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Frustrated.

I am absolutely furious.

Last night (after a very nice dinner with Karen and J), I went to bed at a blood sugar of 101 mg/dl.  My Dexcom showed a flat line throughout the night, and I woke up at 89 mg/dl.

Nice.

So I showered and got ready for work.  Dexcom has climbed to 130 mg/dl, but I took .5 u after getting out of the shower (to cover when I was disconnected), so I expected things to be cool.   Commuted to work (10 minutes) and settled in at my desk. 

But I'm already starting to climb.   

Cup of coffee - drained.   I decided not to correct the climb because I had already taken that 0.5 u and besides, I didn't want to completely compromise my new basal settings.  I needed to give this at least a week or two to see how it really worked.

Started answering emails at work.  Checked Twitter.  Sent off a few columns.  

BEEEEEEEEP!  Still climbing.

I tested and saw 189 mg/dl.  Fine, I'll correct this now.  Laced in a few units to correct and to cover my morning snack, and went back to work, headphones in a music blaring.  About an hour went by.

Then I noticed that everything seemed "off."  My eyes felt sticky in my head, like every part of my body was dehydrated.  My mouth was dry, my skin felt too tight, and I was exhausted.  The words were swimming around on the computer screen, and the papers on my desk were a blur of type fonts. 

So I tested.  And motherfucker (sorry):  364 mg/dl.

Taken with my KerriBerry - and it shows the ridiculous climb.

If I had not been at work, I would have thrown something.  Instead, I ripped the headphones out of my ear and grabbed an insulin pen from my emergency kit at work.  I dialed up a correction dose and injected into my stomach.  I wanted relief from this high - I felt like absolute garbage.

While my overnights are completely fine and stable, my mornings have turned into a chaotic tumble of terrible numbers.  I don't know how to fix this, so I am consulting my logbooks, my battered copy of Smart Pumping, and drafting a "HELP!" email to my endocrinologist.  My A1C goal of under 7% will not be achieved while these mornings are mucking up the works. 

But besides all that, I'm pissed.  These highs feel very frustrating and they aren't little, peaky "180s" but instead whopping "360s."  My ability work feels compromised, and I can't chew enough gum to get these sweaters off my teeth fast enough.   I'm drinking water by the liter and skin is so dry and so cracked that my hands started bleeding while I was typing.  I feel "sick."  That makes me mad, because for the most part, I don't feel very sick. I usually feel capable enough to move past whatever is chewing on my nerves.

Today?  I want to crawl back into bed and ride out this high under the covers, hiding from the reality of life with diabetes. 

Except that Siah is most likely face-planted into the bed.  So no hiding for me.

My only option is to relax, try to get some work done, and wait for my blood sugar to come back down.  No need to add more stress to an already-stressful moment.  But when I get home from work tonight, I need to figure out what needs to be done.  This can't go on.  Not for even one more day.  I have a birthday to celebrate this weekend (mine!), and I'm sure as hell not going to do it at 360 mg/dl.  ;)

Comments

Here's to a better rest of the day. And don't apologize for the MF bomb, it is completely understood.

Oh how frustrating! I sympathized and empathize. Here's hoping you get it figured out.

I've been having the same issues for about the last two weeks myself. Unexplainable morning spikes which inevitably ruin my BS the rest of the day. I was so frusterated that I completely cut out all carbohydrates yesterday. My prize a very nice and happy BS of 84 this morning. Decided to leave out the carbohydrates at breakfast this morning as well and what do I get? A nice spike of 189 at 11am. I swear everytime I start to figure my diabetes / body out it decides to change. Just trying to stay positive and get through these highs too.

I'm sorry, there's nothing like ketones to F up your morning. How's your infusion site? I've had a few issues like that lately. I tear everything out and put in a new site. Even if that's not actually the problem, I think it makes me feel better because I've actually done something. It makes me feel like I have some control. =O Go ahead and throw something, tomorrow will be better.

When I have an unexpected high blood sugar, rather than immediately reaching for the insulin pen, I give myself a bolus via pump and wait 15 minutes. If my blood sugar doesn't lower itself, then I change out the set and the insulin in my pump.

If you just inject with a pen, there is no way to know whether your set has gone bad, you had bubbles, etc.

I know it can be excruciating to be high for longer than you want to be. But if you don't rule out your set or insulin in the pump, you may have problems all day long.

PS-Diabetes is a tricky disease and no one is expecting you to be perfect with your A1C. Stop thinking about the internet and just do what feels right for you.

