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Oh, High!

Sunday morning started off with promise - a fasting blood sugar of 99 mg/dL, a healthy breakfast of tea, a banana, and some scrambled eggs, and I remembered to grab my curling iron out of the fridge before meeting my ride to the airport.

I took an aggressive bolus for breakfast (because travel sometimes makes me  run a bit higher, for whatever reason), so I was surprised to see double-up arrows on my Dexcom graph while I was standing in the airport security line.  

"Hmmm … 172 and double ups … with three units of insulin on board."  The diabetes mental-math made sense to me. "I'm going to let this blood sugar ride out instead of rage blousing."

But by the time I was in my seat on the plane, I was at 312 mg/dL.  I do not know why.  I calculated breakfast.  I bolused well before I ate.  And I didn't feel stressed or nervous or whatever.  

But now I was high. And I felt high.  High, high, high.

It's a thick feeling in the base of your brain, like someone's cracked open your head and replaced your gray matter with sticky jam.  I find myself zoning out and staring at things, and my eyeballs feel dry and like they're tethered to my head by frayed ropes instead of optic nerves.  Everything is slow and heavy and whipped with heavy cream.

During the first hour of my flight from Austin to Baltimore, I tried to write but the words were stuck in my teeth.  I tried to read a book but I kept skimming the same sentences over and over again without really reading them. And I watched my blood sugar holding steady in the 300's, despite my boluses.

Rage-bolusing is a hard thing for me to avoid, especially once I'm so deep into a high blood sugar that I'd do just about anything for a bottle of water and a 120 mg/dL.  When I'm high, my back aches.  My eyes hurt.  My breath smells like the glue you use to assemble model airplanes.  My whole body is wrapped in cotton balls and I'm reduced to a lazy, lethargic lump in a seat, without a shred of energy and zero desire to smile.  I want to bang on the buttons of my pump, ringing through a billion units. I want to know why my breakfast bolus didn't make a dent, and why these subsequent "fix it" boluses aren't doing shit.  Is my infusion set crapped out?  Is my insulin vial spoiled?  Am I dehydrated?  Did I miscalculate my breakfast bolus?  Did one of the fifteen thousand diabetes variables go rogue on me?

I didn't want to swap out my infusion set in the bathroom on the plane and then have to wait, wait, impatiently wait to see if another bolus will hit my bloodstream.  I tested my blood sugar again and saw that I was up to 360 mg/dL, and the Dexcom graph didn't show any promise of a drop anytime soon.

Which is how I ended up busting out my insulin pen on the flight, about two hours into my flight, sneaking in a quick injection into my belly while the girl next to me read her biology textbook.  (She didn't notice.  Even after all these years on a pump, I can still manage to inject discreetly.)

The plane was up high ... and so was my blood sugar.  It's almost too literal; I can't take it.

By the time I was on my connection flight, I had settled back into range. Was it the string of small boluses, finally catching up with me?  Can I thank the injection?  Either way, the molasses in my veins had been replaced, once more, by blood.  Game over for diabetes chaos.

And looking at my Dexcom graph, I realize that diabetes gives a whole new meaning to "mile high club."

:: rimshot ::

Comments

Rage bolusing!! I *finally* have a name for that pesky over-bolusing I do when I'm so high & literally can't take it anymore! In all ,seriousness, the way highs can make you feel are no joke. I think you described the "high feeling" pretty accurately. Glad you came down, that Dexcom spike is wicked looking.

Nice job, Kerri! Did you eat a little bit during your precipitous drop, causing that little mini-rebound, before settling so nicely into the zone? Better a slight bump than a crash, especially on a flight!

I can think of a few Dex graphs of my own like this one...and the mixed feelings of lethargy, the desire to rage bolus, and also intermittently zone out are the same. Your recovery from it is a best case scenario in my book.

Sometimes bg excursions are explainable while other times they remain mysterious. Go figure.

J.B.

I hate those unexplained highs the worse. I never really figure out the highs for no reason. Glad you got it down. The highs seem to wipe me out more as I get older.

I absolutely hate days like that. For the love of all that's holy, you only had tea, a banana and eggs! So one BANANA makes you skyrocket--drives me well, bananas! I can definitely relate.

Gotta love the days when the CGM graph looks more like the Presidential mountain range...

I also love that sense of relief when you finally get back down to normal, even if you aren't 100% sure what got you there!

How is that you know exactly what is happening in my life? I am traveling too, for college visits with my son and my BGs are running high for no apparent reason. I have had to hold myself off from rage bolusing for two days now. I had to refill the cartridge and put in a new site today and finally it appears that things are back to working. The last thing I want to be thinking about when on this trip is fussing with my BG levels. But, there's no vacation from diabetes, is there?

My sympathies :( I can't tell you how many non-diabetics I've explained (or tried to explain) "rage" bolusing (and/or SWAG bolusing) to.

