Category Archives: Random Glucose

Still sick, but better.

December 27, 2012 – 11:39 am

“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?
 
 
 

By StephenS | Tagged , , , | Comments (3)

I don’t like you, your highness.

November 20, 2012 – 10:14 am

Please excuse me for a moment while I rant. It’s been a strange month or so around here. These frickin’ high blood sugars are driving me crazy.

I’ve been very lucky. Since about six months before I went on pump therapy, or about three years ago, I’ve been doing absolutely great managing the glucose. My A1c results have been super.

At my last appointment with my endocrinologist, she was concerned that I was managing things a little too well (my words, not hers), and she had me make a couple of adjustments to my basal rates. So now I have to get used to seeing numbers that are above what I would like.

That’s hard enough for me (not too hard really, but still…). But the last month or so has seen a lot of days where nearly every BG reading is higher than 180.

I don’t like it. I don’t like how it makes me feel. I hate that dry mouth, go to the loo more than usual, feeling lethargic, grab another bottle of water, wait to eat feeling.

And I really don’t like thinking about what this is doing to my future A1c result coming up in December. I mean, I know this is probably not a big deal in my overall diabetes care. But just this short time North of the Border is starting to really do a number on my psyche.

So, what to do? Well, I probably need to listen to my own advice. I’m fond of telling my fellow PWDs that yesterday is yesterday, and you can’t change it. Today is what counts, and if you can put enough good todays together, you’ve got a great future. This isn’t the end of the world, after all.

But I’m pretty mad about it right now. Better get ready, high glucose. I’m coming after you. And I’m not giving up.
 
 
 

By StephenS | Tagged , , , | Comments (3)

Random Glucose.

October 4, 2012 – 7:03 am

My day Wednesday started with a BG reading that was practically perfect in every way:

Hard to believe I wound up with 100, since I’ve been major stressed this week. But I took it as a good sign and started on breakfast. Then I went to work.

Move on to lunchtime. Only it wasn’t the normal lunchtime, because everyone at work needed a piece of me yesterday. On top of that, we’re working on a big project that goes live at the end of the month. And a long-awaited vacation is just around the corner, so I’m trying to cross as much off of my list as possible before Friday. Now, where was I? Oh yeah, my BG just before my late lunch was:

64 mg/dL

I brought my lunch with me, so I was able to eat right away. The salami & cheese sandwich and grapes were very good (but I had to brush after).

Then, of course, I went back to work, and I wound up working like a mad dog. And late too… about two hours late. I walk to the subway after work, about 1/2 mile from the office. By the time I got there, I decided to check to see how I was doing since I was late. The result: 61 mg/dL

I quickly popped a couple of candies that I had in my pocket (not a big fan of glucose tabs), and I was okay for the ride home. Of course, once I made the short drive from the station home, and then took a few minutes to say hello to everyone who was already home, my glucose was… wait for it… 67 mg/dL

A little juice, and some soup and cornbread for dinner. Finally, about 10:00 p.m., I checked one more time before bed:

144 mg/dL

What’s the moral of this story? Preparation, preparation, preparation. And don’t wait so long to eat. A few years ago, I might not have had anything extra around to help me if I was low at work. Or on my way home. I wouldn’t have stopped to test prior to getting on the train. I would have eaten when I ate, whenever that would be, if I ate at all. All of that adds up to a lot of uncertainty. I’m okay with dealing with things as I go along. But in this case, I’m not sure I would’ve liked the result.
 
 
 

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The Accu Chek Nano.

August 28, 2012 – 7:20 am

This isn’t quite a product review. The reason why is at the bottom of this post. But I wanted to touch on something I think about every time I change meters or almost anything else.

At my last visit with my endocrinologist, I mentioned that my meter is kind of old and asked if she could recommend a new one. Fortunately, my insurance doesn’t severely limit my choices meter-wise (or strip-wise, which is what they’re really doing). Well, it turned out she had an extra Accu-Chek Nano meter she could let me have, and I gladly accepted.

