65 mg/dl

On the second day of blood sugar my meter gave to me, a 65 mg/dl at 6:45 AM!

I would say last night I accomplished the no eating after 8 pm feat again (there were a few almonds, but who’s counting?)..

Let me explain a little more what the function of this goal might be in terms of nighttime blood sugar management. I want to be clear that it’s not just self-restraint for general health purposes.

‘Insulin on board’ is a term to describe the amount of insulin you have previously injected that is still working in your system. In general, insulin takes 20-30 minutes to become active in the body and has a duration of action of between 2 – 4 hours. That’s a big range, but I’ve noted that the max action of insulin is typically over for me after about 2 hours, and I don’t think much past 3 hours back when I’m considering insulin on board.

All this means that if I stop eating at 7 pm, like I did last night, then when I check right before bed, the number I’m dealing with will be more static, and thus easier to alter without as much unpredictability.

Last night I had a beef taco and a chicken tostada with a friend of mine at a taco stand, before going to a concert and puppet show in a shed. It was a little weird, but it fit just fine into my health resolution, so that must be a good sign.

I knew I’d be a bit high because I took a conservative insulin dose so I wouldn’t have to deal with low blood sugar while driving. When I got home later in the evening, my bg was 167. I took a unit of insulin but did not come down at all over the next hour. I took another half unit before bed.

65 is a little low. Below 70 is considered hypoglycemia. Times like these I wish I had a CGM so that I could see if I’ve been low for hours or if I had just gently arched down to this level right before bed (the latter being a preferable outcome).

I’ll explain more about ranges later. It’s important to remember as a reader, that management is highly individualized, and this is just my particular style.

Happy Monday.
Katie

119 mg/dl

On the first day of blood sugar my meter gave to me!

a 119 mg/dl at 9:20 AM.

9:20 AM?! – I know! Who gets to sleep that late in adulthood? The weekends are my sleeping time. I am like a bear, storing up for the next 5 days of waking up at 6:30 AM.

NOTICE: I am going to use “bg,” “blood sugar,” and “blood glucose,” interchangeably in these entries. They all mean blood glucose.

So how did this 119 mg/dl come to be? Well let me tell you, it was hard fought.

When I came up with this bg blog reporting idea, I didn’t consider the fact that it would expose my schedule and social activities, or lack thereof. Last night, Saturday night, I had no plans, which was exciting, so I cooked dinner, finished before 8 pm, and thought, “I’m well on my way to one of the four days!”

At 8:30 my bg was 96 mg/dl. Whew! I love a 96. Sometimes when I feel down about life, I check my blood sugar and it’s in the 90’s and I think, “Well, I’m sure doing something right!!!”

But I did not trust the stability of this reading. At 9:30 I checked again, just to see the trend. 149 mg/dl. Hmm, a slow rise that could very well have stabilized. “Great,” I thought, maybe I’ll even dip back down a little before bed.

At 11, I checked once more, just prior to laying down. 220 mg/dl. “Ugh”. Not good. So you know, my ideal range for prior to bed, if insulin action has ceased is 90 – 130 mg/dl. That’s just me. I was well above that.

I chose to take 2 units of fast-acting insulin. I also took 2 units of long-acting insulin, because on weekends when I sleep in past my morning dosing time, if I don’t take a little the night before, my bg will creep up in the AM hours.

At 2:30 AM I awoke, still caught up in my dreams, and feeling a little confused. 2:30 AM is sort of confusing time of day anyway, but I decided to check just in case. 101 mg/dl. Hmm. “Great!” Right where I wanted to be. I went back to sleep.

5:30 AM, I awoke again. Slippery mental state. Definitely low. 59 mg/dl (I hate to admit this, because night time lows scare people, but my body is great at waking me up…thanks body). So I ate 2 small spoonfuls of honey (about 1 tbsp in all), 2 cheddar crackers, and half a spoonful of peanut butter. Not scientific, just going on feeling.

Back to sleep!

I expected to wake up around 8 and be a little bit high. When I woke up at 9:30, I thought, “Ugh, I’m going to be really high.” But! But!? Somehow, 119 mg/dl.

So, there you go.

That was tedious huh?

Thanks for sticking it out.

Until tomorrow,

Katie

 

Diabetes Resolutions

I’m a person who loves resolutions. I love the celebration of shedding old parts of ourselves and adopting new habits built on all of the tremendous self-growth of the past year. That’s what the New Year symbolizes for me. Whereas other times of the year we resist change, both in the external world and the internal world, right around 12/31 we start to act like we think it’s the greatest thing ever.

So I was asking myself, in addition to my all of the resolutions I’d like to make in every other realm of my life, should I have a diabetes resolution? And then I decided, no. Basic diabetes management is a big enough resolution. It’s like asking your friend without diabetes what their health goal for the coming year would be and them saying, “Well, I’d like to start pricking my finger 8 times a day and counting all the carbs I eat and explaining very intimate details about my body to both my closest friends and to complete strangers multiple times a day. I’d also like to introduce a lot of self-shaming and restraint into my eating, exercise, and general lifestyle habits.”

I mean that’s big enough right?

