“People with diabetes shouldn’t inject insulin publicly!”

[Fear Itself]

My biggest concern about this thread is the "filthy bathrooms". Why the fuck are ANY of you eating anywhere with filthy loos! Surely filthy loos are not the norm. I can't remember (since Eygpt) eating anywhere with dodgy loos.Some people are obsessed with restroom germs; by their definition, all restrooms are filthy, because you do filthy things in there. We've had threads about people who think using telephones in the restroom is gross. I've always wanted to ask them where they keep their toothbrushes.

[calm kiwi]

Not anywhere with flushing loos it seems. :)

Sensibly we put the loo in a seperate room from the toothbrush (usually), but I would be more concerned about eating somewhere with a "filthy bathroom" then I would with be a diabetic injecting themself at the table next door.

[Left Hand of Dorkness]

OKay, perhaps I'm really asking in the wrong place, but Qadcop earlier gave a medical opinion that injecting at the table didn't subject other diners to any health risk, and one of the links from this thread said that injecting through a layer of cloth didn't subject the diabetic to any health risk. I'm just wondering, does anyone have any specific information either way on whether injectng in a restroom subjects the diabetic to any health risk?

Note that I recognize there are plenty of bacteria in a restroom; nonetheless, it is conceivable that an insignificant number of these bacteria find their way onto the insulin needle in the couple of seconds that the needle is exposed. Any accumulation of bacteria on the skin would presumably remain there after the diabetic has exited the restroom.

Even if there's no risk from injecting in a restroom, that doesn't mean diabetics are obligated to do so; it would just be an additional data point.

Daniel

[Hentor the Barbarian]

Even if there's no risk from injecting in a restroom, that doesn't mean diabetics are obligated to do so; it would just be an additional data point.

DanielWhile I find the idea of taking my son to the restroom to give him his injections distasteful for several reasons, the filth & florum aspect (while on the list) is not primary for me. More pressing would be the fact that so few restaurant restrooms (at least where we go) have a shelf or surface to set things down on, unless you would propose that I work from the floor or the diaper changing station in the restroom. It also doesn't get past the problem of eliminating the risk that a casual glancer might happen upon us during the process. It also continues to strike me as taking particularly unnecessary steps in the process of managing my son's diabetes in order to avoid upsetting an apparently small portion of the population, some of whom have problems keeping out of other's business.

I would regret causing distress for the smaller subset who both witness the event during a casual glance AND are unduly troubled by it.

In your case (or our case, I should say) it seems that we would have to come down to trying to negotiate whose disorder takes precedent in terms of accomodation for the other. That's an argument for which I see no clear resolution. My apologies if you are ever so exposed, and I am sorry that you are not able to obtain appropriate treatment.

[calm kiwi]

Your son's condition definetly takes precadence over "EWWWWWWWW".

Each and every time.

[Una Persson]

OKay, perhaps I'm really asking in the wrong place, but Qadcop earlier gave a medical opinion that injecting at the table didn't subject other diners to any health risk, and one of the links from this thread said that injecting through a layer of cloth didn't subject the diabetic to any health risk. I'm just wondering, does anyone have any specific information either way on whether injectng in a restroom subjects the diabetic to any health risk?

Note that I recognize there are plenty of bacteria in a restroom; nonetheless, it is conceivable that an insignificant number of these bacteria find their way onto the insulin needle in the couple of seconds that the needle is exposed. Any accumulation of bacteria on the skin would presumably remain there after the diabetic has exited the restroom.

Even if there's no risk from injecting in a restroom, that doesn't mean diabetics are obligated to do so; it would just be an additional data point.
While I posted earlier that I did not want to poke holes in my body in the toilets, I have to say that for the most part, I don't honestly believe I'm at great risk of infection in there, or even necessarily any more than, say, doing it in a seat on an airplane. It's more a matter of personal preference, and if I feel it's best to go to th the toilets then I go in there and don't get upset.

One big problem, which I experienced just yesterday, is needing to take a shot on the plane when you are 1) unable to get up due to flight restrictions, or 2) the toilets are full, with a line of anxious looking males standing outside them waiting to evacuate their Chili's Two nachos and beer feast they had at the airport, or 3) I'm stuck by the window with 500+ pounds of humanity to crawl over to get to the aisle. So I typically take my shot(s) (multiple on overseas flights) in my seat. Thankfully, people almost never notice. I mean, great Jesus, every single flight I'm on is filled with people who can't figure out which seat they're in, which row, or who, somehow, against all impossibilities, get on the wrong freaking plane (how is this even possible post 9/11? But it happened yesterday!). So given the general cluelessness and desire to avoid human contact on the plane, no one notices me. One time someone did pointedly ring for the stewardess and complain that I was using an "unapproved electronic device" on the flight (my meter), even though the in-flight magazine said "personal electronic medical equipment may be used at ALL TIMES". Oh well, you go on nearly 1000 flights, you meet some creeps.

