Self-injection anxiety
March 2, 2015 1:37 PM Subscribe
I am developing horrible fear of self-injection that is preventing me from administering my medication. Help?
Several months ago, I was prescribed medication to be taken in the form of an intramuscular injection. The first few times I performed the injection on myself, I was a little bit nervous, but I managed to complete the task without too much trouble. Lately though, I've been developing what I can only describe as severe anxiety about the whole process—I end up putting it off as long as possible, and then when the time finally comes, I find myself completely unable to perform the injection. It will take me literally hours to work up the nerve to put the needle into my skin.
I mentioned my increasing anxiety to my doctor, who suggested trying a subcutaneous injection instead, saying that it's easier and faster than IM. I tried the subcutaneous injection earlier today, and the anxiety is worse than ever before—I could not force myself to put the needle in, no matter how hard I tried. The full syringe is still sitting on the table next to me.
The whole process of working up the nerve to inject myself (and all the crying and frustration and anger that I experience during the process) is exhausting. I'm really starting to get sick of it.
The strange thing is: I've never in my life been afraid of needles! Whenever I get blood drawn, or get a shot at the doctor's office—no problem, I'm completely unfazed. But for some reason, when I'm performing the injection on myself, I just start freaking out. And unlike other fears that I have, I can't explain this one in any rational way—it's completely disconnected from any internal model I have about how my mind works. The closest I can come to an explanation is to say that I find the sensation of the needle breaking the skin to be really... gross, and I have a vague fear that I might be "doing it wrong" and thereby endangering my health. I don't know why I think these things, and all my normal techniques that I use to calm myself down enough to do something scary or difficult (deep breathing, talking things through logically, distracting myself, offering myself rewards) haven't been working.
I am seeing a therapist and we have discussed this issue in some detail and I plan to continue discussing it with her in the future. Whenever we do discuss the issue, I leave feeling confident that I have the tools in place to perform the next injection with less anxiety—but for some reason that all falls away in the moment. I've read some stuff online about self-injection anxiety, but most of the material seems to focus on people who have never been able to inject themselves, and who are working themselves up to doing it for the first time, which doesn't apply to me.
So I guess my question is: what are some techniques that I can use to make this process easier? If you've successfully overcome self-injection anxiety, what steps did you follow?
If it's relevant: I'm in my thirties, I am a woman and I live in the USA.
Several months ago, I was prescribed medication to be taken in the form of an intramuscular injection. The first few times I performed the injection on myself, I was a little bit nervous, but I managed to complete the task without too much trouble. Lately though, I've been developing what I can only describe as severe anxiety about the whole process—I end up putting it off as long as possible, and then when the time finally comes, I find myself completely unable to perform the injection. It will take me literally hours to work up the nerve to put the needle into my skin.
I mentioned my increasing anxiety to my doctor, who suggested trying a subcutaneous injection instead, saying that it's easier and faster than IM. I tried the subcutaneous injection earlier today, and the anxiety is worse than ever before—I could not force myself to put the needle in, no matter how hard I tried. The full syringe is still sitting on the table next to me.
The whole process of working up the nerve to inject myself (and all the crying and frustration and anger that I experience during the process) is exhausting. I'm really starting to get sick of it.
The strange thing is: I've never in my life been afraid of needles! Whenever I get blood drawn, or get a shot at the doctor's office—no problem, I'm completely unfazed. But for some reason, when I'm performing the injection on myself, I just start freaking out. And unlike other fears that I have, I can't explain this one in any rational way—it's completely disconnected from any internal model I have about how my mind works. The closest I can come to an explanation is to say that I find the sensation of the needle breaking the skin to be really... gross, and I have a vague fear that I might be "doing it wrong" and thereby endangering my health. I don't know why I think these things, and all my normal techniques that I use to calm myself down enough to do something scary or difficult (deep breathing, talking things through logically, distracting myself, offering myself rewards) haven't been working.
I am seeing a therapist and we have discussed this issue in some detail and I plan to continue discussing it with her in the future. Whenever we do discuss the issue, I leave feeling confident that I have the tools in place to perform the next injection with less anxiety—but for some reason that all falls away in the moment. I've read some stuff online about self-injection anxiety, but most of the material seems to focus on people who have never been able to inject themselves, and who are working themselves up to doing it for the first time, which doesn't apply to me.