But I was writing in my journal this morning and as I always do I made a note of my morning bg (this is not a ‘health journal’, just my journal journal), and I was moved to also note that the elevated number was likely due to late-night snacking. Now here, I want to make a critical explanation, because I hate overly simplified diabetes rhetoric. It makes it seem like, “Well, if those people with diabetes could just do what they were supposed to do, it’d all be fine!” No! my blood glucose could just as easily sneak high in the night without me having a late-night snack, if I didn’t have enough insulin in my system to cover the sugars my liver is naturally pumping out all the time (just like everybody’s is). And sometimes, not eating after dinner makes this more likely to happen – especially if I finished dinner early and had less insulin in my system overall, perhaps because it was a dinner particularly low in carbs.

The complexity of diabetes is what originally inspired me to write a blog. It’s like being part of a secret world – the ins and outs of blood sugar. I imagine myself like Mrs. Frizzle. taking her class to the pancreas for a day. So I thought, why not make a diabetes resolution and a.) use my blog for accountability, and b.) take you all along on the complicated journey that is every blood sugar reading.

I realize this plan has some flaws. People with T1D are gonna be like – “why would I want to read about her blood sugar when I have to manage my own?” And people without T1D are gonna be like – “why would I want to read about her blood sugar when I don’t have to manage my own?” But whatever, this is my resolution.

So here it is, stated clearly, my small diabetes resolution-experiment:

  • 4 out of seven days of the week, I will cease eating by 8 pm unless I have a low blood sugar and have to treat it (treating it means eating something, FYI).

What this really means for me is that I’ll be prompted to eat dinner earlier and eliminate post-dinner snacking on those days.

I’ll post my BG every morning along with a brief explanation of my theories behind the number. I could be right, I could be wrong, and we’ll literally never know!

With a Minute to Spare

Chapter 2

So at 8:05 pm I’m sitting on the plane to Miami muttering, “Come on, come on,” under my breath, and hoping they start the engines soon. By 9:00 I felt like I had aged several years and my cortisol was jumping up and down like a jack russell terrier. I had one of those little in-flight tracker screens right in front of me, and although I enjoy many traditional flight hobbies like writing in my journal, doing crossword puzzles, and reading SkyMag, this time all I could bring myself to do, literally, for two hours, was watch that little plane icon move slowly through my home state (Georgia), and onwards towards the tip of Florida.

At 9:05 the estimated arrival time had jumped back from the original 10:15 (which remember would leave me with a total of 5 minutes to make my connecting flight) to 9:44 pm. I would have, calculating time for deboarding, at least 20 minutes of straight running time before the gate to my second flight closed. At this time, I did decide to update my journal. In it I wrote:

24 minutes to destino. Quick update, I’m on the plane. BG (blood glucose) is 320 mg/dl. Was so low in Raleigh that I couldn’t think. Didn’t take insulin for a long time. We are set to arrive @ 9:44 and then depart at 10:20. As long as no gate change I’ll be at F25 (only 20 gates away from where we arriving). I’m going to write an update at 10:40 pm saying I made it, and my BG will be perfect. Then I will fall into a nice sleep until 4 am, then write for an hour. Someday I’ll learn Portuguese.

This was my last journal entry for four days.

Back on the plane, as we declined in elevation towards our destination, I looked at the screen, then back at the overhead compartment, then at my purse, then at all the people around me, in a nervous loop. There were so many people in front of me, and I knew I had to get off of that plane. A flight attendant walked by. I asked her if she could help me. I said, “Hello there…I know this might be a weird request, but my connecting flight leaves at 10:20, and that lady up there, hers leaves pretty soon too, and if there’s any way we can get off this plane, like, first, or sooner, that’d be great.”

She agreed to make an announcement over the loudspeaker. She was very kind.

5 minutes later, as people rustled around and the captain updated us of our status repeatedly, a quiet announcement urging passengers to allow those with close connecting flights to depart first, was made. The attendant warned me that most likely, people would take little heed, especially those in first class.

And yet a door opened. Behind me, a couple on their way to an island off the coast of Florida, anticipating their vacation, had heard my anxious request. “You’ve got a close connector too?” One of the women asked. I sighed. “Yeah, it’s pretty close…” “Yeah ours got crunched with the delay. What’s yours?” she asked. I told her. “OH, that is close. That makes me feel pretty good about ours.” Despite this, she was very sympathetic. ”Here’s what you need to do,” she said. Follow us off of here and we’ll get you pointed towards the Sky Train. You’ve got to get on the Sky Train because where we are, you’re never gonna make it on foot all the way to your next gate. This airport is a giant.”

Now remember, our flight was arriving considerably early. It was 9:40, and we were descending towards a gentle landing. At 9:44 we touched down.

At 9:55 we were still waiting behind several other planes on a slow, slow pathway towards deboarding. Our huge machine idled in the queue. I began to feel flushed and frantic (noticing a theme?).