Obviously, accuracy is of utmost importance in any glucose meter. And the Nano is promoted as 23% more accurate. Actually, that’s not exactly what they’re saying. The meter isn’t supposed to be more accurate, the strips are. In fact, Roche (maker of the Nano) states that their SmartView test strips have been tested against a 23% tighter specification. That’s great, but I’m not sure how stringent the 23 percent lesser specification was. And in the long run, it doesn’t matter. As long as it’s consistently in the ballpark.

Here’s what I mean: my first reading of the Nano side-by-side with my old Contour meter was an exact match.

And then I proceeded to test side by side with the Contour over the course of about 3 1/2 weeks. While the readings were close most of the time, the photo above was the only match between the two. But how do I really know which one was more accurate? I kept the Contour for a lot longer than I should have because I was happy with its consistency. And that’s what I want from a new meter.

Honestly, three months after you start using a meter, you’re probably not thinking about accuracy anymore. At that point, what’s on the meter is just the new normal, whatever it says. Now, I know that we don’t want big inaccuracies in our meters. But as long as it’s consistently close to where my BG is at, that’s what matters for me.

I have to admit to really liking the back light feature on this meter. Makes it easy to read wherever you are. Also, I like that the reading stays on the screen for an extra second or so after I pull out the test strip. I can’t tell you how many times, out of habit, I’ve pulled a strip from a meter and proceeded to forget the reading almost immediately. And I’ve liked how small it is… fit in my pocket pretty easily.

That’s about as much as I have on the Accu-Check Nano right now. Unfortunately, even though it fit into my pocket easily, it also slipped out easily while on the train home about a week ago. Never even knew I lost it until the train pulled away at my stop. So I’ve gotta go back to the old standby while I troll Amazon and eBay for a deal on a new one.

Here’s hoping your new normal doesn’t involve getting two new meters in six weeks.
 
 
 

By StephenS | Tagged , , , , | Comments (3)

Public Diabetes.

August 6, 2012 – 6:37 am

I went to New York on Saturday to hang out with The Great Spousal Unit’s brother and his family. I’ve made no secret of that fact that up until about a year ago, I never took my meter out in public. In addition, I never really wanted to show my pump in public either. I always had it under a big shirt. And I was very careful to kind of turn away from everyone (even if it was friends or family) when I used the pump to bolus or adjust my basal.

It’s not that I really care about anyone seeing me. Anybody who has a problem with it can just shove it, you know? But I don’t want anyone to get sick once they see the sight of blood on my finger. And I’ve certainly noticed how freaked out people get sometimes when they see me using my pump, like I have some sort of really scary problem. Well, it is a scary problem. But that doesn’t make me scary, does it? Anyway, I don’t want anyone to be afraid of me. And I don’t want anyone to look at me with pity. Those kind of things make me feel bad… like it could be avoided if I just hide it away for a while. So until now, I’ve either left the meter at home, or left it on the bus. While I was away, or at least while I was in Manhattan, I was guessing about basals and boluses.

But I’ve been reading posts in the past year or so from many in the DOC who show that testing, set changes, pump adjustments in public are no big deal. It’s just part of what you do. Those posts were powerful, empowering examples for me. I started to realize that at some point, my health and my care had to become a priority. And damn the consequences. So this time, I put my meter in my pocket and used it all day.

I used it at lunch (142 mg/DL). And then about 45 minutes before I got on the bus to go home, I stopped in a small place to grab a sandwich and some iced tea. After walking around all day (that’s what you do in New York) in the 95 degree heat, I was feeling pretty crappy. I wasn’t moving well, and I was thirsty, my mouth was dry. I was certain I was still high. So much so, that I almost didn’t even check. But then I thought: no, I have to know… coming down from 150 requires a different strategy than coming down from 250 or more.

So I pulled out the meter, and right in front of about 35 people, I checked: 52 mg/DL

If I had just bolused based on a guess, how long before I would have gone hypo? What would that have looked like? How would I feel about myself the day after?

I’ll name it: I overcame fear Saturday. Ridiculous, stupid, ego-based fear. Stupid, dumb, vain things that I’ve been feeling and keeping deep inside for a long time. Saturday, it could have affected me in a very bad way.

Don’t be me. Make your health and your care the top priority. Today. Right now. And who knows? Maybe your initiative could serve as an example to someone who’s still hiding their diabetes from the rest of the world.
 
 
 

By StephenS | Tagged , , , | Comments (1)