Diabetes Details 11: Doesn’t That Hurt?
A quick recap for newer blog readers: I’ve had type 1 diabetes for 13+ years, and I blog about it occasionally for several reasons:
- Because I know other writers read this, and it makes me cranky when stories get the details of my disease wrong.
- I’m comfortable talking about it, and I think helping people understand this stuff is a good thing.
Previous diabetes posts are, shockingly enough, tagged with the diabetes tag.
Anyway, one of the questions I get fairly often is “Doesn’t that hurt?” People asked that more back when I was taking 6-7 injections every day. Now that I’m on the insulin pump, all they see is the fingertip blood tests. But they still ask, and understandably so. Diabetes is a pretty needle-happy disease. (So if you’re needlephobic and don’t want to read about ’em, this is your cue.)
The answer is … yeah, sometimes. It depends.
Let’s start with a picture I’ll call Jim’s Collection of Stabby Things. On the left is a typical insulin syringe. I keep some around just in case I ever have trouble with the pump.
In the middle is a spring-loaded tool designed to insert the catheter for my insulin pump. That white thing on the end is an adhesive sticker and a metal needle threaded through a teflon (I think) catheter. The spring jabs it into my belly, I pull out the metal needle, and the sticker holds the catheter in place for 2-3 days at a time, allowing the pump to deliver insulin.
I love technology.
On the right is the finger-stabber I use to draw a small drop of blood from my fingertips to test my glucose levels. I’d describe it as essentially painless. I test my blood without thinking, and I can’t remember the last time I noticed any pain. Which is odd, considering that this was the hardest thing for me to do that first time back in 1998. I remember holding that thing for several minutes, sweating as I tried to make myself press the button. These days, I don’t even think about it.
The ones they use for finger checks in the hospital, on the other hand, are the real-world equivalent of a gom jabbar from Dune. They’re one-size-fits-all, designed to pierce cave troll skin. Thankfully, mine’s adjustable, meaning the needle goes just deep enough to draw blood.
Diabetes syringes weren’t usually painful either. The needles are very thin. Every once in a while I’d hit a nerve or a blood vessel, which stung like hell, but that was the exception.
Getting the pump catheter into place … yeah, that hurts sometimes. It’s a slightly longer needle, and the spring shoots it in quickly to prevent the teflon catheter from kinking. I’d say about half the time it goes in with little-to-no pain, maybe 30-40% of the time it stings, and 10-20% of the time I shut the door so the kids don’t hear me swearing.
Beyond that, it’s been a fairly painless disease so far. Every once in a while someone at karate will forget and punch me in the insulin pump site, which isn’t fun, but it’s not crippling pain. More like getting whacked on a cut or bruise. And there are potential complications that could change things for me eventually — nerve damage being a big and nasty one. But considering this disease would kill me in days if I stopped treatment, I think the occasional painful jab to the belly is more than worth it.
I should point out that my experiences aren’t universal. Some people find the fingersticks very painful. (There are meters now that will let you test a blood sample from the forearm, which has fewer nerve endings to irritate.) I have a harder time with the pump than some people. I had to try several different styles before finding one that worked, for the most part, with my body. So take this as Jim’s Diabetes Experience, not The One True Path of Diabetes Pain.
Questions are welcome, as always.
Kameron Hurley
March 22, 2012 @ 8:44 pm
My answer to this question is always “It beats dying.”
Jim C. Hines
March 22, 2012 @ 8:48 pm
Yep.
And I remember how crappy I felt 13 years ago before I was diagnosed, when the disease was messing me up. The needles definitely beat feeling like that again, too…
Rob Reed
March 22, 2012 @ 9:03 pm
How well do the infrared “no poke” monitors work? Or are they for some other purpose or not fully developed tech?
(Btw, I’m “Trebor1415” from LJ and I know you from Penguicon)
Jim C. Hines
March 22, 2012 @ 9:06 pm
Hi Rob! Are you going to be at Penguicon again this year?
Sadly, I’ve never used the infrared testers, so I can’t speak to how well they work. I wouldn’t mind doing away with the fingerpokes someday, though…
Hava Winterton
March 22, 2012 @ 9:58 pm
Thanks for these posts. My brother was just diagnosed and I knew almost nothing about diabetes. So far you’ve saved me from being an insensitive prick 3 times!
K.A.T.
March 22, 2012 @ 10:23 pm
Hi! I’m a nursing student and the daughter of a type 1 diabetic (who uses a pump and a continuous glucose monitor) so I just wanted to say thank you for feeling comfortable enough to discuss this! The more people who are aware of the details the better.