[Left Hand of Dorkness]

While I find the idea of taking my son to the restroom to give him his injections distasteful for several reasons, the filth & florum aspect (while on the list) is not primary for me. More pressing would be the fact that so few restaurant restrooms (at least where we go) have a shelf or surface to set things down on, unless you would propose that I work from the floor or the diaper changing station in the restroom.

Ah, that makes complete sense. Again, I'm not saying that people SHOULD have to go to the restroom to inject--I was just unconvinced that the "restrooms are full of cooties!" argument is relevant.

But the inconvenience argument (along with the point that a casual glancer might still see) is perfectly convincing.

And again, given that I've never ever noticed a diabetic administering an injection, I'm not the least bit upset over this issue; I'm only continuing in the thread because I think it's interesting.

(FWIW, I suspect that Kalhoun remains in the thread only because he's backed into a corner; I don't think any amount of clever insults or reasonable debate will get him to back down, although it might be satisfying for the insulter/debater).

Thanks!
Daniel

[eleanorigby]

FWIW, the germs in my own bathroom are mine-and my families.

the germs in a public restroom are who knows? And Lord knows where they've been etc.

Shared space involving body fluids is always a higher risk to folks. In normal healthy people, the risk, while higher, is still quite low-thank goodness for immune systems and intact skin. You may catch a cold from the "clean" faucet in the restaurant bathroom, but not much else.

I doubt that any diabetic injecting in a public toilet would immediately succumb to some nasty contagious bug. But the chance that he could pick up an infection of some kind is higher. Why take the risk?

As a nurse, I would never counsel anyone to do any type of invasive procedure in the confines of a public restroom--and that includes inhalers.

The staff may do an hourly wipedown, the place may look clean--it is not. Not only is it not clean, you are not resistant to all the germs present, like you are at home.

beckwall--I'm with you- I too hope that eyes have been opened with this thread. People carry with them tremendous burdens, all unseen for the most part. More kindness and charity of thought are needed in this world. <sermon over>

[swampbear]

One big problem, which I experienced just yesterday, is needing to take a shot on the plane when you are 1) unable to get up due to flight restrictions, or 2) the toilets are full, with a line of anxious looking males standing outside them waiting to evacuate their Chili's Two nachos and beer feast they had at the airport, or 3) I'm stuck by the window with 500+ pounds of humanity to crawl over to get to the aisle. So I typically take my shot(s) (multiple on overseas flights) in my seat. Thankfully, people almost never notice. I mean, great Jesus, every single flight I'm on is filled with people who can't figure out which seat they're in, which row, or who, somehow, against all impossibilities, get on the wrong freaking plane (how is this even possible post 9/11? But it happened yesterday!). So given the general cluelessness and desire to avoid human contact on the plane, no one notices me. One time someone did pointedly ring for the stewardess and complain that I was using an "unapproved electronic device" on the flight (my meter), even though the in-flight magazine said "personal electronic medical equipment may be used at ALL TIMES". Oh well, you go on nearly 1000 flights, you meet some creeps.

Yet another example of how I am either extremely polite or extremely dense. As much as I fly, I have never noticed anyone taking an insulin shot. Odds are it has happened quite a few times and no doubt right next to me a time or two.

Heh! People getting on the wrong plane. I see it too. Even been told that I must be in the wrong seat cause "my ticket says I have this seat." Indeed you have this seat, on the flight boarding five gates down. You know what gets me even more? Somehow the ticket checker person actually let the person on the plane to begin with. :confused:

Oh, and Una the bolded part of your quote? Thanks for adding to the list of reasons why I fear airplane toilets. :eek:

[Left Hand of Dorkness]

I doubt that any diabetic injecting in a public toilet would immediately succumb to some nasty contagious bug. But the chance that he could pick up an infection of some kind is higher. Why take the risk?
Eleanor, I hear what you're saying--I'm just not convinced that the risk is appreciably higher. That is, I'm not convinced that, by injecting in a restroom, one in a billion diabetics would gain a disease that they would not otherwise have gained. I'm not convinced that in the history of diabetics injecting in bathrooms, this risk has ever materialized.

I *could* be convinced, mind you; there very well might be a 50% rise in disease risk from injecting in a public restroom. But I'd be curious to see data to that effect, not conjecture based on data that may or may not be relevant.

Daniel

[eleanorigby]

My point is that the mix of bacteria in a public toilet is one that might boggle the mind. I am sorry that I do not have data for you as to the number and variety of germs--do you not think they are present? SD did a column on the cleanliness of public bathrooms awhile back. If I ever figure out how to link, I will. I doubt that a study has ever been done that looks at injection infections: restaurant setting or lavatory setting, but seems anyone can get a grant these days....... :)

Probably extraneous background info, but it makes me feel better posting it:

In nursing (and in health class, really) there are sterile things, clean things, and soiled/contaminated/dirty things. Your actions with each depends on the task involved and the risks to the pt.