So I guess my question is: what are some techniques that I can use to make this process easier? If you've successfully overcome self-injection anxiety, what steps did you follow?
If it's relevant: I'm in my thirties, I am a woman and I live in the USA.
could you have someone else, a friend or partner, do it for you? I had to inject myself with medication in the past, and I even got a co worker to do it for me (I work in a hospital). I found that after the first few times having other people do it, I was giving the other person so many instructions on how I wanted them to do it that I ended up feeling like "heck, it would just be easier for me to do it the way I want it done."
posted by treehorn+bunny at 1:50 PM on March 2, 2015 [2 favorites]
posted by treehorn+bunny at 1:50 PM on March 2, 2015 [2 favorites]
I take medicine via needle and briefly developed this problem. First, use alcoholic wipes/wash as thoroughly as you need to. Read up as much as needed if you don't believe in the sanitizing ability of alcohol. It works. Second, I got over it by inserting the needle as slowly as possible and watching it the whole time. Sounds backwards, but trying to speed through it was making it worse. I still do it a bit slowly today, but I'm over it.
posted by michaelh at 1:54 PM on March 2, 2015 [1 favorite]
posted by michaelh at 1:54 PM on March 2, 2015 [1 favorite]
I use an autoinjector for a subq, and it actually hurts a fair bit (the medicine, not the needle.) Fortunately, I live in a state with medical marijuana, so I just get good n high beforehand, and that makes it both hurt less and stress me out less.
I totally relate to the first-few-times-were-fine thing, too - didn't bother me at all until it really did. It's not the pain exactly - I have quite a high pain tolerance, and five seconds of a moderate burning sensation is less bad than what I routinely do in the gym, fercrissake, but there's something about the injection that's just a barrier to cross. So I guess what I'm saying is break the anxiety however you have to - benzos, pot, whatever - and make it as routine as possible.
posted by restless_nomad at 2:03 PM on March 2, 2015
I totally relate to the first-few-times-were-fine thing, too - didn't bother me at all until it really did. It's not the pain exactly - I have quite a high pain tolerance, and five seconds of a moderate burning sensation is less bad than what I routinely do in the gym, fercrissake, but there's something about the injection that's just a barrier to cross. So I guess what I'm saying is break the anxiety however you have to - benzos, pot, whatever - and make it as routine as possible.
posted by restless_nomad at 2:03 PM on March 2, 2015
I suggest asking a partner/close friend to do this for you for a few days/weeks. Get out of the anxiety spiral. Then there is a point when that person has to hand the needle to you, ideally actually physically hold it with you and inject with you several times. Then they can move to a cheerleader/coach mode where they are with you (forcing you to not procrastinate) and encouraging you to do yourself, until you become comfortable.
posted by latkes at 2:10 PM on March 2, 2015 [2 favorites]
posted by latkes at 2:10 PM on March 2, 2015 [2 favorites]
I had a pinwheel fan that I would blow as hard as I could when I did my injections. The distraction of the pinwheel fan really helped. I had it stuck in some florist's foam so that it could stand on its own.
I used to have a lot of medical anxiety and I found that basically just sucking it up and making myself do it with as little anxiety as possible made it a lot less terrible. I know that sounds wayyy easier than it is ("just don't be anxious!") but really, I trained myself to just think about something else, to not be nervous, to just get through it and grit my teeth and do it - and the reward of not being all flooped and goofed afterwards (which yes is incredibly tiring and hard on your system) reinforced not getting anxious for me.
Also ice cream: can you have a treat that you give yourself after you do the injection, and just focus on the treat? "Ok, I'm going to dish out my ice cream, and then just do the shot, and then it's ice cream time, oh no, it's going to melt, here, i'm blowing on my fan, shot's done, ice cream!" and before you know it it's over.
posted by sockermom at 2:14 PM on March 2, 2015 [3 favorites]
I used to have a lot of medical anxiety and I found that basically just sucking it up and making myself do it with as little anxiety as possible made it a lot less terrible. I know that sounds wayyy easier than it is ("just don't be anxious!") but really, I trained myself to just think about something else, to not be nervous, to just get through it and grit my teeth and do it - and the reward of not being all flooped and goofed afterwards (which yes is incredibly tiring and hard on your system) reinforced not getting anxious for me.
