Tag Archives: bg

Wounded. But tougher.

I don’t know why, but it occurred to me recently that People With Diabetes get wounded a lot. Not a shocker there. We are wounded daily on a physical basis, and wounded occasionally on an emotional basis. But either way you look at it, we’re wounded a lot:
 
 
– Wounded when we prick our fingers multiple times per day.

– Wounded when we inject ourselves with life-sustaining insulin.

– Wounded when we change out the infusion sets on our insulin pumps.

– Wounded when we change out the sensors for our continuous glucose monitor (CGM).

That seems like a lot right there. Our bodies are constantly poked, with various devices, to varying degrees, in the pursuit of perfect glucose nirvana. Oddly, better technology means getting jabbed more often than ever before. Any veteran PWD can show you multiple sites on their bodies where they can hardly remember what it looked like before their diabetes care forced a sort of self-mutilation. But I can keep going, and I’ll bet you can too:

– Wounded when we go to the doctor (usually multiple doctors) and blood is drawn for testing.

– Wounded if we fall into hypoglycemia and need to be revived by EMTs who start an IV with glucagon.
Here’s hoping this never happens to you.

– I’m wounded each time I donate blood and a large needle is inserted into my arm.
This is something I’m happy and proud to do, so I really don’t mind this one.
 
 
Then there’s the emotional side of diabetes. Unfortunately, many of us have experienced something like this:

– Wounded when someone asks “Can you eat that?”.

– Wounded when someone treats you like you’re responsible for your diabetes diagnosis.

– Wounded when the boss calls you in and says “What are we going to do to stop these low blood sugar episodes?”. Like a simple rewrite can avoid another installment of must-not-see TV at the office.

– Wounded when stubborn lows won’t come up and stubborn highs won’t come down.

– Wounded when our hemoglobin A1c number doesn’t reflect our expectations or how hard we’ve worked in the past three months.
 
 
I wouldn’t think of trading the better care (and much better awareness) of diabetes today for what it was like when I was diagnosed two decades ago. But there’s no denying the fact that better care and awareness (or lack of awareness) comes with additional punctures, both to our bodies and our hearts. Sometimes, the enormity of it all makes it difficult to imagine continuing in such a way. And yet sometimes, in a perverse kind of way, it seems to make us tougher. I like to think that with all of our holes, we’re even stronger than ever. I think I’ll cling to that today as I check my glucose and change my infusion set.

What about you? What wounds you today? What makes you tougher? Feel free to share your thoughts.
 
 
 

Tour de Talbot recap.

Okay… My 55 miles in the Tour de Talbot on Saturday was not my favorite experience on the bicycle.

I was running late all morning, I forgot to put on sunscreen (no burn issues after all), I almost forgot to put on my riding gloves (and I’m soooo glad I didn’t), the weather was iffy, and my BGs did not want to play fair. But when do they ever play fair? Heck, I didn’t even get a photo of anything on Saturday, except my dog when I got home. Not to worry, I won’t bore you with it here. But I did complete the 55 mile journey, in roundabout fashion, and today I have a sore behind and a sense of accomplishment.

So let’s start at the beginning. BG at the start: 219 mg/dL. This is entirely due to the fact that I didn’t bolus for breakfast. I woke up at 81 mg/dL, and I didn’t want to be nearly that low when I started the ride. And yeah, I ate a lot of carbs for breakfast. I set my temporary basal rate at 30 percent for 5 hours.

This is the most laid back event ever. I think I mentioned that last year too, but it’s true. Somebody gives a speech at the beginning that hardly anyone can hear, then we’re off without a horn, or crowds cheering, or any of that. Down a paved two lane driveway and out onto the highway that goes between Easton, Maryland and St. Michael’s (more on that later).

We wound around a bit and then, about three or four miles in, suddenly we’re on a gravel road. Gravel. On my thin little road bike tires. This went on for about three or four miles, I think, and the whole time I’m hearing the same complaints and hopes coming from the other riders. Mostly, “I hope I don’t wipe out on this gravel”, and “I hope I don’t get a flat tire from this gravel”. Oh, and “Who’s idea was this?”. And these are still roads that are traveled by vehicles, mostly local residents and big farm trucks kicking up gravel as they pass by. And this was just the first gravel road we traveled. I started counting the riders on the side of the road with tire issues. I counted ten in 55 miles.