Example: patient has 3 or 4 deep, open, infected wounds. You use clean technique(gloves) to remove the old dressing on wound #1. You then use sterile technique to reapply a new dressing. But you do not go straight from wound to the next.

Even though the wounds are on the same pt (and most likely share "his" germs) you still handwash, don new nonsterile gloves to remove the next open wound's dressing. And yet again for the third-IOW, you treat each wound as a separate entity. Lots of time and lots of gloves. This applies to dressings done at the bedside. I am not speaking of OR stuff (any OR nurses here/).

We are taught (Ha! more like drilled so that girls used to wake up crying out, "I'm sterile, I'm sterile!" during their OR rotations. It was as funny then as it is now) to respect the differences and act accordingly-in all aspects of care.

Hence, as a nurse, I would never use the same measuring graduate to empty a Foley (bladder catheter) and also a wound drain. The risk of cross contamination, while it might be small, is present. Why take it? In the hospital, we don't prep meds in the patients toilet--it is considered a dirty area, and it IS dirty.

Why would a public toilet be any different? Hentor has already addressed the common of a decent, DRY surface on which to place the kit. That alone is reason not to use the bathroom for this purpose. Alot of germs are spread via contact. You put the kit on a wet sink ledge, then pick the kit back up--the germs are carried on the kit and are now on your hands etc. Why go there? Why introduce the possibility, however small?

If someone HAD no choice but to use a toilet for injecting, I would reccomend that 1. wash your hands
2. wipe down with a dry paper towel the area around the sink.
3. discard paper towel.
4. wash your hands again, using a paper towel to turn off the faucet.
5. place a few layers of paper towels next to the sink-you are creating a "clean" field.
6. put the kit on the paper towels.
7. wash your hands again.
8. test blood sugar
9. prep injection.
10. wash your hands again, if you feel that you might have touched something during the above process that may have contaminated you.
11. inject insulin.
12. zip up kit, after disposing of sharp appropriately.
13. clean up area.
14. wash your hands again*.
Leave the restroom


It may sound OCD, but it's not-it's being careful and cautious. I do not know if diabetics do all this--I doubt it; most probably wash their hands using hand gel and do this at the table, which provides a clean, DRY surface for the kit. Simpler, easier and faster.


*if, for some strange reason, I were to be the one injecting YOU in a public restroom, this is what I would do--it's quicker than it looks, because it is second nature to me now. If I had clean gloves, I would not do #7 or #10, unless I had contaminated the gloves somehow.

Diabetics are at higher risk for all infections, and caution is the watchword. Sorry to sound school marm-ish, but there it is.

[Left Hand of Dorkness]

My point is that the mix of bacteria in a public toilet is one that might boggle the mind. I am sorry that I do not have data for you as to the number and variety of germs--do you not think they are present?
No, I absolutely believe those germs are present; I'm just not sure how they'd get onto the needle. Does the diabetic's hands touch the needle at any point? I was under the perception (quite possibly incorrect) that the sterile needle was covered until seconds before the injection, that the only solid it touched was at the point of the injection, and that there would be very little opportunity for any bacteria to contaminate any part of the process except by settling on the skin at the injection site. Bacteria that were so settled would remain there even after the person returned from the restroom, such that injecting at the table afterwards wouldn't reduce the risk of contamination.
Diabetics are at higher risk for all infections, and caution is the watchword. Sorry to sound school marm-ish, but there it is.
Not school marm-ish at all. You're a nurse, and I'm not, so of course you know more about the process than I do. I'm just wondering how the bacteria in a restroom would manage to contaminate the process.

Your examples seem to describe how a contaminated solid should never touch a wound, or touch something that would cause a wound. Does anything, contaminated or not, ever touch the needle pre-injection?

Daniel

[Hentor the Barbarian]

Does anything, contaminated or not, ever touch the needle pre-injection?

DanielIt shouldn't, and I would probably just use a new syringe if it did. The syringe is firmly capped until you have to draw up the insulin. So the needle does touch the material covering the insulin bottle. One presumes that this is clean enough. After drawing the insulin, we almost always cap the syringe, because it is usually coming from the fridge, so we have to warm it between our fingers for a few seconds or it is more painful. When we are out, this is less of a requirement, and we may be more likely to go from having drawn it up to giving it immediately. The exposure to air of the needle should be thus fairly limited, and the only surface that it should touch prior to skin is the top of the insulin bottle.

[Una Persson]

Oh, and Una the bolded part of your quote? Thanks for adding to the list of reasons why I fear airplane toilets. :eek:
The worst ever is coach class toilets on overseas flights - especially loooooong overseas flights, with LOTS of kids on the plane. I think after about 6-8 hours many parents just give up and decide to let the children regress to the level of barely trained gibbons, where everything in the loo - and I do mean EVERYTHING - becomes a new toy of infinite wonder and discovery. I've been on flights with a quarter-inch of "liquid" sloshing around on the matting, and "stuff" smeared like fingerpaints on the walls, handles...

