New to juv. diabetes---insulin pen question

[WendyJB]

My 4 year old son was dx with juv. diabetes last month.  He has been on Humulog and Lantus since hospitalization.   He does well with the finger pricks,  but does not like the shots.  Tonight I had to pin him on the floor with my knees on his legs and arms in order to give him his two evening shots.  It was awful and even my five year old who was observing started to cry.  I asked my endo (the PA) about the pen at our last visit.  She said she had heard that they didn't work well (efficacy?) and that she hadn't been detailed on the pen yet---but expected to in the next two weeks.  Has this product not been out for some time???
We have an appt. tomorrow and I am looking for some input on this pen.  I have never heard that the pen is innacurate but did read tonight that the Humalog pen must be held to the skin for a count of five---that could be ugly.  We can't use the Lilly pen anyway because we need one with half units.  I guess we would have to change to Novolog to use their pen.  Any pen users with children have input???

Thanks in advance---Wendy

[lbihappy]

Hi I am the parent of a newly diagnosed child.  My son is eight and he uses the insulin pen with Novalog.  I agree with all the other parents, I think the pen is great.  Just a word of advise, we have figured this out through trial and error, we have come across two types of needles for the pen.  One is just the needle (it screws on to the top of the pen) the other is a needle (it also screws on to the top of the pen) but it has a plastic cylinder around the needle which you need to press firmly against the skin in order for it to retract the plastic then   exposed the needle.  My son found this needle very uncomfortable.  When pressing down on the plastic covering the needle, it was pinching him.  That pinch gave him more pain than the needle.  Hope this helps.  Good luck from one frazzled mom to another.

[JDRF-VOL-SG]

I totally agree with LS's answer to you. It will get easier in time. Your child may be testing you at first until this becomes a normal routine. I am not so sure that the pen will be that different than hypodermic needles, for the delivery is still going to sting a little. And some places are more sensitive than others. In time, you can discover which injection sites work best for your child. You might want to try giving your 4-year-old a choice as to where the injection will be given so as to make him part of the process. And I would try to do this without the 5-year-old being present for a while. His distress at watching his brother struggle isn't helping the situation. It may be calmer with just one child and one parent dealing with the shot.

I babysat a diabetic toddler for his mom when she was pregnant and needed to go to her OB appointments, and I helped the grandmother watch him when the mom went to have the baby, and I made a game out of the procedure, complete with prizes. Be creative and see how you can make shot time "fun". Believe me, a child will pick up on the fun elements quicker than the not-so-fun elements. I used a reward system for the toddler, and we would do the reward activity ONLY after taking the shot. I found something delightful in the way of a toy that he could only enjoy after a shot. Rewards should be changed often enough to keep some "magic" happening.

Also, try hard to keep YOUR attitude as positive as possible. You must be feeling some distress yourself at having to give shots to your little one. And your child is probably sensing your distress. So the calmer YOU can make yourself, the better. I know that this is easier said than done, so I don't mean to trivialize the trauma that both of you are feeling. Just to encourage you to take care of your own emotions before shot time so you can be as cheerful and positive as possible.

My bet is that some creative ideas will be available from other parents who have been where you are now. Do visit the JDRF website and ask to be matched up with a more experienced parent, and I think you will find some helpful suggestions.

Trust me, in time, this will just become a routine. But your child is probably testing now to see if he can do things to avoid the shot. Once he finds out that the shot is part of life now, without question, he will stop struggling. The shots really are not all that painful.

[Forum-VOL-LS]

Dear Wendy,
As a 'newly diagnosed' family, information is coming at you from all directions, and it's often difficult to sort thru the info at the same time as everyone is dealing with the emotional issues related to a beloved child having this disease.

We are all volunteers here and not medical professionals, so I encourage you to follow up with a pediatric endocrinologist *and* with JDRF's Online Diabetes Support Team.  Visit the JDRF website:  http://www.jdrf.org and click on the linke for Newly Diagnosed.  Like we are, that site is also staffed with volunteers, but unlike us -- they can provide 1:1 help and can connect you to others in your area who're ahead of you on the learning curve -- for this question and the hundreds that will follow.  The support you'll experience is a terrific supplement to good medical care from a knowledgeable team.  

They physical restraint you needed to use tonight must've been frightening for all of you, and the stress undoubtedly made the process painful on multiple levels.  With help from parents who've been there & done that & have found other ways, you all will be able to get thru this time.

Insulin pens *have* been around for quite a while.  Many of us have also used Humalog and then moved onto to Novolg.  Novolog seems to act more quickly & to stop acting more quickly, but like all insulin, we learn to see how it affects us individually -- and how to work with/around how it works.  Once you've learned about insulin:carbo ratios and insulin sensitivity, you may also talk with your son's pediatric endo about an insulin pump.  There are fewer pokes with a pump, and yet they do require a deep understanding of the details that're best learned with shots or pens initially.

Good luck; there's a lot to learn and relearn over the years.  For your sake, your son's sake, and your family's sake, reach out to JDRF's Newly Diagnosed folks, too.  You'll be happy you did.