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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:

  1. Because I know other writers read this, and it makes me cranky when stories get the details of my disease wrong.
  2. 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.

Mirrored from Jim C. Hines.

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( 50 comments — Leave a comment )
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hechicera
Mar. 23rd, 2012 12:23 am (UTC)
Very generous...thank you.
deborahblakehps
Mar. 23rd, 2012 12:35 am (UTC)
I used to use an experimental medicine (back in my chronic fatigue syndrome years, which were many and long) that required me to give myself shots twice a day. Just subq, which meant grabbing a roll of belly and jabbing the reasonably small needle in. You know, over the course of two years of doing this twice a day...I NEVER got used to it. Or, really, much better at doing it :-) It wasn't so much the pain, which was minimal, but more the fear that I would do it wrong and somehow, I dunno, rupture my spleen. Never happened, of course. But still, it would probably be good if I never became a diabetic.You have my sympathy, and my respect, for dealing as well as you do.

[Ironically, I have a cat now with chronic renal failure, and I have to give her subq fluids every day. I keep telling her that I practiced on myself first, but she doesn't seem to find that any kind of consolation.]
jimhines
Mar. 23rd, 2012 12:50 am (UTC)
Huh. I have a friend the doctors thought had CFS for a while, and I remember him doing subcutaneous shots at one point too. I wonder if it was the same thing.

I have given myself literally thousands of shots, and I have never ruptured my spleen. I think you'd need a much bigger needle for that :-)
(no subject) - deborahblakehps - Mar. 23rd, 2012 01:20 am (UTC) - Expand
tiamat1972
Mar. 23rd, 2012 12:36 am (UTC)
That might not be painful but it sure looks like it would be. *shudder* Of course, I have very small veins, so anything to do with needles is very uncomfortable for me. I don't even think I could donate blood because of that. Tried donating plasma once; can you say agony?

I salute you, you're a braver soul than I.
jimhines
Mar. 23rd, 2012 12:47 am (UTC)
I don't know about brave ... I always hated needles, but when the alternative is a rather unpleasant death, you learn to do the needles. It also helps that the injections are all subcutaneous, which means they're not going as deep as the ones that need to hit veins. Thinner, shorter needles and fewer nerves to hit.

I have to do blood draws every 3-4 months to check my long-term sugar levels. Those are less fun. (Though I've found a lab in town that has good techs, which helps a lot. I have big veins, but they like to try to roll out of the way.)
(no subject) - dulcimeoww - Mar. 23rd, 2012 06:37 am (UTC) - Expand
(no subject) - tiamat1972 - Mar. 23rd, 2012 11:39 am (UTC) - Expand
suricattus
Mar. 23rd, 2012 12:49 am (UTC)
Thank you for reaffirming the reasons I monitor my insulin-freaky body chemistry and forego things to maintain it. I may be (mostly) over my needle phobia, but mostly t'ain't entirely....

Edited at 2012-03-23 12:54 am (UTC)
jimhines
Mar. 23rd, 2012 12:54 am (UTC)
I fully support anything that will help my friends stay healthy!
(no subject) - suricattus - Mar. 23rd, 2012 12:56 am (UTC) - Expand
roseaponi
Mar. 23rd, 2012 01:02 am (UTC)
So... Does the hospital get many cases of diabetic cave trolls?


Modern diabetes sounds like its improved since Stacy of the Babysitters Club books - for that matter, since my grandmother-in-law. Thank you for the post - I'm trying to stay up to date since my husband has the family history for it.
jimhines
Mar. 23rd, 2012 01:09 am (UTC)
Oh, yeah. Diabetes is surprisingly prevalent in troll populations.

My father is also a diabetic, and it's amazing to compare the tools he had when he started out to what we've got today. I remember him having to dip test strips in urine, then compare the color to the canister to get a rough approximation of what his blood sugar was four hours ago. Whereas my meter gives me a result in five seconds.