No way do I use those for a shot. No fucking way.

[Lynn Bodoni]

Really? I'm surprised. From your posts, it seems like disrobing your child in a restaurant would be perfectly acceptable to you. Or do you just save that particular performance for special occasions, say birthday parties, 1st communions, and Christmas? :dubious: milroyj, quit being a jerk. This is the fifth warning for you. I am going to discuss this with the moderation staff.

Lynn
For the Straight Dope

[swampbear]

The worst ever is coach class toilets on overseas flights - especially loooooong overseas flights, with LOTS of kids on the plane. I think after about 6-8 hours many parents just give up and decide to let the children regress to the level of barely trained gibbons, where everything in the loo - and I do mean EVERYTHING - becomes a new toy of infinite wonder and discovery. I've been on flights with a quarter-inch of "liquid" sloshing around on the matting, and "stuff" smeared like fingerpaints on the walls, handles...

No way do I use those for a shot. No fucking way.
AWW GEEZ! Are you just trying to torture me! I have to fly across country Saturday morning. I may not drink or eat anything at all from now til then. :eek:

Regress to the level of barely trained gibbons... now that's comedy gold!

[Lynn Bodoni]

Diabetics are at higher risk for all infections, and caution is the watchword. Sorry to sound school marm-ish, but there it is. And not only are we at higher risk, we tend to heal more slowly when we get infected. Infections also tend to raise blood sugar levels, adding yet another complication to our lives. A couple of years ago, I had a major abcess/boil in my right arm. The swelling was the size of a grapefruit. From start to finish, I think that I spent about four months trying to get that thing healed, including some time in the hospital. I had several courses of oral antibiotics and a few different kinds of IV antibiotics. I developed an allergy to another antibiotic. I had to have a home health nurse come out to my house for a few weeks to give me antibiotics by IV after I was released from the hospital. All told, I think that my out of pocket expenses for that abcess totalled at least $5000...this isn't including what my insurance paid out. I would really, really prefer not to go through that again. It wasn't fun. I will do my best to avoid any germs I can.

[eleanorigby]

No, I absolutely believe those germs are present; I'm just not sure how they'd get onto the needle. Does the diabetic's hands touch the needle at any point? I was under the perception (quite possibly incorrect) that the sterile needle was covered until seconds before the injection, that the only solid it touched was at the point of the injection, and that there would be very little opportunity for any bacteria to contaminate any part of the process except by settling on the skin at the injection site. Bacteria that were so settled would remain there even after the person returned from the restroom, such that injecting at the table afterwards wouldn't reduce the risk of contamination.

Well, those germs most likely don't get onto the needle. But people drop things or miscalculate where the counter/table is and knock stuff off etc. Excluding the lavatory as a possible place is just increasing the safety net for a good, clean injection--in an injection, only the needle and the insulin are sterile. If Hentor was to fumble with the bottle of insulin at the table, chances are it will fall either in his lap or on the table(and it wouldn't break). Not so in the toilet-where the tile floor would break the glass vial. If he dropped the syringe, chances are he would disspose of that one, and get a new one-I wouldn't use a syringe that had dropped on a bathroom floor, no matter if it was capped-but I could see using a needle(capped) that fell onto a clean, dry tablecloth. Hope that helps, you Daniel . :)

So, really, using the "clean" environment of the table just eliminates potential problems--both physical and emotional. Except for those souls who are rocked to the core by the sight of a father taking care of his son. Perhaps this thread has given them food for thought and now they will volunteer to clean all the public restrooms wherever they dine out. :cool:

Lynn --you bring up very valid points. I was going to, but hesitated after the strawman/drama queen tactics. It only makes sense to eliminate as many potential problems that one can. Noone expects a bad asthmatic to sit in the smoking section--why do we expect diabetics to increase their exposure to hazards?
I hafta work tomorrow, but already feel like I did a shift! ;)

[Larry Mudd]

Some people are obsessed with restroom germs [...] I've always wanted to ask them where they keep their toothbrushes.In the medicine cabinet, for the last six years.

Why was that again? Oh, right (http://www.theglobeandmail.com/servlet/ArticleNews/TPStory/LAC/20050512/SPILL12/TPNational/Toronto):Take it from me, if you do nothing else, put your toothbrush back in the medicine cabinet after use.

[Larry Mudd]

Whoopsie. Don't know how that happened.

Corrected link (http://www.straightdope.com/classics/a990416.html).

