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Medical Forum / Diseases and Disorders / Diabetes / April 2008

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Dietician and education

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Julie Bove - 11 Apr 2008 00:35 GMT
First I met with the nurse to learn about the Lantus.  She didn't tell me
much I didn't already know.  Told me that Lantus was no more likely than any
other insulin to cause a dangerous hypo when taking a hot bath or shower and
that was unlikely to happen unless you injected into a muscle.

She seemed somewhat unfamiliar with the sharps container.  She told me to
put the cap back on the needle and put it in the container.  I told her that
the one I bought had some special way to remove the needle from the pen, but
I didn't fully understand it because I hadn't actually seen the needle.

She did tell me I had to clean the top of the pen with alcohol each time
before using.  I wouldn't have thought to do that.  And that I have to wash
my skin with soap and water before the injection.  Then there was the
injection.  Eeek!  That wasn't fun.  She couldn't have me use the pen
because she said the stuff in it wasn't safe to inject.  Instead she had me
use a syringe with saline in it.  I was to push the needle in slowly.  I
think I did it too slowly.  Then she told me to pull it out after a count of
five.  The needle did hurt when I pushed it in, but not as badly as it did
when I pulled it back out.  Boy did it hurt!  Burning and stinging that
lasted badly for about 10 minutes.  I thought I was going to pass out.  And
there is still pain in the area.  I see a red spot and some swelling around
it.  She said nobody else has ever had this reaction before.  I don't know
if I did something wrong or am allergic to the needle or what.  It has been
about 2 hours now and I still have a burning pain whenever I move or
anything touches that area.  I did the injection into the stomach.

The dietician went very quickly.  She showed me how to read a nutrition
label.  Of course I already knew this.  And told me that women should eat
between 30 and 45 grams of carb at each meal.  So I was right on there,
but...  I generally don't eat lunch and this was a bad thing.  She said I
need to eat every 4 to 5 hours and if I don't want to eat a meal I have to
have 15 g of carb for a snack.  She said this would lower my BG even though
when I tried this, it raised it.

Ow!  Got to stop typing now because my arm is making contact with where I
gave that injection and it is really smarting!  I hope all the shots are not
like this or I'm not going to be happy.  I also have to go back in three
weeks for a follow-up but I can't fathom why.
RJ-Giga - 11 Apr 2008 04:27 GMT
Julie:

I'm not on insulin, so I cannot say that "I feel your pain". But my mother
had been on insulin for more than 5 years now (probably even 10 years, can't
remember exactly). And you know what, she said that insulin injection was
the best thing that happenned to her diabetic life. She also started with
longer needles (the 1-inch ones, so I imagine it would be more painful when
she started). I know that she was really sad when she first had it, but the
wonders it did on her overall well-being made everything worth it for her.
She said that it doesn't bother her anymore and does it everyday. My Dad and
Uncle, too, recently started insulin injections and they've seen a great
improvement. They both were starting to have eye problems prior to the
insulin injections, and now his eyesight has improved.

Hang in there. Good luck and I'm hoping you will soon feel much better about
the injections. Good luck!

RJ

> First I met with the nurse to learn about the Lantus.  She didn't tell me
> much I didn't already know.  Told me that Lantus was no more likely than
[quoted text clipped - 36 lines]
> not like this or I'm not going to be happy.  I also have to go back in
> three weeks for a follow-up but I can't fathom why.
Julie Bove - 11 Apr 2008 04:35 GMT
> Julie:
>
[quoted text clipped - 13 lines]
> Hang in there. Good luck and I'm hoping you will soon feel much better
> about the injections. Good luck!

Thanks!
hemyd - 11 Apr 2008 08:00 GMT
> First I met with the nurse to learn about the Lantus.  She didn't tell me
> much I didn't already know.  Told me that Lantus was no more likely than
[quoted text clipped - 36 lines]
> not like this or I'm not going to be happy.  I also have to go back in
> three weeks for a follow-up but I can't fathom why.

Hello Julie,

My diabetic specialist gave me very basic instructions on how to inject, as
I told her I was quite OK otherwise. Basically, if injecting into the
stomach part, you squeeze an inch or two of your stomach together and injext
into that. This is so that you don't inject "into your stomach", but rather
into the skin area.