XXX000

Oh I'm so sorry! I completely understand your frustration!! I HATE unexplained highs and lows!! All I want is for it to at least make sense! If I have a high after a piece of cake, that makes sense. But after a perfect night....it doesn't make sense. The waiting for it to come down is the most frustrating part in my opinion! And I have a tendency to get frustrated because it's not responding and OVER correct, bringing me low and causing me to yo yo all day.
So at this point you just want to try and get it back to a good range, and keep it there without the yo yo! You can have a good day from here!
I'm sorry to hear about your skin cracking and such. Ouch. I know the feeling of getting so lost in my work that I don't notice lows/highs. I have lows around 10:30am a lot and I won't feel it at all, but all the sudden I'll notice that I'm having a LOT of trouble reading the words in the email I'm reading and I'm really hot/sweaty. I test and it's 42. How does it get that low without me noticing at all? VERY FRUSTRATING! Sometimes diabetes makes me want to throw heavy things at walls!
So, I wasn't much help, but I always feel better when someone can relate with me! Since I don't actually know a single type 1 diabetic except online. :)

I'm new to your blog and I absolutely love it. I stumbled upon it while voting in the Medical Bog Awards. To tell the truth, I don't have diabetes but your blog is very compelling. I can empathize as I work with my own medication tweaking and health issues. I am thoroughly enjoying reading each day. But I am so sorry you are having such a frustrating time right now.

It's not a somogyi is it?...that might well fit with your overnight hypos.

Is there any chance that you have a hidden infection somewhere doing this to you? Bladder, kidney, tooth, sinus?

Just seems so unfair to work so hard to get things in line only to have them pop out of control somewhere else. I am sorry!

You will figure it out, though, and get those sugars in line and your A1c down soon.

Thank you for sharing your life with so many--you really are a special person.

That sucks, Kerri. I hope you start having a better day.

Oh no, that sucks!! You know, I think the weird waiter put some kind of a Blood Sugar Curse on us. I took a more than ample SWAG bolus for my dinner roll, chicken and 8 ziti, but on the way home from dinner my CGM High alarm went off. Took me two corrections to come back down. So yeah, when in doubt, blame the wacko waiter. :)

I'm right there with you. Mornings have always been my trouble spot -- who says dawn phenom is just for kids and teens?

Keep you head up, you'll get a handle on it. Hope you have a better remainder of the day!

Take care --J

I've been having the opposite problem - lows for no reason. I even had to tweak by basals and change my carb ratio. This could be due to a new BP med I've just started taking (in preparation for pregnancy), but it's not listed as one of the side effects.

Anyway, is it possible that you're actually sick? If your body is fighting something off, you're going to spike (I know I don't need to tell you this - you know). I actually spiked to a nasty 390 at my endo's office a few weeks ago (completely unexpected since I haven't been that high in months). Turns out, I was having an allergic reaction to something (complete with super high BP, hives, rapid pulse, etc.). Not a fun moment.

I hope you're feeling better soon.

Riding that train right along with you today, Kerri. I woke up at 184 after going to bed at 200 (not great, I know, but I'll take it after battling Officially Scary Lows the last three nights in a row!). Did my usual morning commute and felt 'off' when I finally got to my desk--I hadn't eaten a thing and somehow my BG had skyrocketed to 334. Three Diet Cokes and four units of Humalog later, I'm still coasting in the low 200s. Double sh**, as Bridget Jones would say...:(

Diabetes sure is a [bleep!] sometimes. Hang in there.

hmm..tricky, pesky highs. A couple of things to ask yourself.. Are you sure you're not getting a cold or flu? Or on the flip side.. are you PMS-ing? When in doubt, eh....?! LOL I remember you were concerned with that after stopping the pill a couple of months ago. (avid reader here! haha)

I totally love your column, and read it daily.

I'm still on MDI's and haven't been able to take the leap to a pump. I'd love to hear/read your pro's and con's about switching over to a pump. (A blog idea, perhaps?? *hint hint*) :)

Take care, girl! I hope you can work out those morning highs. I had a perfectly normal BS day yesterday with a range of 3.1 - 6.8 (~56 - ~124) so... it CAN be done! LOL Haven't done that in months, tho'. There is always something to throw it off!

Just tested at 300, was frustrated myself, so I checked into your blog to see what was up. Looks like we're in the same boat today. Hope the rest of the day is better - hang in there.

Fustration , p..... off , anger, I can identify ; we try so hard 24/7.I also know, that it is not what we eat or do not eat.
My A1C up from 7.0 to 7.2 , however I think , that I am onto something good this trip ...I changed to Paradigm Silhouetes and manually inserted the infusion set for about 3 months...started to use the serter 3 weeks ago and numbers are better( the angle is better ) ...may this be a solution for you too ?? Change type of infusion sets ??
All the best..