[Left Hand of Dorkness]

Well, those germs most likely don't get onto the needle. But people drop things or miscalculate where the counter/table is and knock stuff off etc. Excluding the lavatory as a possible place is just increasing the safety net for a good, clean injection--in an injection, only the needle and the insulin are sterile. If Hentor was to fumble with the bottle of insulin at the table, chances are it will fall either in his lap or on the table(and it wouldn't break). Not so in the toilet-where the tile floor would break the glass vial. If he dropped the syringe, chances are he would disspose of that one, and get a new one-I wouldn't use a syringe that had dropped on a bathroom floor, no matter if it was capped-but I could see using a needle(capped) that fell onto a clean, dry tablecloth. Hope that helps, you Daniel . :)
It does; my curiosity on the subject is satisfied, and I agree that doing theses shots in the bathroom seems like a bad idea for sanitary reasons. Thanks for being patient with me!
Daniel

[Left Hand of Dorkness]

doing theses shots
"Dude, gimme another hit off that Sociopolitical Analysis of late-20th-Century Capitalism in post-Keynesian Lithuania!"

Daniel

[Caricci]

A hearty fuck you right back at'cha for being so inconsiderate of everyone else at the restaurant. I can't say I'm revolted by the idea of someone injecting a needle into their body but it's certainly an unusual site and there are some who are really squeamish about such things. Is it really so hard to use the needles elsewhere? If not the bathroom then why not the car before entering the restaurant or is this kind of thing so time sensitive that you've got to do it moments before eating?


Marc

I see this is a huge thread and I've only just gotten started so forgive if I'm being redundant in my comment but I just want to say that, for the most part, unless other diners are totally minding business other than their own, there is no reason to even notice. My sister has to inject pretty much while the food is in front of her (because, God forbid she should watch her diet - but that's another story) and is able to do it so quickly and matter of factly that I've never actually caught her doing it and I'm right at the table with her. She injects insulin into her abdomen. It's like a little magic trick almost! Same goes for the blood testing which is done in her finger.

[Fear Itself]

In the medicine cabinet, for the last six years.

Why was that again? Oh, right (http://www.theglobeandmail.com/servlet/ArticleNews/TPStory/LAC/20050512/SPILL12/TPNational/Toronto):Yeah, I remember that one. Especially this part:As Professor Gerba's research would later determine, however, the bathroom was hardly the most dangerous part of the house, microbe-wise. The real pesthole: the kitchen sponge or dishcloth, where fecal coliform bacteria from raw meat and such could fester in a damp, nurturing (for a germ) environment. Next came the kitchen sink, the bathroom sink, and the kitchen faucet handle. The toilet seat was the least contaminated of 15 household locales studied. "If an alien came from space and studied the bacterial counts," the professor says, "he probably would conclude he should wash his hands in your toilet and crap in your sink." So where do you prepare your food, again?

[Cagey Drifter]

I just have one thing to say:

I hope that our society will someday evolve to a state where a man's welfare will be considered more important than cosmetic appearances and other such selfish concerns.

[Troy McClure SF]

I hope that our society will someday evolve to a state where a man's welfare will be considered more important than cosmetic appearances and other such selfish concerns.

Amen. I consider "Miss Manners" and her ilk to be trolls of humanity.

[Cagey Drifter]

Amen. I consider "Miss Manners" and her ilk to be trolls of humanity.I'll never forget the day 7 years ago I saw a sign declaring "no sleeping on stairs" next to a church staircase. still, so many years later, it rings so symbolic to me.

I Thank God there are some compassionate people out there (http://sfgate.com/cgi-bin/article.cgi?file=/chronicle/archive/2005/03/27/ING8MBSSIB35.DTL)

[Oy!]

Amen. I consider "Miss Manners" and her ilk to be trolls of humanity.


If you were to actually check out Miss Manners (can't speak to her ilk - does she have any?), you would find that she never, ever, ever suggests endangering health to accomodate people's over-squeamishness. In fact, she has commented quite negatively on such squeamishness.

Ann Landers, on the other hand...

[Troy McClure SF]

Oy!, not so much on this issue, but the idea that one random putz is arbitrarily supposed to be this font of wisdom about shit that no one should ever spend more than a second thinking about anyway just bugs the shit out of me.

[beckwall]

Cagey Drifter, thanks for the link. That's what I'm talking about, just showing some compassion to your fellow humans.

[Don't Call Me Shirley]

Ok, second time I have to ask. What is "hateful" about what I said? I don't have anything against you, nor would I ever post anything negative about anyone's child.

I am only reacting to your posts in this, and one other thread. I happen to disagree with you, perhaps strongly. That doesn't equal "hateful", my friend.
FTR, it sounded hateful to me. I am quite amazed at how people continue to maintain some decorum while discussing this with you, when obviously all you want is 15 rounds of name-calling. I find it much easier to just give you what you want, call you a fuckstick, save my words for someone who will listen, go on my merry way, and let you rot in your own pissed-off world.

Fuckstick.

[DoctorJ]

I hope that our society will someday evolve to a state where a man's welfare will be considered more important than cosmetic appearances and other such selfish concerns.
After reading this whole thread, this is what I don't get.

