Do you pretty aggressively rotate pod/pump sites? I know you’re supposed to, and we try, but back of the arm is the preferred spot. Since EH is less than 1 month pumping, right now, I think it’s fine to be getting the hang of it there. But how much do you shift the sites?
Not overly aggressively – like not miles apart. Because of lipoatrophy from childhood injections, I’m limited to begin with. There’s a sweet spot high on the back of the arm I can use twice in a row – once with a pod pointing up and then with the pod pointing down, with the insertions about an inch apart, and then I stay away from the arm for a couple of weeks. I get better results and longevity out of my Dexcom when it’s on the front of my abdomen, an inch or so away from my navel, but since the pod isn’t supposed to be placed too close to that, I tend to move pods in a sideways J shape at least 2 inches away from that. And because I sleep on my side, I have to keep the pods on the same side as my Dexcom, which these days are lasting me 28 days minimum, so I’m probably pushing it as far as overusing one general area is concerned.
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Yes. We have 6 sites. Each site rotates, and the “direction” they face also rotates. So, if his POD is on his upper thigh with cannula facing upward this time around, the next time it’s on that thigh, it faces downward. All notes / changeouts are kept in a log book so that I’m always sure where to put it next. 2 years in and our Endo said she can’t even see that he’s ever worn a pump/cgm.
After we remove each device, we also apply a small amount of Neosporin on a spot bandaid and keep it there for at least a few hours.
We use his 2 upper thighs, 2 side thighs and 2 upper buttocks areas. Each area rotates and the directions of the PODs rotate each time. We only his his arms for the CGM…we swap right bicep to left bicep at the end of the 2 week period.
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Your logbook is something that I envision when I’m swapping sites and not keeping track. That thing is epic. 
I recognize how smart it is and we just are not there yet.
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I rotate around about general 12 locations in a counter clock-wise fashion. - as @ClaudnDaye mentions the pods flip around - so every rotation around my body I flip the pod over which gives about 24 general locations that I use. - The sites I use are the back of my arms and about four general locations - each side of my body - in the area between 2" from my spine on my back to about 2" away from the belly button on my abdomen. The body locations I go from my rib cage down to the belt line so there is some vertical variation on all the locations.
If I ever give shots, I just use my legs to give them some attention. If I want to do a intramuscular injection I use my calf.
I change sites every three days - so far (touch wood) no problems with absorption.
Edit: I have tried other locations with the pods (like the side of my butt and my legs) but I had problems with adhesion and cannulas pulling out. I do not have a lot of fat on my legs so they tend to be a no-go zone.
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I am not sure I am quite getting that. Would you be able to draw a sketch by any chance?
We change pump sites every two days. We have 10 sites we rotate between. Back of arms, low butt, upper butt, stomach.
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I haven’t tried upper butt, thinking pressure on the pump or motion might cause a problem with the cannula. (I’m a podder.) Right now I am wearing it on my upper thigh–seems okay. Definitely need to cintinue giving my abdomen a rest so might try upper butt. Can’t do @Eric’s rib placement–no fat there.
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i am absolutely terrible with rotations. if i find a sweet spot on one side of my abdomen or other, i will continue using that area until it becomes too physically sensitive., and then i will move to the other side. (i dont use the same spot, but the same area)
i am very lean and have no fat at all in the tummy area, so thats always been a difficult spot to stick the insertion needle. sometimes i wait till after a swim (very cold water helps numb the area and makes insertion much easier), otherwise i might ice the spot for a little bit.
i change my set every 3rd day.
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I am pretty sure our Endo said the site does not have to move far to be considered “moved”. So if you are using the same area but not exactly the same spot then you may be doing it perfectly. I am not positive but I think our Endo said if the infusion site center is moved at least 2 inches then it is far enough to be considered a good move.
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well, to be brutally honest, i do not move it 2 inches; maybe one inch at most. but i do get incredible absorbtion without any problems. 
always have. just lucky i guess.
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That’s how we understand it also. As long as the insertion spot moves, the site is effectively considered “moved”…so we also, in addition to alternating our sites and rotating the cannula ensure that we don’t reuse an old spot (most of the time we can see the spots that have been used frequently) during our change out. Just moving it 1/8 inch left, right, up or down results in an entirely new site.
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That’s good to know. I was thinking it had to be at least an inch, and the further the better, but that’s probably from the old days. Now I don’t feel I’m putting my tissue at such risk.
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I don’t either, but it seems to work fine regardless. I know the Dexcom sensors are supposedly better in areas with fat, but the insulin works about the same for me even if it is just under lean skin.
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Just make sure to pinch up the skin when inserting and see how it works for you! Never know unless you test it!
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Well, may just have to give it a try!
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I think that depends on how much insulin you take. The insulin spreads horizontally through layers in the subcutaneous tissue, not in a sphere, and the goal in changing a site (to avoid “scar tissue”) is that any specific spot is only directly exposed to pure insulin for 3 days at a time, followed by a month or more of recovery.
I note that the 3-day figure is just an FDA recommendation. Apparently some folks can go 7 days without developing scar tissue and absorption problems, while others need to change the pump site after 2 days to get good results, so YDMV. I stick with 3 days and use lots of different sites (in vertical rows up my sides and back) because it seems that this may help me keep my subQ tissue in good shape.
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I put my pods anywhere I can pinch up the skin and put pods in places where I would never think to inject. There does not need to be fat - just enough skin to get the canualla in without hitting the muscle.
@michel - Thanks to some internet people here are the “site locations” that I rotate my pod through. There are about 32 locations so if I rotate the pod that becomes about 64 sites in total. As I said, I rotate in a clockwise direction from my right spine to my left spine and then to my left arm and right arm. So the two sites on the arm see a lot more action than the area on my body. (i.e. I will do the top row on the body then arms - then the middle row - then arms - then the bottom row - then arms).
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@Aaron, this is truly an outstanding location map, I love it. It inspires me!
Some clarifications:
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We normally keep the abdomen for the CGM. Where do you locate yours?
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are you able to locate and insert your pod on the back on your own? This seems hard to access alone, particularly higher up?
@Michel -
I am pretty boring with my CGM locations - I just use either side of my belly button on my abdomen (but not too close to he belly button). So occasionally there is a POD/CGM conflict in my rotation schedule.
I can stick the POD on my back by my own without any trouble. Sometimes taking it off can be a bit of a stretch so sometimes I have to resort to using something like REMOVE to help dissolve the adhesive so I can pull it off without having to pull a muscle.
I love having the POD on my back. I hardly notice it and it does not move that much - The side can be a bit annoying when I have to drive a long distance in my car (hard bucket seats that wrap around) because you can get some rubbing between the pod an the seat. I have another vehicle with softer seats and I have not problem.
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