insulin syringe

Thank you, Frederick

It’s World Diabetes Day, the anniversary of Frederick Banting’s birth. Banting discovered insulin, and without his discovery, I’d have died at the age of twelve. In the wake of the election my diabetes and chronic illness advocacy has been neglected to the point where I am only addressing Diabetes Day now, at ten at night. A weird part of me – the part that has normalized an existence wherein I am always one tiny miscalculation, one computer error, one missed test, or forgotten alarm clock setting away from death – has felt like this wasn’t as important anymore. In the face of Trump’s election, I felt compelled to tackle every social injustice I could find. Suddenly it was as if all I’d done for education, science literacy, women’s rights, and diabetes awareness weren’t enough. Why had I not also been more involved in politics? In racial justice? In environmental protection? I felt ineffectual. Flaccid.

But I’m not a super woman, and I don’t know how to fight every injustice (at least not yet!), and I can’t give up fighting the battles I’ve been fighting so long. And after all, my diabetes advocacy does intersect: for with Trump and his team’s threats to the ACA and the heath care social safety net in general, people like me are at very real risk. 

Advocacy requires education, but don’t worry, if you don’t know the story of Banting’s discovery of insulin, it is anything but dull!

You must first imagine a time when diabetes wasn’t a punchline about fat, lazy Americans. Before it was a hashtag accompanying photos of greasy and sugar-filled treats. Before it was something anyone laughed about. It was 1920, and diabetes was a universally feared death sentence that almost always befell children. 

Type 1 diabetes, the type I have, is an autoimmune disease. There is no prevention and there is no cure. It is not caused by diet or “lifestyle”, and it does not discriminate; it can emerge in anyone, from infancy through adulthood, of any level of physical fitness. A full understanding of the disease has not yet been reached, but what is known is that it is at least in part genetic, and is likely triggered by environmental factors such as viral infection. A person develops type 1 when their immune system starts attacking their body’s own insulin-producing beta cells. Without insulin, energy from food consumed cannot enter cells. Before the discovery of insulin, this meant certain death.

In the early 20th century, large hospitals would have entire diabetes death wards, usually filled with children, all slowly succumbing to the disease while their grieving families sat by, waiting for them to die. I can imagine what it would have been like to be a child in such a ward. I can tell you exactly what it feels like to die from diabetes, because I almost did. Twice. 

The first time was when I was twelve. It started as malaise. I was a bit more tired than usual. I was somewhat nauseated a lot of the time. I started to become emotionally depressed. As the month preceding my diagnosis progressed, I became weaker. I did not know that my body was cannibalizing my fat and muscles for energy, that my blood was slowly turning acidic, and that my organs were beginning to fail. My weight dropped rapidly. I was winded walking up a flight of stairs. My vision got a bit blurry and my thinking muddled. And I was so, so, so thirsty. Like, unless you’ve spent three days in the Sahara with absolutely no water, you cannot imagine how thirsty.

Had I not been diagnosed I would have starved to death. The inability of my body to convert food into energy causing me to waste away, and eventually to die from heart attack, stroke, or systemic organ failure as a result of Diabetic Ketoacidocis (acidic blood), slipping mercifully into a coma first…maybe lingering for a few days. And so was the fate of every child before a young Canadian doctor, Frederick Banting, discovered insulin. 

Now picture this in your head: the year is 1922. In a diabetes death ward in a children’s hospital in Toronto, a couple hundred children lie in metal-framed hospital beds. Their bodies are emaciated, some are in comas, all suffered as I suffered. The air is sweet with the smell of their breath and urine, for a diabetic’s breath is like fruit and their urine like honey. Their Gibson Girl mothers weeping, their besuited fathers trying to uphold the emotionless masculinity of their age, their siblings in petticoats and newsboy caps kneeling at their sides. Then a dashing young doctor, Banting, and his partner, Best, enter the ward, insulin syringes in hand. One by one, they begin injecting the children, and by the time they get to the last child, the first have already begun reviving from their comas. 

Suddenly, diabetes is no longer a death sentence. It is a disease that could be managed. Children who were skeletal and comatose become plump and active once more. It is the epitome of the inspirational tale. But this is not a story of hope, because that is not where the story ends.

Managing type 1 is both difficult and expensive. Although insulin is nearly 100 years old, patent-loopholes allow drug companies to keep tight proprietary control over the most effective formulae. A lack of regulation of the pharmaceutical industry in the United States means that US patients often pay more than ten times the price for a bottle of insulin than our fellow diabetics in other countries. The insulin that keeps me alive, Apidra, costs between $280-$480 a vial depending on which US state you buy it in – and bear in mind, depending on the patient one month’s supply can be anywhere from 2 to 10 vials. In Canada, the country of insulin’s discovery, the same vial is about $30. Further, effective type1 management means testing one’s blood sugar 8-20 times daily (each of my test strips costs $2, so that’s up to $40 a day), delivering insulin via syringe or pump (a pump runs between three and seven thousand dollars), using a few other medical odds and ends like sterilization alcohol, medical adhesives, etc., and regular doctor visits. The total annual cost of my diabetes medication and supplies, without which I will die, is about $26,000 before insurance.

That cost is not prohibitive, it is impossible. And because of that, I almost died of diabetes a second time.