Also ice cream: can you have a treat that you give yourself after you do the injection, and just focus on the treat? "Ok, I'm going to dish out my ice cream, and then just do the shot, and then it's ice cream time, oh no, it's going to melt, here, i'm blowing on my fan, shot's done, ice cream!" and before you know it it's over.
posted by sockermom at 2:14 PM on March 2, 2015 [3 favorites]
When I first started self-injecting, it was still sort of a new and fun experience (not sure if fun is really the right word to use), and I was excited about proving to myself I could do it. After a few months, the initial enthusiasm faded and now it's something that I have a lot more difficulty with. There isn't usually any pain and when there is I can deal with it, but there seems to almost be some sort of self-preservation instinct that kicks in that keeps me from purposely stabbing myself with a sharp piece of metal.
Going slower helps for me - most guides to self-injection I've read say to try to get the needle in as fast as possible, but that has always freaked me out. I also tend to inject right before I go to bed, when I'm more tired and don't really have the energy to obsess over it.
Switching from intramuscular to subcutaneous injections helped because the needle was a lot smaller - I started out using 21g 1.5" needles, then I was using 25g 1" needles, and now I use 27g 1/2" needles. Another advantage is that you can do it more places on your body, there have been a few times I went with my stomach instead of my thigh, and I know people who do it on their butt or arm. It's really difficult to mess up a subcutaneous injection, as long as you're not injecting directly into a vein or using used needles you found on a random street corner you'll probably be fine. When I started injecting I was given really specific instructions all about disinfecting everything in sight and switching needles a bunch of times in the process and holding it at a certain angle and stuff like that, but I don't usually follow all of them and haven't had any issues yet in over three years of weekly injections. I'm not advocating deliberately being unsafe, but just know that there's a pretty big margin of error where you're not doing everything 100% perfectly, but there probably won't be any negative consequences.
Some suggestions I've heard other people use that I haven't tried myself are using ice or some sort of numbing cream beforehand, distracting yourself with loud music, deep breathing, or giving yourself a reward afterwards. Depending on what medication you're taking, there might be some sort of window where you can put it off for a few hours/days, and come back when you're feeling less anxious.
Some of it, though, does just come down to hating it but doing it anyway because it's better than the alternative. Getting someone else to do it for you can be a good short term solution, or something that you do every once in a while when you're really struggling, but depending on your life situation and how long you think you're going to be injecting it might not be a great thing to have to depend on long term - friends and family might move out of state, or go on vacation, or there could be some sort of falling out where you stop talking to each other, and going to a doctor could take time and money that adds up over a while. You might be in a place in your life where those aren't really issues (insurance with no co-pays and doctor next door, close with family members, in a long-term relationship, only doing it for a few more months, etc.), in which case that could be another solution.
posted by CJF at 2:55 PM on March 2, 2015 [3 favorites]
Going slower helps for me - most guides to self-injection I've read say to try to get the needle in as fast as possible, but that has always freaked me out. I also tend to inject right before I go to bed, when I'm more tired and don't really have the energy to obsess over it.
Switching from intramuscular to subcutaneous injections helped because the needle was a lot smaller - I started out using 21g 1.5" needles, then I was using 25g 1" needles, and now I use 27g 1/2" needles. Another advantage is that you can do it more places on your body, there have been a few times I went with my stomach instead of my thigh, and I know people who do it on their butt or arm. It's really difficult to mess up a subcutaneous injection, as long as you're not injecting directly into a vein or using used needles you found on a random street corner you'll probably be fine. When I started injecting I was given really specific instructions all about disinfecting everything in sight and switching needles a bunch of times in the process and holding it at a certain angle and stuff like that, but I don't usually follow all of them and haven't had any issues yet in over three years of weekly injections. I'm not advocating deliberately being unsafe, but just know that there's a pretty big margin of error where you're not doing everything 100% perfectly, but there probably won't be any negative consequences.
Some suggestions I've heard other people use that I haven't tried myself are using ice or some sort of numbing cream beforehand, distracting yourself with loud music, deep breathing, or giving yourself a reward afterwards. Depending on what medication you're taking, there might be some sort of window where you can put it off for a few hours/days, and come back when you're feeling less anxious.
