Thursday, February 21, 2008

Aunt Minnie and me.

I've read a couple of posts recently on two of my favorite diabetes-related blogs (Kerri's and Scott's) that made me want to bring up a topic that upset me pretty badly recently. Ready for the whine? GET YER CHEESE OUT!

The "etiquette" of testing your blood sugar.

Okay, I have to be up front and say that that sentence alone makes me want to snort in disgust. Ridiculosity abounds! My gut reaction as a Type I is that testing blood sugar doesn't fall into the realm of napkin-on-your-lap excuse-me-please societal rules. It's just something diabetics have to do or we die. End of story. most of us folks with diabetes know, the rest of the (diabetes-free) world may not identify with or understand that at all. Even if they SAY they understand it, they don't.

So I read about Kerri and Scott's trials and tribulations when it comes to actually getting the used strips in the trash can. I'm not pretending like I don't have the same problem - just emptied out my purse this morning and there were about 10 of the little boogers hanging out at the bottom. I find them on the floor of my bedroom, on the kitchen floor, in my shoes . . . the point is, a diabetic is going to leave some detritus around at some point no matter how vigilant or clean we try to be. Usually our diabetic trash involves blood. Yeah, the blood is often a minuscule amount, but it's still blood. The idea of coming into contact with blood, even SEEING blood, squicks out many a non-diabetic (and many a diabetic as well). So how to deal with the etiquette problem of testing your blood sugar/taking a shot/changing your pump site in public, or in mixed company of any sort, when it's sure to cause at least mild disgust for one or two witnesses?

This very subject came up on a thread last week at the popular Etiquette Hell forums. Most of the posters chiming in agreed that testing blood sugar or taking a shot at the dinner table was just not in good form, at all. ANY blood in public is unacceptable (but I guess that guy coughing into his sleeve over there is okay, he can't help it and he's doing his best to contain his mucus). I mean, guys, can't you go to the bathroom and do that gross stuff? Jeez. My Aunt Minnie faints if she sees blood. How come you aren't taking my Aunt Minnie into consideration when you start splashing blood around at the dinner table?

The diabetics on the thread said hey, we've gotta do this, we're pretty discrete about it, we try to be clean, we're not always able to test in private. Some apologized for not taking Aunt Minnie into consideration in the past; some said they tested in the car before going into the restaurant or tested in the bathroom stall to avoid making others feel uncomfortable.

I have to admit that although I respect that some/most people have a serious problem with blood, I was flabbergasted by the attitude shown by the non-diabetics and the apologetic diabetics (ha, rhyme!) We don't care if you have to do it: we don't want to see it. It's gross. It's rude. Your best efforts are not good enough, if I have to see it.

Here's what testing involves, in my world:
  • About ten tests a day. Before I eat, and after I eat. Whenever I feel "off," too.
  • A lancet device, with a hidden needle to prick my skin.
  • A small drop of blood, that I touch to a test strip immediately after it surfaces. (In other words, I'm not starting a catheter up or squirting blood across a wall a la cheap horror flick.)
  • Disposing of any excess blood on a piece of tissue in my testing case, or, yes, in my mouth. YEAH, I'M A LICKER.
  • Tossing the used strip into the trash, or keeping it in my case until I can get to the trash.
  • Whole process takes about 10 seconds. I can do it my lap. 99% of the time, no one is the wiser.
Sometimes I'm testing under ideal conditions. I'm at home, or at my desk at work, and I can do the test privately and get on with my business. My blood sugar is good and my hands are steady. Other times, not so ideal. I'm in the toilet paper aisle in Target and I realize there is a problem. I'm shaking as I guide my finger to the strip with a Herculean effort while I stand behind my cart. Walking to the bathroom at that point, across the store, would be kinda fricken dumb. Am I supposed to consider the feelings of others when my blood sugar is 35? Or should I focus on not passing out or having a seizure? Where does etiquette come into play here?

While I admit licking blood off of my fingers is pretty gross, I take umbrage with the opinion that taking a shot in the car before a meal is preferable to taking it at the table. There is no guarantee when eating out that food is going to arrive in time to cover that insulin I oh so politely dosed ahead of time. That just doesn't work in the real world - in my diabetic world, that is incredibly foolhardy. I also take offense that because I could possibly leave a red blood cell on the table, I should be testing in a toilet stall in a public restroom and introducing gosh-knows-how-many pathogens into my bloodstream. In both of these situations, I'd be putting myself into real, physical danger because of the possibility of offending someone else.

The risk of not testing, or of testing in a grossly inappropriate place, seems to me of much greater concern than the comfort or disgust level of the non-diabetics around me. And the practicality of dosing insulin or testing when I am absolutely alone or in a private place 100% of the time is close to nil.

Am I rude? Do I care too much about what other people think? Is a diabetic's used test strip on par with radioactive waste that the general public should be totally sicked out by? What do you guys think?


Lili said...

