I use a Levimir pen for my basal with the shortest needles (4mm, I think). I am still new at this and figuring things out.
My D-nurse told me if I bruise at the injection site it indicates that I am pressing too hard. Being a needle-phobe means that I am SUPER slow and careful when doing my injections and even so I still have yellow bruising all over the various areas I inject. Maybe I just bruise easily. I am curious if this is common. Am I doing it wrong? Is there some trick to avoiding it? As much as I respect everything my nurse taught me, I am worried about getting stressed over something that is totally not a thing. The bruises go away like normal bruises, but even as I get more experienced using the pen I am not bruising myself any less.
Have any of you ever gotten a “dull” needle? I’ve had a few bad test strips, but this would be the first time a needle failed me. And by failed, I am saying that it was painful, difficult to penetrate (in an area that never is) and I bled for a while after (I rarely have and only a drop). I stopped because I couldn’t make myself push any harder and the needle wasn’t even half-way in. I dumped the needle tip, the dosage and started over. The second try was fine. I am thinking it was the needle and not me, but don’t know if I am being ridiculous. And could I have/should I have dumped the needle tip, screwed in a new one and just used the already primed dose?
Burning sensation? I have been on the same insulin, inject in the same general areas, etc, etc. My Levimir pen is kept at room temp and before I start a new one, I get it acclimated. And yet, randomly I will have an injection that feels like I am forcing liquid fire into my body. It can last for about 5 minutes. I can handle the sporadic pain, but am again wondering if I am doing something wrong.
Annette, it is so great to see you become more proficient at everything!
Our son is only 12. he never bruises, but I think that adults are more likely to bruise (possibly women? I am not sure). So I don’t have an answer.
We have never have a needle fail on its first use, in the sense that it has never been really difficult to penetrate (some times a bit more than others though). But, occasionally, the insertion hurts, or generates a tiny bit of blood (not much). So I would not worry at all about that part. When we reuse needles, eventually they become duller and harder to penetrate.
Yes, for us it is common to have that happen, maybe once every 2-3 days, randomly as you write. I would not worry about that either.
So, except for the bruising that we don’t see, probably because of my son’s age, everything seems to be very normal, congratulations!
If you are sensitive to injections, make sure you always use a new needle. I have used them over and over, but they do get dull. A dull needle will hurt you more and leave a bigger exit on the skin. It is possible to make a needle dull if you let the tip press against a hard surface, so just be careful with it.
Are you saying you do the actual injection slowly? Or do you mean that you are just doing the preparation slowly?.
I know some people are doing them slow nowadays, and some studies say a slow injection does less tissue damage. But I always did them quickly. Like a quick jab.
Did the nurse tell you to insert the needle slowly? If so, it’s funny because that means I have done it wrong about 75,000 times. We were taught quick insertion way back in the stone age.
Sometimes. It’s just seems to be luck-of-the-spot. It just happens sometimes, not sure if you can ever totally eliminate it 100% of the time.
@Annette13 when my son injects he bruises quite often. He is very careful (i.e. gentle) about insertion and he still bruises quite often. So I don’t think what you are seeing is out of the normal. Also the pain on injection is pretty common as well. Just one of the “fun” things with inject-able meds.
For what it’s worth, I used to find that shortest needles actually were worse on a lot of levels than slightly longer ones, in terms of discomfort. Counter-intuitive, but may be worth experimenting. Also I definitely prefer a quick jab—you don’t want to slam it into with force, but you can do it lightly and quickly.
Also, injection sites vary a lot—where are you injecting? I stopped using my arms because I’d bruise a lot and it would be visible. I find the butt to be most comfortable; I usually rotate between that, thighs, and belly myself. I bruise easily generally, and while I don’t bruise with every shot, I have occasionally for the entirety of my 26 years as a diabetic. I sometimes forget about it, and if someone new is seeing me with less clothing on, they can get really concerned before I reassure them, ha.
Bruising more likely indicates you nicked a blood vessel in the way in… that’s just a fact of life sometimes
Injections will be more comfortable if you jab swiftly but not too hard— think of gently throwing the pen needle into skin like a dart.
Some insulins sting some people… Some don’t…
Occasionally like once every few hundred I’ll find a pen needle that’s actually dull— like it never got properly sharpened…
The needles are coated with a lubricant that wipes off with first use and they start getting dull. I don’t use mine more than 2-3 times at most… generally best practice to replace every time… that’s what all the official guidance will tell you to do
Quality counts with pen needles… there are better and lesser quality ones
All three questions (bruises, dull needle, and burning sensation) make me wonder if you’re either (a) injecting into a sub-optimal part of your body or (b) not squeezing to create some tension.
