Now Can You See Why I am Going Crazy?

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This isn’t a heart rate monitor. It’s my daily average for the last month, kindly recorded and tabulated by my Diabetes App. Yes, I’m aware it costs an arm and a leg, but it’s great for me to keep an eye on my average. (A perk for working in the Apps world is that I didn’t have to pay for it.)

The dots are my average reading per day. (And if I happened to be checking repeatedly to battle a high, they all got recorded unfortunately.) The white line down the center is my “average” or what my A1C might look like when I test it in February. (About a 6.4%/138 average or so.) The green line is my goal: a 100 average, as that’s apparently what they want you to be as a pregnant woman.

It’s a great dream to have, but I don’t think I’ll ever make it that far. If I DO get to that point, but still maintain this bi-polar control, could you imagine what my lowest average days would look like? I don’t really want to think about how much more juice I’d have to buy.

I just sent my CDE a lengthy email detailing that my bolus rates are all wrong and I’m changing them again. Of course, tonight I’m going to dinner with friends and I’m not sure that’s the BEST place to try out a new insulin regiment. Wish me luck.

 

Stopping Bad Habits

I failed my basal test early last night. Why? Because about 2.5 hours after I ate, I dropped into the 60s, which leads me to believe that my dinner bolus ratio is still too high.

Or is it?

I have a horrible habit of overriding my pump. I feel that if my blood sugar isn’t under 200 2-3 hours after a meal, I must have seriously miscalculated my previous meal’s insulin intake. So I rage bolus (feverishly administering mathematically-inaccurate amounts of insulin just to make blood sugar readings do something) until I get down to a normal level. Never mind that there may be 2, or 3, or 5 units still working through my system that haven’t done anything yet.Don’t care. I just don’t want to be 289 anymore please, thanks.

Herein lies the problem. Rage bolusing blindly often just stacks insulin against you, resulting in an epic tumble down to no-man’s land and leaves you crawling to your fridge for another glass of orange juice. My doctors and CDE have told me, repeatedly, to stop this practice because it just sets me up for all the lows that I’m diligently trying to avoid. However, when you test every hour for four hours straight with an average of 170, you start to think something isn’t doing it’s job. (Yes – pump air bubbles – I’m blaming you… because who else can I blame?) I have been “conservatively” over correcting in places, rather than just administering an entire correction at will. A unit here… a unit there. If it’s still not enough, another a half hour later.

By the time dinner rolls around, I’m hanging out between 120-140 mg/dl with about 4 units of insulin on board. What possibly could go wrong?????

Oh hey… maybe I should try NOT micromanaging my sugars for an afternoon to see what my dinner blood sugar will actually be around 5:00 pm. Hmm.

Today was an exception. I was treated to a luncheon/learn session by a local PR association, which was catered by one of my favorite restaurants. (And was held in a nightclub I used to frequent when I was 24… weird…) I had a salad of mixed greens and <*goat cheese!!!*>, a half turkey sandwich… and an epically huge brownie. I started the meal at 112 and felt myself falling. Lunch popped me up to nearly 300 and kept me there. all. afternoon. I still haven’t really come down to stay down yet. (But that may have been the veggie pizza I had for dinner…)

BUT – before I headed to dance class at 7:15, just barely an hour after I ate that pizza, I was 116. Maybe all of that insulin I was correcting with finally kicked in. (Only to have the fat in the pizza negate all my progress.)

I should take my own advice. Maybe I’ll have an accurate test here soon. But that involves not having a social life or a need for sleep for three evenings.

Wordless Wednesday: Wine on the 2

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Oddly enough, I don’t like dancing Mambo. But – it was a ballroom dance featured on a wine bottle. So I had to buy it! I hope it doesn’t share the same fate as the Tango label wine I bought this summer. (Which was crap.)

Except I can’t have any tonight because I am basal testing overnight and I measured my dinner carbs to a T so I wouldn’t overdo my bolus ratios. (As an aside, I’ve never been so frustrated with a scale in my life.)

I’ve also had “Mambo Italiano” stuck in my head since I bought the bottle. This can’t end well.

And now for something completely different…


Starving for Enlightenment

These basal tests are really starting to get to me. On first glance, it feels like a carefully planned eating disorder. You skip meals, poke yourself repeatedly for blood, and then binge because you’d skipped a meal, thus throwing the rest of your day off because you are correcting your indulgence. Because diabetes management relies on discovering patterns and adjusting accordingly, each test requires at least 3 attempts per time of day. (Unless the basal rates are perfect the first go-around.)