For the record, my position on this is that if someone is capable of being discreet about it, then testing sugar or giving insulin at the table is just fine, and if it is some sort of three-ring production that guarantees every eye on you (as it is for some people who do it--probably a rare few), then it's probably a better idea to excuse yourself to somewhere more private. I skew to one side on this; I don't blow my nose in public, and I tend to excuse myself even to take the medications I have to take periodically (by mouth). I don't think less of people who do those things publically, and I'm certainly not grossed out by them; it's just the way I am.

But let's be clear--this isn't about anyone's needs or welfare. Of course that person needs to check his sugar and take his shot; I spend what seems like half my life reinforcing this need. There are, however, few reasons why it would have to be done right there at the table. I don't buy the "bathroom germs" argument; it's only an issue if you're using poor technique, at which point your location is not your biggest problem. No one's HbA1C is going to be affected by the one-minute walk to the bathroom or to a less-populated corner.

The issue is one of convenience for the diabetic, and whether that convenience is worth making some people uncomfortable. I say that in most cases, it is worth it, hence my position above. There is an interesting discussion to be had here, but let's not ruin it by acting like anyone wants to deny the diabetic the chance to take care of himself; it's just a question of where it is appropriate to do it.

[milroyj]

There is an interesting discussion to be had here, but let's not ruin it by acting like anyone wants to deny the diabetic the chance to take care of himself; it's just a question of where it is appropriate to do it.

Exactly. And the dinner table is not that place. That's all I am saying.

[Mockingbird]

Exactly. And the dinner table is not that place. That's all I am saying.

And saying, and saying, and saying...

[Broomstick]

One time someone did pointedly ring for the stewardess and complain that I was using an "unapproved electronic device" on the flight (my meter), even though the in-flight magazine said "personal electronic medical equipment may be used at ALL TIMES". Oh well, you go on nearly 1000 flights, you meet some creeps.
Jimminy Cricket! If the flight conditions are such that a glucose meter is posing a dire threat you've got more serious problems than injection etiquette! Then again, the way adrenalin dumps blood suger into the system perhaps an insulin injection would be advisable prior to the Big Crash :D

Fucking nosey busy-bodies! As if the average airline passenger would even know what is and isn't an "approved electronic device" or how to make that determination!

I suppose this same jackass asks pacemaker recipients to turn them off prior to takeoff?

[Oy!]

Oy!, not so much on this issue, but the idea that one random putz is arbitrarily supposed to be this font of wisdom about shit that no one should ever spend more than a second thinking about anyway just bugs the shit out of me.

Etiquette has a real purpose. The next time you'e in a book store, take five minutes and read the forward to one of Miss Manners' books.

[Hentor the Barbarian]

if it is some sort of three-ring production that guarantees every eye on you (as it is for some people who do it--probably a rare few), then it's probably a better idea to excuse yourself to somewhere more private.Interesting. I've not met anyone like that. What do they do to make it a three-ring production? How are they guaranteeing every eye on them?

[Ellis Dee]

Interesting. I've not met anyone like that. What do they do to make it a three-ring production? How are they guaranteeing every eye on them?This example reads like it came pretty close.

Is this entire thread a strawman?

[Qadgop the Mercotan]

There are, however, few reasons why it would have to be done right there at the table.
One reason ought to be sufficient, like the patient's pediatric endocrinologist instructing her to take her humalog midway thru the meal. Need more reasons than that?

[DoctorJ]

One reason ought to be sufficient, like the patient's pediatric endocrinologist instructing her to take her humalog midway thru the meal. Need more reasons than that?
See, there's a great reason. :)

[DoctorJ]

Interesting. I've not met anyone like that. What do they do to make it a three-ring production? How are they guaranteeing every eye on them?
I guess I'm thinking mostly of a subset of people who want full attention drawn to their medical conditions for one reason or another. I have known people (and, again, I'm talking about a very few people here) who will go to great lengths to inject their insulin in public and draw attention to themselves as they do it.

The fact that these few people stand out in my mind, knowing how many insulin-dependent diabetics are out there, tells me that most are able to do this without being noticed.

[Dangerosa]

I guess I'm thinking mostly of a subset of people who want full attention drawn to their medical conditions for one reason or another. I have known people (and, again, I'm talking about a very few people here) who will go to great lengths to inject their insulin in public and draw attention to themselves as they do it.

The fact that these few people stand out in my mind, knowing how many insulin-dependent diabetics are out there, tells me that most are able to do this without being noticed.

And once again, no one is arguing that diabetics are showing great courtesy when they turn injections into a floor show. They are arguing that, as long as they take pains towards discretion (which it appears most do), they shouldn't be sent to the restroom or the car to inject.

There is no way a stranger can determine what protocol the diabetic's doctor has recommended. Therefore, there is no way a stranger can be in a position to judge, provide dancing girls wearing feathers don't deliver the syringe.