We hit the first rest stop 12 miles in. Even though it’s only quarter past eight in the morning, the salty pickles out on the table at this stop really looked good. But I passed them up in favor of a salty/sweet nut bar. These are usually my go-to snack on these rides. BG at this stop: 129 mg/dL. Pretty crazy, right? I dropped 90 points in about 45 minutes. With a 30 percent temp basal and breakfast carbs still working in my body (I think).

The next part of the trip wasn’t too bad. 18 miles to the next stop. Someone drafted behind me for about the last ten miles of that segment, but it was okay and we made good time. I made the mile 12 to mile 30 segment in a little less than an hour. That’s pretty good for me, on a long ride anyway. At the stop I had another nut bar and waited about ten minutes to let my body calm down a bit after working hard. BG at this stop. 82 mg/dL. I don’t want to worry anymore, so I just shut off my pump for the rest of the ride, and grabbed a banana at the rest stop too. Instead of climbing a steep incline after the stop, I decided to walk my bike to the top of the hill before climbing on for the next 12 mile segment. I’m glad I did.

The next 12 miles were probably the hardest 12 miles I’ve ever biked. About a mile after the rest stop, we turned onto another gravel road. Not as bad as the first gravel road we were on, but I had to make sure I didn’t get too far toward the shoulder or I would definitely have been in trouble. But I also had issues with the weather.

The same front that brought rain to the JDRF Ride for a Cure in Nashville was making its way toward the mid-Atlantic. Ahead of the front were some pretty strong 15 to 30 mile per hour winds from the south. On this stretch, we were riding south (on the gravel road) for about five or six miles. The rest of this part went pretty much straight south too. Straight into the wind. In short, it was brutal. I was never more grateful to reach a rest stop.

I took a moment to sit down and collect myself, and check my BG again: 66 mg/dL. Are you kidding me? My pump’s been off for an hour (and yes, it took me an hour to bike 12 miles). So now, I have to decide if I can even continue. I started with some glucose tabs, then loaded up on handfuls of pretzels for about 20 minutes. When I checked after being at this stop for 30 minutes, I was at 149 mg/dL. At this point, I felt like I could make it the final 12 miles, especially since we weren’t supposed to go any further south.

Shortly after leaving this stop, I connected with a couple of riders who were on my route, so I decided to ride in with them. Now it gets even more interesting. We’re about six or seven miles away from the finish, and we must have missed a turn. Because it wasn’t marked. I had been hearing about issues like this all day. Signs pointed in the wrong direction by pranksters. Arrows marked along the roadway pulled up. That must have been what happened to us, because before we knew it, about the three of us were in the heart of Easton. This was not on the route map. Now what to do? Well, I knew how to get back from where we were, and I wasn’t interested in going back to look for a missed turn, and I didn’t know whether the rest of the route was marked properly either. My decision was to go the way I knew to go to reach the finish. The two riders I had been with since the last stop thought that was the thing to do too, so we rode right through historic downtown Easton, then over to the main highway back to the start/finish.

Then, the final joke: When we near the finish, there were volunteers at the two lane driveway, which was now closed, directing us to go to the next driveway and turn right. So we did that, turning onto the worst stretch of one lane gravel road on the entire trip. With vehicles leaving the venue, coming right at us.

Somehow, we made it through and I was able to finish. BG at the end: 88 mg/dL. I can’t say that I’ll sign up for this ride next year. There were a lot of tough, grind it out miles, but overall, I can say that I’m happy to have been tested and passed the test. We claim our victories were we find them. This one wasn’t pretty, but in the end, it was a success.
 
 
 

#StripSafely Update. And a question.

Safety of the test strips we use, and the meters we plug them into, is a great big deal to everyone living with diabetes. It also means a lot to the people who love me and count on me to be there for them.

So I aligned my views with those in the Diabetes Online Community who also believe that A) The 20 percent +/- factor that’s currently allowed for test strips is NOT NEARLY GOOD ENOUGH, and B) The fact that the FDA has no post-approval mechanism in place to verify the continued accuracy of test strips they approved earlier, or pull them from the market if they’re not, IS NOT OKAY.

As a measure of support, and to help in getting these wrongs righted, I wrote my elected officials in Washington. U.S. Representative Dutch Ruppersberger, D-MD, and U.S. Senators Barbara Mikulski and Ben Cardin, also D-MD, received e-mails from me expressing my concern and asking them to assist.

That was nearly three weeks ago.

But hey– a week ago I received an e-mail response from Senator Mikulski, the longest-serving woman in United States Senate history. I’ll share it right here, but be sure to come back after reading, because I want to ask about something.

