Hi everyone -- I'm less than a month into testing my blood glucose levels, and bit by bit I'm getting a method that works. But I figure I could save myself (and maybe some other people) some suffering by getting advice...
[1] How do you prepare your fingers? Do you wash with soap and water every time? The water at our house takes forever to run warm but using it cold doesn't work. I've done some tests without cleaning if I've washed my hands recently but I'm curious if this is safe.
[2]Also on preparing, do you shake your arm, or run your other hand over your wrist, hand, and finger.. or what? I've had to re-do way too many tests because no blood came out and I think some of those problems must be due to not enough prep.
[3] How often do you change your lancets? I've read both Dr. Bernstein's book and Jenny Ruhl's book (links on my first blog post, excellent reads) and they rarely change. I've noticed, though, that changing every morning seems about right for me.
1. I wash my hands with hot water and mild soap (antibacterial or not just something mild as I have hand eczema) every time. It takes forever to warm up at my house too but it's worth it as the blood comes out really easily. I don't want to test without washing my hands as I fear it'd distort the results as I don't know where my hands have all been. Might be a bit of a paranoia thing but regardless every time I do that.
2. I shake my hands a bit before testing then gently push on the lower part of my finger and if I do that it seems blood comes out.
3. I rarely change my lancet unless it gets really really dull and starts just hurting and no blood comes out, usually every few months. I'm a bit lazy and it's the last thing on my mind .
4. My major tip that helps me is try whatever works with your lancing device and play with the depth settings. I have to set mine pretty high with my delica lancing device but my other ones don't need that. Sometimes it's better to use the lighter setting (Bayer microlet 2's come to mind) but sometimes I need the higher settings (Delica) to get any blood to come out. If I use the higher settings on the microlet 2, for example though, that can hurt a LOT more and also bleed a lot more which is also kind of unnecessary. Try different devices too, don't just stick to one if it doesn't help you get blood out. I've heard great things about accucheck lancing devices but I haven't tried them, for example.
I don't bother with washing unless I have just prepared food or my hands are dirty. I often have trouble getting blood as I have poor circulation. For the first test of the morning I have the most trouble and so run my fingers under hot water which really helps. I don't do any kind of preparing, just push on the finger once I've pricked it to try and get enough blood. I find if I wait a bit after initial pushing I can get more. I change lancets once in a blue moon. I use Accu-check drums and haven't replaced my supply (100 drums, 6 lancets each I think) since I was diagnosed in 2007.
Only tip is rotate, rotate, rotate, using all the fingers you can conveniently reach (I don't use thumbs) and all parts of the finger.
I don't wash my hands or do any kind of preparation. Back 20 years ago, in the days when you needed a giant "hanging drop" of blood, I used to "milk" my finger, but the drops of blood you need nowadays are so small that I don't need to do that. I just prick my finger, if the first finger doesn't work I move on to another and usually get some blood from that one (I have my lancet set to 3 out of 5 for depth).
I do wash my hands if I have some reason to think the reading might be inaccurate, or if I've been out in public all day or somewhere else fairly dirty.
I probably change my lancet once a month. I have the MultiClix which stores 6 lancets and changing is as easy as twisting a dial. Before I had this, I probably changed mine twice a year or so.
I wash with warm water and soap. I let warm water run over the fingers I normally use, I think it helps the blood flow better. I hardly ever change my lancet, maybe a couple times a year.
Hi Rosana! Congrats on your first month... sounds like positive habits are already forming! After 16+ years of poking, here's what works for me - may not be textbook what you "should" do, just what I do!
- If I have recently handled food, I will wash my hands. If, say, I've been reading a book or watching TV, I typically don't. If I get a reading over 175ish and haven't, I wash and retest.
- I test exclusively on my fingers. If they are cold I will warm them by rubbing them together for a bit. While I do not intentionally favor, I have found (for whatever reason) that I can more predictably get enough blood from my ring and middle fingers. I keep my poker turned up to a 7 - if you are finding you aren't getting enough blood, you may want to turn yours up (not sure what kind you use, I'm on OneTouch). Lastly, when poking, I apply pressure below where I'm poking on the finger with my thumb (think of "scrunching up" the tip of the finger) (That may not even be a real word...hopefully you get the visual.)
- I'm with Dr. Bernstein on this... I wear them out until they're dull. I remember feeling so validated the first time I read his book and realized that "someone like HIM" does this, too!
- Other tips: When I first became diabetic, I was very self-conscious of testing in public... I would end up going into a bathroom stall, trying to balance my tester on the top of the toilet paper dispenser, inevitably dropping something and getting really frustrated. (Not to mention...uh...it's a public restroom!) Nowadays I do it wherever, whenever I want. I know this varies from person to person greatly, but taking my testing out of the closet, so to speak, made me much more comfortable with doing it.
(1) I only wash my hands if they are distinctly dirty OR I have been handling carb-intense foods.
(2) Have to echo what Jen said. Back in the day when a good-sized drop was needed, I would lower my arms below my heart and "milk" the finger to get a usable drop. The meter I use now requires such a tiny sample that I need not bother with any of that, and haven't for a long time now.
(3) I change the lancet oh, I dunno ... every few months. If it ever got noticeably dull, i.e., excessively painful, I would change it then. That almost never happens.
Over the years I have several times had to experiment with different depth settings to get the one that produces sufficient blood with a minimum of discomfort. That's why they make them adjustable! ;-)
One other piece of (possibly) useful information. I use the pads of the fingers and three different sites on each: left, center, right. That gives me a total of 30 sites and by rotating thru them each one gets a day or two of rest before it gets used again. That works well in keeping my fingers from getting sore or otherwise bothered.
