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Location: Minneapolis, Minnesota, United States

Diagnosed with Type 1 diabetes in April of 1980. I recognize the incredible mental struggle of living with diabetes. I hope to share my struggles, my successes, and everything in between.

Thursday, February 22, 2007

Back on the map!!

I'm so ashamed that I haven't come up with a single diabetic related joke. Pitiful. I'm going to have my license revoked if I don't come up with something funny soon. G-Money has run away with the laughs, and I'm here just totally paralyzed by the pressure.

I spent a good part of today in outer space. You know, above the stratosphere? Up so high that you couldn't see me. An official astronaut I was.

There's that point, if you graph your blood sugar, where it goes so high that it is literally "off the chart!". And there is the point where you are "back on the map" - a point where you can, once again, actually see your blood sugar on the chart (what a relief!).

I left for space somewhere around 1:00 p.m., directly from the YMCA during basketball. I returned somewhere around 3:00 p.m..


How was the trip? Pretty shitty actually. My muscles felt funny, like they just wanted to cramp up. Especially my triceps. A slight nausea, but not too bad. But this was all at the peak of the journey, right before starting my descent back down.

After I was done with basketball, I just wanted to sleep. I sat down against the wall, tested my blood sugar, took a boatload of insulin, and just closed my eyes for a while. It felt so good to just rest my eyes. I could have laid down on the hardwood floor and caught some ZZZ's. I was startled back to reality by a guy coming into the gym and bouncing his ball.

What happened? Well, I'm not exactly sure!

It had something to do with my site change this morning. I've talked about those damn site changes more times than I can remember. The lack of constant behaviour is a huge deterrent in applying myself to figure something out. Sometimes it acts crazy - other times it's smooth sailing.

Scar tissue?

Maybe.

Great - another variable to keep track of.

No. thanks.

Here's the "play-by-play" description of how it all went down (or...up?).

I woke up a bit high - 202 mg/dl. I took a correction bolus and started my day. I changed my infusion set, a day later than scheduled. I finished getting ready and headed off to work. I got to work, settled in, and a while later I tested 124 mg/dl. Nice. Can't ask for much better than that!

Hmm. It's pretty late. 9:45 a.m. or so. I don't want to have breakfast now - I'll be playing basketball soon. That's one of the things the dietitian talked about - eating breakfast early to give my insulin a little more time to do it's thing and be done. 9:45 a.m. is not early.

I figured that I would just delay eating for another hour or so. I figured I would grab a bite to eat right before leaving for ball.

11:00 a.m. - 157 mg/dl. I took that as evidence that my temp basal rate reduction was working perfectly. 11:10 a.m. - I stop by the cafeteria and make a sandwich.

Two slices of whole wheat bread, some mayonnaise on both slices, a slice of swiss cheese and two slices of yellow american.

Yes. I know. Not much of a sandwich for you meat eaters (no, I don't eat meat. no, I don't consider myself a vegetarian (um, due to lack of vegetables mostly...)). A good old fashioned cheese and mayo sandwich. A staple in the Scott Johnson diet.

I step on the court about 25 minutes later, and test 220 mg/dl. Humph. A bit higher than I want, but considering I was out of my normal routine I was not too concerned. I did not bolus for that sandwich. I was also anticipating some great basketball action for the next couple hours, so there was no way I was going to take a correction bolus.

An hour later? 289 mg/dl. My highest test in a long time (a month maybe?). Ok, I'm frustrated now. Not feeling my game, not in my "groove".

Why? Because my damn blood sugar is high. I took what I consider an aggressive correction bolus - remember, exercise super charges your insulin. 1.5 units. I wondered if I should have bolused for that sandwich.

Back to the game. Back to stinking up the court. I dedicated myself to just working hard and at least trying to get a good workout. You know - something that I could feel much later in the day. A fatigue. A "good" tired. And I did work hard the rest of the session.

At the end of basketball, I sat down near my goody bag and tested my blood sugar. 363 mg/dl.

Holy WTF Batman?

A bunch of thoughts race through my mind:
- Something wrong with my infusion set (remember I just changed this morning - it hasn't been proven good yet)?
- Adrenaline rush (not likely, but possible, I guess...)?
- Ketones (I've never had them hit me like this before...)?