Also, this obviously had to be linked. ;)

It's so good to hear everybody else goes through this, too! I can't believe you didn't bottom out after your rage-bolusing (love the term). Last time I did that, I ended up at 41 mg/dL, and didn't find out until I returned home from the grocery store, where I KNEW I was low but didn't want to deal with it. Why do we get stubborn when we are low (and high)?
Another thought - I realized that I sometimes have bubbles in my tubing (Medtronic) and of course forget to think of that when I hit one of these mysterious highs. Next time I might blame it on that instead of blaming myself.

I am always asking Briggs to describe to me what "high" feels like--he just says he feels fine. But I recognize these symptoms. Not just the glue smell, but I remember that smell--my boys BOTH had it as babies when ever they had fevers, and I remember smelling it often right before Briggs was diagnosed (and thinking "he smells like he has a fever. Oh, well.") Thank you for translating the experience for the inexperienced.

mile high club. you're hilarious. love it.

I think the scariest thing about situations like these are when you've done the raging boluses and are not concerned if they just not working at all, or if they are slow to work, as they sometimes are. The thought of now taking an injection for almost the same amount and doubling your needed insulin is a very difficult decision to make. It's probably why most pump manufacturers advise to use a needle instead of the pump when your BG is over 250.

Thanks for sharing!

Reading your story of breakfast, bolus, going high, going higher. Before reading the next paragraph of your blog, my brain when into survival/suggestion mode and I wanted to shout out to you. Check your set! Take a shot! Then you came thru with your plan to get your bs down.

PWD have to deal with these survival skills everyday.

This is one of the best desriptions of what a High BG is like.

I hate it when the dexcom spikes like that but find it funny that it looks like it's giving you the finger.

Last summer Lauren described what it feels like to be high for an extended period of time. I will never forget it. I wonder if I can get her to write it one day -- it's very, very, very interesting. (and scary).

I wonder if this was a case of your liver finally responding to the low it looks like you had in the early part of the graph. In a non-diabetic, that glycogen response is nice and speedy, but for us pancreatically-challenged folks, it can kick in hours too late ... as in "Yeah, thanks, Mr. Liver, but I dealt with that one myself while you were snoozing."

I love you as a writer. Diabetes may be your subject, but I'm sure you could tackle a lot of other ones as well. Your descriptions show your talent!

Bananas make my bloodsugar go bananas.., not sure if your body responds the same way but I always go crazy high after I eat them for some reason (even if I've correctly calculated the carbs and have bolused the right dose).

I know exactly how you felt - because if you look at my post from Monday you will see a picture of my CGM as I boarded my plane on Sunday - with a 312!!! Mile High Club Twins, rocking the same crappy number on the same day. Yeah, I totally get it.

Not to know where the high comes from (maybe a late rebound high from the low your dexcom seems to indicate during night?), is the WORST. I don't tend to rage boluses but to freak out and get really insecure. After all, if I don't know where it's coming from, how am I supposed to know how to react appropriatly?? Glad you landed safely!

Maybe you had a very bad low at night and were rebounding?
Or are fighting an infection?
Bring out the crystal ball!

Thank you for helping me understand what it must feel like for my kids. I've tried to imagine but you really brought it home. When I have presented the JDRF Kids walk I explain to the students that a person's blood is usually the consistency of milk. It flows freely through their bodies. BUT a person with diabetes that has too much sugar in their blood might have blood the consistancy of molasses - too thick and slow to properly feed move through the body - depriving the cells not only of energy but also oxygen. Sound about right? thank you again for providing the visual - sorry you experienced it.

Dear blogger,
I totally have had the same experiences as you! When that happens, it is 99% of the time because my pump is not delivering! The MOST annoying thing in life is beep...beep...beep "NO DELIVERY." This happens to me probably more often than it should. By now I am so fed up with no delivery alarms that I usually calculate (with my pump) how much my correction bolus SHOULD be, but then simply take that dose with a syringe. I will test 30 minutes or so later to confirm it really indeed was a problem with the pump, and not a problem of expired insulin. Changing the site, switching my cartridge, or completely changing the infusion set usually helps!

Being diabetic is better when you have a community with whom to live the path together.

peace,
Juliet

I am glad to read you have the same problems that I do! I just discovered your blog!! Thank you for sharing!

I too hate the inexplicable highs, which make us inherently more resistant to the insulin we bolus. Rather than insulin pen, I like to give a dose of Symlin with the appropriate correction dose (though not FDA approved for this use). Drops the high like its hot and all is good again.

This is the best description I have ever read of what it feels like to be high. It must be, becuase it really explains exactly how my son looks when he is high. Which lead me to realize thats exactly what he must feel like -
http://teamcoleson.org/midnightcheck/2012/04/21/so-thats-what-he-feels-like/

At night Sometimes I get soooo tired caring for my type one daughter....I fear I will fall asleep and it will be my fault if something happens to her and I didn't do better. It adds a lot of stress. My 11 year old is going through a growth stage/womanhood and her sugars are up, down, and all around! Any advise?

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