My sensation of pain ranges from not feeling anything (about one third of
the time), to slight prick (about half the time), to intense pain (only in a
few cases), but then the pain is brief. Occasionally the pain will be
accompanied by a burning sensation. The issue on pain was discussed in an
earlier thread a few months ago, and I believed the posters who said it
depended on whether the needle hit a nerve or muscle tissue. Occasionally,
when you hit a blood vessel (you're not meant to inject into those, but it's
not dangerous), you will get a spot of blood appearing afterwards, or a
bruise. As I said in an earlier thread, and here, the pain is brief, and is
far outweighed by the benefit Lantus gave me.

You can easily get a hypo with Lantus. In my case the endo gave me a starter
suggestion of ten units in the evening. After experimenting for two days, I
settled down to a steady dose of 21 units. Keep in mind though, that the
numbers I mentioned may have no bearing whatever in your case. The dose
depends on a combination of the level of exercise during the day, the carbs
you've eaten and many other factors I cannot think of here. When starting on
insulin, in my opinion it is critically important to increase your amount of
measurement. This is to get to know what the insulin is doing. If you inject
in the evening, I also suggest you have something sweet or carby lying
around to stop a hypo.

Special note about stopping those hypos: I have never had to take jelly
beans or sweet drink. I usually prefer to "feast" on something relatively
healthy like a fruit (or two or three - depending on the hypo). And, very
important - don't keep on gorging yourself until your bg goes back to
normal. The food takes time to be absorbed, so if you keep on eating for
half an hour, and then stop when your bg is normal, your bg will later go
much higher. You'll be on the proverbial roller-coaster.

Stick with it, Julie! Get to know your insulin, and you'll be right! The
benefits of normalising your bg far outweigh the small discomfort of
injecting.

Henry Mydlarz.

(By the way - there are many more insulin users here, many of whom have been
using it far longer than I have and may know much more than I do. I will not
dispute their opinions).
Julie Bove - 11 Apr 2008 08:34 GMT
> Hello Julie,
>
[quoted text clipped - 3 lines]
> injext into that. This is so that you don't inject "into your stomach",
> but rather into the skin area.

Yes.  The skin.

> My sensation of pain ranges from not feeling anything (about one third of
> the time), to slight prick (about half the time), to intense pain (only in
[quoted text clipped - 6 lines]
> a bruise. As I said in an earlier thread, and here, the pain is brief, and
> is far outweighed by the benefit Lantus gave me.

I got a spot of blood both times when I injected.

> You can easily get a hypo with Lantus. In my case the endo gave me a
> starter suggestion of ten units in the evening. After experimenting for
[quoted text clipped - 6 lines]
> insulin is doing. If you inject in the evening, I also suggest you have
> something sweet or carby lying around to stop a hypo.

I always do.

> Special note about stopping those hypos: I have never had to take jelly
> beans or sweet drink. I usually prefer to "feast" on something relatively
[quoted text clipped - 3 lines]
> half an hour, and then stop when your bg is normal, your bg will later go
> much higher. You'll be on the proverbial roller-coaster.

I can't stand fruit and shouldn't have it with the gastroparesis.

> Stick with it, Julie! Get to know your insulin, and you'll be right! The
> benefits of normalising your bg far outweigh the small discomfort of
> injecting.

This was not a small discomfort and it still hurts very badly where I
injected the saline.  I don't know why.  When I did the insulin injection
(if I did...may have not gotten any insulin), it didn't hurt.
hemyd - 11 Apr 2008 09:16 GMT
>> Hello Julie,
>>
[quoted text clipped - 50 lines]
> injected the saline.  I don't know why.  When I did the insulin injection
> (if I did...may have not gotten any insulin), it didn't hurt.

Unfortunately I can't offer an opinion why it still hurts, Julie. Many
posters here have been on insulin for ages. They may offer some input. Try
some Googling, maybe using key words such as "insulin" "injecting" "pain"
all together.

Henry Mydlarz
Julie Bove - 11 Apr 2008 09:24 GMT
>>> Hello Julie,
>>>
[quoted text clipped - 56 lines]
> some Googling, maybe using key words such as "insulin" "injecting" "pain"
> all together.

It wasn't insulin I injected. It was saline.
Robert Miles - 11 Apr 2008 16:41 GMT
>> Hello Julie,
>>
[quoted text clipped - 50 lines]
> injected the saline.  I don't know why.  When I did the insulin injection
> (if I did...may have not gotten any insulin), it didn't hurt.
I wonder if whoever mixed the saline used too much salt for the amount
of water used?
supercommodore@mail.com - 11 Apr 2008 19:57 GMT
On Apr 11, 8:41 am, "Robert Miles" <robertmi...@bellsouthNOSPAM.net>
wrote:

> >> Hello Julie,
>
[quoted text clipped - 53 lines]
> I wonder if whoever mixed the saline used too much salt for the amount
> of water used?

