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Thresholds.

Pastiche on the Hill.Thresholds.  Levels of tolerance.  For an English major like me, numbers take on a more connotative and emotional meaning.  And diabetes numbers play into a whole host of variables.

Like when I'm about to get behind the wheel.  I've heard people discussing what numbers are "safest" to drive at, and I think that's a personal preference.  For me, numbers like 131 and 92 are friendly and make me feel road-worthy.  I'll drive at 180 - 250 mg/dl as well, so long as I'm making attempts to correct it down.  But numbers close to 70 mg/dl or over 250 mg/dl are key-passers for me.  As in "Hey, you drive."  (See:  yesterday, when a freak incident caused me to throw a blood sugar over 400 mg/dl.  Chris drove.  I drank water and slept.  Miserable.)

Or when I'm going to bed.  Bedtime basals have been nailed down solid for just over a year now, allowing me to go to bed at 99 mg/dl and wake up at 110 mg/dl.  There's barely a flux.  A few years ago, I would have stolen a swig of juice or popped a few glucose tabs to keep me steady through the night.  At Clara Barton Camp, anything under 120 mg/dl warranted a "double snack" coupon (which was awesome when it was pudding and graham crackers night but sort of sucked on apples and peanut butter night).  My thresholds for nighttime sugars are much tighter now.

Different numbers at different times.  Go to bed at a blood sugar of 90?  Yes, please.  Go to the gym at 90?  No way - time for some crackers, a swig of juice, and a pump disconnection.  I don't like starting a cardio workout at anything under 150 mg/dl, because exercise hits me like a ton of treadmills. 

A blood sugar of 150 mg/dl at the beach?  I'd leave that one alone because the sun and just five minutes in the ocean makes me drop hard.  

Feeling anxious?  If I ring in at 120 mg/dl and I'm feeling very keyed up, I know that a half of a unit of Humalog needs to course in to counteract the stress hormones that hijack my A1c sometimes. 

Each number plays different offense in varying situations.   It's a challenge to follow the playbook. 

The human body is absolutely amazing in the way each organ works together with such precision, maintaining our homeostasis and keeping us kicking.  But the mind of a diabetic is pretty damn amazing, too.  We have trained our minds to think like a pancreas.  We are the people who know how many carbs are floating around in a bowl of pasta.  We are the ones who can take a blood sugar number and fold it into any situation - 140 on the soccer field means more orange slices while 140 at the dinner table means correcting the high and navigating the meal.  We are the ones who are trying to compensate for some cells that simply gave out on us.  It's not an easy task, crawling inside the thoughts of a working pancreas and trying to mimic it's performance.  There are moments of elation.  There are moments where we stumble.  And moments when we just plain fall flat on our faces. 

This is very tough some days.  I had a bad weekend, blood-sugar wise, hitting both the 442 mg/dl and the 36 mg/dl ends of the spectrum.  I felt like I had been hit by that truck with the penguins, who are all carrying suitcases filled with bricks.  It was a perfect storm of crummy conditions, sending my meter average into complete disarray. 

I felt damp and wrung out with frustration at a few points. 

But then I had a cappuccino and a fruit dessert with Chris at Pastiche on Federal Hill.  I tested before at 87 mg/dl and two hours later at 132 mg/dl.  And then I found this in Newbury Comics:

For Shannon and Darrell.

And thought of how much Shannon and my brother Darrell would enjoy it.  Toofuses for all!  (Toofi?)

My threshold for certain numbers varies every day, but my threshold for laughter is without boundaries. 

Comments

We are the ones who are trying to compensate for some cells that simply gave out on us. It's not an easy task, crawling inside the thoughts of a working pancreas and trying to mimic it's performance. There are moments of elation. There are moments where we stumble. And moments when we just plain fall flat on our faces. - This was a perfect expression, Kerri. I loved this post.

I'm thinking the pancreas must be a good-humored gland - because I've met many diabetics with that same massive threshold for laughter - think like a pancreas, laugh like a pancreas?

Damn, having you spell out your "playbook" like that astounds me with how much PWD's have to cope with.

Let someone who is judgemental about PWD's taking care of themselves read this post and see just how judgemental they remain (God help me if they're still judgemental...I'll have to knock their toofus out).

OMG, Twinkle Toof made my day, LMAO!! How amazing.

Great post Kerri! You're so right about numbers meaning different things depending on the circumstances. "High" and "Low" are subjective terms aren't they?

What a great post Kerri, but do you find that your correction amount or the amount that you fall during exercise etc can change depending on the time of day too?

I just got caught up on 4 of your posts. Two things:

1) I too had a rough weekend with bloodsugars. Woke up one morning at 44, went up to 400 the same day. I empathize with you on that one.

2) I laughed out loud when I read about the enGAGment party invitations. I say send them out that way too. Or, just sqeeze in an "e" with permanent marker before you send them. They'll never know. ;)

Kerri, I think you describe it perfectly. Sorry to hear about the rough weekend, hope the penguin truck is long gone (and not headed my way)!

Great post Kerri.

Pardon my ignorance, but what is it about a high that makes it difficult to drive?

I imagine a low makes you feel like you're drunk???

Does a high make you feel the same???

Thanks!!

Shannon - My highs, especially the wicked ones, make my eyes feel like they're olives. Olives stuffed with socks. I feel sleepy, my reaction time is crumbs, and sometimes I get a nice, ripe headache. Not the best driving conditions. I can drive when I'm high, but if the option to pass off the keys exists, I send them packing. :)

Thanks for describing it. I always get a whole new perspective on diabetes when you and others describe how it feels.

I found your number of 150 for exercise interesting. I always feel like my blood sugars go up before they go down when I exercise which means that if I were to start at 150 I feel like crap after about a half hour while my blood sugar climbs. I've always described high blood sugar as feeling like I have lead in my blood. It makes me sluggish and weak. Problem with exercising when you are to low is that the drop in blood sugar about an hour into it can be a little rough.

My numbers don't climb when I exercise - they plummet. Except when I'm doing weight training, and then sometimes they go up. But cardio workouts make me drop like crazy. The frustrating thing is that once my levels hit about 90 mg/dl, I feel so physically strong. It makes me frustrated because I know that is how it would feel to work out and not be diabetic. Pisses me off a bit.

Instead, I hit the 90 mg/dl mark and have to swig juice because 90 leads to 80 which leads to 70 which leads to cookies on the treadmill. ;)

You did it again Kerri - "because I know that is how it would feel to work out and not be diabetic. Pisses me off a bit." That's it exactly, in my mind. Because I plummet too when I exercise... And if infuriates me when I start off so strong and end up tired and weak - and not from the workout.

I had a lot of majorly high sugars when I was engaged. Thank goodness I was only engaged for 4 months! These were many times due to stress.

Sorry about your rough weekend. This was an amazing post. You always put everything together in just the right way!

The best part - you know how to handle all of these different situation in your life!

We, the people with diabetes, are secretly math magicians who can give you a solution for any situation!

Sucks about the rough weekend. I can't imagine your frustration. We have our own frustrations, but damn that sucks.

Nice toof.

I once read that learning to play the piano increases a person’s IQ by 10 points. I wonder if we get the same results dealing with our diabetes.

Even worse is when we have to factor in the weather to the formula - a run on a humid day will require different alterations then a run in the cold. But you're right its all about learning how to think like a pancreas. Glad you're back on track.

That last line was the best ending I've read in ages!
: D

I told all my exercise stories to my endo and how I avoid most movement lately because of my lows and she suggested counseling. I just don't think counseling is gonna cut it. No one gets it except another diabetic. :(

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