Dec 4
Since it’s December now, I hope it’s okay to revisit a video that includes a festive ol’ tree in the background. This video is about how awesome coffee is … and why it matters that the order is RIGHT.
(See also: Now I put my own fake sugar in the cup, instead of playing coffee roulette.)
Nov 6
The American Diabetes Association cites the following symptoms as indicative of high blood sugar:
And if high blood sugar goes untreated?
“Hyperglycemia can be a serious problem if you don’t treat it, so it’s important to treat as soon as you detect it. If you fail to treat hyperglycemia, a condition called ketoacidosis (diabetic coma) could occur. Ketoacidosis develops when your body doesn’t have enough insulin. Without insulin, your body can’t use glucose for fuel, so your body breaks down fats to use for energy.
When your body breaks down fats, waste products called ketones are produced. Your body cannot tolerate large amounts of ketones and will try to get rid of them through the urine. Unfortunately, the body cannot release all the ketones and they build up in your blood, which can lead to ketoacidosis.” – ADA website
But what does a high blood sugar feel like? Because when you see someone who is working through an elevated blood sugar, they may not look terribly out of sorts. But what is happening inside of them is real, and plays out in a myriad of ways for every person with diabetes. I’ve tried to write about it several times, but each high is different, and affects me in different ways:
“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.” – Oh, High!
“There’s something about a high blood sugar that makes my body feel weighted down, like I’m wearing a chain mail suit (not one of those “Forward this or a rabid snail will imbed itself in your ear!” kinds of chain mail – I mean the legit, medieval kind). Or that I’m exercising with weighted boots on. Even when ketones aren’t present (and I always check for them if I’m over 240 and heading to the gym), high blood sugars make slogging through a workout akin to traipsing through waist-high snow drifts. It’s crappy.” – High Flying
“A normal day with diabetes doesn’t wring me out, but yesterday did. Concentrating on work was really difficult, because my high-brain was too sluggish and too thick to let synapses fire. Writing was impossible. Sitting at my desk for more than twenty minutes was impossible because I kept having to take breaks to get more water and then to pee. (I went for a run and a mile and a half into it, made the wise decision to turn around. A good idea since, by the time I got back to my car, the need to pee was amazingly all-consuming. Oh hydration!) My whole body felt like it was submerged in Jell-O, and I tried to swim through it for the majority of the morning. Instead of making beds/doing laundry/cleaning dishes/writing/answering emails/phone calls, I wanted to climb into bed and sleep off the blood sugar hangover, but that wasn’t an option. Life doesn’t wait for diabetes.” – Ketchup and Mustard
One thing that remains consistent is the permeating feeling of failure that coincides with out-of-range blood sugars:
High blood sugar feels like failure. Usually I feel like, "Argh – why?!," but this time it was a clear mistake that I made. #dayofdiabetes
— Kerri / Diabetes (@sixuntilme) May 24, 2013
Is it something I did? Something I could have done better? A combination of both? A symphony of nothing and everything all at once? The cause-and-effect of everything in diabetes, in addition to the guilt, can make high blood sugars feel overwhelming.
But I can check my blood sugar often and consult the trends of my continuous glucose monitor in efforts to keep from cresting up out of range. And when I do have high blood sugar, I have the benefit of insulin that I can inject to help bring my numbers down (and a quick skip to the gym is also great for lowering blood sugars). It can be a challenge, but the benefits of attempting to manage my diabetes far outweigh the costs.
Oct 30
Blood sugar excursions are one thing (little trips to the grocery store, short flights to Canada … those sorts of excursions are fine) but the long-haul ones are not okay (BOS -> MEL). I can deal with a sticky high of 180 or 200 mg/dL without getting fired up, and lows are less frequent these days, so I’m not as irritated by them. Issues seem weekly rather than daily, which is a lovely change of pace.
Except for yesterday.
Holy shit, Yesterday. You sucked.
The day began with a low alarm in the morning – not a deep one, but a shallow low, easily managed by turning down my basal rate for 45 minutes and popping one glucose tab. Before breakfast I was 107 mg/dL. After breakfast, I was 302 mg/dL. The eff? I have a breakfast bolus recorded in my pump, but it clearly didn’t make a dent (either that, or the stress of the morning sent me cruising up into orbit). My goal of bringing my blood sugar down within a few hours was thwarted by a thorough combination of a bloody infusion set (was that why my breakfast bolus didn’t register?), insulin that may have been borked (my pump cartridge was a potluck of dregs from older bottles), the regular stress of work coupled with exacerbated stress of having a high blood sugar … it was gross.