My friends from a few seats back knew that everything wasn’t going to go as smoothly as they’d originally presented. They amended the plan. “Ok, here’s what you’ve gotta do. As soon as we get up there, and they turn off the seatbelt sign, we’re gonna stand up and make an opening for you so you can get your backpack and get off of here. And then, don’t look back. Don’t wait for us, we’ll just slow you down. You gotta get off this plane and run like hell. You gotta get to gate 11 (9 gates away) and get on the Sky Train. I think you’ll have to go up some stairs…”

At that moment we docked.

The seatbelt sign went off.

My friends stood up, and I began to act.

I heaved my Osprey backpack from the overhead compartment and hiccupped down the aisle, meeting the line as it slowly moved off of the plane. I stepped onto the connecting bridge and could see the light of the airport at the other end, but I was still blocked by a throng of passengers. I tried to wait patiently because I don’t like pushing through crowds or running around other people who I could potentially crash into. So I slowly trudged along, until suddenly, in the Miami airport, at what was now 10:08 pm, I saw an opening, and I made a break for it.

My backpack was flapping on my back because I hadn’t buckled the waist strap and my purse was bouncing repeatedly into my stomach. If I had ever pushed myself this hard in high school track, I might have placed in a race. I had never run like this before. I also had never run before wearing a 35 lb. backpack. There was no one in the airport, no one out in front of me. Which is sort of a figure of speech because there were a few others, walking on the moving sidewalks which had been disabled because of how late it was. After about two minutes of running, my hair flying into my face, cheeks red, eyes wide, heaving breaths from the exertion, I see a business man and I think, he must know how this airport works. As I pass him on my right, I turn my head like a frenzied bull and with panic in my eyes I scream, “Where’s the Sky Train?!” “What?” he queries back. “THE SKY TRAIN?!!!”

I still don’t know where the Sky Train was. He failed my question a second time and I waved my hand at him in dismissal before continuing to sprint through the deserted airport.

Up ahead, one of those little cars was sitting horizontal in my path. As I approached it, I yelled to the conductor, “Please, sir, I’ve got to get to gate F25,” and instead of dodging it, I jumped on (not recommended behavior).

I learned my friend’s name, and where he was from, and that he had no faith that I would make my flight because moments before he had taken the last passenger who they were calling for over the loudspeaker to the very same gate.

I disagreed with him, but I was grateful for his kind presence and effort, nevertheless. We sped (at 5 mph) through the airport. My hair flew behind me, finally out of my mouth and eyes. I began to try to breathe again, although my lungs burned and my chest was tight. I was invigorated, I was going to make it. I had 1 minute before they would close the gate at 10:10 pm as we neared F25.

…To be continued.

Spice of the Unknown

“Well thanks for coming on this adventure with me today,” I said to my friend, without really thinking about it. We had planned to take a walk after class in the forest together and we accomplished that, but only because she stuck with me as I rode the waves of my blood sugar.

First as my post-lunch bg got up to 170 or so I stood by her at the bus stop, drowsy and dull. The bus was 11 minutes away so I suggested we walk down to the next stop or so, hoping that might bring me down a little. She pushed her bike alongside her and I tried to explain why I felt dizzy and why walking would help. Fifteen minutes later we got onto the bus and 45 minutes after that made it back to my house and my car, to the forest entrance, waited behind men in trucks doing something, and then onto the access road.

I loaded up my Ecuadorian fanny pack with glucose tabs and as we headed off into the woods I felt the muscles of my face and neck finally relax. Sometimes I hold tension when my blood sugar is high and I can’t exercise to bring it down but I also can’t take insulin because I’ll be moving soon. Since we had plans to walk together, I couldn’t just abandon my desires to walk in the forest and respond to high blood sugar by walking around campus in uncomfortable shoes to bring it down. I followed through. Sometimes I feel like following through is a rare event for me because blood sugar sidelines me. Or because I’m not feeling great I’ll decline plans with friends because I don’t want to drag them onto the rollercoaster with me.

We walked 2.5 miles in the splendid mid-October falling leaves, a little less luminescent here than in the mountains but still beautiful. Back at the parking lot I checked before driving and I was 67 mg/dl, so I suggested we wait while my bg came up. As I ate glucose tabs we talked about our classes. When I said, “I’ll check again, I think we can go now,” my friend admitted she had no idea what we were waiting on. People just don’t know! When you live so intimately with a condition you start to assume that it’s evident on your face or in your words, that people understand it like you do, but that is so rarely the case. I explained why before when my bg was high movement helped me feel better, and that when I am low I need to eat something. I explained why I would treat a mild low before driving vigorously with several glucose tabs whereas if I was just going back home I might eat one tab and then have a snack.

After I thanked her, back at my house, she thanked me for the education. I thought about the name of my (somewhat dormant) blog. Diabetes has a way of making everything an adventure because it always throws in that spice of unknown. You have to adapt to it constantly, get creative, think about solutions. You have to be willing to change plans, be thrown off course, and clamber back to your path. It’s like inviting that oddball friend on the road trip, the wild one who is always suggesting weird detours. How wrong my thinking was ten years ago when I was diagnosed: that life with this condition would be boring.

And maybe most importantly, letting my friend come along on the adventure of blood glucose with me and being vulnerable in that way created a deeper trust between us and gave to us both.

surfing with friends
surfing with friends