There are four tests you can and should take: overnight, breakfast, lunch, and dinner. If the test fails by having the blood sugar go too high (over 250) or too low (under 70), you repeat the test the next day or whenever convenient to see if a pattern arises. Adjustments will be made and tests are to be repeated to try the new basal rate or to get more conclusive results.

Yesterday was my second dinner time test since before Christmas. On my first attempts, I decided to try gluten free meals for both tests I took. Bad idea. Apparently gluten free meals don’t hold the same carb breakdown as non-GF meals, so my insulin dosage at lunch sent my sugars plummeting around 3:00 pm. I was advised to eat “real” food at lunch and try the test again. (Or just food I would typically eat, rather than stuff I was experimenting with.)

On these last two tests, I tried two variations: first day was quinoa and some Indian spinach curry and cheese, second day was a plain ol’ PB sandwich on wheat. I survived my 2:00 pm and 4:00 pm checks, which means my lunch dosage is as it should be. On both days, however, precisely at 6:15 pm, my blood sugar dropped to 63 and 65 mg/dl, respectively.

A pattern! (And the test is over… I can have dinner after all.)

Not only did this tell me something was wrong with the basal rate at this time, but it also explained all of the strange issues I was having in November and December. During those months, I’d get off work at 5:00ish, go grab a Subway sandwich, and eat dinner before my 6:30 pm dance lesson. Shortly after eating my sandwich or during the lesson itself, I would plummet down to hypoglycemiaville. (Which made spinning and learning choreography that much more complicated.)

My CDE and I were trying to adjust my dinner bolus rates to account for my activity levels in the evening. Hmm. Maybe we fixed the wrong thing.

Now that we have a pattern, we’ll probably adjust. Which will then lead to another round of testing to see if the adjustments succeed.

Sigh.

These tests aren’t for people with active calendars. During these tests, you are supposed to keep activity, stress, high fat foods, (life), to a minimum because, as all PWDs know, anything can have an effect on blood glucose control. Never mind that you aren’t eating anything for about 8 hours straight. (Or trying to.) Since I have a lot of evening plans, explaining that I need to skip dinner three nights in a row is impossible (which is why I didn’t test during the holidays). Not doing any exercise for three nights in a row is also impossible. If you are female, you can pretty much forget testing one week out of the month.

I am still struggling with my morning rates, so there are a couple of skipped breakfasts in my future. Possibly even an overnight test because I’m not quite sure if that’s effecting my mornings. (Which equates to getting up at midnight, 2 am, and 4 am.) All in the name of science, I suppose.

As much as I hate starving myself repeatedly and the wrenches that get thrown into plans when I can’t pass, the results are quite enlightening. I just wish there was an easier way to see if you were administering the correct doses.

Don’t Mind Me… Just Ruining My Average

My further attempts at basal testing seem to only be ruining my well established average.

I can’t seem to get through my tests without dropping lower, which causes me to over treat, and then my sugars sky rocket. (Well… higher than what they have been. 180-240.)

Once again, I’ve proven my docs wrong on their thoughts that I’m administering too little of a basal rate. So my CDE appointment on Tuesday should be really interesting and bring up even more questions. Hmph.

On the docket this week is the showcase dress rehearsal tomorrow, teacher training final exam on Thursday, show on Friday and Saturday, with some last minute practices in between. This on top of work planning, Christmas shopping, baking, cleaning, etc.

I’ll be real surprised if I can keep this fairly decent average going this week. I have a feeling I’m just going to have to write this month off, sadly.

Basals Work You

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Well… that’s exciting.

Another round of basal testing today. This time, trying my morning rates out. I woke up at 5:30 am, which isn’t normal. (Usually I can sleep in a bit longer.) But I have class today, so I work earlier.

Started the day off at 120. Not fantastic, but I’ll take it. I shower and prep for the day as normal, sans the whole eating breakfast thing.

Since my form says start the test at 7 am, I recheck again. I’m 182. Hmm. Interesting. Normally, disconnecting for 20 minutes doesn’t affect me THAT much. But – since I need to see where this is going, I don’t correct and head to work.

