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The Pinging and the Ponging.

Target lows struck again yesterday, only in the form of a "didn't test until after I ate and was only 53 mg/dl" sort of thing.  (Which made me wonder how low I was as I stumbled through the aisles of the store.)  I had BSparl with me, strapped into the shopping carriage, so I opened and consumed half a package of orange slices (happened to be in the party aisle I was perusing) without blinking.  With sugar-coated teeth, I smiled at my The pinging and the ponging and the game, set, match of diabetes bullshit.daughter, assuring her that I was fine.

"Mama is totally fine.  We're going to rock this low right up into the stratosphere with those candies.  Mama is going to need a whole bottle of insulin to fix this!" 

(She clapped her hands and cheered at the word "bottle.")

Low blood sugars have always frightened me because of the immediacy of their danger.  A blood sugar of 70 mg/dl can (and for me, often does) tumble into the 50's.  And 30's and 40's can quickly become part of the party, too.  Lows feel tangled and confusing.  I know they don't look too intense from the outside, but the panic and delayed response of my body that's internalized is exhausting and scary.  My body, and my brain, don't react accordingly to extreme lows.  While I should have found somewhere to sit down and eat, instead I felt a weird burst of energy and pushed the cart around with vigor while my blood sugar was in the trenches.

But what scares me even more is the rebound high that comes with such a scrappy low.  The lows that hit while I'm outside the comfort of my home - particularly when I'm solely responsible for my daughter - are the ones I over treat the most, because I just want to be high again.  I would gladly trade a 28 mg/dl for a 228 mg/dl.  But the reality is, I most often trade a 28 mg/dl for a 328 mg/dl.  I mean, we can talk about willpower and carefully calculated carb dosing, but what really happens is that when I'm excessively low, I eat anything I can get my hands on.  And fast.  And without wondering how many carbs are in it or how high the rebound might be.  I will do anything to make the tunnel vision and the shaking hands and the cotton-encased confusion STOP.

Yesterday's Target low rebounded up to 408 mg/dl.  I haven't seen a number that close to the gas prices in several months.  "Whoa," I murmured when the number flashed up at me from my meter.  "Hang on a minute, let's check that again."  323 mg/dl this time.  (I love how this passes for "accurate enough" in glucose meter technologies, but that's an entirely different post.)  My Dexcom looked like a carnival ride.  My mouth was now wearing the warm, wooly sweater of high blood sugar.  And I was pissed at diabetes.

I hate the pinging and the ponging.  Honestly, I'd rather hang out at 140 mg/dl all day long and take whatever consequences come as a result of that, instead of this wild swing of multiple hundreds.  Bad lows wipe me out, emotionally and physically.  As do their often-corresponding rebound highs.  And in the middle rests that guilt of "if only I had the restraint to not over-treat," or "if only I had checked my Dexcom earlier and caught that low."  

Diabetes isn't a perfect science.  Not even for a second.

Instead, I feel like I'm a mad scientist.  ... does this gives me license to work on an evil laugh?

Comments

I pinged and ponged all over the place last Friday and Saturday. Woke up high, then crashed from over-correcting, then soared back up to the high 200s.

Nothing makes me feel worse -- mentally or physically. It's frustrating and draining.

And it's so damn HARD to resist every survival instinct that's telling you to snort those orange slices ASAP.

One time at JDRF Government Day (Yes I did say that just like the girl who says "One time. .... at band camp . . .") one of the adults with type 1 started WOLFING a bag of sour patch kids. Like I have NEVER seen before. I think she would have eaten the actual bag if she could have. The funny part was all the "D Moms" and "D Dads" losing their focus on the presentation and instead collectively leaning in toward her thinking . . . She's low!

I *just* used that same metaphor with my husband on Tuesday. I started with the pong, though: Up around 250 (with my pump tweeting at me during a PRESENTATION), treated, ate a snack, then went to work out. Then I was smacked down to the 50s in the middle of our hike. After swallowing half of my little canister of glucose tabs, by the time we got home I was back in the 140s. Such smacking, no fun.