[Left Hand of Dorkness]

Therefore, there is no way a stranger can be in a position to judge, provide dancing girls wearing feathers don't deliver the syringe.
Frankly, this would make the whole experience a lot easier on me. Or else it would give me a phobia of dancing girls with feathers.

Daniel

[lorinada]

I hope this has not been mentioned already, but I have trouble keeping my mind focused on any threads that go beyond about 3 pages (maybe it's all those 27 blood sugars over the decades) but:

Hentor, I think you need to educate yourself - and I mean REALLY educate yourself - on the effects of abnormal blood sugars.

I can't imagine that waiting 15 or 30 minutes after eating would make that much of a differnce in the long run. So, two hours later, your son's BS is 170 instead of 70? More than likely, it's 120 instead of 70.

Guess what. It has been proven, both by anecdotal evidence and by clinical trials that repeated, high BSs are what makes a person more likely to suffer long-term complications. And by "high" the cut-off figure is considered to be 250, not, say, 156.

I think you and your son would do well to learn to relax. Unless you're going out to eat every meal, or even every day, or he's having two desserts after dinner, waiting until he gets to the car is not going to cause him to be on a kidney machine.

I have been type 1 for 25 years now, and I have seen both sides of the BS spectrum hundreds of times, probably thousands, and I can tell you that NONE of them have been traced back to me checking my BS an hour before I eat as opposed to right before I eat. As someone upthread mentioned, these little portable meters are not even that accurate. Unless he's already eaten an uncovered snack or just come of the basketball court, his BS is not going to change significantly enough in an hour to justifying never varying from the routine.

I always check my BS either before leaving the house, or in the car. Oftentimes, if it's a spur-of-the-moment thing, I take a "standard dose" and check after the meal when I get home. Same with shooting up - if I can guarantee I'll be getting my meal within 15 minutes, such as at a fast-food joint, I'll just take my shot in the car right before going in. Otherwise, I take it right before, but I only do it at the table if I can ensure I will not be noticed (like if I am on the inside seat of a booth, or have a tablecloth to work under AND I am with people who already know I am diabetic and aren't squeamish. I just pull my syringe and vial out, draw up under the table, and poke my leg through my clothes. If I can't do that, I go to the lady's room. Not ideal, but I do know how objectionable the process can be to other people - whether or not I'm at a restaurant. If the bathroom is that unsanitary, I just take my shot in the car after the meal.

To the uninitiated, re: checking your BS in the bathroom - not always possible. It's a two-handed procedure with most meters so you have to have someplace to lay your meter down. Not possible in a stall, and if you're not in a stall you're still "grossing people out". If the basin and vanity are dirty or wet (and they have no towels, only blow-dryers) you really don't want to be laying your equipment down in all the filth. But I still believe that's no excuse for doing it right at the table. Checking your BS can not be done as discreetly with most meters as taking a shot, plus it involves blood-letting, now matter how small a drop. I personally believe it should never be done at the table, public or not. It can wait 30 minutes.

JMHO and experiences.

[eleanorigby]

Hmmm.

I would think that each diabetic is different and their response to therapy is idiosyncratic.

My sister, a diabetic for 30 years, had fairly good control--it was when she went in to the hospital for something "unrelated" (like ankle surgery) that she would get into blood sugar troubles. See, the staff at the teaching hospital thought she should have X dose of insulin for a sugar of Y--my sister was incredibly sensitive to insulin and so she would seesaw terribly( this was in the days before Humalog. I don't know if she ever took Humalog--she died in August of 2004).

It was only after a few episodes of "watch L's BS fluctuate like a mad thing" that they decided to let her manage her own dosing. Voila! No more outrageous swings in sugar. She knew her body and its responses much better than any resident or endocrinologist.

I relate this to illustrate my point. Hentor et al are managing the treatment regime just fine for them. While it's nice that you, lorinada, have had different results, that might not be so for Hentot .


Just saying.

[eleanorigby]

Shoot!

Forgot to add....Bring on the dancing girls!

This could revolutionize diabetes management........ :)

[Qadgop the Mercotan]

It can wait 30 minutes.
JMHO and experiences.
Your experience is not universal, does not allow you to generalize for millions of other diabetics, and contradicts recommendations by endocrinologists and other diabetic specialists for many of their patients.

Many diabetics need to take their insulin during a meal, and yes it does make a difference, and no it can't wait 30 minutes.

QtM, treating MD to a few thousand diabetics in my career.
Father to an insulin-dependent diabetic.
Taking insulin myself for nearly 10 years.

[DoctorJ]

Guess what. It has been proven, both by anecdotal evidence and by clinical trials that repeated, high BSs are what makes a person more likely to suffer long-term complications. And by "high" the cut-off figure is considered to be 250, not, say, 156.
Gotta disagree with you there. One of the big trials, the UKPDS, showed a reduction in complications in the group with a HbA1C of 7.0 (corresponding to an average glucose of about 150) compared to the group with a HbAiC of 7.9 (corresponding to about 180). (For the uninitiated, HbA1C reflects the average glucose over three months.)

