Friday, October 27, 2006

Painless Pricks


One of the common objections to testing blood glucose more frequently is a fear of pain from testing. If you are suffering pain when you test, you are doing it incorrectly.

I learned this the hard way in my first year after diagnosis. I hope it helps you.

Do not use an alcohol swab to clean the test site unless there is no other choice. Repeated use of alcohol over time for that purpose will dry out the site and may cause skin problems.

If possible wash your hands in warm soapy water, rinse well and shake them to get the circulation going. Check your lancet-holder; it should be adjustable. Mine is a Soft-clix, made by Roche and is usually painless. That brand has an excellent reputation among the diabetics I know, but any good lancet device should do the job. I get an occasional tiny sting and it lets me know if it's getting blunt sometimes, but I tested over 5000 times in the first four years after diagnosis, before I stopped counting, without any trauma. That's from a guy who was, and is, needle-phobic.

Start with the second lowest setting (1 or 1.5), hold it firmly against your skin on the side of a finger near the tip. Don't flinch when you release the button. The button releases a spring-loaded tiny needle which makes a tiny hole in your skin and instantly retracts. Using the side of your finger-tip has two advantages: there are less nerve-ends than on the pads, and it doubles the number of test-points so you can rotate through the positions.

Massage gently (milking a cow) until a drop of blood forms sufficient to put on the test strip. If this setting doesn't provide an adequate quantity, move the lancet setting up one notch for the next one. If you got a large sample and it hurt a little, go to the lower setting.

And that's all there is to it. Sometimes it helps to shake your hands a little more, or warm them up if it's cold.

The manufacturers advise changing the lancet needle every time; I change mine when I remember or if it gets a bit blunt. I have never had an infection as a result of doing that, nor have I ever heard of it happening from the people I talk to on the web. You do what you are comfortable with, subject to doctor's orders.

Cheers, Alan, T2, Australia.
Everything in Moderation - Except Laughter

Up-dated 10th July 2009


25 comments:

BBB said...

Mate,

thanks for this - I am totally and irrationally fearful of this part of managing the disease and I get my first tester this week.

We have chatted on the ADA site - I'm the new chum who in Aussie now living in the US.

Alan said...
This comment has been removed by the author.
Alan said...

G'day BBB

Good luck.

The important thing for you is to hold it firmly against your skin and don't flinch when you press the button. You'll be fine:-)

Cheers, Alan

Maura said...

Okay, I just got diagnosed with this last Tuesday and I wanted to know something. Everyone is talking about having to test on their fingers but I was given a lancet-thingy specifically for use on other parts of my body such as the palm of the hand, inner arm, thighs, calves (although why my doctor would want me to get blood from a baby cow is anybody's guess..hahaha!). So, MUST I bite the bullet and test on my poor fingers? I've been getting my blood from my arm and my arm is starting to get sore in places but not nearly as bad as my fingertips that the nurse skewered last week! Thanks for the info., I certainly appreciate it.

Alan said...

Hi Maura

In my opinion there is no MUST at all. Do what works for you. However, be aware that there may be a time delay between BG levels reaching "alternate" sites and the fingertips. I don't know why, and only experimentation will show how pronounced it is for you, just be aware of it.

The fact that alternate site testing is available doesn't mean you must use it. Have you tried your fingers, using the technique I described? Just a thought; as I said, there is no MUST.

But remeber, your skewring nurse hasn't read "Painless Pricks":-)

Cheers, Alan

Anonymous said...

I tested on my fingers for the first 4 days, looked at the pin pricks....only brave/silly enough to use one side of a couple of fingers....and said, "how unsightly and ouch!". I have been a forearm "baby" ever since. I test freely because I have no fear of pain. I suppose if I actually knew someone, face-to-face, who could guide me and show me (I'm a visual learner) I would be less resistant to finger testing. You have brought up some good points that I keep in mind about forearm testing. However, I'll continue to test on my arm...

Alan said...

If you could see the results of your tests more than half an hour afterwards as unsightly, and you also had an "ouch", then your lancet was set far too deep.

Try again on your finger-tip-sides, starting at 0.5.

Best wishes,

Cheers, Alan

Pubsgal said...

I tried your advice today: I dialed back my the lancet device to half-depth, hardly felt the prick, and got enough blood. I thought I wouldn't get enough blood if I didn't set the device at maximum.

Nice blog, by the way! I liked your food planning advice, too.

Gretchen said...

Alan, you dear sweet man, I am so new at this and flich every time I test, I will have to give this one a go.

Pepper said...

Thank you for this. If and when I get a meter, it will be very helpful. A few questions:

-Why is testing on the fingers the common way to do it? Is it possible to test somewhere else consistently? (Fingers are so sensitive, and we're always using them!)

-Do you worry about infections, either of yourself or other people, through the break in your skin? (Besides being a needlephobe, I'm a bit of a germophobe.)

Thanks.

Alan said...

Fingers seem to be the best indicators of real-time blood glucose levels. There are meters which can be used for "alternate site testing", for the forearm or other parts of the body, but I haven't used them and can't really comment on whether they are more or less painful than fingers.

The reports I have from others is that there can be a significant delay in blood glucose levels peaking on alternate sites; the fingers seem to get the peak first. Again, I don't have personal experience of that, just anecdotes from others.