Hi Kerri! OT but I am having an issue with my daughter and I wonder if you have any thoughts. She is 15 and was dx'd 01242005. It is standardized test season and as a freshman in HS it is the PLAN test, but the PSAT and ACT will be following fast enough. Her first four hour test was the HS placement test and her 501 stop the clock plan had her in a room with all special needs kids. For the PLAN they give the kids with diabetes each their own room. SHE HATES THIS. They post the room assignments and "everyone" asks her why she is not in the correct alphabetical order room. She vehimently doesn't want any special treatment. The test is today. I told her I would inspect the dexcom when we are at home and if she's in the zone for the whole period, I will think about possible change for the future. It is such a thin line. In order to get to stop the clock, you have to claim a disability but you don't feel disabled in any way. I don't know how to approach this issue. Do you have any thoughts? Thanks. Carol

I always overtreat lows when I'm out of the house. My snacks (at the house) are all carefully calculated to be in increments of 15-17 grams. Outside, a carton of chocolate milk with its 58 grams does the trick. Then, I chase the high for the rest of the day.

awww, i just blogged about this too (well, in relation to postpartum hormones)....sorry, kerri. if it's any comfort, i beat you out! i had a 428 over the weekend (hence, the blog post, haha). oy, i f*ing hate this disease. hope things are going a bit better...

This post is so timely! I have been battling lows and rebound highs..well my 4 year old son has and I am the driver behind the wheel. He has had some really low lows this week and some have come at night. LIke you over treat when you are out with your daughter, I have a tendency to over treat in the night time hours and(so I can get some rest and not be up worrying all night). I feel like a mad scientist too..with my notebook and scribbles and basal adjustments..it wears a person out!!

I overtreat sometimes, too. When I find myself doing this I give some insulin for the extra carbs I'm having and this way my blood sugar stops around my target and doesn't go any higher. Works like a charm :) er..usually.

I hear you Kerri! After two and half years of T1 (diagnosed at 27), I think my "honeymoon" is officially over, and now I feel like I have absolutely no control over this disease. Eeeps! I hate ping ponging, as it totally wipes me out as well. Let's just keep putting one unamputated foot in front of the other and try not to get overwhelmed, shall we?

Diabetes may not be a perfect scientist, but endos seem to think it should be....

Kerri, I know EXACTLY what you mean about "Target Lows."

I really don't know what it is about that place, but those happen to me there more than any other venue while I'm out and about. And it's not because I'm there so often, either!

I'm sure it's doubly hard to be practical about dosing when you are carting around a toddler. I mean - you have to be repsonsible for her and treating your fuzzy-brained self all at once. Who could be patient and perfectly pragmatic in that situation??

The effort you're putting in is not to be underestimated.

j.b.


When I am out and I go really low I tend to just shove food in until I feel better. Then my blood sugar skyrockets up and I feel horrible to which I overcorrect. Typically at this time I am blaming my pancrease for being a lazy out of work, velvet sweatsuit wearing, useless, piece of organ.

Ironically, I still feel bad when I bring half a bag of what ever up to the register because it looks like I couldn't wait to get to the candy goodness. Often I feel as if I had to explain this to the person at the register and they typically look at me with a blank stare. One time I got a really bad low and wandered into a grocery store, ate something and wandered back out without paying, oops.

Ping Ponging is the worst. I am the same way when I am low! I want to eat everything I can get my hands on. Do you keep glucose tabs? I know they aren't as exciting, but I have found they are the only want I don't over eat.

Ugh - I've been going through the same ping ponging. So frustrating. I feel like screaming at my body - "what the hell do you want?!"

Oh, I hear you. Woke up at 43 and 39 two days in a row this week. Easter candy around the house helped. And the snickers minis and the toffee needed milk, what can I say? I, too, ofter over eat because I need to eat UNTIL I FEEL BETTER. And hey - 30s!! BAD! I need extra carbs! Of course, then, I have to correct. Fun times. Fuuuunnn times.

I also have the same problem. I always over eat. My biggest problem is at night. I get a low at midnight and get up at 4:30 or 5 with a 300. Great fun.

The other day I hit 49 mg/dl and drank a juice and then proceeded to sit on the floor and scarf tortilla chips. I have found that they are one of the few things that have an IMPROVED taste when I'm low. So I tend to eat them...and eat them...and eat them.

I remember, wandering around, surged with adrenaline, kids in tote, seeking out the simplest source of carb i could find in the grocery store. Some scary stuff. That loss of control really sucks!

I used to be terrible about treating lows. At one point, I refused to even acknowledge a low until it was waay under 70 (I now treat for under 80 for various reasons). And even then, I would eat one chocolate-flavored nip (the caramel sucking candies), which not only don't have enough sugar to treat, but also don't absorb fast enough because they're so full of fat. I also once treated a 54 with a protien bar. Very smart...

