Diabetes

So. It had come to this.

She stood in her bathroom, looking at the supplies neatly arranged in front of her. A box of pre-packaged alcohol swabs. A big red container with a yellow and red sticker on it, warning of its contents—or, more accurately, the contents it was about to receive. A big bag of long and narrow cylinders, orange on one end, white on the other.

And an innocuous-looking little glass bottle with a bright orange top, filled with a milky fluid. Ponulin 70/30.

She’d heard all the potential horrors of her condition: nerve damage, kidney failure, blindness. Done her very best to avoid this day. Moderating her sugar intake as best she could, even though having Sugarcube Corner right there had made it hard. Getting exercise on a regular basis … well, as regular as she could manage, what with one thing and another. Taking the pills, first white, then white and green, then white and green and brown.

But her numbers kept going up. 125 became 150 became 200. 7.8 became 8.2 became 10.3. And finally Doctor Sticker had made it official: she needed to start taking insulin.

She looked up at the bathroom mirror. Blue eyes met violet, and they both smiled. At least her friend was here for her; she didn’t know if she could have managed this alone.

“Okay, just follow the list,” her friend said. Twilight was good at following lists.

Step one. Wash hooves and gather supplies. To expose plunger, twist white cap to break seal, then pull off.

“Doesn’t this count as two or three steps?” she wondered. Her friend just smiled and shook her head.

“You’re stalling,” her friend said. It was true.

Step two. Wipe top of insulin bottle with an alcohol swab. If you are taking cloudy insulin, roll the bottle between your hooves until it is uniformly cloudy. Never shake a bottle of insulin.

She blinked, taking another look at the Ponulin bottle as she cleaned it. “It says ‘shake carefully’. Why would it say ‘shake carefully’ if you’re not supposed to shake it at all?”

“Doctor Sticker said it was okay if you shook it, remember?” her friend said. That made it two to one. She picked the bottle up gingerly and gave it itty bitty shakes for a moment, until her friend, sighing, took it away from her and began shaking with more vigor, though still gently.

“I’ve been doing this for a few years now, okay?” her friend said. “It’s really not that big a deal.”

She couldn’t help but be nervous, but nonetheless she offered a smile, taking the bottle back.

Step three. To expose needle, twist orange cap, then pull straight off, being careful not to bend the needle or let needle touch anything. Done. The needle was surprisingly thin. Her blood-testing lancets were bigger, and they didn’t have to put anything into her body.

Step four. Pull plunger down to let desired units of air into syringe. You need air in the syringe equal to the amount of insulin you will take. It was tricky getting the plunger at just the right spot, even with Twilight’s magic helping out, but she managed.

Step five. Push needle through the center of rubber top of insulin bottle and push plunger down completely. There was a little white circle in the center of the orange top, and sure enough, the needle went right through it.

Step six. Leave needle in the insulin bottle. Carefully turn bottle and syringe upside down, so the bottle is on top. She watched the little bubble of air in the bottle rise, the insulin hiding the needle completely.

Step seven. Pull plunger down slowly, aligning the thin black line of plunger with desired number of units on the syringe. “You should put a little extra in at first,” her friend suggested, and she nervously complied.

Step eight. If air bubbles appear in syringe, push plunger down, injecting insulin back into vial and redraw insulin to desired number of units. That was why she’d drawn some extra, she supposed, clearing the air from the top of the syringe. Pull syringe out of bottle. There was no sign of a hole in the rubber once she’d done so. The tip of the needle glistened with a tiny cloudy drop.

Step nine. Clean a small area of skin with an alcohol swab. Let alcohol dry completely before injecting. The nurse had said she didn’t need to do that if she was injecting in her stomach, but she did it anyway. The coolness of the swab was soothing, and she needed some soothing.

Step ten. It was a long one, so she read it all the way through.

Hold syringe like a pencil. Done.

Pinch up your skin. A bit awkward, but done.

Push the needle quickly through the skin.

She looked nervously at her friend, needle hovering just over her stomach, near her thigh.

“Just a hop, skip, and a—” Pinkie said. The needle went in.

And it didn’t hurt. Okay, it hurt maybe a tiny little bit, but the lancets hurt way worse than that. It felt more like she was poking herself with a pin than actually sticking one into her. She wouldn’t even be sure it was in there if not for feeling the body of the syringe bumping up against her.

Push the insulin in with the plunger. She felt a brief cool sensation. The bottle’s packaging had said she didn’t need to keep it in the fridge now that she’d used it once, so hopefully next time would be even more comfortable.

Pull the needle out of your skin. Destroy and dispose of needle safely, following your local ordinances. Use syringe only once. She put the caps on the syringe, orange and white, then dropped it into the sharps container.

Twilight Sparkle and Pinkie Pie shared a smile of relief. It had been one thing for her friend to tell her that diabetes wasn’t the end of the world. It had been another to learn for herself that insulin was just another thing to add to her daily routine.

“You can handle this by yourself next time, right?” her friend asked.