Before the ACA, I was uninsurable. My type 1 considered a pre-existing condition. After I was dropped from my dad’s insurance, I had to pay for everything out of pocket because of my uninsurable status. Even re-using single-use only insulin syringes to the point where each injection left a massive bruise on my abdomen, even reusing finger-prick lancets until they were literally too blunt to work anymore, even fasting every other day to take less insulin, I couldn’t afford the cost of my disease. In my mid-twenties I began insulin rationing. I would test my sugar only once a day and take the bare minimum of insulin to keep me alive, keep me working my three jobs.

Then one morning when I was 26, it caught up with me. I’d lost 20 pounds in a month – I woke up vomiting that morning: the Diabetic Ketoacidosis from not getting enough insulin was so extreme that I lost seven more pounds in one day. My roommate drove me to the emergency room where I had five IV lines put in, was put on oxygen, intravenous potassium, and spent three days in Intensive Care. 

President-elect Trump is already waffling on his stance on the ACA, but that doesn’t stave off the real fear of me, other diabetics, and others who have pre-existing conditions for our lives. Literally, we fear for our lives because we know that people like us were left to die before the ACA. We are hoarding our medications and supplies and taking every step we can to hedge against loss of insurance.

I said this was not a story of hope, but neither is it a story of despair. For, like I said, there is a part of me that has normalized fighting for my life. I have done it, in a very literal sense, every minute of every day since I was twelve and a half years old. And so too have other type 1s fought. And so too have type2s fought. And so too have all those with chronic illness and disability fought. We fight because our lives are worth fighting for. Because an enlightened society recognizes our intrinsic value as human beings, despite the flukes in our physiology. We fight because we know that, despite the misconceptions and stereotypes society has about us, we have something to offer humanity: something immense, something those who’ve never had to fight for there lives cannot understand.

Our bodies may be damaged and weak, but we are strong. And we will take our fight to the steps of the White House, to the feet of the men who want to strip us of our means of survival. Who want to strip us of our Right to Life. We will use our damaged, sick, and broken bodies as blockade. We will use our clever and quick thinking minds. For if anyone knows how to fight, it is us. 

Type 1 children, before and after insulin treatment: 

Dr. Frederick Banting, Nobel Laureate for the discovery of insulin: 

Banting and Best, with one of the diabetic dogs they successfully treated:

Thank you, Frederick. 

Broken

Ten years ago I was a student on my own in NYC. The price gouging of insulin in the US was just beginning. I have been type1 diabetic since the age of twelve. When I think of the struggles I’ve gone through in the past twenty years just to stay alive, a few memories stand out like shards of glass: clear, pointed, and bloody. This is one of those shards…

I am twenty. My alarm wakes me at six to get ready for class. It wakes me at six to begin the strict and unforgiving regimen that keeps me alive.
Before anything else I test my blood sugar – blearily, groggily, automatically. The meter is a crappy drug store brand. I miss my old meter but I can’t afford to use that one anymore – the test strips were $75 a bottle. $375 a month. $15 a bottle for this one.
Slide the strip into the meter and prick my finger. This meter requires more blood than my old one, so the poke has to be deeper, and I squeeze until a gory crimson pearl forms on my fingertip. The dull lancet hurts: you’re supposed to change them out after each use, but I change it out more like once a week, because a box of lancets is $20, and who can afford that?
This is the first of between 8-20 tests I am supposed to each day: when I wake up, before and after each meal and snack, before, during, and after exercise, before bed, any time I feel “off”, and maybe a middle of the night check because I’m afraid of dying in my sleep.

Dead In Bed Syndrome is the number one cause of death for young type1s.

Truth be told, I don’t test as much as I am supposed to anymore. I can’t afford that. Once, when I tried to refill the script for my strips a week too early, the pharmacist told me coldly, “You’re testing too much.”
“I’m type one,” I replied, nonplussed, thinking he should recognize the obvious implications of that statement.
“You test four times a day. Prescription for four times a day,” he said patronizingly through a thick accent.
In a rare moment of assertiveness fed by desperation, I slammed both hands on the counter, “Do you even know the difference between type one and two?” I asked, “You’re not a doctor! I’m testing exactly as much as my doctor told me to.”
That was when I realized it was the insurance company I must defer to in matters of health, not my doctor.
During class in the morning I feel hazy. Prof gets a bit blurred around the edges. Can’t make out the diagram of a neuron projected on the screen.

