Tag Archives: bg

Sometimes the highs are worth it.

I have a lot to talk about this week. But first, I need to get this thing out of my head from yesterday. It’s about a low. One of those nasty, thrashing around, call 911 hypoglycemic events that we all hate to think about. Or talk about. I’m fine, no real harm done, and the EMS people were only at the house for about five minutes because I’m always better by the time they get there anyway, though the thing I hate most about those times (which have been very infrequent) is that they have to be there at all instead of being out helping someone who really needs to be helped.

The thing about the situation yesterday is that it could have been avoided. There are two ways that I could have avoided such a low. And I have a real point to make at the end, I mean it.

The first: I should lay the groundwork here by saying it was around five o’clock, it was already a full day, with a warm afternoon which included my first outdoor bike ride of the year and catching up on cleaning the kitchen within an inch of its life, cleaning the bathroom within an inch of its life, and doing the laundry. I had just come up from the basement after switching over the laundry for the third time, and Maureen said “Whoa, slow down, come sit down, you look pale”. I could feel myself getting low downstairs, and I took an extra couple of minutes (7? 8? 10? Who knows?) to finish everything down there before going back upstairs. You can see where this is going, yes? So I knew I was low when I came up. But I sat down anyway without getting anything or even grabbing my meter. Maureen is like, “You look low… I’m getting some juice and something to eat”. I told her not to, I have a tube of Glucolift tabs in my pocket, and if she could, please get my meter. I didn’t want to overtreat and kill my appetite for what was shaping up to be a nice Sunday dinner. I wanted to know where my BG was so I could ingest an appropriate amount to get back up to an appropriate range.

So in about two seconds (she’s superhero fast like that) she brings me juice, honey, and my meter. “Here, drink this before you test”. “No, I want to test first”. “No, drink this first”. I had to move her hand away from trying to hand me juice while I tried to get a drop of blood to my test strip. And now, with my brain turning to mush, each attempt by her, each word by her, meant that I had to start at zero again and concentrate from the beginning to inch my way toward that strip. And in the end, that drop of blood never made it there, and the meter, myself, and Maureen all made it onto the floor.

If I would have been left alone for just a few seconds, I probably (probably…) would have gotten that reading and then started treating right away.

The second reason: Of course, the worst could have been avoided if I would have just obeyed orders and immediately started drinking juice and eating honey. And popping Glucolifts like they were candy (they do taste like candy, I confess). But I didn’t. And that’s what brings me to the crux of this post.

Here’s what I learned from this experience: Sure, if I would have been on my own, I probably would have tested first, and I’m pretty sure everything would have been okay and there would have been no need for EMS intervention or anything like that.

But the thing is, I wasn’t by myself. There were two people in this scenario, and other than physically, the other person was affected just as much or more than I was by the whole episode. People With Diabetes: Do you think that the other people in your life aren’t affected at all by what you go through? Do you think that they don’t feel for you at these moments? Do you understand that they feel responsible, sometimes guilty for not helping you enough? If I can help it, I do not want to be responsible for heaping more on my loved ones than they already have to endure.

What I learned from this is that sometimes, it’s just better to risk overtreating and suffer the high BG later in order to save your loved ones the unbearable and unnecessary grief, guilt, and fear of the next time. Holy crap, I would give anything to erase that now. Including a little bump in my A1c or a CGM graph or a downward-carb modified dinner.

Still sick, but better.

“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?

I don’t like you, your highness.

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.

Random Glucose.

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.

Just Words.

My company offered a great incentive recently. Answer a few questions, go through a health screening, get your blood pressure, cholesterol, and your glucose checked. At the end of it all, they put a few extra bucks into my flexible spending account, which I can use to pay for things my medical plan doesn’t cover (like the co-pay on test strips).

So I went for my scheduled screening about 20 minutes after my lunch. I informed the screener that I was Type 1 so he wouldn’t have a cow when he checked my BG. He went through all of the tests, including the glucose check (with a One Touch meter).

The result: 160 mg/dL

So I’m thinking
, “Hey, I’m at 160 only 20 minutes after lunch? Brilliant!”.

And that’s when the screener said: “Sir, of course you know this because you’re type 1, but you should always maintain a blood sugar below 140”.

Me: “But I just finished eating a little over twenty minutes ago”.

Screener: “Yes, but FDA guidelines suggest that you should keep your blood glucose at 140 or lower constantly”.

Me: “Okay, first of all, I’m pretty sure that’s incorrect, and second, I just ate… wait a minute… you just came back before I sat down right?”.

Screener: “That’s right”.

Me: “Did you just eat?”.

Screener: “Yes”.

Me: “Go ahead and test yourself. I’ll bet you’re at 160 or higher right now”.

Screener: “Sir, what my blood sugar is doing is not…”

I stopped him right there. I don’t usually like to interrupt people, but I had to do it right then. I stopped him mid-sentence, and said “My point is this: Everyone, every situation is different. When you paint everyone with a broad brush like that, you’re going to scare the crap out of some people who may not have diabetes, and you’re going to make some people with diabetes feel bad”.

Maybe I overreacted. He was just doing his job. Just repeating what he’s told to repeat. They are just words, after all. I was just thinking that I don’t want the next person who sits down after lunch to worry unnecessarily, or feel bad about themselves.

As I was finishing up, he handed me a flyer with some general health information. Among the other items in the 3-sided pamphlet was this nugget, near the bottom of the page:

Hey, it’s just words, right? And maybe I’m a little over-sensitive to these kind of things now. But last time I checked, there wasn’t anything I could do to prevent my diabetes. Or anyone else’s Type 1. And eliminating my diabetes? Sorry for the cliche, but that’s a little like reversing pregnancy.

I know it’s just words, but I did get the e-mail address from the vendor doing the screening, and I sent an e-mail telling them that they should rethink the way they’ve worded their little handout. Again, it could make people feel bad. People who develop diabetes, or have already developed diabetes, could think that they’ve failed somehow. When really, they didn’t have anything to do with it.

Hey, it’s just words. But words can hurt. Or they can heal. Your choice.

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