Had one 18 years ago for “frozen shoulder” and swore I’d never have another. Neither the orthopedist nor I knew the effect of a cortisone injectinon on a T1’s BG levels. I was still on R/N back then, which didn’t help. Couldn’t figure out wtf was going on until I called my PCP, who had a sub-specialty in diabetes, and he said “Of course, it’s the effect of the cortisone.” Took a couple of weeks to wear off, and I swore Never Again!
And then this agonizing case of tendonitis in my right thumb came on with exquisite timing back in mid-March, just on the cusp of Covid lockdown. Called my current hand surgeon: no appointments until June, she said. Ibuprofen, icing, Futuro hand brace, weeks going by, only slight improvement. I swore I’d take the shot–anything to make the pain stop. It turns out we have opposable thumbs for a reason, and not being able to use the one on your dominant hand without breathtaking agony makes you keenly aware of that fact. After weeks with it not getting better I was all about the shot, BG be damned.
Fun fact: my surgeon’s husband is a T1, so she knows this stuff. Her husband’s on Lantus + Afrezza, but we talked about how having a pump & CGM makes this a whole different proposition from what it was for me back in 2002. Plus the amount of cortisone for a thumb joint is a lot less than you get for a frozen shoulder, so there’s that. I’ve set a temp basal to 120% for the next 24 hrs, maybe a bit aggressive but I will be relying on Dexcom to keep an eye on it and stay safe. I’m definitely seeing some upward pressure eight hours after the shot, but it’s not too bad even given my BG OCD.
It would suck to be cut off from the optimal treatment for this kind of orthopedic pain, so I thought I’d post this as an experiment in getting over a deep-seated resistance to it based on an outmoded insulin regimen. I’ll check back in and let y’all know how it’s going. If anyone else has recent experience with the dread cortisone shot feel free to weigh in.