My meter beeps quietly when I test, and the bro next to me grunts, “Do you have to do that now?” having assumed I was fiddling with a phone or PDA. I crumple and say nothing. Time to calculate a correction.
My entire life is math. I calculate how much insulin I need to correct – to bring my blood glucose down to the normal range. I calculate how many grams of carbohydrate are in anything I eat, and how much insulin I’ll need to compensate for them. I subtract for the insulin that’s still in my system. I subtract for any exercise I’ll be doing. I add for lack of sleep. I add for emotions: for anger, for sadness, for fear. I add for hormones: menstrual, cortisol from the stress of school, of working two jobs, and ironically, from the stress of not being able to afford my insulin.
Surreptitiously under my desk, I draw the insulin up into a syringe and jab it into my belly. I don’t swab with alcohol first, because I can’t afford alcohol swabs. The shot hurts despite the needle being a hair’s thin gauge and only a half-inch long. It hurts because it is dull from overuse. Insulin syringes are single use only, but I can’t afford that. I put the biohazard orange cap back on and save the syringe for next time as another bruise forms on my belly. My belly is a constellation of pinpricks and bruises.
I got into the habit of skipping meals to save money. I’d contemplated going low-carb, not because it’s trendy or healthier or better for type1 diabetics (it’s not), but because low carb means less insulin – I could save money! But the diet itself is expensive, so that evening I start boiling water for plain oatmeal. Five bucks for the extra large carton; a meal a day for a month! I could eat like queen if I didn’t spend all my money on prescription copays. But I remind myself as I stir my soggy beige repast that I am lucky to even have insurance.
I am one of the lucky ones, I think, as I roll my vial of insulin gently between my palms to warm it and mix it when it slips from my hands and falls to the floor. I am one of the lucky ones. It shatters on the rust colored tiles and the reek of the hormone that keeps me alive (imagine concentrated Eau de Band-Aid) surrounds me like the Worst Cologne In the World.

The puddle on the floor is a week’s wages.
The puddle on the floor is worth half a month’s rent.
The puddle on the floor is worth two months’ food.
The puddle on the floor is my life.

I sink to the floor next to the puddle and sob. And I am one of the lucky ones.

Some people let themselves go into DKA (Diabetic Ketoacidosis, a near-death state) so they can be taken to the ER. There they will be chastised for not taking their insulin – the term doctors use is “non-compliant”, like we’re parolees failing to meet the terms of our release. Like we’re snorting sugar like blow. But at least with the contempt and the upbraiding comes a free vial or two.
For some this is the only way they know how to get insulin; each incident of DKA doing just a little more damage to the tiny blood vessels that feed their kidneys, to their eyes, their nerves, to their hearts, to their lungs. If they don’t die this time, they’re gambling with their future.
But I’m still a coward. It’ll take another few years before I get pushed far enough to boldly (stupidly) play those odds myself. This time…this time, after three hours of sobbing, I walk to the pharmacy.
Swollen face and red eyes. The cacophony of traffic and sirens and catcalls blend together into aural soup. The buildings, traffic, people around me blurring together too, unreal and waxy like a swirl of melting crayons. I’m not truly seeing or hearing: I am mathing.
What if they won’t refill my prescription early? How much food can I afford when the currency is units of insulin? How long will I last? Maybe a few days? Maybe a week? I don’t actually know exactly how long I’ll live without it, but I’ll start feeling the effects within hours: my vision will blur, my thirst will become unquenchable, nausea and hunger will battle for reign supreme over my tummy. I’ll lose weight rapidly; I have an athletic physique now, but that will disappear almost overnight. I’ll get weaker. I’ll be winded walking a few blocks or climbing a flight of stairs. My muscles will twitch. I’ll vomit. I’ll faint. I’ll hyperventilate as my lungs desperately try to expel the toxins building up in my blood. My fingers will wrinkle until my hands look like a striga’s. My heart will pound. Then something will give way. Maybe a heart attack first. Maybe suffocation. My organs will fail in one order or another. I will die. And it will hurt.
Maybe I can last long enough to scrounge up the money – borrowing, working extra shifts, saving: hey, I think darkly, “If you can’t afford to eat, at least insulin will last longer!” Silver fucking lining.
The florescence of the drugstore rescues me from my mind. I head straight to the pharmacy, and to a pharmacist I’ve never met before. Thank god there’s no line. She is a woman in her forties with wavy auburn hair. In her white coat, she is the first thing I see with clarity. She is pretty. She has freckles.
I ask for a refill. I tell her I broke my bottle. “You’re not due for a refill for a month,” she says.
“Please?” I say…I don’t have anything else to say. I don’t have anything else at all.
She consults her computer.
She makes phone calls.

I pace and try not to look at the fitness magazines, with their diet and exercise advice. I try not to think about how people micromanage their nutrients, count their calories, and run, run, run from the Reaper. I will never be healthy. I am what they fear. I am what they are running from.
The pretty pharmacist tells me there’s nothing she can do. Insurance won’t fill it for four more weeks.
I don’t cry because I have no tears left, but I don’t know what to do, so I collapse against the wall in desperation, my arms wrapped around me, trying to think and trying not to think.
How can insulin cost so much? How can they refuse me when my life literally depends on it?

How can my life be worth so much and so little at the same time?

I don’t know how long I stand frozen (or am I shaking?), against the wall when I feel the hand on my shoulder. I look up at a halo of auburn hair, but I can’t meet the eyes that look at me. She slips a refrigerator-chilled box into my hand, inside, a vial of insulin. “Don’t tell anyone,” she says, and walks away.

2

I switched from insulin syringes to pens! I use the blue pen for my Humilin N and my pink pen for my Humolog. I haven’t noticed a huge change in the comfort level from syringes to pens, though I pens are a lot shorter (well, only 2mm, but it seems like a lot [I used 6mm syringes and am now using 4mm pen needles])

I like the look of pens way better than syringes it is more discreet which I really like. People don’t automatically assume you are shooting up drugs when they say you with a pen, unlike when you are using a syringe :)

BTS REACTIONS : Finding out you have diabetes but you’re too afraid to tell them.

