In the early 1990s when I was in elementary school, I took part in a study through the Joslin Diabetes Center which examined whether or not patients “liked” new, shorter needles on their insulin syringes. We had to fill out a chart with smiley faces for “minimal pain,” sad faces for “painfulness,” etc. It’s probably why I remember this: the artistic part was fun.
A creature of habit, I emphatically voiced my displeasure with the new, short needles. Big sad face for you on the chart, “new thing meant to help me!”
My parents, perplexed that I would elect to use the “behemoth needle model,” decided that it would be in my best interest if they switched out the needles unbeknownst to me. I believed that I was still using a large needle, when in reality it was a short needle. Not one to complain much about insulin injections to begin with, I did not notice the difference or care to vocalize it if it was there.
(Sorry to Joslin if we messed up your study! I believe the switching out of needles was probably done after our part of the study concluded). Also, #sorryimnotsorry to my parents for still being a little miffed about this. I’m all about patient autonomy, albeit my parents were simply trying to lessen my diabetes burden at that time.
So, why am I reflecting on this during Snowmaggedon 2015? Perhaps I have too much free time on my hands today. But I’m also just plain kind of sore from injections right now. The skin on my stomach bounces the needle off in protest after ten years of insulin pump sites. Can I really blame it? My upper left butt cheek looks like a game of pin-the-tail-on-the-donkey gone wrong, although the right side knows how to handle the infamous “Lantus Burn” like a champion.
Needles are the easiest part of diabetes in many regards, but somewhere along the line I have noticed in social media groups that there is this pressing need for some to announce that diabetes never hurts. Well, for some of us, it does. And trust me, as a kid I was the first to judge the “insulin shot cry babies.” Mine was a face of stoicism from a young age. But as an adult making an effort to accept my emotions more freely, I can admit that sometimes the needle hits a sore spot and a few swear words are mumbled.
What can one do about this- this reality that needles keep you alive whether or not they cause pain? Running with our theme of doing what works for you, exercise your freedom here. If you like the bigger needles, use them, and then draw a big smiley face on your chart for good measure! We have options here, and plenty of them at that rate.
#ItMakesSenseIfYouHaveDiabetes: Perhaps short needles work on some sites using a particular type of insulin, but larger needles work better in different areas with different insulins? BD Nanos (4 mm) are the tool-of-choice for Lantus injections in my backside, while the BD Short (8 mm) needles work better for Humalog injections in less-padded areas. Humalog does not pool at the injection site as often with the larger (confusingly named “Short”) needles. Yet the Shorts with Humalog have the pin-the-tail-on-the-donkey effect on my left side- go figure. Maybe I will employ Nanos for those sites? Again, #ItMakesSenseIfYouHaveDiabetes.
This is my personal configuration that works well for me, so I’m going to stick with it. When I need to make alterations, I will do so under my own good intentions. And, in some weird sort of psychological spin on things, I acknowledge that I am a fan of the same method as I was two decades ago: using a combination of long and short needles to get the job done while maintaining my sense of independence in living with type one diabetes. Ultimately, it is about how you feel as the individual; however wacky your methods may seem, do what works for you.
***Update: Erin Gilmer over at healthasahumanright.wordpress.com brought up a good point with me via Twitter. Not everyone has these numerous treatment options due to various obstacles to proper health care: limited insurance coverage, out-of-pocket expenses, socioeconomic status, and so on. While I am a firm believer in fighting hard for the health care that you want, I must concede that there are certainly limitations to this idea.
I meant to disclose previously that I paid for the 8 mm needles out of pocket. My insurance had already covered a regular syringe prescription when I first switched back to shots. Then my doctor and I chose to go with pens out of convenience, so obtaining the Nano pen tips took a lot of jumping through hoops until insurance was kind enough to override my refill a few weeks early. When it came time to try the Short 8 mm needles after the Nanos weren’t working on my stomach, I purchased a box on my own out of fear of insurance tightening their pocketbook with me. If I remember correctly, the box of 100 pen tips cost about $45 out of pocket.
I will blog about the health care coverage loop-de-loop at a later time, but wanted to acknowledge Erin’s point here, as I believe this is an important one, too. Patients can fight for their health, but the health care system needs to give back some of that same effort in order to help us to get well.