Then it hit me. That sandwich was the first thing I had eaten after changing my set. That's when it always hits me. A super high, not after my set change, but after the first meal after that set change.

Looking back on it, even if I would have considered that sandwich being the first "meal" after a set change - I was sure not about to load up on the insulin right before going to play basketball. That would be begging for a nasty low. I probably would not have done anything different.

I would have hoped that my aggressive exercise would counter act that possible rise in my blood sugar. Maybe evening the field so that things would "even out" and make for a day just like a non-set-change day.

No such luck.

I was able to get things back under control a bit later in the afternoon, so I know my infusion site is fine.

Now? Just before bed? 54 mg/dl. Damnit. Test THEN brush...

And testing low right before bed brings up a whole mess of fears and worries - a topic for another night maybe.

I also wondered if writing a post while low is as potentially dangerous as writing after a few drinks? Just kidding Julia - couldn't resist the opportunity. Love ya!

Ok, I'm off to bed now. I'm hoping to dream up a few funny d-jokes in my sleep...

22 Comments:

Blogger George said...

All those variables are so frustrating. Scar tissue, set change, exercise, stress, adrenaline. It is very frustrating man. I am glad you are back in the zone again.

Don't sweat the joke thing man. It'll come to you and then you will run away with the laughs!

1:03 AM  
Blogger Lori Rode said...

Well, it sounds like a really sucky day.

If it helps any, I think the Mayo and American Cheese sandwich may qualify as an official joke and help you keep your license.

Wandering off before you throw a basketball at me...

2:56 AM  
Blogger Heidi said...

Such days suck big time, but you made it through anyway!

Exercise can really be challenging - even if we knew all those variables and their influence on our sugar, do you think we would be able to get it right every time?

Keep up the good work, Scott!

3:06 AM  
Blogger Drea said...

I've had this happen a few times...I figure from the "higher then normal" BG before exercising...if I am above 12mmol (220mg) I will likely go higher from the exercise...GO FIGURE. There is some ketone relation - but long and short of it all, that - combined with the YUMMY SOUNDING cheese sandwich you had may have caused the rise....

It is tricky with exercise, a small window to work in....if I am below 5 (90) before starting at the gym I will go low. If I am above 12 (220) before starting at the gym I will go high.....usually I just roll the dice and gamble :)

George is kicking your butt with the jokes HAHAHA

I'm heading to the gym today....I'll let you know how the gambling goes :) Take care!

8:04 AM  
Blogger Carey said...

Diabetes blows! The guesswork drives me insane. I wonder how many perfectly fine sites we've changed, thinking IT was the culprit.

Hope today is a better day for you.

8:16 AM  
Blogger Chrissie in Belgium said...

Just too dam many variables. We cannot always get it right. Sounds like your "typical" highs after the first meal after a new insertion site maybe is the answer. Maybe! It is horrible not understanding, b/c we feel it will happen all over again, but sometimes we just have to admit it. We don't understand. We can't understand . Current D knowledge just doesn't give us an adquate answer. I am so sorry for your rotten day. When the line goes off the chart - ugh it hits you in the face like a hard ball. I have been there too - we all have!

9:20 AM  
Blogger Vivian said...

So glad you are back in the atmosphere. Sorry it was a tough day, maybe today will be much better. Big hugs.

12:15 PM  
Blogger Anne said...

Hey Scott,
What kind of infusion sets are you using? Maybe you need to prime it more than recommended? I use the Comfort (what Animas calls it; it's the one that goes in at an angle) and always prime a full unit (or "fill cannula" 1.0 U), even though I think the recommendation is for a little late.

Sorry about the super-high, though. I know that feeling and it stinks. I also get cramping in my arms sometimes when I'm really high. Although, come to think of it, that hasn't happened in a while.

I love the cheese sandwich, too, but I have to go with Miracle Whip. Sorry, no mayo for me! :)

Hope your weekend is better...
-Anne

3:18 PM  
Blogger Anne said...

woops, I meant, the recommendation is for "less" not "late." Maybe I was thinking of when I arrived at work today! :)

3:19 PM  
Blogger Scott K. Johnson said...

Thanks everyone!

Don't worry Lori, I won't throw anything at you!

Anne - I usually prefer miracle whip too, but I have to take what I can get at the cafeteria.