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Monsta X version (here)

Namjoon would find out as you were on the phone with your dietician, thinking you were on a diet he would ask you questions so you had no choice but to tell him. He would feel a bit down that you didn’t tell him because it could’ve affected your health, but he wasn’t mad. “You know you can tell me anything. I’ll take care of you from now on.” He would pull you in a hug and pat your head. The day after he would be looking on the internet for healthy meals the both of you would enjoy. 

Jin would be very understanding. Being in a relationship with him for a long time, you felt like it was time for you to tell him. He would ask you some questions about how long you’ve been diagnosed with diabetes, what type is it or things like these. He would be very considerate, going with you at your doctor’s appointment and being a very supporting sweetheart. 

Suga would find out by finding one of your insuline syringe in the trash can. He would not think about diabetes at first and be extremely worried you were doing some kind of drugs. He would be a tad mad but it was because of the way he found out, but not for long. “You could’ve just told me, the things you eat when you’re with me are not good for your condition. The worse could’ve happened..” You would sit down next to him and apologize. In the end he would just laugh it off and squeeze you because of the crazy scenario he imagined when he saw the syringe.

Jimin would be very startled because of the way he found out. Both of you were on vacation and went for a hike. You made the mistake to forget your diabetes treating kit (?). Thinking you would be fine you carried on hiking, but it didn’t go as planned. Almost an hour into hiking you were very short of breath and had to take more breaks, you were low on sugar. Jimin would start to get very worried as your face was very pale “Are you okay? Do you want water?” you shook your head and asked if he had a sugar or something quite sweet on him. He gave you a sugar and you just had to tell him. He didn’t react badly, even though he felt responsible for not noticing but he would make sure you are feeling fine. Telling him it wasn’t an obvious thing, you both took a long break before going back. 

You didn’t want to hide it from Hoseok anymore so you decided to tell him. He would feel very happy that you trusted him enough to tell him about your diabetes. Just like Jin he would ask a lot of questions to understand this condition more. He would be worried for you whenever you would be taking your insuline or checking your blood level because it looked painful. You’d always reassure him, telling him it wasn’t that bad. He would buy a couple recipe books made for diabetics and help you prepare the healthiest meals.

Taehyung would be upset but it was because he cared for your health. Finding out one day when you were not feeling the best, he wanted to take you to the doctors because he was so worried. Feeling bad for him you decided to tell him. “Why didn’t you tell me earlier?” He asked and you told him you were afraid he would be always worried for you. He softly smiled and pulled you into a hug, then laid down next to you in bed and cuddled you, hoping you would feel better as soon as possible. “I will take care of you.” He said while kissing you on the forehead.

Jungkook would overreact a bit, he would think that you are in pain and be extremely worried. He would find out by seeing you testing your blood sugar level and then ask you about it. You would reassure him though, telling him that it’s been awhile since you’ve been diagnosed with it. He would be very cautious of what you’re eating, of you taking care of yourself and you would find it so adorable.

Common T1D myths

Cause by sugar: T1D has no known cause, but being someone who grew up in a sugar-free, no sweets-allowed environment, I can assure you that too much sugar does not cause T1D. Scientists have also concluded that there is no correlation between too much sugar and T1D

Caused by a vaccine: Scientists have found no link between vaccines and T1D

Caused by carrying too much weight: Though obesity and inactivity increase the risk of developing type 2 diabetes, they don’t have a correlation with type 1

“You got the bad kind”: Technically speaking, there is no good kind. Also, it’s hard to compare the two since they are considered two different diseases. Both need to be managed well 

“Is it contagious?”: Absolutely, not.

Type 1 diabetics can’t have sugar: Sugar is a necessity for diabetics in the event of hypoglycemia. However, too much sugar will make a diabetic’s blood glucose spike and too much may make it difficult to manage.

Can’t play sports: Believe it or not, sports and exercise helps regulate blood glucose and can make it easier to manage, so please play sports. The exercise is good for you. Just watch out for lows caused by exercise and always carry some form of sugar

“Shouldn’t you have control over it by now?”: T1D is a difficult disease to control. Many factors such as puberty, illness, stress and lifestyle changes will affect diabetes.

“You don’t need insulin, just change your diet and exercise”: T1D can’t be cured (as of now) and it can only be treated with insulin. Don’t think that T1Ds can cure themselves with lifestyle changes and/or supplements.

Why do you still have a glucose meter when you have a pump and/or CGM?”: A continuous glucose monitor (CGM) doesn’t replace a glucose meter. A CGM gives a blood sugar reading over the course of the day. It isn’t 100% accurate, but it allows for a T1D to recognize trends that happen at certain times during the day and can correct for that. CGMs require a blood glucose calibration in order to remain accurate. Insulin pumps allow T1Ds to replace insulin syringes and pens for an easier method of giving insulin. Insulin pumps do not replace glucose meters. They require readings from a meter to correctly calculate the needed insulin bolus. DO NOT TAKE READINGS FROM CGM AS BLOOD SUGAR INPUT UNLESS A METER IS NOT AVALIABLE. 

Pumps fix blood sugar: No, they doesn’t. Insulin pumps can help blood glucose managing become easier, but they don’t fix any blood sugar problems.

