Chicken with Needles – by Olly Double
What do most people think of when they hear the word ‘diabetes’? It’s got to be injections, hasn’t it? When my younger son Tom was diagnosed back in 2000 before he was even two, most of the sympathetic comments were about needles and injections.
‘Poor little boy, it must be so difficult giving him his injections knowing it’s going to really hurt him.’
‘Yes, thanks for that, you’ve made me feel a lot better about having to inject him several times a day with that joyful thought.’
In fact, needles were the least of our worries when he was first diagnosed. Raging highs, terrifying hypos and generally not knowing what the hell was going on with his blood sugar control were much more immediate concerns.
Nonetheless, I shudder when I think about the number of times he was injected and the number of times his fingers were pricked for his blood glucose monitor in his early childhood. Even today, now that multiple daily injections have been replaced by an insulin pump, he still has to have a big old needle inserted into his soft tissues three times a week in order to change his infusion set. Then there are the needles used to insert the sensors for the continuous glucose monitoring system (CGMS) that he uses – which both he and his older brother Joe, who’s also on a pump and CGMS, both say are worse than set changes.
Given all of that, it seems bizarre that Tom is terrified of having any kind of needle inserted into him that’s not part of his regular diabetes control. The main culprits are the flu jab he has every autumn, and the blood test he has every year as part of the annual review by his diabetes team. That’s very different from the regular finger-prick blood glucose tests he has several times a day, because it involves sticking a proper big needle into his vein and drawing out a much bigger amount of blood. A couple of years ago Tom had a particularly horrible year because not only did he have his blood test and his flu jab, he also had to have an extra inoculation for swine flu.
We went to Joe and Tom’s diabetes clinic in London on Tuesday, and when Tom was asked if he wanted to ask the team about his diabetes, the main question was, ‘When will I next have to have a blood test?’
His consultant – who’s not only a fantastic medic but also has an enviably easy-going and affable manner – replied, ‘Oh, not for ages yet.’
But Tom’s terrors were not so easily derailed. ‘Will it be this year?’
‘Well yes, it will be this year, but not for months.’
That wasn’t a very reassuring answer for Tom. Even if the answer had been ‘never’, it would still have been too soon for him. The time just after a blood test is one of the happiest moments of his life, because it’s the longest possible time until the next one.
Now to contextualise this, I used to be pretty terrified of blood tests and injections myself, and indeed I come from a whole family of needle-phobics. My older brother fainted after his BCG jab, and two years later my older sister fainted after hers. I was such a chicken about needles that in the four years between my brother having his jab and me having mine, I regularly sat and fretted about it. I’d try and think of ways I could get out of it and fantasise about new ways of doing the injection that didn’t involve needles. When it finally came to it, the nurse had to keep telling me to relax my shoulder. I was cacking myself so much that my puny adolescent muscles had gone as hard as rock. Then the needle went in and it was far less painful than advertised. I went away chiding myself for having wasted four years worrying about such a little thing. And thinking my brother and sister must be wimps.
Like me, Tom tries to work out ways of getting out of his blood test, and he shared some of his creative thinking with the team at his clinic appointment.
‘Couldn’t I just do lots of finger prick tests and save them all up in a jar and just use that blood instead? Or couldn’t I have a cannula like for my infusion set and just take the blood out of that?’
My wife Jacqui chipped in and said that Tom had once told her that if he ever has a seizure through having very low blood sugars, he’d like them to take a blood test while he’s unconscious so they can use that for his annual review and he won’t have to know anything about it.
In the course of gently explaining why none of these were good solutions, the lovely diabetes nurse said that lots of young people with diabetes dread blood tests just as much as Tom does. Those who’ve not experienced diabetes – let’s call them ‘civilians’ – might find this hard to understand, but as she explained, many children had their first experience of blood tests around the trauma of diagnosis and having to experience them again brings all of that unpleasantness flooding back.
I’m not sure if that’s why Tom hates them so much. As he was so tiny when he was diagnosed, he has no conscious memory of it all. My theory is that it’s about control. He used to do his own injections and now does his own infusion set changes. It must be easier to put up with things pricking through your skin if you decide exactly when it’s going to happen and you control the whole process.
But maybe I’m wrong. Maybe he just hates constantly having sharp objects prodded and poked into him, and the blood test is just the final bloody straw.