If you use the sides of your fingertips you should have no problems. Most of the sensitive points are in the pads, not the sides.

In over six years of re-using lancets, sometimes for months, I have never had a resulting finger infection myself. That is despite also having a compromised immune system (hypogammaglobulinemia).

I know of only one other person who has had a minor infection, and she is not certain that re-use was the cause. I know of no reported case of infection from self-testing in the literature on diabetes that I have read. The only other case of infection that I can recall was in a nursing home where the same lancet-holder was being used on many successive patients; the nurses were changing the lancets but failed to clean the nacelle of the lancet-holder between patients. I'm afraid I have lost the reference for that one.

You'll be fine mate. Test, test, test:-)

Pepper said...

Okay, thank you much for the info. I'm still working on the courage part. Be patient with me. ;-)

Anonymous said...

Alan
thank you thank you, no one showed me how to use the equipment I was handed after giving the RX to the drug store. I was actually given an accu-check ativa with the lancet device along with a huge box of the soft lancet. I tried the device but because no one instructed how to use it I gave up and went to the other style and suffered the pain that goes with uncontrolled depth. I now can test more often which means I can get more meaningful readings. Not just my morning fast reading. I'm only prediabetic so I am so very grateful to your information.

Frank SC USA

xenablue said...

Alan,
Thank you for this info for painless pricks - it helped me immensely! I thought about using other sites on my body to take the blood from, but apparently the reason the fingers are best is that it's capillary blood, which is what gives better BG readings.

Anonymous said...

Hi all. I just got a Bayer Vaculet device and it is great. I teach and my hands are always dirty so I prefer not to test on my fingers. (Too many nasty germs out there!) With my first lancing device I couldn't get enough blood from my foreare or thigh. The vaculet actually forms a slight vacuum and draws the blood out. It is great! I test on my thighs without pain and always get enough blood. One word of advice - the first 2 times I used it I bruised because I used in incorrectly. Once the device is against your test site, press the plunger right away and then allow the vacuum to draw up the blood. For some (dumb) reason I held the vacuum in place before I pricked my skin with the bruise resulting from the blood being drawn to the surface of my skin with no where to go! Anyway, I truly love this device.
Lorraine

Zepp said...

I'm new to this -- My fingers sorta sting and I can't seem to get enough sample. I look at my meter like it's a vampire!

I'm thinking of coating the lancing area on my finger with a bit of Ambesol ---- washing it well, then using the lancet ...

I wonder if that would screw up the readings?

Alan said...

I can't say whether it would affect the readings. However, it sounds like you are either setting your lancet depth too low or you aren't pressing it firmly against the side of your fingertip when you press the button.

Try pressing more firmly first, and don't flinch as you press the button. If that does not solve the problem adjust the depth by one click.

Brigadoondays said...

I am a complete Newbie, to both diabetes and this site, suffering extreme information overload. If my question has already been addressed, please point me to the answer.

Is anyone using a satisfactory Excel spreadsheet for recording blood glucose several times per day, calculating fasting averages and total averages for any 7, 14, and 30-day period? Thank you.

Debbie said...

Thank You,Thank you,Thank You ! I just tried your tip of using a low setting and using the upper side of my finger..it worked without pain. I was set at 5 and using the middle tip of the finger....ouch ouch ouch

Anonymous said...

I am new at this. Is it best to test on mt forearm, or finger. I must be flinching. because sometimes I am making a long cut.

Alan said...

I can't really say for you, but my preference has always been the side of my fingertip. I've never needed to try any other test points.

Try starting at the lowest setting, hold it a little more firmly, and try not to flinch. If that does not supply an adequate blood drop, move up one setting. Keep adjusting until you get the correct setting for you.

Cheers, Alan

Kate said...

Hi Alan,
Thanks so much for this information! I got my meter last night and felt much more confident having read this first. I probably would have freaked out at the process otherwise, but it was "no big deal" in the end. This blog is so helpful in so many ways to this newbie (you pointed me to it in a comment on dLife) - so thank you!
Kate

Alan said...

Thanks Kate, glad I could help.

Unfortunately, you may be the last person to come my way from dLife. That forum has had some changes. A lot of people left when the software was changed recently. Now a new moderation team has decided to change the rules for those remaining.

I have been banned for doing exactly what I did for many years on dLife and what led you here: suggesting newly diagnosed people read the tips on this blog.

Best wishes, let me know if you need further assistance.

Cheers, Alan

desertdweller said...

Hi Alan...another newly diagnosed diabetic. Just had my 1st nutrition class and all the info is over loading me but it will come. Your info has been great.Just found it and read a post tht you are no longer allowed to do it.Is there a site we can all connect again on with out the restrictions? Thanks so for taking the edge off. I'm a young 60 year old female and this is not easy to digest.A1c was 6.5 so not as bad as it could be.

Alan said...

Hello DesertDweller

I am still involved with several forums; these are probably the most active but there are others:

ADA forum: http://community.diabetes.org/

TuDiabetes: http://www.tudiabetes.org/forum

DSF UK: http://diabetes-support.org.uk/diabetesforum/index.php

I'm happy to chat with you on any forum :)

Cheers, Alan