Some of it, though, does just come down to hating it but doing it anyway because it's better than the alternative. Getting someone else to do it for you can be a good short term solution, or something that you do every once in a while when you're really struggling, but depending on your life situation and how long you think you're going to be injecting it might not be a great thing to have to depend on long term - friends and family might move out of state, or go on vacation, or there could be some sort of falling out where you stop talking to each other, and going to a doctor could take time and money that adds up over a while. You might be in a place in your life where those aren't really issues (insurance with no co-pays and doctor next door, close with family members, in a long-term relationship, only doing it for a few more months, etc.), in which case that could be another solution.
posted by CJF at 2:55 PM on March 2, 2015 [3 favorites]
Since you mention that you feel prepared to do the injection when you're talking about it in therapy, how about at your next appointment you bring your medication with you and work through the entire process together? It might help to have your therapist right there when you get to the actual anxiety rather than just talking about what you'll do next time you're alone and experiencing anxiety.
posted by cecic at 3:14 PM on March 2, 2015 [3 favorites]
posted by cecic at 3:14 PM on March 2, 2015 [3 favorites]
I inject insulin several times a day. I am also supposed to test my blood sugar regularly using a spring loaded "pen" lancet needle to draw blood. The insulin is ok. The blood testing I find incredibly difficult to bring myself to do, and to my great discredit it rarely happens. All down to techniques and as CJF rightly says, a natural reluctance to stick pointy things into myself that hurts (I know the blood testing is meant to be painless but ow no it really isn't).
One thing that works for me (and which might help with the icky popping sensation of needle into skin) is to grab as big a pinch of skin as you can and make sure the needle is going in as close to 90° as you can manage. Having the skin taut means I don't feel the needle going in at all. There's also the feeling of pressure from the pinch, which again distracts from the injection sensation - it's somewhat easier to bear a self-inflicted pinch-y pain than a self-inflicted scratchy one.
posted by Martha My Dear Prudence at 3:16 PM on March 2, 2015 [2 favorites]
One thing that works for me (and which might help with the icky popping sensation of needle into skin) is to grab as big a pinch of skin as you can and make sure the needle is going in as close to 90° as you can manage. Having the skin taut means I don't feel the needle going in at all. There's also the feeling of pressure from the pinch, which again distracts from the injection sensation - it's somewhat easier to bear a self-inflicted pinch-y pain than a self-inflicted scratchy one.
posted by Martha My Dear Prudence at 3:16 PM on March 2, 2015 [2 favorites]
All good suggestions. Another thought, how about hypnosis? It works for things like smoking. If I was in your situation (and at one point I was heading in that direction when I had to inject myself for gestational diabetes, so I literally have felt your pain) and it was at that point and nothing else worked that is what I would do.
posted by Jubey at 3:44 PM on March 2, 2015
posted by Jubey at 3:44 PM on March 2, 2015
Insulin-dependent diabetic here. I'm firmly in the "relax and do it quickly" camp. Do your best to relax - don't tense up ( a good inhale and exhale helps)- and then deliver the needle quickly. You don't have to jam it home, just a nice, smooth motion. After a few times with good results it'll be a piece of cake. Note: sometimes, even if you do it right, you'll get a little sting - that's normal and very temporary. Best of luck. You can do it.
posted by Benny Andajetz at 3:59 PM on March 2, 2015
posted by Benny Andajetz at 3:59 PM on March 2, 2015
If it helps, I'm also an ER doctor and I've never seen a patient come in due to doing a self injection 'wrong', except for people who were freaking out so much when trying to use their Epipen that they had it turned the wrong way around and injected their thumb instead of their thigh, or, you know, the self injection was heroin.
I know fears like these aren't usually based in anything rational. I just wanted to reassure you that it's nearly impossible to do these self injections wrong, anyway.
posted by treehorn+bunny at 5:11 PM on March 2, 2015 [2 favorites]
I know fears like these aren't usually based in anything rational. I just wanted to reassure you that it's nearly impossible to do these self injections wrong, anyway.
posted by treehorn+bunny at 5:11 PM on March 2, 2015 [2 favorites]
Can you experiment with different injection sites? I have to inject a medication subcutaneously via one of the spring loaded pens, and the two recommended injection sites are on my upper thigh or on my belly. I was starting to develop the same fear you describe when doing my injections in the thigh. Then I switched to the belly and for whatever reason it's soooooo much easier.