Now, I usually use juice boxes or pre-packaged candies. This way, I neither overtreat nor undertreat. For me, the rebound isn't a high but another low, and usually worse than the first one.

The weird thing is, I did once rebound high from a low. I treated with pretzels because I'd been chasing lows all day and I couldn't stand the thought of more candy (there's the logic of a 56 mg/dl for you). I rebounded to the mid 170s and stayed there for a good while. I don't know why or how this happened, but it's sure something I'm gonna talk to my endo about!

Finally, I've resorted to doing crazy things to treat my Target lows. I once came very close to opening a huge jug of apple juice and downing it on the spot. But that would be very stupid, so I hightailed it over to the candy aisle and ate a twix bar (also stupid, but no one says you have to be logical when you're low, even with hypo-unawareness).

I am 32 and have had T1 since I was 7years old. I always overtreated lowes. (due to the overwhelming need to eat) It is exactly the same feeling you described!!

Kerri,

As another Mom with type 1 it does suck to be low when you are taking care of a little one! Even worse in public. Trust me, BSparl will take it in stride because you take it in stride! You are doing a great job, even when it feels like your numbers aren't cooperating!

I have the same problem! I tend to overeat the most in the middle of the night because I don't want to have to get up again to deal with it and because some combination of low and sleeping = STARVING. I do like Sysy said and try to wait until my bloodsugar starts coming up again and bolus for some of the extra carbs. This doesn't always work perfectly, but it usually helps to at least keep me from popping up to the 300s ro 400s. I do the same thing though, I feel guilty and inadequate when I'm low and then guilty and inadequate when I'm high. Of course I never pay much attention to the "good" numbers in between! Oh yah, I also try to carry glucose tabs (which I definitely get sick of) or granola bars with me at all times which helps to keep me from getting into other goodies when I'm out and about. But hey none of us are perfect and even if we were, diabetes would find some way to mess us up...it's a tricky little bastard...(sorry for the potty word, but it's better than what I was thinking!)

Finally! Someone who is so articulate, is so unbelievably accurately able to put down so eloquently how I have been for the last 4 days in a row. High waking up, low before breakfast, high after, low by lunch, high after, low by dinner. you get the message...

Thanks Kerri for making me feel so "normal" with this anything-but-normal disease!

My daughter w/ diabetes is only 3 and we're all new to all of it - and I really appreciate how you explain the feelings. I know it's different for everyone, but I have no idea how she feels and she can't begin to explain it right. Sorry to hear you're struggling, but thanks for using it to help us out!

We have all had the same episodes. It is so scarey. It is so frighting and overwhelming and all we want to do is fix it.

When you first started your story, with the baby, in the aisle, trying really hard to recover from the low. I freak a little as to where your story may be going. I'am glad all went well other than the 408 bs.

My first thoughts were, "Kari could benefit from a Diabetic Alert Dog like my Lily, who notifies me way before the Dex sounds of a low in the 40s". Then I hit myself in the forehead picturing you unloading a service dog and BSparl and then pictured you walking around with BSparl on your hip, a purse in one hand, a diaper bag in the other hand and then holding a dog leash in your 4th or 5th hand. Too much on one plate equals too much on one plate. Party On, you are doin fine!!!

Thanks to my hypo unawareness and being prone to extreme lows, my doctor always told me that it's better to run a little high than swing from one end to the other. She's the only one that told me that, but it makes sense to me. Our bodies are struggling enough...going from one extreme to the other can't be helping.

i am wondering how many out there do not feel the lows? i dont. my family can almost always tell. i do a test, and see a 1.9 or a 2.4 and think "wth?? pretty sure this thing is broken" and then i get out the sugar bowl. and i think to myself "holy moly, i feel perfectly fine. i feel as if i could just hop in my car and drive." and then i realize how dangerous this is, and how much damage i could do to others. i am trying to keep my blood sugars at around 8, so that i will regain the feelings of a low. so far, it's not really working out as planned.

Same-Same...except I am pinging and ponging my son's blood sugar around like an orangutan slings shit. It sucks.

When those lows hit, it's some kind of survival instinct to keep shoveling food until you feel better. The rational brain that knows the "right" way to treat isn't getting enough glucose to think straight. When I'm in shovel-mode, I bolus to cover the extra carbs. I also love juice boxes when I'm out and about.

I hope you'll record an evil laugh and post it on YouTube.