I'm in the middle - I don't think it's rude to test or inject at the table, but I also do it discreetly. I know another diabetic who always does it really obviously, and this is someone with a needle phobia themself, so I don't understand that. I try to be respectful of people with needle or blood phobias by being discreet. I would never go into the bathroom to test or inject, though. I mean, unless I was at a job interview.

Kendra said...

I am in agreement with you lili, in that I don't think it's necessary to be obvious. "HAY GUYZ HERE'S MAH NEEDLE! Watch me jam it into my flesh!" Nah, that isn't showing any class. I just don't think that the default etiquette ruling on testing/injecting in the presence of others should be "Rude!"

feya said...

You know me, I don't care when you do it :P Half the time, I don't think I even noticed it, even when we were living in the same room. Seeing as how you could die otherwise, I'd much rather you do that at the table than the hacking up of phlegm example.

Never understood how anyone, especially a female, could cringe at the sight of blood anyway. Don't we do it every month? And don't men have to live with it? Yeeeah.

Scott K. Johnson said...

I'm a licker too!

I think most of the time someone would have to be paying pretty close attention to notice me doing my thing.

Kendra said...

Hi there, feya! ;D

Scott, I'm glad I'm not the only licker. I'm not a PROUD licker, but I don't think shame will stop me. We're all a bit too germ obsessed these days . . .

Jeff said...

Hi Kendra.

Often, people who take offense at another person maintaining his or her own health are actually LOOKING for something to be offended by. They simply aren't happy without something or someone to complain about, and that's an awful lot of power to give to someone else.

They're OK with someone using crutches, someone using an oxygen tank, and someone wearing an eye patch. Just don't you dare check your sugar.

I'll do my part by testing as inconspicuously as possible. But why should I be concerned if someone happens to catch a glimpse of my tiny drop of blood? Their problem is seeing blood, my problem is checking blood. We've all got our problems now, don't we?

On a packed flight from Providence to Philly yesterday, I was the lucky contestant who got the aisle seat across from Mr. Cough. Why is spraying germs for an hour and a half on everyone in the area more socially acceptable than doing a five second blood glucose test?

Thanks for writing about blood sugar "etiquette," and for letting me vent. I'm glad you're posting here again, and I look forward to stopping by often.

Kendra said...

Jeff, always feel free to vent. I feel like I complain a lot here and I hope it's not too off-putting...but since I don't know that many diabetics "IRL" it's definitely a great outlet for me.

A couple of points you made really stand out to me...

"Their problem is seeing blood, my problem is checking blood. We've all got our problems now, don't we?"

Haha, yes, absolutely. I agree! I think a point made on E-Hell was that seeing blood was terrible enough, but the FACT THAT IT WAS BLOOD was the real kicker. (A poster who worked in a hospital and did "150-200 tests a day, so I know what I'm talking about" was very adamant on this point. Yeah, but did he/she know the difference between a hospital testing kit and mine? Holy heck, they leave huge bruises on your fingers in the hospital and get blood EVERYWHERE! That doesn't happen to me at home.)

Anyway. Maybe I just don't get it. Sure, a diabetic could have a serious blood-borne illness - I understand that. But that guy sitting next to you could also have e. coli all over his hands, and the woman you sat next to on the bus could be harboring the flu and be point was, we're surrounded by everyone else's body fluids and germs all day long. It's inevitable. I don't understand how my bodily fluid happens to be so much more dangerous or volatile just because it happens to be blood.

"They simply aren't happy without something or someone to complain about, and that's an awful lot of power to give to someone else."

I feel this way about a lot of etiquette rules and rabid etiquette nerds. The point of etiquette is for everyone to be as comfortable as possible - treat others as you would like to be treated, etc. However, I think some common sense and decency is often lost in translation when interpreting etiquette rules - and even etiquette mavens lose a sense of empathy when faced with the unfamiliar. I would rather be treated with pity than a cold, "polite" shoulder because I wasn't following the rules, and that's saying something.

Jennifer said...

AMEN, sistah! I totally agree. I'm a plop it on the table and do my test as I need to kinda gal. I've been doing this since I was 6-freaking-years old for God's sake. I will not hide my disease. All those complainers should go donate $10 to the ADA so that we can get rid of it! Oh, and vote for someone who supports stem cell research from now on, please!

Bernard said...


I'm with you on this one. I've got a pump, so shots are no longer an issue. When I used to inject I could do it into my thigh and most people didn't even notice it.

When I test I usually keep my meter and strip on my lap and I hope that only those sitting right next to me would notice it at all. I lick my finger, but the amount of blood on it is probably not noticeable to anyone.

If I'm in a public place where I'm likely to be shaking hands, I will test on my left hand. That way I don't have to worry anyone that I may be passing some disease to them by shaking their hand.

This is something we have to do. We try out best to be discreet. If we get it wrong sometimes, that's a pity. Next time, look away.