posted by MsMolly at 6:17 PM on March 2, 2015
posted by MsMolly at 6:17 PM on March 2, 2015
I watch youtube clips while doing the injection as a distraction, something mildly funny like QI. Get the needle ready, then start the clip, and while I'm half-absorbed watching, do the injection. I bruise less and it hurts less to do the jab slowly than fast, and I've also had better luck with holding the skin taut.
posted by viggorlijah at 10:14 PM on March 2, 2015
posted by viggorlijah at 10:14 PM on March 2, 2015
I was prescribed a daily subcutaneous injection medication over 5 years ago and I can relate to a lot of your question. Fortunately my medication comes with a specially designed "auto injector" so in reality all I have to do is press a button, but I was shown how to do it manually as well. I would ask if there's any device you can use (like an auto injector) as it totally saved me. I never had a fear of needles and so was a bit confused by what turned out to be very strong anxiety over the whole thing, so much that I remember being reduced to tears after hours of almost injecting myself. Part of it was because the mechanism in the auto injector makes a very loud bang and I got extra anxiety the sound would make me flinch and the needle wouldn't go in right (you're supposed to hold the injector still, while it plunges the syringe over about 10 seconds). But I also had a hang up over the needle going into my skin, which is why I really couldn't handle doing it without the auto injector as it was supposed to be a fast jab and then hold still while plunging the syringe. It was like I was imagining it going through all the layers of skin and whatever else and that it was wounding me, inside, and if I moved while it was going in, it might cause extra damage? Like each injection was creating a little tunnel into me and... it maybe isn't logical to dwell on it, but truly it took me a long time to "get over" that part.
Eventually a nurse associated with the pharmaceutical company clued me in to the idea of using headphones with loud music to distract me and to cover the sound of the autoinjector. Thus began over a year of blasting this song on headphones once a day and hitting the button on the beat as it hits the chorus. The lyrics actually became sort of part of it for me as I was scared and angry over my diagnosis that led me to having to give myself this stupid needle in the first place and this angry screamy song talking about scars and "shooting" was exactly what I needed to help me through this stupid thing I didn't want to do (plus there was no way I could hear the auto injector over it, which I could with mellower music).
I share this part with you because now I don't need the headphones anymore but I did need them and the screamy music for well over a year because my life was totally thrown upside down by my diagnosis, (as well as a bunch of other major life changes), and I thought perhaps some of your anxiety might be similar to mine. I didn't have a therapist at the time and so I had to cope using things like that song and lots of medical marijuana. Have you processed the fact of having to do this to yourself? It can be a pretty big deal! I have to do this for the rest of my life? I still feel like I'm wounding myself, but it's been over five years, so eventually i got used to the fact that I have to take this medication.
I eventually became pretty used to the whole needle thing and now I bite the fleshy side of my finger (pretty hard) and that pain is distracting enough that if I do end up choosing a spot that hurts, I won't squirm (not all injection sites are equal!). If you have any extra "padded" areas, they will hurt less than areas where the skin is thin and you are going into muscle. My go to method if I'm feeling sensitive is to adjust my waistband to create a roll of fat on my hip that has no chance of having actual "meat" inside (like even squishing it a bit so it's a bulge of only fat) and making sure I'm 90 degrees to the skin and making sure that the skin is taut.
posted by smartypantz at 2:47 AM on March 3, 2015
Eventually a nurse associated with the pharmaceutical company clued me in to the idea of using headphones with loud music to distract me and to cover the sound of the autoinjector. Thus began over a year of blasting this song on headphones once a day and hitting the button on the beat as it hits the chorus. The lyrics actually became sort of part of it for me as I was scared and angry over my diagnosis that led me to having to give myself this stupid needle in the first place and this angry screamy song talking about scars and "shooting" was exactly what I needed to help me through this stupid thing I didn't want to do (plus there was no way I could hear the auto injector over it, which I could with mellower music).
I share this part with you because now I don't need the headphones anymore but I did need them and the screamy music for well over a year because my life was totally thrown upside down by my diagnosis, (as well as a bunch of other major life changes), and I thought perhaps some of your anxiety might be similar to mine. I didn't have a therapist at the time and so I had to cope using things like that song and lots of medical marijuana. Have you processed the fact of having to do this to yourself? It can be a pretty big deal! I have to do this for the rest of my life? I still feel like I'm wounding myself, but it's been over five years, so eventually i got used to the fact that I have to take this medication.