I would love to meet anyone who's never had ping ponging. It happens to me after almost every bad low (read: 40-55ish), even after 12 years. I use glucose tabs but like to reserve them for out of the house lows in case I can't find juice or something else I actually like. There is not enough willpower in the world to stop me from overtreating (sounds remarkably like overeating, huh?) in the middle of the.night during a low.

I feel your pain, Kerri. I dropped down below 60 a total of 6 tested times today, yet was 256 at 2PM and am now 213. Fantastic. I feel like we can do the same exact thing every day and still have these kinds of days - just gotta roll with the punches, I guess!

I love how I'm reading this with a stomachache, in part from overeating after a nasty low....not.

I think a lot of us have the same problem (clearly, looking at the comments!) It really is a fundamental biological drive to EAT and EAT and KEEP EATING when you're low. The worst part is, studies have shown that glucose intake improves self-control....so being low puts you at a disadvantage to begin with!

I don't do it all the time, but I find that social support helps the most when mustering up the willpower to put down the Skittles/pretzels/Cadbury eggs/what have you. I've seen several others do it too-- post on Twitter or something, saying, "Ugh, I'm low, need some cheerleading to stop at 15 grams of carbs! GO DOC!" And poof! Instant support. I did this once in the grocery store (which, you'll agree, is hell on earth when you're low....SO MUCH DELICIOUS CARBY TEMPTATION!), and it was the only thing that saved me from embarassing carb overload and bringing five half-opened packages of candy to the register.

The bad part was, I think people misinterpreted my "I need help!" tweet....so I was pushing my cart down aisle five when I suddenly got multiple calls and texts from panicked DOCers asking "Caroline! Are you still alive?!" etc. etc. A touching problem to have, though. :)

Oh, so, so know how you feel. I was at the gym yesterday and I had a BAD low. It just snuck up on me and hit me hard. Anyway, my response was to RAID a candy stash. Seriously, I consumed more candy in 10 minutes than I think I've consumed all year. It was horrible. And my BG was not stellar afterwards to say the least (although it wasn't as bad as I expected, which makes me think I must have been pretty low).

i'm T2 but also often have the urge to mainline carbs NOW when i'm low. i've taken to bringing peanut M&Ms with me when i'm out as i can (usually) gauge how many i can eat to not overcorrect. hormones, though, play hell with my numbers and toally shatter any illusions i have of being in control. i hate that.

The funny thing for me, being diagnosed with Type 1 in 1985, is how back in the day I used to feel guilty about treating a low after hearing all the time from people to stay away from candy etc. I would sneak away from people so that they wouldn't see me treating it. It's amazing what happens when you mature (cough, cough) and attempt to treat the lows more sensibly, but there are still those days when I get a juice in one hand and M&M's in the other hand and double fist those things like there's no tomorrow!!

This is my first time to post, but I have been reading for a while. Love your blog.
Anyway, my hubby is the one with the diabetes and he wakes up with lows in the middle of the night, but with 13's and 15's not 40's. Trust me I over-treat, and then deal with his mood ALL the next day. But at least I can go back to sleep and not lay there watching to see if he will go low again in 15 minutes.
I don't mean to sound selfish, and I hope I don't, but sleep is good, you know?

I ping and pong all over the place. I also was afraid to be alone with my son who is now 9 and have a low. I check my sugar very often as I don't feel the low blood sugars. Now I have to worry about me being low and my son who recenlty became diabetic. Oh what fun!!!

I just started reading your blog. I have been a pumper for close to a year now. Hearing your stories sounds much too familiar. My lows have been better since going on the pump. You're so right though that when you have a low and you are out of your comfort area(home), you just eat anything and everything to bring your BG up. I am 53 and have been a diabetic since age 20. I am always having the fight with myself and hating diabetes. Too many doctors and doctors appts. I have a physical later this week. Eye issues, neuropathy in my feet, trigger finger in thumb and tendonitis but my weight is good and I am still running 3 to 4 days a week. I signed up for the Foxboro 5k Run for Diabetes in June. Life goes on and I keep on plugging away. Now that I have found your blog I will keep on reading. Thank you. xoxo Steve

so today after school I brought my 12 year old daughter to Target to pick up a few things... she felt high before we went in, but didn't feel like testing, so we decided we would run in and test after. When we came out to the car 1/2 hour later she was pale and shaking... she tested at 53!!!! and I am totally serious... what's that about??? :)

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