I hope this can clear up any confusion in regards to what T1D is and isn’t

-HumanPincushion

Buzzing Bella: Part II

“I want daddy to do it.”

Bella, age six, was stark naked as she uttered the words. Her tiny hands were clenched into fists, and she stared at me pleadingly with tear-filled eyes. Her expression mirrored that of her father, Chris, who was sitting cross-legged on the ground next to us. Meanwhile, I was on my knees, holding a pistol-like medical device limply by my side, feeling like some sort of evil monster.  

“Bella, sweetie, we told you,” said daddy in his best, most soothing voice. “Samantha is changing your pump site today. You have to let her try. Please?”

“Nooo,” she wailed, the suggestion barely out of his mouth. 

She turned her fists backwards to shield her exposed rear where, moments earlier, I attempted to align the menacing contraption, which she was now eyeing with great intensity.

Her dread, though highly inconvenient, was justified. If she allowed it, the apparatus would pierce her skin with a long needle, leaving behind a few millimeters of plastic tubing. We would then connect the tube to an insulin drip, which she would be forced to wear on a small pack around her waist at all times—the synthetic solution to the destruction of her body’s beta cells when she was just a baby. The doctors called it type 1 diabetes, but Bella just called it unfair.

I was also diagnosed with T1D as an infant, which perhaps made the situation worse. I understood her trepidation completely, while also being the source of her despair. As one of my fingers inched idly toward the trigger on the insertion device, Bella—watching me like a hawk—flinched horribly, swatted the tool out of my hands and onto the floor, and erupted into renewed hysterics.

My chest ached watching her cry. She was visibly shaking; her innocent brain trying desperately to comprehend what she had done to deserve such terrible punishment. Somewhere in the depths of my mind, a visual of a familiar little girl with bright blue, watery eyes manifested. A younger version of my mother appeared above her holding an insulin-filled syringe, begging the girl to stop squirming. 

Originally posted by slashermovie

The girl sobbed, “Mommy, no, please!” and drew her knees tighter toward her chest. I nearly dropped the device again in an act of surrender, whatever resolve I had mustered at the start of the task fading along with the memory.

Chris and I exchanged dejected glances. I knew he, too, would give anything to alter the circumstances so that his beautiful little girl was no longer subjected to an endless procession of pokes and prods. Yet we had an obligation to her health—he as her parent, and me as her babysitter—though such logic was meaningless in the face of her immediate fear.

“Bella,” Chris began once more, and this time his voice was firm.

“Samantha is going to change your site this weekend—whether you like it or not—because mommy and I will be on vacation. Wouldn’t you rather she practiced while we’re still here?”

“No!” she screamed with finality, and it was clear there was no hope of me succeeding. Defeated, I passed the insertion device to Chris and left the room to assuage his daughter’s growing fear that I would attack her the minute her white-knuckled fists unclenched.  

A short while later, Bella returned to her bedroom fully-clothed with a crisp pump site on her butt, gnawing forlornly on the lollipop she had been promised as collateral for her cooperation. Back in the kitchen, I tried my best to convince Chris that he and his wife need not cancel their trip—their first ever since Bella’s diagnosis— assuring him that I would devise a genius strategy for Saturday when her next site change was due.

“You have my permission to use whatever means necessary,” Chris offered. “Treats, gifts, lies. Whatever it takes. If you promise her something that you can’t immediately deliver, we’ll take care of it when we’re home.”

“Don’t worry,” I said with all the confidence I could muster. The echo of my younger self weeping at the sight of a syringe lingered below the surface, but I continued: “I’m sure I can handle it. I’m sure everything is going to be just fine.”

Originally posted by yourreactiongifs

Only I was exceptionally, most certainly, unsure. How was I going to convince headstrong Bella to allow me anywhere close when our test run had gone so awry? Whatever trust I had gained as her babysitter evaporated the minute her dad passed me a loaded needle-gun with her name on it.

Though I willed it not to come, the weekend abruptly arrived. Bella’s parents departed with the sole instruction to text or call any time for anything (“no really, anything”) and I halfheartedly assured them that they had absolutely nothing to fear. After tucking Bella into bed, I spent Friday evening imagining various worst case scenarios before eventually drifting into a heavy sleep, punctured only by visions of giants wielding skyscraper-sized syringes.

The next morning, Bella sat across from me at the kitchen counter shoveling cereal into her mouth, talking animatedly about her friend Sasha who had once succeeded in lodging a cocoa puff into her left nostril.

“That’s crazy,” I said, but I was hardly listening. Instead, I was preparing my opening, though there seemed to be no good time. Bracing myself for the inevitable rebuttal, I began, “Hey, what do you think? Should we do your site change before or after dinner?”

She twirled her spoon in the air thinking for a moment, and then decided, “Mmm, after.” I breathed a sigh of relief, taking it as a positive sign that she had not challenged the idea outright.  

The morning and afternoon passed without issue. We went to the park, played board games, had lunch, corrected a low, corrected a high, watched TV, and finally, had dinner. As Bella pressed me for dessert, I decided I could wait no longer.

“You can have dessert, but only after we do your site change.”

To my surprise, she nodded without contest, and headed toward the bathroom where I had placed a freshly primed insertion set by the sink.