I eventually became pretty used to the whole needle thing and now I bite the fleshy side of my finger (pretty hard) and that pain is distracting enough that if I do end up choosing a spot that hurts, I won't squirm (not all injection sites are equal!). If you have any extra "padded" areas, they will hurt less than areas where the skin is thin and you are going into muscle. My go to method if I'm feeling sensitive is to adjust my waistband to create a roll of fat on my hip that has no chance of having actual "meat" inside (like even squishing it a bit so it's a bulge of only fat) and making sure I'm 90 degrees to the skin and making sure that the skin is taut.
posted by smartypantz at 2:47 AM on March 3, 2015
You are me, except my medication can't be taken subcutaneously. I had really awful injection anxiety, but I have no problem with needles in general whatsoever, and am the kind of person who watches when the needle goes into my arm for a blood draw because I think it's kind of cool.
What really helped me was having background noise. I still need that - I turn the bathroom fan on when my partner is performing the injection. As my anxiety got slowly worse, I started turning to music - I would turn on a station that seemed appropriate (for me it was Covenant radio on Pandora, which I also use for working out and associate with powering through discomfort) and decide that I would take one, maybe two songs at most to prep the injection and give myself the dose. Having a "time limit" really helped me.
I also found it easier to do when I broke down the process into mechanical movements and pretended the leg belonged to someone else. I would sit down and focus on the motion of my arms, keeping the movements all at roughly the same speed as I went from one process to the next, and would refuse to allow any stalling in my movements. I tried to think of it like a factory machine - my arms perform these motions in this order, and then when everything is done I can turn off the machine and go back to being a normal person.
It also helped me to always do it in the same space. I always did the injection in the bathroom. I don't revel in using the facilities, brushing my teeth, showering, etcetera, and I certainly don't revel in cleaning the bathroom. The bathroom is a place for things I don't really care to do, but which must be done, and which I do all the time. If the bathroom works for you in that sense, go for it.
Oh, and if you're like me, don't count to 3 or any other number above 1 when you go to give yourself the shot. Counting (either up or down) always upped the anxiety a lot for me.
Oh, one other thing: While you're doing all this, make absolutely, 100% sure you still inject in the correct spot, especially if you're doing intramuscular. It's extremely important with IM to do that - make sure you get the muscle you're aiming for, and make sure you aren't in a vein or artery when you inject. I've missed the spot a couple times, and on one occasion it created long-term annoyance because I hit a large nerve spot (I have a numb spot on my thigh now).
posted by Urban Winter at 8:52 AM on March 3, 2015 [1 favorite]
What really helped me was having background noise. I still need that - I turn the bathroom fan on when my partner is performing the injection. As my anxiety got slowly worse, I started turning to music - I would turn on a station that seemed appropriate (for me it was Covenant radio on Pandora, which I also use for working out and associate with powering through discomfort) and decide that I would take one, maybe two songs at most to prep the injection and give myself the dose. Having a "time limit" really helped me.
I also found it easier to do when I broke down the process into mechanical movements and pretended the leg belonged to someone else. I would sit down and focus on the motion of my arms, keeping the movements all at roughly the same speed as I went from one process to the next, and would refuse to allow any stalling in my movements. I tried to think of it like a factory machine - my arms perform these motions in this order, and then when everything is done I can turn off the machine and go back to being a normal person.
It also helped me to always do it in the same space. I always did the injection in the bathroom. I don't revel in using the facilities, brushing my teeth, showering, etcetera, and I certainly don't revel in cleaning the bathroom. The bathroom is a place for things I don't really care to do, but which must be done, and which I do all the time. If the bathroom works for you in that sense, go for it.
Oh, and if you're like me, don't count to 3 or any other number above 1 when you go to give yourself the shot. Counting (either up or down) always upped the anxiety a lot for me.
Oh, one other thing: While you're doing all this, make absolutely, 100% sure you still inject in the correct spot, especially if you're doing intramuscular. It's extremely important with IM to do that - make sure you get the muscle you're aiming for, and make sure you aren't in a vein or artery when you inject. I've missed the spot a couple times, and on one occasion it created long-term annoyance because I hit a large nerve spot (I have a numb spot on my thigh now).
posted by Urban Winter at 8:52 AM on March 3, 2015 [1 favorite]
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