"What just happened?"
I had an authentic "What just happened?" moment today.
As many of you know, I play basketball a few times a week. Usually about an hour and a half or two hours at a shot. Great exercise. Great fun. Great challenge in managing blood sugars.
You would think, that after playing routinely for a while, that I would have things pretty well figured out. Well, that's just not the case. I do my best, and most of the time that works out relatively well. Let's take a look at a day from a few weeks ago:
A little trouble after breakfast, but I evened out nicely during basketball. A pretty "low maintenance" afternoon on the court. Again some trouble trying to prepare for another (yes, I know I'm crazy) session of basketball later in the evening. You can see that as I started basketball, both times, that my blood sugar went down. The drop in the evening was farther and steeper than I'd like. The point is, basketball = drop in blood sugar. Most of the time.
I am aware of the whole adrenaline thing, which can in some cases make your blood sugar go up. I'm also aware that the presence of ketones can make your blood sugar go up. There is a delicate balance between the exercise and insulin, which drop blood sugar, and the other "raisers" that, um, raise blood sugar.
I feel pretty comfortable with my basal rates on the mornings of my basketball days. I also feel pretty comfortable with a routine that usually works pretty good for me. My troubles are usually self-inflicted. Due to bad eating decisions. Today? An english muffin with butter & peanut butter for breakfast, and some type of protein/nutrition shake before basketball. Most of the time, this works great. Same exact thing as last time (minus the 1/2 sugar cookie last time. Shhhhhh...). Let's take a look at today.
Sigh. Started the day off at 75 mg/dl. Almost low. I did not treat this. My blood sugar rose up to 110 mg/dl by the time I got to work. 8:45 am, I had breakfast. My english muffin with butter & peanut butter. I bolused for 30g. 10:15 am, blood sugar is 129 mg/dl. Not bad - about an hour and fifteen minutes from hitting the court. 11:00 am, 119 mg/dl. Lower than I would like being only a half hour out from playing. I have my sport shake in the car. 27g.
I get to the gym, get changed, start to warm up. Blood sugar? 161 mg/dl. Perfect. Right where I like to be. A bit of insulin on board from breakfast, but I've got my temporary basal reduction and that sport shake balancing it all out.
Amazingly I didn't check my blood sugar again until 1:30 pm. For one, there were exactly 21 people in the court. Two games going at all times. Breaks in between just to get the next players switched out and then the games started again. I felt good. I felt confident. I was not worried about my blood sugar going low - which is the usual danger I have to watch for.
1:30 pm, games done, people are packing up and heading to the locker room. I sit down next to my bag and check my blood sugar again. 270 mg/dl. Huh? What the hell? What just happened?
What was so different today from other days? Ketones? I really thought so at first, but tested negative once I could finally test for them. Besides, it's unusual for them to cause such a high and rapid spike all by themselves. Infusion site trouble? No - I came down just fine afterwards. I just don't know what happened.
I DO know that I wish I would have tested more often! I'm sure that my stamina & performance was affected by the high blood sugar. If I could have caught this earlier I may not have spiked so high, and may have enjoyed the latter part of basketball even more. Lesson? Test more often! I usually do - four or five times during ball most days. I found myself concerned about making 9 other guys wait around while I "tended to myself" for 10 seconds or so. Silly, I know. Especially because many of them know I am diabetic and have to do that. Lows demand attention - but target and highs do not usually present "symptoms" for me.
I chalk this up to being another "what just happened " day, a "WTF" experience. I am determined to take a few seconds to check on myself better, and try to head this one off in the future. We cannot always explain what happens, and it's even harder when you don't have much data to "explain" it to you. Take what you can from it and move on. It's the only way to go.
* Excel logbooks courtesy of Kevin at parenthetic (diabetic)
As many of you know, I play basketball a few times a week. Usually about an hour and a half or two hours at a shot. Great exercise. Great fun. Great challenge in managing blood sugars.
You would think, that after playing routinely for a while, that I would have things pretty well figured out. Well, that's just not the case. I do my best, and most of the time that works out relatively well. Let's take a look at a day from a few weeks ago:
A little trouble after breakfast, but I evened out nicely during basketball. A pretty "low maintenance" afternoon on the court. Again some trouble trying to prepare for another (yes, I know I'm crazy) session of basketball later in the evening. You can see that as I started basketball, both times, that my blood sugar went down. The drop in the evening was farther and steeper than I'd like. The point is, basketball = drop in blood sugar. Most of the time.I am aware of the whole adrenaline thing, which can in some cases make your blood sugar go up. I'm also aware that the presence of ketones can make your blood sugar go up. There is a delicate balance between the exercise and insulin, which drop blood sugar, and the other "raisers" that, um, raise blood sugar.
I feel pretty comfortable with my basal rates on the mornings of my basketball days. I also feel pretty comfortable with a routine that usually works pretty good for me. My troubles are usually self-inflicted. Due to bad eating decisions. Today? An english muffin with butter & peanut butter for breakfast, and some type of protein/nutrition shake before basketball. Most of the time, this works great. Same exact thing as last time (minus the 1/2 sugar cookie last time. Shhhhhh...). Let's take a look at today.
