“Sick, sick. He’s always sick. Why can’t he write about something other than being sick?”
That’s because I’m sick.
I’ve been up and down over the last few weeks, with a persistent cough and an occasional fever. Baltimore is a nice place to visit, but you don’t want to come here right now because there’s some kind of wicked virus going around, and everyone has it.
Which leads me to the point of this post. After all these years with diabetes, I’m still trying to figure out how to cope during this scenario:
On Saturday, this virus decided to attack my insides harder than ever (and just 24 hours after I had finished a round of antibiotics). I felt bad in the morning, before breakfast, but I figured if I just had something to eat, I’d be fine. And I was, for about 3 hours. Then, about 11:00, I started feeling bad again. I laid down on the couch for about half an hour, then tried to eat an early lunch. Good thing I decided to eat early, because my BG before lunch was: 64 mg/dL
I only got a little bit of lunch before I started feeling really bad. At this point, I informed The Great Spousal Unit that I was going to go to bed to try and sleep it off. Because I hadn’t eaten much, I checked again, and my BG after eating was: 84 mg/dL
This isn’t pretty, but suffice to say I didn’t make it to bed before everything came up, including lunch, breakfast, and any coffee I had in between. Now the question was before me: What to do about my blood glucose management?
I remember the only Diabetes Educator I ever worked with, in the hospital after my diagnosis. She said, emphatically, that if I ever had a situation like that, I needed to eat, or drink juice, or something, anything to keep my glucose levels up. I think that made sense for the times (1991), because I was on MDI (multiple daily injections). I was dosing insulin only twice per day then. So in that situation, I would have injected half a day’s worth of insulin in the morning, and would have needed to back that up with some carbs to remain at a safe level.
But since I’m on pump therapy now, I reacted differently. I immediately suspended my pump. Then I crawled into bed and slept for three hours. When I woke up, I still felt terrible, but somehow summoned the energy to test my BG again: 111 mg/dL
Then, back to sleep. For another 2 ½ hours. The pump was still suspended, and when I woke up, I checked yet again: 147 mg/dL. Now I decided to try to eat again, but could only manage a little soda and half a slice of toast. No bolus for that, even at 147. And back to sleep again.
When I woke up around 8:00 p.m., I checked my BG for the sixth time that day: 236 mg/dL. I had developed a fever by this point, and I guess having the pump off for 8 hours also contributed to this level. But at least I felt good enough to finish the toast that I started earlier.
Finally, I started the pump again and went to sleep, and kept sleeping until about 7:00 the next morning, which is very late for me. I felt better, good enough to eat breakfast, but still not too good. I still haven’t been able to eat a decent sized meal (more than half a plate of food, any food) since then. Haven’t had any coffee since then either. I worked about six hours from home on Monday and we cancelled our plans with friends and family both Christmas Eve and Christmas Day. No sense infecting those not already cursed by this virus. I’ve been getting to bed at around 8:00 every night since then too. The good news is that I feel better today than I’ve felt in a few weeks.
I think I handled the no eat, no insulin blood glucose management thing okay this time. But it’s interesting to think that I thought this out all on my own. I didn’t consult with anyone about what to do. Not sure who I would’ve talked to anyway, since my doctors were all unavailable on Saturday.
I don’t know if my strategy was clever or ridiculously dangerous. I know I’ll ask my endo about it at my next appointment. At any rate, it’s another example of how things are different today than they would have been a couple of decades ago. Diabetes changes, and the way we treat diabetes changes. Okay by me, as long as we stay healthy in the long run.
I hope this scenario never plays out for you. But if it does, is this how you handle things?