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Penguin Truck.

We're planning for a pregnancy, so I've been working tirelessly to stalk my blood sugars.  I'm wearing the Dexcom, testing regularly, and really aggressively chasing highs and lows in pursuit of that nice "between the lines" look on my blood sugar graphs. 

So when I changed my infusion set last night and neglected to take the 1.0 u bolus in anticipation of the high (which seems to be the only way I can keep the highs at bay after a site change), I knew I was in trouble.  Sweaters on my teeth, and my tongue thick with dehydration, confirmed by the 254 mg/dl on my meter.  I cranked up a correction bolus and sent it cruising in, along with some frustration and a few choice curse words. 

A few hours later, I was on the steady but seemingly safe decline, with the Dexcom keeping tabs and my meter serving to confirm.  No worries.  I ate a snack (cottage cheese with some frozen raspberries) before bed and snuggled against the pillow (read: cat) at a blood sugar of 187 mg/dl.  Higher than normal, but I knew it would continue to come down.

Didn't anticpate the 3:30 am wake-up call of BEEEEEEEEEEP!, though. 

I have no idea what my blood sugar was.  The Dexcom showed me only as "low" and I woke up crying, for some reason.  Chris was next to me, fast asleep, but I didn't wake him up.  I don't know why.  A bottle of glucose tabs sat on the bedside table but I didn't reach for them.  I don't know why.  The shape of my body was outlined in sweat on the bedsheet and my hair was sticky, and for some reason combing my hair down before I went to get juice took priority over eating something to correct the low. 

I don't know why.

I don't remember a lot of this low, and that scares me.  I was dizzy.  I was stupid for not waking Chris up and asking for his help.  I remember hearing the Dexcom wailing from the bedroom as I stood at the fridge in the kitchen.  I drank the juice directly from the carton, drinking well past my eight sips and gulpinThese guys can just go right to hell.g until I couldn't catch my breath.  Yet, I remembered to wipe down the floor to clean up what I spilled.  I don't know why.

Hitting that stride, hugging close to the center lane of 100 mg/dl, is really what I'm aiming for.  I've been doing better lately, so every time I'm way off target, I feel the symptoms too late for lows and very intensely for highs.  I know this is a signal that I'm in tighter control, but once I'm stuck in the spin cycle of high-to-low-to-high and back again, it's hard to climb out.  And a lot of time my morning number sets the stage for the rest of my day.  Last night's low blood sugar left me at 199 mg/dl this morning, and I still haven't settled back into range.  I feel frustrated, knowing my A1C is being drawn at the end of July.  But last night's events kicked my ass too thoroughly for me to focus on anything other than muddling through the day.

It's that pesky penguin truck again.  I hope the tire tracks aren't too visible this morning.  

Comments

Ah Kerri, tough night. Why is it that we always have good intentions of using glucose tabs, but when a nasty middle of the night low hits, we head straight for the fridge?

Thankfully, those isolated incidents won't throw off your A1c too much. It's really the consistency of your blood sugars, which sound to be getting lower for you.

I'm also planning a pregnancy and getting back into tight blood glucose control. It's a lot of work.

The one unit bolus at site changes is a good idea...I too end up running high for an hour or so after a change.

I hope your day turns out better than you expect! :)

Because I wear my CGMS all the time now, I start feeling my highs and lows WAY earlier. It's a pain. But I know it's a good thing in the long run.
I hope the penguins ease up on you soon!

Ugh! It's like your body and brain do NOT want to work together. Worse, it generally takes most of the (next) day to re-synch.

It all works out though, so hang in there! :)

Tough night! And Mark is SO right - it seems to take the whole day to start to feeling back to normal. Thank you for sharing - I can't tell you how much it helps to know that someone else is on the same roller coaster. I'm sending good vibes for a "flat line" on the CGMS :)

Hi Kerri! You are so hard on yourself! I am sure you are doing such a good job - don't beat yourself up for the highs and lows. As long as you correct the highs quickly then its ok. I'm tryin to get pregnant and feel your pain.

Hi Kerri - I definitely agree with Katie in the post above. Don't drive yourself crazy trying to be perfect in your glucose management. Pregnancy will be enough of a challenge (and a joy as well - we're expecting #2 in August) without having to worry about every single high or low. Best of luck and please keep us posted!