I feel like crap. All of those weeks of running much lower has made me REALLY aware when my blood sugars are misbehaving. Now, if only I can recognize the lows better. But – another blog post to worry about.

Expecting to be sky high and ending this test early, I test at around 9 am. I’ve dropped. Not much, but enough to tell me that my basals are holding me in one place.

Near the end, I’ve nearly corrected myself to my original blood sugar.

Um, what?

 

Back to your Regularly Scheduled Program

I’m slowly getting my sleep patterns back on track after this weekend. It was a fun weekend, and I’m glad I experienced this convention. But holy hell… I’m pretty sure I got a collective 10 hours of sleep during the entire weekend. And upon my return on Sunday, I promptly fell asleep on the couch at 8:15 pm, only to be prodded by the hubs to head to bed around 9. Wow. All in good fun and thankfully, my blood sugars behaved for the most part.

I also don’t recommend competing with hypoglycemia. Especially if you are unaware. Just saying. Yeah, it happened.

So after all my sleep deprivation, the only natural thing I should do come Monday morning is run a basal test, right? Sure!!! Who needs coffee or food when the high from the weekend can keep you awake and sustained?

Right…

Good news: I passed the afternoon basal test, which disproves my doc’s hypothesis that my extremely high bolus rates are compensating for my extremely low basal rates. In fact, I managed to stay between 77 mg/dl and 88 mg/dl for about 6 hours. This still leaves the question as to why my blood sugars sky rocket to oblivion an hour after I eat and just stay there. Do I really need a 1:3 carb ratio? Seriously?

Bad news: This test is shit! Seriously. Could NOT do anything productive because I ate at 7 am and could not stuff my face until 5 pm. (And I did… still paying for it now…) I was starving. I was waiting for the inevitable crash that never happened and seriously wanted to just fail the test so I could eat my left overs. I had 3 major headaches throughout the day and pretty much stared at my computer screen for 2 hours pretending to be productive. By 4:30, I wanted to eat my laptop with a side of the contract for our company Christmas party. (You know, because paper has fiber and stuff.)

I’m assuming that since I passed with flying colors that I only need to do this time period test once. (Because why would anyone want to do this three times, as instructed???)

Lesson learned kids: starving is bad.

November is Diabetes Awareness Month

Duh – of course my situation needs it’s own month. So, if you are following the blog and see me regularly, be sure to give me an extra hug or something this month. 😛

Anyway, I survived Halloween with very little excitement other than the complete error in carb counting judgement of my lunch. (Bounced up to over 300… ouch.) Apparently that uber delish eggplant, spinach and sundried tomato sandwich had a lot more in it than slices of heaven. (Yes, kids, it was THAT good. Or maybe I was just reallllly hungry.)

My day started, however, with a trip to my new endocrinologist. At 8:00 am. About 35 minutes from my house. After I had been out dancing the night before. Yeah – I dragged.

The doc is new to the facility and kind of has a “take-no-bullshit” attitude. Which is maybe what I need. My last endo was nice enough, and the educators were nice, but I always kind of felt that they just settled for my 7.0 A1C and said “well that’s what you are… the end.”

He immediately commented on the fact that I don’t wear a med ID (I have a pump on!), don’t have a Glucagon kit at home (horror stories from my childhood plague me still from that stuff), and why I refuse to have a flu shot (not that I’m anti vaccines… just I feel this one just doesn’t work.) And then told me to stop taking the Statin I’ve been on for the last 8 years or so because it’s pointless to take drugs “for prevention” at my age and there are no indicators that I am at risk for high cholesterol (THANK YOU!)

I also got hypo while at the doctor’s office. And got to awkwardly search for glucose tablets at the bottom of my purse. Doc finally gave up and got me juice from his office. (By the way – warm OJ is gross.)

But no babies until the blood sugars are down. (sigh.) And I’ve developed a tiny bit of Neuropathy in the tips of my toes. Kind of normal… but sad because this is the first it’s been noticed. But really, I’ve been a diabetic for 30+ years now. It was bound to happen at some point.

So he gave me the number to the diabetic educators’ office, sent a referral, and scheduled a follow up in 3 months. And since NO ONE can figure out my 445 pages of medical records from my previous med facility, I’m quite literally starting clean and establishing brand new base lines.

In my near future shall be lots of record keeping, adjustments, blood work, and basal testing (bleh!).

I’m gonna be stressed. Remember that hug thing earlier? Yeah.