One thing I’m curious about – when you do your fingersticks, do you use the middle of the finger or the side of the finger? In school they taught us to use the sides of the fingers because it helps prevent losing sensation in the front of the finger but I notice a lot of people are still using the front/center and I was curious about your perspective.
And I haven’t been following your blog for long so maybe I missed this, but have you ever posted about the HbA1C tests or the yearly monitoring I’m assuming you go through, like the monofilament for the foot? I am betting that would also be interesting to get details right in stories, although it probably doesn’t come up as much since it’s not a daily occurrence. (Checking feet every night, though…) Oh, and flying with the pump! I went to China with my parents and my dad had his pump and it was not at all problematic, but it was interesting. And it made the actual vacation so easy!
Laurie Robey
March 22, 2012 @ 10:37 pm
Thankfully, we diabetics now have little laboratories that can tell us in 5 seconds how much glucose we have in our system. Whenever someone asks me “Does it hurt?” I tell them it beats dying!
Jim C. Hines
March 23, 2012 @ 7:30 am
Very glad that they’ve been helpful, and I hope your brother is doing well.
Jim C. Hines
March 23, 2012 @ 7:33 am
I generally use the sides of the fingers, not because I’m worried about losing sensation (I hadn’t heard that before – good to know), but because there are fewer nerves on the sides than in the middle. If I use the tip or the middle, it does tend to hurt a little more.
I don’t think I’ve posted the test results. It’s pretty boring, actually. Which is a good thing. I do the HbA1C every 3-5 months, and that usually comes in between 6.0 and 6.2. The monofilament test has never found any damage, nor has the annual eye exam.
I’ve flown twice with the pump so far, and in both cases the TSA folks knew what it was and didn’t give me any trouble. (I don’t know if the fact that I’m a small white man has any affect on that, though.)
Pam Adams
March 23, 2012 @ 1:31 pm
I’m a Type-II diabetic, controlled medically- no insulin yet. I agree on using the side of the finger versus the front for pain-avoidance reasons.
The micro-filament test was mentioned. I think that it’s important to know about neoropathy and numbness. I have complete numbness in my feet, and check them daily-a fair-sized hand-mirror works wonders.
Rob Reed
March 23, 2012 @ 4:02 pm
Jim,
Yeah, the wife and I will be at Penguicon again this year. I’m sure I’ll be in the audience of one of your panels. I’ll try to say, “Hi.”
Btw, if you aren’t scheduled to be on a panel, The Ferret posted today that he specifically needs writers for panels. Send him an e-mail
R
Jim C. Hines
March 23, 2012 @ 4:06 pm
I’m already in touch with him 🙂 Thanks!
Andrew Betts
April 6, 2012 @ 2:22 pm
Always glad to see your diabetes posts. Seeing you being more open about it always helps me do so to when people have questions.
I’ve been on my pump since November (the week before Thanksgiving) overall its made a big change for me, but I had a time a couple months ago that had my test strips arriving late and I had to cut down my testing a lot (twice a days TOPS for about 2 weeks … stupid insurance/pharmacy). Ever since then I’ve been having trouble getting back in routine. I’m debating trying to get a CGM to help out with that, but my insurance has already denied it once and won’t discuss it with me.
Worst part with the pump … I gained 30 lbs in less than a month. Gotta exercise more (I tell myself that all the time, but usually when it comes to studying and relaxing after a long day with a toddler and school, or going and exercising, the exercising has lost out.
But as always, thanks for these posts. They’re always nice to read (and I go back and re-read them from time to time).
Jim C. Hines
April 7, 2012 @ 1:49 pm
I’m really glad the posts have been helpful.
I’ve had to fight with the insurance company once or twice about test strips. I’ve got fairly good coverage, but at one point they decided they were going to switch to a new brand of meter and strips, and simply stopped shipping supplies. Not cool. (They claim they tried to contact me, but I have no recollection of this.)
I’ve got mixed feelings about the CGM. It sounds awesome, but I don’t like the idea of having a second thing jabbed into me all the time, and I worry about building up scar tissue. I heard rumors once that they were working on a CGM sensor that was integrated with the pump catheter, so it would all be there together, which would be nice. Right now, CGMs still seem to be a fancy, “Oh, you don’t really need that” kind of thing, but I’d expect them to become a lot more standard within the next 5-10 years.