Letter

Other than the fact that this was pretty much a form letter, I was actually happy to have received a response at all. Seriously, even if they’re not busy all the time, senators get requests from a seemingly endless stream of attention-grabbers and favor-seekers on a constant basis.

No, what really struck me were the two images at the bottom of the letter. You know, the Facebook and Twitter icons.

So I want to ask: What if a coordinated effort was put together to bombard Facebook and Twitter accounts of U.S. Representatives and U.S. Senators for the #StripSafely cause? It could start with House and Senate committee members responsible for FDA oversight, and perhaps move on to people with oversight of the U.S. Commerce department. Somewhere in there, we could get around to House Speaker John Boehner and Senate Majority Leader Harry Reid.

I don’t know… Maybe it all sounds a little too “Mr. Smith Goes to Washington”. But don’t we believe in our own cause just as much as Jimmy Stewart did in that movie? And I have to ask: Don’t you think that together, we could make some kind of impact? If there are so many people in on the #DSMA Twitter Chats every Wednesday, wouldn’t the same kind of numbers all tweeting or messaging at the same time, about the same thing, to the same people, get an elected official to take notice?

What do you think, Diabetes Online Community? Good idea? Bad idea? Feel free to leave your ideas below.

For more on this important issue, visit the Strip Safely central at www.stripsafely.com
 
 
 

Wordless Wednesday… That’s more like it.

DSC00868

In Monday’s post I complained a lot about how crazy my glucosity was all weekend. But now it seems like things have calmed down a bit. The photo above is from last night, and it reflects how my BG has been behaving for the past two days. Granted, my high and low markers are pretty high and pretty low, but at least I’m doing better over the last 48 hours or so.

And check out this graph from last night… A little low around 11:00 (treated with juice), then steady during sleep. Mind you, I haven’t really done much different except staying hyper-aware of how I’m trending:
DSC00872

#MakesSenseIfYouHaveDiabetes
 
 
 

Highs vs. Lows.

Seems to me there’s a disparity in dealing with high glucose versus dealing with low glucose. Okay, maybe it’s not as serious as a disparity, but I’m trying to keep this light here, okay?

When my BG is low, I find that there are many things that I can use (read: ingest) to get myself back into a safe range. Among them:
 
 
– Juice

Glucolifts (Cherry… yum)

– Honey

Goetze’s Caramel Creams (addictive)

– Fruit

Level Life Glucose Gel (kinda like the Mandarin Orange)

– Smarties (which are Rockets north of the border)

– Rockets (which are Smarties here in the USA)

– Insert your favorite here (Nutella, Maple Syrup, etc.)

– And, as a last resort, Glucagon
 
 
That’s at least nine items that I can use to bring up my glucose from an unsafe level. Having low BG is no picnic, of course. But those options almost feel like a reward for suffering through hypoglycemia. Almost. But not quite.

But what if my glucose is high? What if my pump has an issue delivering insulin, or it’s a hot day and the insulin loses its effectiveness, or I under-bolus for lunch? Now, I’m hovering near 300 mg/dL and I only have three options available to combat the high BG:
 
 
– Insulin

– Drink lots of water

– Exercise (while drinking lots of water)
 
 
That’s not a lot of options. And they’re not very appealing either. Also, if you have Type 2, you may not be on insulin therapy, so you may be left with only two options. Woo-freakin’-hoo.

In a way, having fewer choices when you’re high takes a lot of the guesswork out of what you need to do. You’ve just gotta do it, right? Using one, or two, or three methods. And it’s likely that you’ll have to wait to get yourself back into range. I mean, when you’re low you drink some juice, pop some glucose-laden product, and you’re often back in range within minutes. When you’re high, you can give a correction bolus of insulin, drink lots of water, and go for a run, and you’ll still have to wait some time before your BG comes back down.

I think this disparity in available options and time needed to correct explain why I absolutely hate being high, and why I try to do everything I can to avoid it. That doesn’t mean that I’m doing everything I can to be low. It just means that I don’t worry about being low as much as I worry about being high, if you know what I mean. Plus, I’ve got to admit, I hate how it makes me feel.

I suppose I could use this discussion to push for development and approval of faster-acting insulin. But I’m not thinking about that right now. I’m thinking about how high BG makes me feel, physically and mentally. And how that’s completely different from how I feel about low BG.

What about you? Do you worry more about high BG than low BG? Do you still worry about low BG, but secretly like the fact that it allows you some seemingly guilt-free indulgence? I’d love to hear what you think about both ends of the glucose spectrum.
 
 
 

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