Wednesday’s Prompt for Diabetes Blog Week: Yesterday we gave ourselves and our loved ones a big pat on the back for one thing we are great at. Today let’s look at the flip-side. We probably all have one thing we could try to do better. Why not make today the day we start working on it. No judgments, no scolding, just sharing one small thing we can improve so the DOC can cheer us on!
My biggest shortcoming when it comes to my diabetes is something that I have no idea of how to improve with anything besides the passage of time. This is going to be a hard post for me to write, so I guess I’ll try to start at the beginning.
I’m scared of needles. Really, really scared of needles.
I don’t know when my fear of needles grew into a full on phobia, but it was sometime between the age of 5 when I first remember being completely terrified but also completely fascinated the first time I had blood drawn, and age 11 when it took two nurses to hold me to get me to stop violently shaking long enough to get a tetanus shot. I was not diabetic at that point, that would come over 10 years later. Maybe if I was, I would have grown out of the shaking, crying and occasional vomiting that went along the threat of needles.
When I was first diagnosed in my 20s, the ER sent me home without any real instructions as I already had an endocrinologist (for a thyroid problem) who could see me the next day. It was sitting in his office that I gave myself my first shot. It took about 2 hours of my very sweet doctor and his no-nonsense nurse playing good cop/bad cop between seeing other patients before I finally got up the nerve to push the pen needle into my stomach by myself. I threw up immediately after and then sat and cried in my car for another hour before being able to drive home.
I could not cope.
I restricted food to avoid having to take insulin. I shut myself in the bathroom at work at lunch time so that I could cry for the requisite 30 minutes before every shot. I began creating bizarre and complicated sets of rules that dictated when I could eat and what I had to do before each injection. For a while, I was blowing through insulin because I insisted on sending off a 10 unit “test fire” into the air every time I injected *just to make sure* nothing was clogged, as insufficient delivery would mean another shot later.
Very, very slowly my rituals shifted into more normal routines, my A1c started creeping down, and within about 6 months of my diagnosis, I stopped crying with every injection. I hadn’t conquered my fear of needles, but I had learned to live with it and figured out how to manage it so that it didn’t interfere with the treatment of my diabetes.
And now for my current problem: infusion sets.
A few months ago, I switched from MDI to an insulin pump. I know what you’re thinking: “Doesn’t this make it much easier? Now you only have to do 1 infusion set insertion every 2-3 days instead of upwards of 6 shots a day!” That was my hope as well, but the thing that eventually made injections manageable for me was the level of control that I had. Being able to tell if a particular injection site hurt more than usual meant that I could move the needle before I’d pushed it all the way in. With my insulin pen, I’d eventually switched to much shorter needles that seemed to work better with my pretty limited body fat AND didn’t terrify me quite so much. Pushing the needle into my skin involved a weird sort of mental bartering where I’d promise myself certain things in exchange for handling the injection well. Now, a spring-loaded set handles everything for me.
The first time I used an Inset 30 was during my training session with an awesome pump trainer, and under her guidance, I handled it like a pro. Wham, bam, thank you ma’am, that thing was in me in under 5 seconds and I didn’t cry, barf or shake. On some level, I convinced myself that not really seeing the needle before it went in was what made the difference. Now, I’m pretty convinced that it was just the adrenaline. Every subsequent infusion set change has involved the same physical reaction as my early shots, and the consequence is that some times I just can’t handle putting it back on and instead switch to shots for a few days.
I know that the pump helps my control. I have incredibly variable basal needs over the course of the day, and my pump is the only way that I can manage those. I have better control, my A1c is better, and my day-to-day routine is so much more manageable when I’m wearing my pump.
I need to get better about site changes, and actually putting my pump back on when it’s time to change a set. I need to get better about not switching back to shots out of fear or leaving myself disconnected for “just a couple hours” or just changing my reservoir while i leave in a site for days until it’s completely dead and surrounded by scar tissue.
I need to figure out how to ask for help with this.