I'm using the Medtronic Quick Sets. I have no idea what the actual fill canula amount is. Because I know I always run high after a set change, I max the fill canula dose out at 1.2 units, and repeat it three (yes 3) times. And that still doesn't do the trick - unless it does and then it knocks me flat on my ass.

I got a chuckle out of the whole less/late thing, but I knew what you meant. :-)

4:20 PM  
Blogger Zazzy said...

It's good to see you around again. :)

You remind me of an old friend who does consider himself a vegetarian but seems to live exclusively on french fries (chips) and cheese sandwiches.

5:50 PM  
Anonymous Theresa said...

Scott,

I usually exercise after lunch. I have to be completely ready to go to the gym which takes me about a 5 minute walk to get to. I need to have my gym clothes on, shoes on, water bottle and towel ready, and glucose tabs and meter ready to go. I cut back on my NovoLog and immediately before going out the door, I eat my lunch and then leave. If I wait 10, 20, or 30 minutes to leave, then my blood sugar starts rising way too high because I have cut back on my insulin. For me, it's all in the timing and it does not always work out the way I hope it will.

Perhaps the fact that you ate 25 mniutes before you started exercising and did not bolus at all for the sandwich, resulted in the high.

I frequently have to make new adjustments when exercising and I am still learning how to handle the exercise, insulin, food thing even after all this time.

I had to laugh at your outer space analogy. :-)

5:57 PM  
Blogger Minnesota Nice said...

The day sounds nothing but exhausting.
You've got to conserve your strength for the snow shoveling that lies ahead!

6:46 PM  
Blogger Bernard said...

Scott

That just sounds like a rotten day. After all that exercise, to get a high like that you must have felt lousy for a long time.

I use quicksets also, depending on the length you're meant to prime 0.3 units or 0.5 units. So if you're priming 3.6 units (I think that's what you said), that's a lot of insulin.

I hope you don't have another day like this for a long time.

6:37 AM  
Blogger Julia said...

Dood. You eat mayo and processed cheese food sandwiches and you're laughing at ME? Some people, man, I just don't know....

I guess you'll just have to add another thing to your list of things to do - extra bolus for the first meal after a site change.

There are far too many variables to this stupid disease.

3:00 PM  
Blogger Molly said...

Scott.
Sorry to hear about your crazy b.s. day. I have the same problem when I change my pump site, which is why I change it right before bed, so that I avoid extra boluses, crazy correction boluses (ccb's), etc. I hear ya man. It sucks. Dam diabetes.

8:44 PM  
Blogger Scott K. Johnson said...

You know what Molly - for me, it doesn't seem to matter when I change the site.

If I change it at night, before bed, it will hold my BG steady all night, but as soon as I eat breakfast - zoom! Off to the moon!

Dam diabetes is right!

It would be nice if it stopped snowing anytime in the next couple of days!

10:48 PM  
Blogger Kevin said...

Late, as usual.

I too hate those "off the map" periods.

And I have to admit, I laughed out loud when I read those coupled parenthetics: "(no, I don't eat meat. no, I don't consider myself a vegetarian (um, due to lack of vegetables mostly...))"

Do you have a name for the diet you consume?

8:53 AM  
Blogger Penny said...

Scott,

Diabetes sucks.

Yep, that's about all I have to add.

11:20 AM  
Blogger Molly said...

Scott,
I just looked at your blood sugar records for the last three weeks. (I love that you do that... I need to figure out how to do it for mine!)
WAY TO GO!! Looks like you have had more consistent blood sugars, and are working hard to measure food, etc.
Just wanted to write and say that I think you should be proud of your efforts! Good work!
Molly

2:38 PM  
Blogger Sasha said...

Hey Scott,
from my experience whenever I skip breakfast in the morning I end up with a high. Also when my sugar is high or even just a bit high and I just bolus for it, the insulin doesn't seem to work as effectively on an empty stomach, it just lows it by 1 point instead of supposable 6 for instance. So may be that could have been the case with your bg's as well.

7:23 AM  
Blogger Wendy Morgan said...

Anne has a good point with the priming thing. My daughter and I both have pumps and use the Quickset. The diabetes educator said to prime her infusion set .5u (6mm infusion set), well she shoots to well over 300 unless I prime 1u. For me I prime like 1.7u for 9mm infusion set.

10:37 PM  

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