Based on several of the comments, I ordered the Accu chek fastclix device and the lancets (2 separate items at Amazon) after doing a bit more homework. This is the newest and supposedly easiest of several lancet devices made by this company. The one before it, which a lot of people like better, is called multiclix.
I'm not including links because it seems to be an ever-changing game of who is selling at the best price. I got the lancets through Amazon prime and the device through one of the companies selling on Amazon.
Wow, I'm impressed with the useful info in the replies! Not to stop the discussion... feel free to add things even much later... but I want to thank everyone who posted for being so helpful. I'm reassured that I was on a pretty good path and it's way better now.
Over the 15 years I've been diabetic, I have heard (and seen pictures!) of "pepper" fingers, numbness, callouses, etc. I try hard to avoid the complications with testing, so my routine is a bit involved.
First, I thoroughly clean the spot on my finger with an alcohol pad. Then, wipe dry with a fresh tissue.
Lance, draw the blood, apply to test strip, then use the same alcohol pad to clean the pricked area thoroughly again. Allow to air dry.
This all takes me about 1-2 minutes. The only additional supply I need to have around is alcohol pads, and I've got those everywhere (in my desk at work, nightstand at home, diabetes test kit, diabetes bag, car glovebox, bathroom, undershorts, taped to the back of my head, in my daughter's left ear, and 2,343,718,255 other places).
So far, my fingers have held up pretty well. No peppering, no callouses, plenty of feeling, etc.
One other piece of (possibly) useful information. I use the pads of the fingers and three different sites on each: left, center, right. That gives me a total of 30 sites and by rotating thru them each one gets a day or two of rest before it gets used again. That works well in keeping my fingers from getting sore or otherwise bothered.
I tried that, but couldn't well enough keep track of the last finger I stuck. I gave up.
ROFLMAO. I have a terrible memory. I keep a log. The site of each finger stick goes in the log along with the reading that resulted, the amount of insulin used, etc., etc., etc.
As someone, somewhere once said: if it isn't written down, it doesn't exist.
I only wash if I have been handling food, especially sweets. Otherwise I give the selected hand/fingers a good rub on my pants. The friction tends to warm them up. I use the sides of the pads. Usually no lower than level of the cutical. Have been experimenting with flesh between joints closer to hand but it is harder to milk if needed. I will wash and repeat if I don't think that the result is accurate.
Also since I use a Dex G4 CGM on the back of my upper arm, I tend to use the hand on the cgm side. Seem to get better correlation between finger and CGM when I do that.
As for changing our the Lancet, I still have the original box of 100 prescribed over a year ago. Only change when I drop my Lancer, the cover pops off and the point gets bent. Or it get too painful and starts to bruise. Most of the time when it starts to hurt its because the setting gets dialed up as its banging around in my pocket not because it's dull.
Interesting; I was told that alcohol tends to dry out fingers more, not less! But I definitely have "pepper fingers" - very descriptive word! Since you say you're OCD about testing, I figure you test a lot per day? I'm thinking there might be something else involved: Good moisturizer? Soft fingers? Area of the finger you use?
True story during instruction by a physician's assistant in the method of testing and shooting... He tore open an alcohol pad and ran it over his fingertip while saying, "The proper way to do this is to wipe the area with a prep pad each time before sticking or injecting." Then he looked directly at me and said, "Most people do that for about a week." Sure enough, I stopped within three days!
It took the better part of three years for me to get through the first box of 100 lancets. Now, after four and a-half years on this T1 ride, I find sticks to be less painful if the lancet is changed at least weekly. (And it makes sense that a sharper needle causes less damage.)
Don't bother most the time. I do if the number doesn't "feel" right, but a lot of the time there are no resources at hand to wash my hands every time. Be that on a bike, or out on calls with work. If a number feels off, I may switch hands or fingers as a double check.
Prep consists of find a not so battered finger, whack it. Done. Repeat if no blood.
I use a multiclix lancet so each cartridge holds 6. Although a lot of the time I do tend to make them last longer than that. Depends mostly on how many spares I am carrying really than anything else or the previous one was blunt.
Don't think, just lancet finger bang done. As soon as you start to think your brain gets involved in the whole you are about to do harm to yourself and will try and make you dance around not doing it. Less thinking the better.
Pads of the fingers as you probably know have far too many nerve endings so hurt more. Sides of fingers or even top of finger below the nail are pretty good. And practice with depths. You don't need to have it set to max unless your skins turned to that of a rhino's. Over time you will probably need to increase the depth setting but early on you don't. Try different lancet devices from various manufactures not just the one off your meter company, some feel better than others or have more practical features for you, and that matters as you'll be using it lots. Same with test strips really, the one which ask for more blood if they don't get enough help as it saves wasting strips and having to do multiple lancet hits if you don't draw enough blood the first time.
I'm actually surprised that my practices are different than those out there.
[1] I wash my Finger Under Test (FUT) every time. I've had too many experiences with contaminated results. And I use soaps that don't contain glycerin or other sugar based compounds after finding they mess things up. And then I dry my FUT completely because water also messes things up. I never use alcohol and have never had an infection and besides, residual alcohol can cause a falsely low meter reading.
[2] I lance the side of my FUT rather than my pad. There are less nerves there and less consequence from lancing, so I set the lance plenty deep. No problems bleeding
[3] I rarely change the lancet, I still have a unopened box of lancets from 2006 for a lance I don't even use anymore.
[4] Finally, every test should be actionable. It is a waste to just test and do nothing with the result. If I am not prepared to make some decision or change based on the test, then I don't test.