It wasn’t until about 2 pm that I was back down to the 200′s, and that was after pulling the infusion site and taking an injection. And it wasn’t until about 3 pm that I saw a number under 100 mg/dL. Which started the second half of my day, spent trying to bring up a low blood sugar that wanted its own bedroom. I bounced between highs and lows for hours, not able to properly correct at either end of the spectrum due to a magical combination of user error and pancreas error.
When I looked at my Dexcom graph last night, it was way too much ketchup and mustard (aka “highs and lows”) and not nearly enough time spent in range.
“Damn hamburger Dexcom,” I muttered.
A normal day with diabetes doesn’t wring me out, but yesterday did. Concentrating on work was really difficult, because my high-brain was too sluggish and too thick to let synapses fire. Writing was impossible. Sitting at my desk for more than twenty minutes was impossible because I kept having to take breaks to get more water and then to pee. (I went for a run and a mile and a half into it, made the wise decision to turn around. A good idea since, by the time I got back to my car, the need to pee was amazingly all-consuming. Oh hydration!) My whole body felt like it was submerged in Jell-O, and I tried to swim through it for the majority of the morning. Instead of making beds/doing laundry/cleaning dishes/writing/answering emails/phone calls, I wanted to climb into bed and sleep off the blood sugar hangover, but that wasn’t an option. Life doesn’t wait for diabetes.
I made lots of mistakes yesterday – should have pulled the site/taken an injection earlier, should have assumed my blood sugar would rise more after turning down the basal, should have checked an hour after eating instead of two. So many things I should have done, or done differently. But my brain isn’t very clever when it’s on the glucose roller coaster.
Oh yeah, and diabetes.
This morning, my fasting blood sugar was 104 mg/dL, a welcomed change after yesterday’s 398 mg/dL, 42 mg/dL, and all the numbers in between.
“Don’t mock me, you little jerkface,” I said to my meter.
If the frigging thing had a tongue to stick out, it would have.
Aug 7
“Huh. Still in the 200′s. That sucks.”
But I’ve been stressed out and was on a train at the time, so I laced in a quick correction bolus and barely noticed that the site felt a little sore as I was sitting on the Acela. Later that day, still in the 200′s. But again, stress? So I went to dinner with a few more units on board and anticipated a drop.
I should have pulled the set. It took a whole night ‘in the yellow’ to remind me that it’s not always my pancreas being the prick – sometimes it’s the infusion set that’s gone rogue. Sure enough, after pulling the set this morning and watching blood pool up where the infusion set had just been, and then inspecting the cannula to find that it had, in fact, gone full vampire on me, I realized being stubborn doesn’t pay.
Here’s twenty minutes after a correction bolus from a new set:
Stubborn Kerri pays the price of being stubborn with sweaters on my teeth and a high level of grouch from hearing the Dexcom going off all night.
Aug 1
The Sparling household has reached a frenzied pitch of stress this week, with a big project for me reaching the finish line simultaneously as a big project for my husband begins. Overall, we manage our family circus (… could Billy ever get anywhere without leaving a trail of dashes in his wake? Gross.) without stepping into the ‘unhealthy’ zone, but the last few days have been an exception.
For me, stress usually leads to higher-than-normal blood sugars, even despite insulin. (Or “to spite insulin.”) And not in that, “Oh, I didn’t bolus enough, so I’ll just correct this high,” sort of way, but in the “What the EFF – I just rage bolused the hell out of that blood sugar and it still won’t budge.” This week has been all sorts of that, with fasting blood sugars as the only ones I’m comfortable keeping. For the last few days, it’s taking 150% basal to keep me even close to range, and my insulin:carb ratio has been tweaked to accommodate the exceptionally busy week.
That 233 mg/dL? All emotional, no other influence. Insulin is good, food wasn’t introduced yet, basal rate was solid, and no I’m not pregnant. I was 108 mg/dL an hour earlier. This high was the product of stress. It always amazes me to see how tightly woven my blood sugars are to my emotions.
The bad news is that my meter average, with which I was very comfortable last week, has gone to absolute shit. I feel more tired and the highs are making me feel grumpier and shorter-tempered than normal. (Which, if you’ve met me, is sadly saying a lot, because my average fuse is the length of a whisper.) I’m not able to parent the way I’d like, because these highs are sapping me of my funergy (energy for fun). I hate when diabetes derails time with my daughter.
The good news is that I know the cause of these diabetes radar blips, and I know things will be much more manageable in a few days. Until then, I need to do whatever it takes to coast. Testing more and correcting while taking the insulin-resistent instigation of stress into account? Trying hard not to consume coffee as though it’s a necessary and actual basal rate? Moments like these make me thankful for the CGM, because I can respond to trends, and I get a head’s up when I’m over- or under-compensating for stress.
For now, I’m in “just keep swimming” mode, hopeful that the highs will abate and leave me the hell alone in a couple of days.
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