Sigh. Started the day off at 75 mg/dl. Almost low. I did not treat this. My blood sugar rose up to 110 mg/dl by the time I got to work. 8:45 am, I had breakfast. My english muffin with butter & peanut butter. I bolused for 30g. 10:15 am, blood sugar is 129 mg/dl. Not bad - about an hour and fifteen minutes from hitting the court. 11:00 am, 119 mg/dl. Lower than I would like being only a half hour out from playing. I have my sport shake in the car. 27g.
I get to the gym, get changed, start to warm up. Blood sugar? 161 mg/dl. Perfect. Right where I like to be. A bit of insulin on board from breakfast, but I've got my temporary basal reduction and that sport shake balancing it all out.
Amazingly I didn't check my blood sugar again until 1:30 pm. For one, there were exactly 21 people in the court. Two games going at all times. Breaks in between just to get the next players switched out and then the games started again. I felt good. I felt confident. I was not worried about my blood sugar going low - which is the usual danger I have to watch for.
1:30 pm, games done, people are packing up and heading to the locker room. I sit down next to my bag and check my blood sugar again. 270 mg/dl. Huh? What the hell? What just happened?
What was so different today from other days? Ketones? I really thought so at first, but tested negative once I could finally test for them. Besides, it's unusual for them to cause such a high and rapid spike all by themselves. Infusion site trouble? No - I came down just fine afterwards. I just don't know what happened.
I DO know that I wish I would have tested more often! I'm sure that my stamina & performance was affected by the high blood sugar. If I could have caught this earlier I may not have spiked so high, and may have enjoyed the latter part of basketball even more. Lesson? Test more often! I usually do - four or five times during ball most days. I found myself concerned about making 9 other guys wait around while I "tended to myself" for 10 seconds or so. Silly, I know. Especially because many of them know I am diabetic and have to do that. Lows demand attention - but target and highs do not usually present "symptoms" for me.
I chalk this up to being another "what just happened " day, a "WTF" experience. I am determined to take a few seconds to check on myself better, and try to head this one off in the future. We cannot always explain what happens, and it's even harder when you don't have much data to "explain" it to you. Take what you can from it and move on. It's the only way to go.
* Excel logbooks courtesy of Kevin at parenthetic (diabetic)
posted by Scott K. Johnson | 8:30 PM
14 Comments:
Test and correct. that's all I can say--these WTF readings happen *all the time* and truly, there's no explanation part of the time.
Your breakfast sounds tasty!
Kudos for your level of logging and organization! Exercise is a big unknown for me too. Most of the time I'll drop lower, but every so often I'll go high for no reason. Doing all of that extra work for you pancreas is damn tricky sometimes!
I go high after exercise sometimes as well but then it goes lower on its own without correcting, it's like a delay of exercise effect kicking in.
I have to comment on your amazingly organised system of tracking bg and isulin. How much time do you spend on it a day?
Yeah, I say let the guys wait the few seconds it takes to test. But I certainly know the feeling of just wanting to get out there and play. You seem extremely good about diabetes management. Impressive.
Scott, isn’t that fun when that happens? I’ve been rising during exercise lately . It sucks.
Quite a bummer to go through all the planning and and to have it back-fire on ya. Sorry, man.
I think Lyrehca hit the nail on the head: plan, test, correct. It's the best we can do.
The biggest challengs seems to be not letting those moment dissuade you from putting in all the effort to get it right in the first place.
Hopefully overtime you'll accumulate more days like the first one and fewer like the second!
What Kevin says is important. I've had enough of those wtf readings lately that I do feel like just giving up. I know, in part, that it's the gastro acting up which makes me totally unpredictable.
You've really been working hard and it really impresses me.
Scott
Sorry to hear about the spike, that hurts.
When I played a lot of racketball, I would test after every game (10-20 minutes). Sometimes I'd start a game at 190 and by the time it was over I've be at 65. So I really needed to test frequently.
Luckily I had forgiving opponents, so if my blood was a little low they didn't mind waiting for it to come up. They also didn't mind if I had to say - sorry can't play any more today.
This stuff stinks.
It kind of feels like playing duck, duck, goose. You know there will be a bunch of ducks but you still get anxious cause you know the goose is coming. =)
Hang in there, you are doing awesome!!
Hi Scott - your comments at my blog really do help. I swear to god that we just do not know what the fuck is going on sith D - someday maybe it will all be clear! YUP another WTF experience. I would have reasoned just like you! Have you seen Kevin's latest post - honestly the way to get good results most of the time is to eat the same, don't exercise and do everything exactly the same every minute of the day. Yeah and even then it throws you a looper. Think if we understood it! Wouldn't that be something else. Another possibility is that since you started high you had insulin resistance so you stayed high..... But you never know the real cause, only in retrospect can we try and explain to ourselves what happened. That isn't by any means avoiding the problem or preventing it in the future.....but it helps our poor heads which seek an explanation.
ooh. nice log book. i gotta get me one of those
You say that you should have things "pretty well figured out," and in a logical world what works once would work twice. Alas, consistency is not a diabetes word!
Scott, in looking at all the data you gathered and all of the comments to the post, I am flabbergasted by the amount of time that we have to spend doing this - collect, analyze, conclude - over and over and over again, day in and day out. That is one of the things that non pwd's just don't get.
My deepest respect to all of us - we miraculously succeed in a most challenging task!!
I have had many, many of those moments lately. I recently got the excel spreadsheet, and it really, really helps point out the "what just happened" moments that I might have missed.
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