You're preaching to the choir, sweetie! I'm SO tired of morning highs... most mornings I feel great when I wake up, and by the time I check my BS at work (usually about 2 hours later) I'm in the mid-250s, even after a bolus to cover my shower. The problem is that on days that I don't work and sleep in an extra 4 hours or so, my morning blood sugars are PERFECT. It's so frustrating! I moved my morning basal increase up from 7am to 6am, so I get some extra insulin while I'm getting ready for work, and that seems to be helping... but it still needs some tweaking.

This is why I need a CGM!!

From reading your blogs I'm not quite sure you are doing stringent basal testing - not eating and closely tracking your trends.

Doing this exercise, without the benefit of a CGM but instead testing every hour, has enabled me to get my whacky basals controlled. I now use 24 basal rates and have 16 changes. My rates range from .45u to 1.85u. To my endo's amazement, this keeps me as flat as a carpenter's wife. A 6.1 A1C for me prior to this was just a dream.

Keep at it!

I agree with Karen on the waiter. I was also a little high and had to take a correction when i got home!


btw, Happy Birthday!!

It's not possible you are already pregnant and don't know yet is it? With all three of my pregnancies this was the very first sign for me. WIthin like a week after conception my blood sugars went wacko. I would have 300s for no reason what so ever for at least two weeks every time. Something to do with the hormones. This also happens to me during ovulation every single month, so that is a possibility too. You might want to start tracking your ovulation and see if it is related. Hope it gets better. There is nothing that sucks the life out of you more than that. I love reading your blog and appreciate your realness : )
Beth

Holy crap- 24 basal rates!? Just reading the blogger above. Wow, I have trouble with 3. I woke up 46 at 2 am (yet again), ate too much sugar to raise it so went to 264, took more insulin at 6 am, then back down to 74 at 8 am, exercised, down again to 68, ate lunch, to a lovely 37 to round out my wonderful day. Today has been an emotional roller coaster for me- I have been in a very angry, bitter, and evil mood. Sometimes I wonder who would ever put up with my s---t. Thanks for making me feel better!

I agree with you, those basically unexplained rises makes you feel upset, angry and depressed all at once, at least it does with me

Is it still tied up with the dawn phenomena? For me, I typically have a rising BG level from dawn to noon. I have a ramping basal rate during that period, (which took quite a while to work out, and as we all know doesn't work all the time), which is quite effective, especially during morning work times, when I am inactive, as I’m in front of a PC screen. Also I found eating carbs for morning tea, during work, particularly as the BG is rising, accentuates the rise (more than you would think) and it can be difficult to work out what is going on, because you are bolusing too, which is most likely inaccurate. I often got high BG, e.g. 15mmol.

So as others have pointed out, there could be a few valid reasons, but as a suggestion, maybe you should look at your morning basal rates, whilst skipping morning tea.

I'm on MDI and I have to bolus 3 units when I wake up every morning to combat the dawn phenomenon. It's not covered by my overnight basal and not strong enough to be covered by my morning basal. I take Levemir and for my basal and I have to split it - it doesn't cover me for 24 hours. Neither does Lantus. I'm not ready for a pump, but its a lot of work - I take a lot of shots per day...keep at it though - you'll figure out what works for you.

I love it when you say how it is, mf bomb and all.

So sorry to hear of the pesky high though.

Through all those comments: as a woman -- period then cold, flu, infection, site.

I always consider my site Last. Especially if it is before the 3 day mark of change.

So frustrating.
Hang in there and you are doing everything you can, your future is bright because you are and try not to pressure yourself too much about a perfect A1C.

Perfect is impossible with this lovely disease.

Best to you always!

argh. grrrrrr. double gdmf! i hate it when things don't make sense, but like my endocrinologist says: "it's just type 1 diabetes. it always throws a curve."

I have the same problems in the morning. Always at least 50 points higher after my shower (no matter how I try to correct before or after).
It gets worse if I wait too long to eat breakfast.
What can I say, my body doesn't like to fast?! :D

Hope you feel better tomorrow (and this weekend!!).

Well, there must be something in the air. It seems we're all experiencing something similar. I've been fighting with my daughter's blood sugars lately. Turns out it was the onset of a mild virus that was messin' with her numbers. She took almost a week to show symptoms, however. I was going crazy trying to make sense of things!

