6
May

Still figuring out the exercise thing

I think I found one of the most uncomfortable feelings basically ever - or in the top 10 at least. It starts with a high blood sugar, but not too high - something around 13 or just over.

13, by the way, is high enough for your body to start producing ketones. Did you know this? I did not remember this. Could happen though. Differs for everyone, but it's still possible.

So let me get back to the least comfortable feeling ever. That feeling when you exercise and in order to exercise you set a lower temp basal so you can exercise safely, but then following your exercise, you spike because your temp basal was probably a little overkill. That's okay though, right? Better safe than sorry. Having BG sitting a bit higher, maybe 12-13, post-exercise is certainly preferable to mid-exercise lows.  (For me, anyways. Lows while I'm fighting traffic on my bike would be mildly unpleasant, probably.)

That post-exercise spike leaves you sitting at 13. You wait to correct the 13 because you're grocery shopping and picking up things for dinner, only by the time you get home your blood sugar of 13 has turned into 13 with  large fucking ketones.

And dinner? Forget dinner. Instead of dinner, you get to be thirsty as fuck while simultaneously fighting the urge to hurl back up all of the water you just chugged.  Fighting rather unsuccessfully, I might add.

Add to all of this the incredibly defeating feeling of failing at exercise, failing at diabetes, and the infuriating helplessness of the fact that THIS. IS. NOT. FAIR.

THAT, ladies and gentleman, makes my top 10 for most uncomfortable way to spend my Friday night.

4
May

First successful bike ride of 2016!

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I made it! After two false starts last week (having some issues with my bike chain), I successfully made it home from work today. I set a 60% temp basal starting 4 hours before I left and continuing 30 minutes into my ride. It's a bit excessive, true, but I wanted to be extra-cautious since lately I've been tending to run low in the afternoons.

Both times last week when my chain got jammed and I couldn't get it un-stuck, the resulting high blood sugars were pretty miserable. I used the same temp basal (60% for 4.5hrs) in anticipation of a 60-minute cycling commute, so after getting home by car I would inevitably be stuck with a stubborn high BG for most of the night. The frustration from a failed ride is one thing, but dealing with the highs afterward made a missed bike ride into a whole different experience*.

I have to say I'm pretty thrilled that I finally made it home by bike. I'm also pretty pleased that I managed it with no lows.

Next task: see if I can manage a stable 7, WITHOUT lows, throughout my ride, instead of the 10 shown above.  Unlikely, but hey! A girl can dream, no?

A crappy one. Briefly; only for a night, but still. Feels pretty crappy.

25
Aug

Rafting and pump supplies

I went whitewater rafting this weekend.  I spoke to my d-team in advance so I could have a solid plan for switching to injections for a day, since my last pump vacation was a bit of a disaster. This time around wasn't perfect,  but it was pretty damn good!

I disconnected from my pump and left it in a cooler in the car (along with my transmitter) after giving a bolus for half of my morning basal insulin.  We decided  to go with half because
     a) rafting is a ton of exercise (possible lows),
     b) I would be in the sun all day (again,  another trigger for lows), and
     c) On my last "pump vacation, " I went super low for a loooong time (so my full dose of basal insulin would probably cause -- you guessed it -- lows!)

I went low somewhere during the safety training. 2 bottles of juice and a banana for me, & then we were off to the boats! The rafting team had my emergency bag in their dry bag; Boyfriend and another close friend both had glucose gel packs in the pockets of their shorts, and I felt as prepared for the day as I could possibly be.

By lunch I was 15.7. Hardly surprising,  since I gobbled down around 90g of carbs to treat the low before we left... At lunch I added together the insulin I'd need for the correction,  the meal bolus, and the "missed basal" bolus, then gave 2/3 of the whole thing, and by the time we finished for the day I was back at 5.6. I think I'd call this a successful(ish) pump-free day. I've obviously got a bit of work to do to fix what happened in the morning, but I stayed safe all day and ended up with a good #, so I'm happy with it!

Of course,  whitewater rafting beat the crap out of both my sensor and infusion set site. The infusion set (big bloody mess) still worked but was extremely sore afterwards,  so it has been changed to a new location. The sensor was also pretty badly squished and abused throughout the day (and gave me a sensor error when I first reconnected it) but seems to be working fairly well again. The excess tape that I had to use to hold it down is making the whole thing feel like a big sticky glob of constantly damp and itchy grossn.ess on my side, but at least it's only 36 hours until I'm due for a new sensor.

2
Jul

First "pump vacation"

Last weekend I took my first "pump vacation."

It was short - very short. I had plans to go waterskiing/wakeboarding/knee skiing with Boyfriend, and since this coincided with a site change day, I figured I'd leave the pump at home for a few hours, rather than expose it to the (however slim) possibility that I'd lose it off of the side of a boat.

I think my problem was that we slept in. I had a late breakfast on Saturday, so my breakfast bolus was still in effect when I disconnected from my pump. When the time came, I figured out approximately how long I was going to be off of my pump (I figured about 4 hours), calculated my basal insulin over that time, and gave it as a bolus - then said goodbye to my pump, double-checked that my purse was loaded with juice boxes, test strips, and the Frio pack that held my Humalog pen needle, and I was off boating!

....enter low BG. I'm not sure if it was the heat (around 40 degrees with the humidity!), the stacking of my breakfast bolus + "missed basal" bolus, or the exercise from waterskiing (or trying to), but I spent the first 2 hours sucking back juice boxes just to stay above 4. The lowest I got was 3.6, but a lot of that was because I had around 8 juice boxes over that 2-hour period.

Yup -- that's 200 grams of carbs.

Looking back, I think I'm lucky it didn't end up worse than it did. I felt mostly fine throughout the day -- a little shaky at times, but overall more excited about water sports than concerned about BGs. It wasn't until later in the day that I realized just how much juice I had gone through. 

At least it helps me to realize that next time I want to take a pump vacation, there's a lot more to consider than just my "missed basal" insulin. Stuff like IOB (insulin on board, or Active Insulin), outdoor temperature, and exercise had a HUGE impact this weekend. I wish I could have anticipated that.

When bad things happen, my tendency (like that of many people with diabetes, I know) is to give myself crap for letting it happen. I'm trying to be better about focusing on how I really did try - I tried to figure out how much background insulin I needed, and I didn't think it would be so hot once I was in the water, so I hoped that the effects of the water would negate those of the heat. I really did try.

So much of the daily diabetes-things seem unpredictable and (semi)uncontrollable sometimes. I'm trying to take credit for the "good" numbers, but also trying to give myself credit for trying even when it doesn't end up going so well.

Saturday did not go well. I am lucky that it wasn't worse.

I am happy that I didn't ruin a fun day with diabetes-related "sick people stuff" that would have held up our water sports.

I am very, very happy that I had enough juice boxes around to keep my sugars from completely tanking.

On top of all of that, I can also say that I've learned something. It could have been worse, but it wasn't, and I can remember this next time I plan to take a short break from my pump.

I am feeling encouraged by the fact that I'm considering this as a learning opportunity. I certainly don't want to downplay what could have been a very serious, very dangerous situation, but I also don't want to dwell on it.

On a lighter note, I hope you had a fantastic Canada day! Cheers, folks! 🙂

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