Before you inject, use your other hand to grab a handful of belly. As you insert the needly, your skin should be a little bit taught. If you don’t do this, your skin will follow the needle if there’s any friction and it could lead you to think you have a “dull needle.” PS: Don’t over-do this “grabbing” action - the goal is to create a some tightness across the skin, but there is no point in squeezing super-hard (that might even lead to some tiny amount of insulin coming back out of the hole you injected into, making your injections routinely short by 0.5 units or something).
I agree with everyone else on the burning sensation - it happens about 1 time in 10 (in the belly, more elsewhere) and seems to be entirely random. My theory is that you hit a nerve or something. You can back it out and fine another spot before pushing the insulin in if you want. The “burning sensation” is also caused by super-cold insulin. If you pull insulin out of the fridge, warm it up with your hands before first use.
I find this interesting, and may be helpful to me some day. But after 50+ years, I have never used an insulin pen !!
When I did injections, I used an autojector. This was a spring loaded device with loaded syringe inside. I was able to reach many places with one hand to deliver injection. So if I ever go on a pump vacation, not sure if I would try pens or go back to my autojector !
I’ve been using syringes since I started insulin 9 months ago, so a first 12mm and now 8mm, and this all sounds familiar/normal in my short experience. I tend to bruise easy anyway, but usually the only time I bruise after injection is when, as @Sam said, I nicked a blood vessel. I try to look closely at the area before injecting to avoid that.
I may just be a wimp about needle pain (I don’t think I’m a wimp about pain in general - made it through a muscle biopsy with only local anesthesia), but I find probably half of the time, it’s painful, and I find some “resistance” trying to push through. It just depends how far I’ve already gone as to whether or not I pull out and try again. I pretty much only bleed when hitting blood vessels, though.
I experienced random burning with Levemir while I was taking it; never really any rhyme or reason to it, and it didn’t seem to affect anything and didn’t bother me too much, so I just shrugged it off as normal.
Probably once in 1000 injections I have gotten a needle that is not quite right. It is rare but it does happen. Usually you can spot that the needle is not sufficiently pointy.
For us, what seems to be the better technique is a very quick jab, followed by a Goldilocks injection (not too fast and not too slow), followed by the usual 10 seconds counted slowly.
I am sorry for being gone so long when I asked the questions.
I use a new needle every single time. The only “rule” I don’t really follow is for the lancet (based on advice from a T1 friend). I only trade those out once a week. Seems to be fine so far.
I insert the needle slowly, but click the pen quickly and when I remove it after the 10 count, I also do that relatively fast. My slowness was not a directive from the nurse. It has to do with my needle phobia. It is just the only way I can make myself do it. It allows me to focus on steady breathing and not shaking.
The burning has been so random that I kind of hoped that it was just “one of those things”. I wanted to make sure I hadn’t missed some easy fix that everyone knows to do.
I generally do gut (where I still have some padding). When my husband was helping me, he did butt. At the time I couldn’t handle seeing it, so it was easiest for him to help me without stressing me out.
Now I find that I need to see what I am doing (weird, I know) which is why I do front and center.
I have read a few conversations on the long versus short needle. I do find that curious how many people really prefer the longer. Mine are prescribed. I will ask my doctor if there is some way to get a handful for testing.
This is going to be life, so trying things out is definitely well worth it. And I am hoping that with more time, I won’t be so weird about the needles and can do this without drawing it out so much.
My wife had to do a lot of injecting a few years ago, and it was not super easy for her to do: she also liked it the same way as you. As time went on, it became a lot easier for her to do! It seems that, for many people, a quick insertion is more comfortable – maybe there is a point in time when you will be able to try it in different ways.
When I was in college, I did not like to have blood drawn. Then I had a bad climbing accident, and spent many months in a hospital. They would take blood from me three times a day! After a few weeks of that regimen I did not care anymore. Although, to this day, I don’t look at the blood they draw from me - strange since I have no problem assisting surgeons in surgery or doing emergency surgery myself. The ways of the brain are not always clear. But I really hope that it will become easier for you with time, as drawing blood has for me!
I definitely prescribe to 1 and 2, but had never thought about squeezing too hard. I will pay more attention to that. I definitely don’t want to go through this process and not be giving myself the full dose because I was trying so hard to feel nothing.
The stupid thing is that the pain is not a big deal. Even when the injections hurt, it is still so minor and forgettable that I feel ridiculous for being horrified about this process. My silly brain.
I love everyone’s notes and your advice. Even if I am not at a place where I can use some of it because of my own personal neurosis, I have goals that have nothing to do with my BG or A1C and this gives me something to strive for, even if I have to go slowly to get there.
P.S. @Sam and @Michel…just like my meter, I had NO IDEA that there were quality differences in treatment products. I just blindly took what was prescribed to me. I had definite sticker shock and my health insurance was very picky, so I was grateful for whatever I got. I know a bit better (because of all of you) and will definitely question things more.
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We were taught quick insertion way back in the stone age.