When we arrived, she removed her pajama bottoms and turned her back to me with unnerving complaisance. As I aligned the device against her lower back, she craned her neck backwards and instructed to the top of my head, “Count down from ten before you do it.”

“Of course, whatever you want,” I said.

“And you have to say ‘zero.’ Don’t do it until you get to zero,” she added, sternly.

I pinky promised to follow her rules, and—once satisfied with the positioning—I began the requested countdown.

“Ten, nine, eight,” I recited.

Bella shifted nervously, watching my hands with the intensity of a cop staring down a perpetrator.

“…seven, six, five, four…”

She was now bouncing from leg to leg, biting her bottom lip. Her nervous movements made it difficult to hold the device in the correct spot, but I did not dare ask her to stop for fear of jeopardizing her compliance.

“…three, two, one!” and I pulled the trigger, but the positioning was all wrong. Bella leaped backwards with a curdling yelp as the tip of the needle jabbed her, missing its mark, but still delivering a sharp jolt of pain.  

“Oh my gosh, I’m so sorry, sweetie! Are you okay?”

“You didn’t say zero!” she bawled, her face red and contracted, her sobs bellowing from her chest and echoing into the bathtub where she had collapsed in shock.

Originally posted by ba1n3s

Whether or not she felt as much pain as she dramatized, I had completely botched the first attempt. This meant we would have to do it all over again. The only problem was that, this time, Bella was not quite so eager to participate. In fact, she was very much hysterical.

And so began a series of bribes for which I am not entirely proud.

“Mommy and daddy said that if you do a good job, they’ll take you to the toy store and buy you ANYTHING you want. What do you say?”

“No!” Bella wailed, her knuckles clenched in defense, snot and tears running down her pitiful face.

“Remember I promised you that dessert? Well, it’s waiting for you in the kitchen. All we have to do is get that site on you.”

“No!” she cried, and I caught her side-eyeing herself in the mirror, clearly impressed with her own performance.

“Bella,” I barked, changing tactics. “If you don’t turn around and let me put on your site, you’re grounded all day tomorrow. No TV. No iPad. Nothing.”

“I don’t care!” she spat.

She crossed her arms and stepped onto the toilet seat so as to position herself above me as I continued to kneel pathetically on the floor. Though tears were still leaking from her bloodshot eyes, she did not hesitate to reclaim control when presented with the opportunity. It was clear to both of us that I was completely powerless.

I scoured my brain for another bribe, another threat; but nothing came. The problem was that I understood exactly how she felt; utterly helpless and full of dread, the anticipation of the pain worse than the actual insertion. At least she trusted her father enough to know he would never hurt her intentionally, I thought. Unfortunately, I had not built enough rapport in this area to make her feel safe. Yet there was no alternative. We would have to sit here until she calmed down, even if it took all night, as I was the only adult in the vicinity trained in the procedure…

Suddenly, a brilliant, crazy idea hit me with such intensity I jumped to my feet. Though my mind was racing, I tried to speak as calmly as possible.

“Alright, Bella. I get it. You don’t want me to do it,” to which she nodded theatrically, wiping her eyes with the back of her hands.

“So I’m not going to.”

“Huh?” she said, forgetting that she was supposed to be acting victimized.

“I’m not gunna do it. I don’t want to hurt you or make you more upset.”

She glared at me suspiciously, her mind searching for the loophole.

“Then who will? Daddy said you need to do it,” she added, suddenly keen on following instructions.

“Well, I don’t want to anymore. But you can do it.”

“What? Me?”

“Yes, you. You’re going to do your own site change, Bella! What do you say?”

She clapped her hands to her mouth, and then a sly grin crept across her wet face.

“But…how? I’ve never done it before.”

“I’ll teach you. Here,” I said, and I placed the insertion device into her small hand to show her just how serious I was.

She cradled the tool with a mixture of fear and curiosity. Then, recalling all the times she had seen her father do it, she placed the prongs of the instrument delicately on her hip, angling the needle slightly, careful not to graze the trigger.

“Like this?” she asked.

“Up a little more,” I said, and I reached over gently to demonstrate. With some hesitancy, she allowed me to position her hands and adjust the device accordingly.

“There, that’s perfect.”

She admired her work and absorbed the compliment. Then, the smile faded from her face as it dawned on her that the next logical step was to release the needle.

“Go ahead,” I prompted.

“I’m scared,” she said.

“Okay. Well, if you don’t feel ready then I guess I’ll have to do it,” I suggested.

“No!” she yelled, and with amusement, I realized how quickly she had weighed the pros and cons of the situation, settling easily on the option where she had the most power.

Despite my continued compliments on her form, she could not muster the courage to pull the trigger even after several demonstrations. At her request, I obtained an additional insertion set and allowed her to pull and release the needle multiple times into my thigh so she could get a feel for the technique. Finally, after I could no longer justify another puncture wound, she felt confident enough to try again on herself.

“Okay, you’re gunna count down again,” she said. “And this time don’t forget zero!”

I agreed, and began the count, hoping this was finally it. As I hit four, however, Bella lost her nerve and dislodged the device, forcing us to begin the process once more. I was beginning to lose my patience, especially as it dawned on me that she had been without her insulin pump for nearly an hour.

“…seven, six, five…”

“Samantha, I’m scared!”

“…four, three, two…”

“I can’t do it!”

