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I'm in the Zone: Cortisone.

So yesterday I went to the orthopedist for this wrist mess.Frigging sting!!

I was all, "I've been wearing the brace and I stopped lifting at the gym and have generally been taking it as light as I can, but no improvement."

And he was all, "Well, we looked at your x-rays from today and your radial and ulna bones are in perfect position, so it does appear to be a tendon issue and not a bone issue."

And I was all, "That's good, right?"

And he was all, "Yeah.  So let's talk about options.  We can move with the brace for another month, or you can do physical therapy, or you can do surgery."

And I was all, "Hmm.  Well the brace isn't helping yet.  And I don't want surgery.  Let's do a cortisone shot and follow up with physical therapy?"

And he was all, "You're an educated patient.  Okay, we'll do a very small shot today and see how that works for you."

So I sat down in a chair in his office and he moved a small table towards me for me to prop my elbow up on.  He left for a minute and then returned with a small bottle, a cotton swap and injection prep wipe, and a massive needle.

And I was all, "Whoa, that's a big needle.  Do you put the whole thing in?  That would come right out the other side of my hand!"

And he was all, "But you do needles every day, don't you?  This should be okay with you."  

And I was all, "Irony, eh?  I hate needles that I'm not controlling.  And that mega-needle?  Scares me."

And my blood in my face was all draining, so I looked white as a sheet.

He was all, "You're going a little pale on me.  Are you okay?"  He swabbed my wrist and shifted my arm around until the proper injection area was exposed.

And I was all, "I'm okay, I'm just not going to watch, okay?"

He nodded.  And the needle was all of a sudden embedded into my wrist and the pressure of the cortisone being injected made me squirm instantly.

I was all, "Ow."

He was all, "Just a few more seconds and I'll be done.  And ... you're done.  You okay?  Do you need to lie down?"

And I was all badass:  "Nah, I'm good.  I'm just going to sit here for a minute while you explain what happens next and I pretend to listen fully despite the pain."  I smiled.  But winced.  Sort of at the same time. 

And he was all, "Elevated numbers for a few days ... increase basals with your endo's help ... keep wearing the brace ... it's going to hurt where I did the shot tomorrow, but you should feel real improvement by about this time next week ... if you don't, we'll want to do that physical therapy and consider maybe another shot depending on how you feel ... you'll be okay ... hey, are you okay?"

And my color was all returning, but slowly.  We finished up, and I tested.  155 mg/dl.  Okay, a little higher than the 114 mg/dl I walked into the doctor's office at, but it must have been a stress bump.  I didn't want to fool with my basals until I was sure that the cortisone would make me high, so I waited a few hours before doing some tweaking

In the course of six hours, I went from 155 to a steady stream of 190 - 240 mg/dl numbers.  I tested for ketones and - low and behold! - the little stick went light purple on me.  Small ketones, prolonged highs, and the pain from the actual shot set in around 8:45 pm.  This morning, I woke up at 213 mg/dl and even after an aggressive bolus, I'm still cruising in that general range.  Basals have since been cranked to 150% and I'm both wearing the Dexcom and testing every hour.

The ketone thing is what's throwing me for a loop.  I hardly ever throw ketones - why now?  I drank a lot of water, ate some carbs, and still had the ketones this morning.  (Poor Chris - I asked him to test himself for ketones because I was convinced the Ketostix weren't working right.  He was all, "Um, I'm negative."  And I was all, "At least I like the color purple.  Blaaaargh.... ")

I hope this was the right decision.  I'm desperate for my wrist to heal.  The doctor said this pain and the highs could go on for 3 - 7 days.   

And I was all, "This sucks."

Comments

See now, I starting reading your post and I was thinking that I was going to reply, and then I was all "That sucks", but then you went and took the words right out of my mouth.

So now I have nothing to say.

Poor Kerri!
I hate needles too. The nurses @ the hospital where I have my bloodwork done...they hate to see me coming cause I get all pale and shaky when they are sticking me. :)
I agree w/ you. It's a control issue. I want to control that darn needle!

eeks! good luck, kerri! i hate being high for long periods of time...it makes me feel like i'm moving through jello. but here to hoping the cortisone shot works and you're back to normal soon! :)

Hope you're feeling well again, soon, Kerri. I'm anxious by your post ~ I have a feeling I'm going to have to go in for one of those cortizone bad boys for my shoulder. I've got a rotator cuff issue.

