would return to an area though.
Then I get to family camp during my senior year, and a fellow volunteer mentions that he cannot really use a pump easily now because of built up scar tissue- no matter how long his pump vacations were.
This really hit me and especially my intensifying OCD- I was terrified of this possibility.
Finding a rotation routine that worked for me
So I brainstormed. I modified my technique.
I would rotate, but would stay in an area so that it was easier to keep track of where I was last. So I do the full “zig zag” and stay in an area then move to the next area once I’ve “used it up.” So I’ll zig zag sites along my right hip, then left hip, then right arm, then left arm, etc.
The pumpsites don’t work quite as well in my legs, but I still go there. It’s gotten better, but I do not want to overuse other areas and have the same thing happen to them. So I increase my insulin intake while I’m there.
I definitely noticed a difference. I’ve had way less failed pumpsites. Less bleeding into sites. Less sites not working. Better insulin absorption. Less painful sites and marks. Etc etc.
It also satisfied my OCD that I was keeping track and doing what I could to rotate. If I feel like I need to be on my “A-game,” I put a site in an area that is my favorite and always a top notch site.
Since I started rotating more my junior year, I haven’t actually taken a pump vacation. It’s made a huge difference in my management.
On April 1, I was curious to see how long it was between site areas. I’ve been excited to write this post, but I still haven’t returned to the area where I started to keep track (feels pretty cool and great to me!). I’m about to approach month 3, and I did some calculations- by the time I reach the first area- it will be over 4 months since that area on my body has seen a pumpsite.
Many of my care providers stated that if an area isn’t working well, that giving it a break for 3 months can help a lot. So I’m doing even more than that. It makes me feel pretty good about management (and hey- look- it doesn’t always have to be about the numbers!)
My next plan is that once I find out exactly how long it’s been between sites, I plan to take a pump vacation. I’m not feeling that really strong desire for one or angst towards my pump, but I want to be more proactive. Maybe it won’t even be 3 months- maybe just a month. (but self-care and mental health are important!)
Growing up- I didn’t care at all about site rotations-
Clinical providers and pump/medical companies have a point-It’s beneficial to rotate your sites!
So if I could recommend something- ROTATE! ROTATE! ROTATE!
And not just your pumpsites, where you check your blood sugar, give shots, and your CGM. (etc).
It actually really makes a difference, and makes managing diabetes very slightly easier- because it isn’t always a factor.
I’m all for shortcuts and doing things to make this usually pain-in-ass disease a little easier to get through. 🙂
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