“Bella, please! I know you can do it. You got this, c’mon!”

She stared at her feet, clearly not believing me. Then, in almost a whisper, she asked,“…will you be proud of me if I do it?”

Originally posted by lil-snuggle-swirl

The purity of the question caught me off guard, and in spite of my frustration, I dropped to my knees, softening my expression.

“Oh, sweetie. If you do this, I will be so, so proud of you. As proud as I’ve ever been. And mommy and daddy will be, too. Just think about how wonderful it will be when you get to tell them you did your site change all by yourself!”

She beamed, and with fresh confidence instructed me to resume the countdown.

“Ten, nine, eight…”

Her grip was firm on the device, and her fidgeting had stopped.

“…seven, six…”

A loud click perforated the air, Bella jumped slightly, and when I looked down, a fresh, but slightly red pump site glistened on her backside. She had broken her own rule, and pulled the trigger before I hit zero. Bella stared at me with her mouth open, equally shocked by her own gall, and I burst into tears.

“Why are you crying?!” Bella asked, chuckling.

“I don’t know! I’m just…I’m so proud of you!”

“They’re happy tears?” she asked.

“Yes, happy tears!” I said, wiping my face, and laughing, too.

We examined the site and confirmed it was functional (“Better than daddy’s, I think!”) Elated, I lifted her into the air, spun her around twice, and kissed her wet little face with my own. Back in the kitchen, Bella enjoyed a celebratory chocolate chip cookie, and I felt I deserved one, too. 

On Sunday, her parents arrived back home looking much more relaxed than I had seen in ages. Bella bounded into their arms, where she was instantly swept up and attacked with many kisses. While bouncing a jovial Bella on his hip, Chris asked, “So? How did it go?”

Bella immediately interjected.

“I did it!”

“Did what, baby?” asked her mom.

“I did my own site change!”

“You did what?!” said Chris.

“I did my own site change!” repeated Bella proudly.

Her parents exchanged confused looks and turned to me for explanation. All I could do was smile and shrug.

“Yup. Told you,” said Bella. “I did my own site change. Oh! And Samantha cried. But don’t worry,” she added, quickly, “they were just happy tears.”

Originally posted by nyxisis

Coming Home Again

pairings: katsuki yuuri/ victor nikiforov
word count: ~10k

Yuuri, given to periodic bouts of paranoia, would often wonder if Viktor is, in fact, a Russian drug lord on the loose, seeking refuge in a nondescript town in America. This would explain a manner of things: his evasiveness whenever probed about his job; the way he’d unpredictably throw out incisive, thoughtful commentary about the morning news over breakfast; his expensive tastes in shirts, watches, and wallets alike; why he’d want to stay here with Yuuri, of all places, when the contents his wardrobe alone could probably afford him a year-long stay at any condominium of his choice in the trendiest part of town.

And <i>then</i> he goes on to discover that Viktor actually has a premium account on club penguin, and that his five penguins are named Peanut Wigglebutt, Luke skyhopper, Zing Zing, Otto Von Longdong, and Mooshoo Vegetable, and beats the idea to death in his head.

also on ao3.

Keep reading

Day 5. Diabetes Challenge 2k17

YAY FINALLY CAUGHT UP!!


Day 5. - Management

Insulin: I started off on Humalog and Lantus vials with those stupidly painful syringes. Always hated having to release the air then draw back the Insulin into the syringe without getting air into it, and then injecting yourself.

Around 2011-2013, I switched to my handy dandy Insulin Pens. I quit using Humalog and went to Novolog (Basically same thing, different names, was cheaper and is cheaper now at this time!). With the Pens, I didn’t always have to worry about air being trapped, I could easily turn the knob and get what I need! I’m still on the Pens!

(I just grabbed some of my pens from the boxes of 5 you get which somehow now only lasts me a month with my dang ratios…)

Meter: I never stayed with one meter for very long. I started with the one touch butterfly thingy and now I’m on the contour next meter by Bayer and Bayer. Every time we went to the endo. they had a new meter for us to try. In my area, diabetic supplies was in high demand and there wasn’t always strips for the meter you had. Over the 8 years of me being a diabetic we probably have spent 2 thousand dollars worth on these meters and strips!!


Diet: Living under your parents household, it’s hard to really diet, unless they do (Which will never EVER happen). But I do put restrictions on my self. My family is big on bread and potatoes, so when we have burgers or hotdogs or what ever, I normally just opt out on the bread. You get glares from people wondering why the hell is she using lettuce instead of bread or eating a damn burger with a fork instead of her hands, but I prefer a 140 bloodsugar than a 300 bloodsugar when I got home. At parties, I don’t eat the sweets (Most of it is like 5 cokes of sugar and carbs anyway). So basically Halloween is a blast. (I eat Halloween candy, but it takes me almost up to the next Halloween to eat it all).

November is Diabetes Awareness Month!

So here we are, November 1st, and I will be a bit more vocal about myself than I usually am.

Name: Sam

When I was diagnosed: January 2005

Which type: Type 1

Fun fact about my diabetes: I actually have two siblings and they have diabetes too!

Pump or syringe: insulin pump since 2007

Favorite celeb with diabetes: Nick Jonas or Crystal Bowersox (who I’ve met!)

I’ll be posting throughout the month using #diabeteschallenge2k17.