I've also seen how much of a difference the insulin pump made for him, how much more freedom and control he has these days. (And I love the fact that I've gone from 6-7 shots/day to one slightly-more-annoying shot every 2-3 days.)
cailleuch
Mar. 23rd, 2012 02:39 am (UTC)
A colleague of mine does so much better on her pump. She is a brittle diabetic. We all had to be vigilant, watch out for her and carry hard candies to be administer when needed. This was our assigned task, vigilance. It is much nicer to not have to do that as much.

I was needle phobic until the cat in the icon was diagnosed with diabetes. I make sure Romy eats and gets her insulin injections and she is doing well. There is now a box of the orange tipped syringes on the counter as well as a sharps container.

spiritdance
Mar. 23rd, 2012 03:59 am (UTC)
Hmm - do you do home testing for the cat? I generally found ear margins were pretty easy, and the cats pretty much didn't care, even in the office.
(no subject) - akiko - Mar. 23rd, 2012 01:59 pm (UTC) - Expand
(no subject) - cailleuch - Mar. 24th, 2012 06:57 am (UTC) - Expand
(no subject) - jimhines - Mar. 23rd, 2012 11:38 am (UTC) - Expand
threeoutside
Mar. 23rd, 2012 03:50 am (UTC)
Information is always good. Thanks for the lesson. There is one question I've wondered about, but never seemed to find an apt moment to ask anyone using a pump: does the tube go just into the muscle, or sub-cu, or right into the abdominal cavity? The last sounds pretty drastic so I'm betting not that, and I am assuming it's not IV because I would think it'd be hard to find a vein on the stomach so often...I'll shut up now.
jimhines
Mar. 23rd, 2012 11:39 am (UTC)
It's subcutaneous. Mine goes in at an angle, and I'd guess the end point is maybe 8 millimeters deep.
(no subject) - eleryth - Mar. 23rd, 2012 12:39 pm (UTC) - Expand
(no subject) - jimhines - Mar. 23rd, 2012 12:45 pm (UTC) - Expand
spiritdance
Mar. 23rd, 2012 03:57 am (UTC)
During my first pregnancy, I had gestational diabetes. i can safely say that the newer meters that use tiny amounts of blood and let you use something other than a finger to test were a lifesaver. It did take a bit of experimentation to figure out where I needed to set the lancet stab depth for my skin, but hey, I could actually use my fingers (at one point I was testing 4 to 5 times daily). I even tested right above my knee a couple of times, and got comparable numbers to the forearm testing (done at the same time - hey, I was in an analytical mood!).

Anyway, now I'm taking measures to reduce my chances of Type 2 later (I'm already at fairly high risk with the gestational diabetes, and family history; I can at least control the weight).

jimhines
Mar. 23rd, 2012 11:50 am (UTC)
The new meters are amazing. I remember what my father was using 30 years ago (he's also a type 1 diabetic), and the progress in diabetic tools is just incredible.

It took me a few tries to get the depth right on mine too, but I love the fact that you can actually adjust the depth.

Interesting that the blood from the knee gave equivalent results. I've heard that this isn't always the case, but I haven't looked into why or done any research myself. Now I'm curious...
(no subject) - feanna - Mar. 23rd, 2012 04:29 pm (UTC) - Expand
elialshadowpine
Mar. 23rd, 2012 04:18 am (UTC)
While not diabetes, I was on methotrexate injections for my RA for awhile. Looooong needle, intramuscular injection. Honestly, unless I screwed up and hit a nerve, the biggest thing was being afraid of the needle more than the actual pain of the injection.
jimhines
Mar. 23rd, 2012 11:48 am (UTC)
Did the shots work? I've found that good results can go a long way toward making shots more tolerable...
julieandrews
Mar. 23rd, 2012 04:26 am (UTC)
My Mom once tested my sugar. She said the trick was to do it on the side of your finger. And it worked. I didn't feel any pain. The same could not be said when I had my sugar tested at a health fair. Right into the pad of my finger. I felt it. Why don't they teach everyone the side of the finger trick?
jimhines
Mar. 23rd, 2012 11:44 am (UTC)
Yep, as I understand it, the side has fewer nerve endings, so it doesn't hurt as much.