Yeah those injections can be bad. Unless you get a great doc who numbs the area first. My doc shoots up the injection area with novocaine prior to injecting the cortisone. VIOLA NO PAIN!! And it keeps the pain back for at least 4-5 hours after the shot so the pain meds have a chance to work.

I've had those injections in lots of places -- both shoulders (had two in one shoulder two weeks ago), both hands/wrists, top of one foot, heel in other foot, and a few others as well. I felt no pain at all during the injections.

Another doc used to give shots without numbing first and it nearly killed me every time. Then one day he numbed it first and I asked why. He said because he had to have a shot like that and found out how much it hurt. I walked out on him and found my current doc (that I've had for ten years now).

Don't put up with that crap. If he won't numb the area first, then find another doc. Period. There's no need for anyone to go through unnecessary pain from a cortisone injection.

Also, once you get home, start icing the area immediately. Then take a pain pill. Repeat as necessary.

Healing takes place much faster when there is no pain. And it's easier to control pain when it's at a low level than to try to kick it when it's bad. That's why pain pills and icing need to be done on a timed basis so the pain does not get so bad that the pain pills don't work properly.

My blood sugar did not increase over my usual levels before or after the injections last week because (1) I wasn't scared spitless because (2) I knew it wouldn't hurt. So there was no stress from the anticipation or from the pain (there was no pain).

Sorry for rambling on so much but it just really makes me mad when doctors dismiss our pain as unimportant. I repeat -- there is NO reason for anyone to suffer pain from cortisone injections and any good doctor will take appropriate steps to see that we don't.

Hope you get some relief - -both short term and long term.

(I found your blog over at your mom's blog!).

Sorry to hear about the problems with the cortizone, that stuff is never really good for anyone.

Our daughter is a type 1 also, and little changes in her body or a minor illness make her blood sugars go way up.

When she's running above the low 200's, she feels really bad also, and sick. These spikes have cause her to miss school often, until she is back closer or within her normal range.

Anyway..hope you feel better and get those ketones all flush from your system.

A lot of people do not understand the differences between doing injections to myself and other people doing injections to me. It's nice that someone else understands, but I'm sorry you had to go through this. It sounds unpleasant all around. Hope those ketones go away soon.

Love the way you wrote the article. It put a smile on my face so thanks for that! :) I'm sorry that you had to deal with that needled... I probably would have done a lot worst then go pale! :)

I'm not a fan of the cortisone. I had an injection in my shoulder last year to help with an injury. I basically doubled the amount of insulin over the next three to fours days to cope with the elevated blood sugars. Fortunately, my doctor didn't cause pain when he injected the needle. Get better soon.

Love the way you wrote this post.
Sorry it sucks like this.
Hope you heal, feel better, come down soon.

I will tell you that cortisone shots make me throw ketones like the dickens. I have learned that before the shot even goes in i up the basal by at least 50% and go up from there.

Uggg cortisol shots - no fun. Pain doesn't bother me but the elevated sugars sure did! I have had them twice for carpal tunnel issues in my wrist, which I still think you should get tested for! Some of the symptoms are very similar to what you have, and people with diabetes as well as heavy computer users (ding ding ding!) are at higher risk for carpal tunnel. I will be getting surgery for mine in July and I cannot wait. The temp relief I got with the cortisol shots was not worth the week of 250 and aboves....

I hate that you're having trouble, but I was all laughing at the format of this post.

On a (barely) related note, I like that one of the benefits of going to the doctor as an adult is that you're not expected to sit on that paper-covered bed/pedestal for the duration of your visit with the doctor. It's nice that you can say "You know what? We're just talking and you're not going to poke at my tummy and ask me to take deep breaths and pull out that little footrest drawer thingie, so I'm just going to sit in this chair over here. K?" It makes you feel like a little less of a museum exhibit that way. Maybe I'm the only one that appreciates that, I don't know. I figure if we spend this much time going to doctors, we have to look for the silver lining.