I appreciate how well you describe the way you feel when you are high or low, Kerri. Not having diabetes myself I often wonder what my Jenna is going through.

Sorry you are having a hard time. I understand your frustration. It can make you feel so utterly lost and out of control.

Well, there must be something in the air. It seems we're all experiencing something similar. I've been fighting with my daughter's blood sugars lately. Turns out it was the onset of a mild virus that was messin' with her numbers. She took almost a week to show symptoms, however. I was going crazy trying to make sense of things!

I appreciate how well you describe the way you feel when you are high or low, Kerri. Not having diabetes myself I often wonder what my Jenna is going through.

Sorry you are having a hard time. I understand your frustration. It can make you feel so utterly lost and out of control.

Kerri, you describe high blood sugars so perfectly! I have those unexplained rises in the mornings sometimes, but I've learned what brings them on in my case.

What I discovered with my own body's habits is that if I eat too much for dinner or in the evening, that food tends to more or less sit in my stomach all night. I think in some ways my digestion rests just like I do. When I wake up. it wakes up. It does it's thing on my blood sugars through the night, but not in a big way at all. It's really as though the full impact of evening foods (including dinner) doesn't kick in until the morning when I wake up and get moving again. I just like to think of it as being in synch with my body, for better or for worse.

While not a popular choice in society, I eat my bulk of calories at breakfast and lunch, with a snack in the afternoon. That way most of the food is accounted for with my insulin by the time I go to bed. It's avoided those morning rises pretty reliably. Not 100% of course, but pretty much most of the time.

It's like clockwork. If I'm out with friends and eat a regular dinner, the morning rise in blood sugar accompanies it. When I skip it, the issue is also skipped. I wish it was not the case and I could eat just like the rest of most of society, but then it's the minority of us who have had long-term Type 1, so I've learned to let my body talk to me about what its schedule is.

I think high BG may cause Tourettes Syndrome. (My apologies to those with Tourettes.)

I've had T1 for 245 (dog) years. Pumped since '92. Haven't been able to get A1c below 7.0 very often in last two years. 7.2, 7.3, 7.1 etc. I recently changed to Ping from Minimed and stayed with a 90 degree infusion set. On MM I used a Quick Set after being frustrated that the Silhoutte needle would often bend on insertion.

When switching to Ping I stayed with 90 degree infusion set (Inset) even though the trainer encouraged me to try the angled set (Inset 30). She said people were really happy with Inset 30 (angled). I love the Ping but my control didn't improve that much and I seemed to have a lot of set failures.

The last time I ordered supplies I decided to try the Inset 30s (angled) and WOW am surprised at the difference in control. Not nearly as many "zingers". More consistent.

Nel Peach made the same suggestion above. But you may want to try a different style of infusion set. I would not have thought it could make that much difference, but it has for me.

I haven't had an A1c since I made the switch which was only a few weeks ago, but my average BG (based on meter) has gone from 137 to 117 in just a few weeks. Give it a try and hang in there!

Kerri, I would probably throw something off my second floor deck and watch it shatter! LOL
Instead of the "Circle of Life" we all have the "Circle of Diabetes". Hang in there. Tomorrow will be better

Have you been eating anything right before you fall asleep? Never good to do this unless you have a low bg.

Also have you increased the amount you have been eating recently during the day or decreased the amount of exercise being performed? Both these can have a direct impact in your blood sugar control.

Lastly, if you are sick, are about to be sick or more stressed out than usual, this can throw your sugars off.

Hope you figure it out. By the way, check out my new blog when you get a chance:
http://www.walkingwithdiabetes.com

I am actually glad it was the flu. How craazy is that to be happy someone is sick? but when youa re diabetic it is always a relief to know it is not something you did or something totally unexplainable - for the moment. I almost e-mailed you to say are you sure you are not just coming s=down with something?

I'm not trying to be a smart-a.. when I ask whether you need to take more ins.? I was having similar problems last year with morning highs. The answer was that I needed to really up my basal rates. It was confusing because the basal checks didn't really show it. I often get stuck in a pattern of trying to figure out "why is this happening" instead of "how do I fix this." I switched over to long-acting ins and mdi for awhile to remove other variables. I'm not sure whether this was a one-time thing for you or if it has been a pattern so my suggestions may not apply. I hope you are able to figure it out.


Knowledge works stole pictures from you blog to make video insulting type 1 diabetes. They show a picture of a morbidly obese child and then your meter. There are other pictures that may also be from you blog as well earlier in the video and later in the video


http://www.youtube.com/watch?v=oWKJ9DApeFI

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