Diabetes Challenge 2k17 Day 11

11. What would you do in an apocalypse or doomsday situation?

I would get my butt and what ever backpack, bags etc to a hospital / pharmacy to get insulin, syringes, glucose tabs, and whatever else i might think would be useful. Cause I would hope to be able to at least make it through some of it, helping people. 

Creepypasta #379: Birthday Cake

For my daughter’s fifth birthday, I made her a special cake.

It was different to the other cakes that I had made her before, on her other birthdays. This one had something special, a surprise for my little girl.

The ingredients themselves weren’t anything you wouldn’t expect; eggs, flour, butter, sugar. It had cocoa powder also, but she had had that previously, on her third birthday.

But this cake was different to any cake my daughter had eaten before.

She woke up on the morning of her birthday, excited as usual. She loved celebrating, no matter the occasion.

I chose to give her the cake first thing in the morning, unable to wait. She could hardly believe her eyes, as I always made her wait until evening usually. She placed the red case she carried with her on the table, and sat on the chair, the anticipation clear on her face. I carried the cake to her, candles lit, and sang happy birthday to her.

She closed her eyes and made a wish, probably for something trivial like a doll or a pony or something. If I had one wish, I would wish for peace. Not world peace or anything quite so great, but peace for myself. These past few years, well let’s just say they have been challenging. All of the hospital appointments, health scares, all of it had been horrible.

But luckily she would not have to deal with it any more.

My little girl blew out her candles, probably with the childlike hope for her wish to come true.

Oh well.

She took her first bite of cake, so happy and so completely absorbed in her birthday breakfast that she didn’t even notice me pick up the red case from beside the cake plate and open it up.

She didn’t even notice me take out the syringe of insulin and empty it into the sink, before throwing it all into the bin.

Wouldn’t be needing that any more.

Credits to: made_in_brizzle

Emmett Carver and "the syringe" in Gracepoint

OK so the lovely whoinwhoville asked me about this the other day–bc I’m a pharmacist and literally have my doctorate in knowing what meds are what and how they are administered XD

Her question was essentially about my thoughts on the syringe in Gracepoint and what it could be, as there are not many medications that are administered like that–what we saw was an intramuscular injection through the anterior thigh.

Now the first thing we need to know is why aren’t medications administered like that? The answer is simple–because it’s too easy for patients to hurt themselves. Meds that are given like that tend to work very very quickly and powerfully. The FDA is not about to approve many meds for patient home use that are that powerful. Pharma companies haven’t pushed the issue–bc rule of thumb is that if a patient can misuse a drug, then one of them probably will, and will likely sue. MDs aren’t likely to even prescribe them for the same reason–medical-legal liability is at an all time high, and patient adherence is known to be pretty lackluster. Furthermore, although clean-needle programs are more accepted now than in years past, there is still always the suspicion that patients will divert syringes for illicit drug use, so many pharmacies and states won’t even allow patients to get syringes unless they absolutely need them.

So while some drugs–particularly things like psych meds for unwilling and agitated patients–are very commonly administered that way by nurses in a hospital/clinic environment (I approve these all the freaking time), you are rarely (if ever) going to see most meds administered as injections at home.

So… if you are an outpatient and at home, what NEEDS to be given through the skin? Three things:

1) EpiPens– aka epinephrine for anaphalactic attacks. This is not likely what we saw in Gracepoint, for several reasons. #1 it looked nothing like an EpiPen. #2 everyone who has an EpiPen should know that as soon as you administer it you fucking go to the hospital asap bc a lot of patients need more than just 1 dose and you could still die (this happens more often than you’d like to believe). #3 while he could have been having an anaphylactic reaction to something (not everyone wheezes… anaphylaxis is clinically defined as multi-system organ involvement in an reaction, it doesn’t specify what those organ systems are), this being Hollywood they would have likely made his symptoms more overt.

2) Insulin–which is not administered intramuscularly, and is certainly not given through clothes and rarely through the thigh. It’s a subcutaneous (under the skin) injection with tiny needles. Moreover, that wasn’t an insulin pen, was filled with waaaaaaay too much fluid to be an insulin syringe, was bigger than an insulin syringe, plus the small fact that you need to draw up insulin and there were no vials present.

3) Anticoagulants–subcutaneous injections of anticoagulants like enoxaparin are given when a patient with a history or at high risk of blood clots starts a blood-thinner regimen. Again, this is not an intramuscular injection and would never be given in the thigh. It is used however in patients with heart conditions and abnormal heart rhythms, because the abnormal heart beat can cause blood to pool in the left ventricle and cause a stroke. But you would never be like “ooh I feel bad so let me inject it”–it doesn’t work that way, you give yourself doses at specified times, not when you feel woozy. So… if Carver DOES have a heart condition in Gracepoint, this could be Hollywood’s ham-handed attempt to show it.

That’s pretty much it.

So my answer about what this could be? That’s pretty easy. It’s Hollywood style bullshit for dramatic impact (and YES we talk about this stuff before/after rounds at the hospital sometimes and mock some of the worst offenders). Syringes look cool, and all emergency-like, especially when you jam it through your clothes like that. But… they’re not frequently used, and certainly not in the manner in which we saw it used in Gracepoint.

Any questions, feel free to ask.