I hate other needles too, especially those wielded by anyone but me. Although a few years ago when I was giving Depo-Provera a shot (hehe), I decided to give that to myself in lieu of paying my $15 copay to have the doctor do it. Turns out, giving myself an intramuscular shot wasn't the piece of cake I thought it was going to be. It hurt something fierce, and I almost passed out on my bathroom floor. Lesson learned.

Anyhoo, a couple of years ago, I spent a year and a half schlepping from one doctor to the next for shoulder pain. After no luck at a couple of doctors, I decided to get the best of the best at the University of Pennsylvania Hospital. That doctor decided to give me a steroid injection. Holy long needle! That ended up doing nothing for me except f-ing up my BG's, and of course, Dr. Fancy-Pants didn't even give me the right diagnosis. Turned out I had frozen shoulder, and finally got myself to an orthopedic surgeon who did surgery.

Hmm, most of that is completely irrelevant except the part about long needles being scary, and cortisone injections sucking. I hope it works for you though because surgery is obviously an unpleasant PIA option. Stick with the PT too. The magic trick is to actually go and do what they say. Who knew??

Cotisone send my bg's higher than a ufo ! Ive been getting them on and off in my left elbow. Just had a mri done and the tendon is somewhat torn from the bone. Oh yippee. Im fine as long as I dont have to do any heavey lifting which is what my job requires. And still trying to recover from almost breaking the head off of my right ulnar bone. Im begining to think that my right wrist is always going to be HUGE than my left wrist. Dont feel bad Kerri I cant stand to watch either when my doctor does that too ! Oh getting old is not for sissys thats for sure ! Oh I finally got my dexcom and loving every minute : )

I went through this mess last year and that is a BIG needle!! The highs lasted around a week for me but the relief lasted months. Hopefully you are pain-free soon!

I feel bad that you're suffering from this wrist problem Kerri :( I do hope that the shot helps instead of messing with your bg for no reason! I had a few shots myself a few months back for trigger thumb so I know what they are like - no fun! I said to the dr "needles are nothing to me" but when he came out with a huge one, jabbed it right into the ligament of my thumb, getting all teary eyed & flushed from the discomfort, I felt a little like a wuss :P The good thing for me is that they did help but the bad thing is that they only helped for a short period of time. I wound up having surgery and it was very worth it. So if in fact you do need surgery down the road, it may be an inconvenience for a time but may be worth it in the end. Just trying to shed some positive light on an otherwise yucky situation. I hope it feels better soon!

Dear Kerri,

Based on your presentation it seems as though the symptoms you have experienced may have been a result of repetitive strain. One of your options or considerations should have been a series of acupuncture treatments. The needles are a lot smaller, and the treatment is much more gentle, and the effects are much longer-lasting.

Hope this helps.

I wish I had an answer for the ketones for you. Especially weird if you rarely get them, and even those numbers seem unlikely to cause them. Weird huh? Must be the cortisone.

LIKE YOUR BLOG. I RECENTLY AGREED TO A SERIES OF 3 LARGE CORTIZONE SHOTS IN MY LOWER BACK. I TOLD THEM I WAS A DIABETIC, BUT THEY WERE ALREADY COUNTING THE $1000./SHOT. MY BLOOD SUGAR SOARED THROUGH THE ROOF. I HAD ONCE MORE SHOT THE WEEK LATER, SAME THING, THEN I CANCELED THE THIRD. AFTERWARDS, A NURSE I KNOW SAID SHE HAS NEVER SEEN CORTIZONE BE HELPFUL WITH A MECHANICAL BACK PROBLEM, WHICH IS WHAT I HAVE.

I'm the same way with needles. I never watch unless I'm in control. My numbers go high within hours and stay that way for about a week. I think I found that doubling my basals generally gives me a better overall range, but I've never had a cortisone shot that didn't cause me to lose weight. I guess that is proof of ketones, too. The funny thing is my orthopedist won't let me chew gum when he gives me a cortisone shot! I hope you feel better soon!

Kerri

Good luck with the cortisone. It's been decades since I last had a cortisone shot. All I remember is the havoc it caused with my blood sugars. If I take cortisone tablets I end up effectively doubling my insulin intake for the first few days. The Dexcom will help you keep a close eye on things, so stay safe.

i notice my ketosticx is purple - got a cortisone shot back in march would this still effect my reading, very concern

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