The point of carefully timing one's insulin shot around mealtime is to prevent the big spike that comes as the food is absorbed. That spike can be huge and fast in some Type 1s, and every one of those spikes raises that average by a little bit. Waiting 30 minutes to take the shot isn't going to do much to stop the spike.

You might argue that very occasionally waiting for 30 minutes before giving mealtime insulin is not going to raise someone's HbA1C, and you'd be right. But occasional exceptions are the first step to lousy control.

In short, what QtM said--no, it can't wait 30 minutes.

[Hentor the Barbarian]

I appreciate the thought lorinada, and I would REALLY like to educate myself, and perhaps the physicians at the Diabetes Clinic at Children's Hospital of Pittsburgh. Do you have any references I could show them to help them see things your way? They've given us a rather different impression of things than you.

Or perhaps we should just stick to the way that we are doing things now, since, as I said, we did see a rise in his A1c when we were a bit lax. Now, certainly, it could have been that some other factor actually accounted for the rise and fall of his A1c, and our tightening up of the timing of the injections was not actually causal. But like most personal things of such magnitude, we prefer to keep doing those things that are associated with positive outcomes, be they illusory or not!

[SteveG1]

I'm upset and jealous now. I've been hit by cars, fell off motorcycles, got dog bit, cat scratched, had headaches, colds measles, I've never ever gotten dancing girls with feathers! AAAAAAAAAAAGHHHHHHH!

[lorinada]

I don't think any one got that I was talking about "occasionally". I'm not talking about every day. I stand by my comments. No one ever lost their eyesight because a few times a year they took their shot 15 minutes later than normal.

[Oy!]

I don't think any one got that I was talking about "occasionally". I'm not talking about every day. I stand by my comments. No one ever lost their eyesight because a few times a year they took their shot 15 minutes later than normal.

You may well be right. But I think you will forgive Hentor, not to mention QtM, if they go with their experience and what their investigations into the research have shown, particularly for their minor children, rather than what 'some person on the SDMB' said.

[Zabali_Clawbane]

No one ever lost their eyesight because a few times a year they took their shot 15 minutes later than normal.

How many clinical studies did you say you'd personally run? Where did you get your degree? :confused: If you don't have a degree or a background in medical science, then don't mind me as I shrug at your words and turn back to the advice of QtM, and that of my own treating physician. I don't have diabetes, but a first cousin on my father's side does.

[eleanorigby]

And sadly, occasionally can become frequently.

The devastation of DM is cumulative--and every time does matter. Retinopathy and neuropathy are silent- often, you aren't aware of the destruction until too late. Better to be strict and well controlled always than to take that chance.

YMMV.

[SteveG1]

I can verify that, eleanorigby. I work with some people like this. Every year it gets worse and more painful for them, and there's nothing they can do about it. These are people who do what they're supposed to. All they can hope for is to slow it down a little. It's cumulative and unrepairable.

[Critical1]

last time I checked the general population of planet earth came equiped with heads attached to necks that were capable of turning under the comands of the brain. its not that hard to turn your head.


and to the people who feel the bathroom is the right place for this...do you honestly think some jackass woulndt have posted how offended they were when they went to the bathroom and saw some kid getting a shot?

its a MEDICAL CONDITION, they arent shooting smack, pull your heads out of your asses and cope. and be thankful you and yours dont have to actually be the ones WITH the condition.
what makes you think that your aversion to something makes that something innapropriate in public? there are people who cant stand the sight of amputees, should some guy who lost his arm in Iraq be placed on house arrest because soe fucking pussy cant handle the sight?
this isnt like a couple homless guys on the corner having sex, its not like the kid is sitting at the table rubbing one out. he didnt crap his pants and start playing with it, the only thing going on here is parents trying to keep their kid healty.

I hope your kid (and anyone else with Diabetes) continues with good health. ignore the people with out the self control to turn their head BACK to whatever they were doing in the first place.
you morons who cant turn your head and not watch are the same dipshits on the freeway causeing traffic jams because you have to slow down to 30 to look at a guy changing a flat tire 40 feet off the road.

[Dangerosa]

I don't think any one got that I was talking about "occasionally". I'm not talking about every day. I stand by my comments. No one ever lost their eyesight because a few times a year they took their shot 15 minutes later than normal.

Hentor's kid will have to manage this his entire life. What is the threshhold of losing your eyesight because your medication wasn't timely. 3 times a year? 5? 25? Its a cumulative effect over time. I wouldn't want to lose my sight as an adult because my parents hadn't been aggressive enough in my management - choosing to put the concerns of other diners over my health.

There may be points in Hentot's life where its much more difficult to manage his diabetes as agressively as his parents can now. He may need all those "occations" for true emergencies and when he gets irresponsible in college.