Hey Julie, I've used pens of 70/30 when I was first put on insulin.
Though I moved to needles because they were easier on my body.

Though I should add that I do take Lantus via needle twice a day at 30
units per shot to control my Blood glucose levels.  I get those
"Lantus stings" from this insulin.  Don't seem to get it from any of
my other two fast acting insulins or any others.

Though I do occasionally hit a nerve when slipping in a needle about
once every two weeks.  Though I tend to inject Lantus more times than
most diabetics I know of.  When that happens, a wince is in order and
if its REALLY painful, a shed or a tear might be in order for 1 minute
and a slight bruise for me lasts about 24 hours.

Jeremy supercommodoreatmaildotcom

Moving from Portland Oregon to Northern NY 75 percent sure.
Where there motto should be:
"nice months on the snow you know, nine months of snow,
You take shovel down and pass it around until the snow is cleared.
Then repeat the process again and again,
because you'll never know when the next snow flake will hit again."
Julie Bove - 11 Apr 2008 21:20 GMT
> On Apr 11, 8:41 am, "Robert Miles" <robertmi...@bellsouthNOSPAM.net>
> wrote:
[quoted text clipped - 95 lines]
>
> Jeremy supercommodoreatmaildotcom

Wow!  Thanks!
Ozgirl - 11 Apr 2008 23:09 GMT
<supercommodore@mail.com> wrote in message news:ae5db670-874b-

> Moving from Portland Oregon to Northern NY 75 percent sure.
> Where there motto should be:
> "nice months on the snow you know, nine months of snow,
> You take shovel down and pass it around until the snow is cleared.
> Then repeat the process again and again,
> because you'll never know when the next snow flake will hit again."

Hi Jer, hows things?? NY is New York? If so, that's a big change for you!
Julie Bove - 11 Apr 2008 21:19 GMT
>>> Hello Julie,
>>>
[quoted text clipped - 53 lines]
> I wonder if whoever mixed the saline used too much salt for the amount
> of water used?

It was a premix.  I just don't know.  I suspect I may have jiggled the
needle once it was in there, or the fact that she had me push it in super
slowly.  Hard to say.  Still have a big red mark there.
percy - 12 Apr 2008 02:24 GMT
> First I met with the nurse to learn about the Lantus.  She didn't tell me
> much I didn't already know.  Told me that Lantus was no more likely than any
[quoted text clipped - 5 lines]
> the one I bought had some special way to remove the needle from the pen, but
> I didn't fully understand it because I hadn't actually seen the needle.

The angled hole lets you slide the pen in and unscrew the needle from
the cartridge without touching it. The opposite end of the actual needle
sticks out to pierce the top of the cartridge when you screw it on, so
it is somewhat dangerous.

Don't sweat the alcohol and soap-and-water thing too much, it's just the
usual CYA. Meal insulin pen users shoot through their clothes all the
time. I'm certain I've injected through pocket lint or a coffee stain at
least once. Whatever you feel comfortable with - but <insert wagging
finger here> no playing in litter boxes or dumpsters without a wash
before injecting ;-)

Did you manage to get your prescription for strips upped?

Welcome to insulin junkie-hood :-) I hope you get the same great results
as Henry and Uncle Enrico.

Vicki
Julie Bove - 12 Apr 2008 02:49 GMT
>> First I met with the nurse to learn about the Lantus.  She didn't tell me
>> much I didn't already know.  Told me that Lantus was no more likely than
[quoted text clipped - 18 lines]
> finger here> no playing in litter boxes or dumpsters without a wash before
> injecting ;-)

I asked her about shooting through my clothes and she said I shouldn't do
that because I would bleed on my clothes.

> Did you manage to get your prescription for strips upped?

Not yet.  She also tried to discourage me by telling me my meter had been
discontinued.  She wanted me to use a Contour because it's faster.  That
makes no never-mind to me!  I happen to like my Elite XL.  *sigh*  I guess I
will have him give me the new prescription for the Contour strips.  She also
told me I didn't need any more strips.  Said testing three times a day was
enough.  I kind of don't think so.  And even if it was, I would like to have
extras in case I have hypos or whatever.

> Welcome to insulin junkie-hood :-) I hope you get the same great results
> as Henry and Uncle Enrico.

I just hope I don't gain weight.  I got a new ring today and it fits my
smaller finger.
 
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