For a couple of years, I have kept this story close to the vest, mostly because I felt quite vulnerable sharing it. I still feel sensitive, but the timing is now right to tell the tale. We are seeing many headlines in the news about nurses today. As far as diabetes blog headlines go, I hope you’ll take a few moments to read this one and to thank a deserving nurse.
Winter. I had recently started grad school and I was optimistically trying to do #AllOfTheThings. This included a regular, intensive gym schedule, a disciplined diet, and very little sleep- just the right ratio of “healthy” ingredients to convince myself that I was not running on vapors in reality.
I booked an appointment with my diabetes nurse, as I was experiencing more frequent insulin pump site problems. We needed to find viable locations for site changes, or perhaps to discover a different type of infusion set that worked better for my body type. Also attending the appointment would be a nurse employed by the insulin pump company.
At the appointment, we had all of our diabetes ducks lined up in a row: various infusion set types, reservoirs, alcohol swabs, IV prep, and Humalog vials.
Historically, I stuck to the abdominal area for pump site changes. We wondered if significant scar tissue had developed, causing the numerous pump site failures.
“Alright, can I take a look at your sites?” D (diabetes) Nurse asked.
“Yeah…” I replied, eyes darting to the floor. I felt weak as I handed the control of the situation over to the healthcare professionals. It’s my body, but now I have to trust someone else with it.
D Nurse gently felt around for scar tissue, but did not find much despite my long-term insulin pump usage. P.S. (pump site) Nurse from the pump company inspected the same areas and came to the same conclusions: no scar tissue, but not much pump site “real estate” to work with.
“Geez, no wonder these sites are hurting you. You don’t have much padding to use!” P.S. Nurse said, making eye contact with D Nurse as if to communicate, “This might be a difficult appointment…”.
In terms of pump sites, my extra sit-ups after the gym workouts were not helping matters much. (Now that I am in my last semester of grad school, I assure you that extra sit-ups are a thing of the past!)
“You can try leg, back, or upper butt sites whenever you feel comfortable. But for today, if you want to continue with the stomach, we can do that,” D Nurse said.
“Okay,” I replied nervously.
We all knew what was coming: the “trial and error” method of identifying infusion sets that would work well for me. The nurses had to be sure that I was inserting the sets properly and that we were not overlooking a better option. Like many diabetics, I have endured thousands of needles in my lifetime. Although unpleasant, at some point you get accustomed to the momentary pokes and prods and you do not dwell on them. Regardless, even at the age of twenty-five, it was a harrowing thought to know that my stomach would soon be a pincushion.
First, I showed them how I inserted my sets. The process was automatic and quick. The nurses agreed that I performed every step correctly and we could cross my name off the list of possible suspects causing the site failures.
“Your skin is tough- literally and figuratively. I think you may be getting some resistance from the insertion devices, which could be kinking the cannulas as they go into your body. Can I try an insertion?” P.S. Nurse asked.
I nodded and allowed her to try without protesting.
“Okay, that was good but I felt the kick-back with the inserter. What if we manually put the site in? You could insert the needle by hand, without an insertion device, and perhaps you can curtail the bent cannulas that way,” P.S. Nurse suggested.
Whaaaat?! I wanted nothing to do with that idea, but was also willing to try anything to get the sites to work better. I made a feeble attempt at manual insertion and watched as the needle bounced back off my skin. Defeated, I slumped down in the chair.
“Do you mind if I try it?” P.S. Nurse asked.
I liked how she always sought my permission before attempting anything. The control was still in my hands to an extent, even though she now held the needle.
“You’re doing so well. You’re so brave,” D Nurse whispered. She wiped the dried blood off of my stomach using alcohol swabs, distracting me while P.S. Nurse prepped for the final insertion.
And just like that, it was over. P.S. Nurse swiftly launched the needle into my side, and I did not feel more than a minor pinch. We high-fived and hugged afterwards, proud of our hard work.
That appointment lasted a few hours. While it may not have been as draining as receiving chemotherapy or undergoing heart surgery, I can tell you truthfully that it was an exhausting afternoon for all of us. Emotions were high in the face of uncertainty, and we had to trust and communicate with one another. If it hurt, the nurses were right there to make it hurt less. Likewise, I had to admit when it did hurt, when I did need their help.
In my lifetime of medical appointments, I have felt the cold stainless steel of stethoscopes from nurses and doctors alike. I can attest to the other tools that nurses use: infusion set needles, alcohol swabs, bandages, medical tape, bear hugs, TLC. A few good nurses can change the entire course of an appointment, making it go from “scary” to “It’s going to be okay” as they work steadfastly to heal their patients. Nurses often handle the difficult moments behind the scenes, with little fanfare. They comfort patients like me when we are scared. They make it hurt less. And they deserve to hear “thank you” more often in our society.