She smiled and nodded, then swept her friend into a hug. “Thanks, Twilight. That was super duper scary! But I feel like a silly filly now that I’ve actually done it.”

Twilight smiled a bit awkwardly, but put a foreleg around Pinkie and returned the hug. “I felt the same way my first time,” she admitted. The look Pinkie gave her on drawing back told her this was not exactly a surprise.

“Well, I better take my pills now,” Pinkie said, pouring a glass of water, then washing down the pills. White, green, brown … and blue. “You know, you really should talk to Doctor Sticker about your anxiety,” she added. “The sertraline’s really helped me!”

Twilight fidgeted. “… I’ll think about it,” she said.

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Comments ( 20 )

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FredMSloniker

FredMSloniker #1 · Jul 9th, 2012 · · ·

As you can probably guess, this story was inspired by two things: a couple of comics I saw on Derpibooru featuring Pinkie getting diabetes and everything being Ruined Forever, and my own experience as a diabetic who just started on insulin. So I decided to scribble this down. Hopefully it's of merit.

Show of hands: who saw the end coming, and who got surprised? And did you come to the right (or wrong) conclusion because you were expecting a twist, or did you take the story at face value?

Alaborn

Alaborn #2 · Jul 11th, 2012 · · ·

I assumed it was straightforward, and that the story was written because of the author's personal experience. (Type II diabetes?).

Personally, I don't think pony technology would allow them to produce pony insulin via recombinant DNA. Perhaps they use magic.

And I agree, Twilight Sparkle needs Zoloft.

MetBoy

MetBoy #3 · Jul 11th, 2012 · · ·

I liked this story! I liked the mature take on things, where magic couldn't solve all problems. I liked the hopeful tone, and how Pinkie Pie was sad without becoming Pinkamina. I'd like to see this continue, actually... Maybe more 'slice-of-life' stuff as Pinkie Pie tries to hide her condition, before fessing up to her best friends why she's been acting oddly. (I can see Rainbow Dash being all "That's it?" when the truth comes out.)

CoastalSarv

CoastalSarv #4 · Jul 11th, 2012 · · ·

That was heartwarming. Good slice of life story :) And yeah, I shook my head at that ridiculous story - I don't think anyone who actually knows anything about modern diabetes treatment could have written it. Of course, pony society being less developed could be different. That's why I assume the pony i the story uses that kind of syringe, btw - I haven't used those in almost 20 years...

(I've had diabetes for 25+ years, insulin all the time, have seen things change, and have taken very little damage despite being hopeless at taking care of it.)

Liked the little bit at the end - I know what sertralin does, although I suspect she would fare better from some lithium medication...

Cyanide

Cyanide #5 · Jul 11th, 2012 · · ·

Cute AND educational!

Gypsy

Gypsy #6 · Jul 11th, 2012 · · ·

this was a good/educational read.

Minalkra

Minalkra #7 · Jul 11th, 2012 · · ·

uhm, i took at at face value. i mean, the description and all, it ... spelled it out.

but as a person who takes 0 pills except an occasional OTC allergy pill when i need it and someone who's not gone to the doctor in 5 years, i can see how something as life changing as diabetes could seem like the end of the world.

uhm, doctors are scary ... sorry.

Usernotfound

Usernotfound #8 · Jul 11th, 2012 · · ·

I like this.

My mum is one though she takes pills for hers.

FredMSloniker

FredMSloniker #9 · Jul 11th, 2012 · · ·

894665
I'm a type II diabetic, yes. And yeah, I figured that ponies wouldn't do things like perform experiments on dogs to isolate insulin. Mainly, though, I used the name because (a) pony pun and (b) that's what I'm taking.

894823
Strange that you should say that...
i.imgur.com/REAUO.jpg
What do you use?

CoastalSarv

CoastalSarv #10 · Jul 11th, 2012 · · ·

895969
diabetestjejen.blogg.se/images/2009/novorapid_flexpen_caja_25914841.jpg
Those - insulin pens. You set it to a certain amount of insulin, stab yourself with the needle, and push a button.

You put on a new needle every time you use it. They look like this.
img.alibaba.com/photo/105150782/Insulin_pen_needle_FINE_JECT.jpg

As I said, I've used slicker and slicker models of those for the last 20 years. The one exception was when I had an accident, and ended up in hospital with no medication with me. The nurses pulled out an old-fashioned set so I could take my meds. I had no idea they were still regularily used by diabetics.

FredMSloniker

FredMSloniker #11 · Jul 11th, 2012 · · ·

896279
It's probably because I'm on... I forget what acronym they're using this week, but state benefits, including medical. The syringes and vial are probably cheaper than some fancy-dancy pen.

Like I said in the story, though, it's not a big deal. I'm currently taking seven units once a day, and I just poke myself after my shower.

CoastalSarv

CoastalSarv #12 · Jul 11th, 2012 · · ·

896499
Well, that explains it. (It works a bit differently here in Sweden.) Good luck with your treatment - and you are right, it doesn't affect the story, as the point stands.