No clue why they don't teach everyone to do it that way :-(
(no subject) - deire - Mar. 23rd, 2012 01:02 pm (UTC) - Expand
mtlawson
Mar. 23rd, 2012 04:58 am (UTC)
Okay, this is probably asking the obvious, but it's 1 AM.

Do you take out the pump when you go to the dojo?
jimhines
Mar. 23rd, 2012 11:41 am (UTC)
Nope. My Monday workouts are three hours long, and going that long without insulin wouldn't be good. I'll take it out when I do the exercise bike on the weekends, but that's only a half-hour workout, and it's more intense, so the aerobic exercise keeps the blood sugar under control for that time.

When we partner up in karate, I will warn my partner where the pump is plugged in, and they avoid that spot.

I've taken it out once or twice during actual fighting practice, but that's over four+ years.
elven_wolf
Mar. 23rd, 2012 05:34 am (UTC)
I have to give myself an intramuscular shot weekly. One time the pharmacy was out of the right needles, so they gave me insulin needles. I was surprised by how tiny they were. They did not get the job done for me. Just a lesson in the importance of proper gauge.

I remember the first few times I had to stick myself. Owie.
dulcimeoww
Mar. 23rd, 2012 06:30 am (UTC)
My husband has to do that, and the pharmacy keeps giving him the wrong needles. They say they don't carry the kind he needs. Where do you get yours?
(no subject) - elven_wolf - Mar. 23rd, 2012 07:53 pm (UTC) - Expand
(no subject) - jimhines - Mar. 23rd, 2012 11:42 am (UTC) - Expand
(no subject) - elven_wolf - Mar. 23rd, 2012 07:54 pm (UTC) - Expand
(no subject) - akiko - Mar. 23rd, 2012 02:02 pm (UTC) - Expand
(no subject) - elven_wolf - Mar. 23rd, 2012 07:55 pm (UTC) - Expand
dulcimeoww
Mar. 23rd, 2012 06:28 am (UTC)
I was getting my insulin monitored while I was recovering from my coma, so I'm familiar with (but not used to) what the finger sticks and insulin shots feel like. The sticks didn't usually hurt too badly, except when they did them a billion times a day, or when my left hand had some nerve damage. The insulin shots basically couldn't be felt, but occasionally my arm would sting for a bit afterward. Overall, I would say it sucks way, way less than an IV.
jimhines
Mar. 23rd, 2012 11:44 am (UTC)
"Overall, I would say it sucks way, way less than an IV."

Totally agree. I've still got a little bruise from the blood draw I got on Monday, whereas the average insulin shot rarely even left a mark.

One problem I've run into with the finger sticks is if I wasn't paying attention and hit a spot I'd already used that day. *That* stings, and I can see that becoming more of a problem if you're doing a lot of testing.
(no subject) - dulcimeoww - Mar. 23rd, 2012 05:08 pm (UTC) - Expand
jakobdrud
Mar. 23rd, 2012 12:52 pm (UTC)
Sounds like you could have an alternative career as a tattoo artist :-)

But seriously, thanks for these posts. I have friends and family with diabetes, but I don't know didley squat about it apart from what they've told me, so I really appreciate you sharing your experiences.
jimhines
Mar. 24th, 2012 05:52 pm (UTC)
You're very welcome! I'm glad they've been helpful.
deire
Mar. 23rd, 2012 01:01 pm (UTC)
Yeah. In my phlebotomy class, guess who the subjects were? You learn faster when your experimental subject is slotted to do the EXACT same thing to you next! Finger sticks were the worst part of the class. Well, that and being dumb enough to volunteer for the very first draw. The other student panicked when blood welled up around the needle in my arm. It was...messy. (4.0! /end brag)
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