I get highs after a set change, too. But I discovered a trick! I leave my old cannula in, and put that "wasteful" little plastic cover over it (from the new set). I put the new set in and set up my pump. And 6-12 hours later, I pull out the old cannula. That way, there's no leakbacks from pulling out the old cannula; I think those leakbacks are what cause the highs after a set change. Just don't leave the old cannula in too long, or it might get infected. (I left it in for an extra day once, and there was some gook in the tube when I pulled it out.)

Bummer of a night. Good post. And I agree. Three weeks of CGMS has really showed me how tough it is to "settle down" after a tough low or high.

How about lowering your HIGH alarm on the Dexcom, that way you'll get earlier warning of a high? I have mine set at 140 so I know when it's going into bad territory, more alarms yes but worth it!

I hate those nights.

What I hate is the after affects. That feeling I get all day of just being beaten up. People don't understand what it feels like post low. I am always a wreck.

Thanks for this post, Kerri. I changed my infusion set this morning and, two hours later, I'm soaring at 15.9mmol/L (a nice 286 for all you milligramers). Needless to say, I feel your pain. I am sorry you had a peak-and-plummet kind of day; I definitely empathize. Thank you for sharing and allowing me to virtually commiserate.

You have a jar of g tabs beside your bed but didn't take them. Me too. I keep tabs all over my bedroom and never never use them when I'm low - I always go to the kitchen and start prowling. I even keep a little Tupperware of tabs on the floor, because there have been a couple of times when I couldn't walk but had to crawl to the kitchen. Argh. Hypos do such strange things to our brains. I have considered hypnosis - have someone plant a message in my brain that says if I wake up in the night, there are tabs just a few inches away.

It seems that when BG is unstable or changing rapidly, CGMs have a hard time staying calibrated and keeping up with the changes.

The main thing my CGM taught me was that I was way too unstable and I needed to make some major changes to improve my stablility.

It never worked too well as a "low BG smoke alarm."

Why I bought my CGM: http://jimhuck.blogspot.com/2009/06/cgm.html

Its like you read my mind. I know I say this in almost every post but your words ring so true to me, and usually at the right time.


As always, thank you for being my voice and teacher, oh and here's to a better night!

Ditto 'Chelle about leaving the old cannula in for a few hours. I just tried that and it worked like a charm!

Also, I eventually got really tired of those post-low rebound highs so I got small 15 carb juice boxes (mine are Junior Juice). You still get juice rather than glucose tabs and you don't have to count sips--just drink the whole darn thing. Might be worth a try...I know how lame it is to have those highs ruining your averages. Been there!

We are having a battle with the 'lows' at the moment. School holidays and lots of running around the garden. But even when he was 2.7 the other day Aleksi was still full of running! Can anyone point me in the direction of information about CGMS and why it only seems to be available to those 7 years and older? Thank you

Sorry to hear about this lousy low. I hope one day we'll figure out a way to break out of the hi-low-hi cycle more easily. The artificial pancreas OR a cure can't come soon enough for me.

Kerri, while the low sucks, this was a great post. Lows mess me up too because I can't seem to restrain myself when treating.

I thought of you (and specifically, this post) this morning after I got out of bed. I woke up at my normal time, but my blood sugar was low and for whatever reason, I was convinced that I had rented my alarm clock and that it needed to be returned this morning. I remember contemplating keeping it, even though I wouldn't get my security deposit back. The mind does strange things when it's low on sugar, I guess.

the dreaded hi-lo-hi OR lo-hi-lo cycle - i wish someone would just punch me on those days and tell me to wise up. 199 is quite impressive tho after the oh-so-lo - i would have surely downed all the OJ and added a bowl of CapNCrunch(with refills until all the milk had been sucked up) - and then suffered a 400mg. my goal - stay out of the kitchen when low. easier said than done.

TOTALLY understand the inability to move and make rational decisions when low - and why on earth that happens, I have no idea...so annoying! I blogged about a time when I got low and for unknown reasons, didn't do anything about it. http://www.irunoninsulin.com/?p=30
Now I know its b/c of the damn penguin truck...haha.

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