Feeling out of Whack

When blood glucose levels rocket to 448 mg/dl everything is off.

“That” feeling woke me up around 2:00 am. Then again at 4:30, 8:30. Extreme thirst weirdly combined with a need to urinate. One feeds the other. Ugh.

Lethargy to the max.

Me at Camp Glyndon (1970) summer camp for diabetic kids. Look at the stylish pants.

I have been type 1 diabetic for 44 years, and for the most part, very fortunate in long term wear and tear and disruption the disease can wreck on a body.

I have all the organs and limbs I came into the world with.

My one bout was with diabetic retinopathy at 27. The prospect of losing vision did shake me out of a lingering adolescent invincibility syndrome and towards better self care. I started regular glucose monitoring, increasing my activity levels. And eventually I got an insulin pump at age 43.

Yet I am not the model diabetic. I like my beer and I really like my food. Portion control is my nemsis. I ought to exercise more. My best A1C (aka Glycated hemoglobin) test has been maybe 6.9 (when I got a silly idea to try running; I completed a few half marathons and one full, and still hated running) and more recently my lowest A1C has been 7.2.

cc licensed (BY-NC-ND) flickr photo by Squallwc: http://flickr.com/photos/squall/4046641

My blood sugar levels do a fair bit of rollercoasting.

Estimate your food wrong, climb the hill. Take too much insulin in response, and you are in the gut dropping descents. Overeat to bring up those lows, and you crest the hill again. You have a lot of factors at play- amount of insulin put into your body, amount and timing of food, amount and timing of physical activity, and a few unpredictables like stress (alcohol is a wild card).

Fortunately I get pretty good signals when I’m at the extremes, though into my 40s I got more unsure after dealing with a few false lows, and then extreme lows that snuck up on me. A few times I’ve actually lost my balance from low blood sugar and fallen to earth.

Low blood sugar is easily treatable if I remember to carry glucose tables. It also confuses people when you start munching chocolate or candy. “I thought you were not supposed to eat sugar!” I see their skeptic gaze but its secondary to my need to elevate from the shaky low blood sugar zone. Yes, I can shift their tone of accusation to one of care — Mmmmmm jelly beans…

Yesterday I drove from Seattle to Vancouver to visit my cousin. The drive was stressful (long wait at the border, and massive tie up at Massey tunnel). It took 3 times as long as I had thought. But we had a nice dinner, my blood sugar was a tad high (245 mg/dl) but I took enough of a dose to deal with it and the planned dinner items (a rather healthy vegetarian lasgana) (with a pale ale). I thought later that my levels were starting that drop, and rather than confirming…. I ate a sugar cookie.

I am human and I err. Frequently.

And thus there I was up in middle, and late middle parts, of the night with the body wake-ups and a heavy dread feeling of high blood sugar. The symptoms are clear. There’s the drowsiness, lack of energy. Insatiable thirst. A very heavy feeling in the stomach. A total lack of appetite (unusual for me). Sometimes it feels that way with a moderate high level blood sugar, like 250 mg/dl, and it can dissipate by morning.

This was not going away. So I took a bolus (a larger than background dosage delivered from the pump) of insulin, maybe 6 units around 6:30am. By the time I felt like going vertical at 8:30am, the number was at 399. I took more, maybe 14 units.

After coffee and waiting for relief that seemed absent, by 10:30 I knew something was not right. I pegged a score of 448 mg/dl. That is really high. I’ve scored a few 500s, and maybe once over 600. I’ve also bombed low with a 34.

Roller coaster.

Sometimes, though very infrequently, the insulin pump tubing gets kinked or blocked by air bubbles. But when I looked at where this attaches to my skin (in the side of the stomach), the problem was clear.

Bent tube on insulin pump infuser.

The delivery tube was bent and not even in my skin. Sometimes the tube (it is about 20 inches long from where inserted into ym skin and the pump on my belt or in my pocket) can get tangled and accidently pull out (e.g. catching on a branch while hiking or wrapping on the knob of a kitchen cabinet). So all the insulin I was sending it out of the pump, none was going into my body.

Hence 448.

That’s bad.

The life drops at the end of the tube. cc licensed (BY-SA) flickr photo by cogdogblog: http://flickr.com/photos/cogdog/16052964201

This called for inserting a new delivery tube (and a bit more guilt because that’s one wasted, and each one is about $10 out of pocket even with insurance). With that done, I took a dose of 15 units of insulin an hour ago, and already can feel the relief as the blood sugar levels drop hopefully to a normal range (actually the blood sugaris still at 404 so I have longer to wait).

Still out of whack.

For the most part, my body feels quite good, and I am not hindered in what I can do, like focusing on my web projects or doing photo editing or digging rocks up in the yard. I loathe this feeling when my body feels unable, uninterested in doing anything, being out of whack.

As a diabetic you can land in a pile of guilt. “I sh0uld take better care of myself.” “Why did I not test earlier?” “Long term I am likely aiming for kidney malfunction.” “Why am I such a _______?”

I flash back to old Dr. Abraham Silver, he the generous MD who started Camp Glyndon, a summer camp In Maryland for diabetic kids I attended. He was of the Tough Scare strategy. I remember him glaring with big eyes. wagging a finger at me, warning if I did not take good care of myself, I would be dead at 25.

I’ve more than doubled the wrongness of his prediction, but still… I faintly hear his voice of warning. At the same time, “Mmmmm bacon cheeseburger”.

Diabetes is quite a volatile (in terms of variation) way of life, you never escape from having to think about it (well there are lapses of judgment). And we are human, and surrounded with temptations.

Diabetes is very self-treatable. And manageable.

But I do fall off of the end sometimes.

While I wait for my “normal” physical/mental experience to restore itself, I occupy myself here trying explain it. I am sure many diabetics have similar stories.

The thing I don’t like is the feeling of my body and mind not working at the same level that is my norm. And I seek empathy towards people with other diseases, afflictions, where what I experience as an abnormal state of “out of whack” is a more normal state.

I am eager to get back to Whack.

Last check… 365 mg/dl. Still dropping down.

Can’t wait to get there. But I have to wait.