Diabetes goes haywire

I have been gone for a month? It’s been quite a month!

I was pretty busy with work, preparing for a conference presentation, and just generally catching up of stuff I have been slacking on… helping husband with job searches and apps, picking up this season’s gardening, and a long commute has not left much time for writing, but I will fill you in.

The most eventful and horribly annoying week is now behind me. I have recently started to almost feel smug about my diabetes management – and deservingly so in my opinion, as achieving consistent averages over months in a row that translate into an A1C in the mid 5s is certainly reason to pat myself on the back and feel like a total diabadass. Of course, when you least expect it, it comes to kick you in the face (or wherever else it sucks to be kicked). 

Two days before my departure to Seattle I noticed that I wasn’t feeling well. Over the course of the following night, I experienced what I can only describe as the worst-ever case of food poisoning or GI bug that I have ever encountered. I didn’t sleep all night, with projectile vomiting and diarrhea, couldn’t keep down fluids, and could barely keep my blood sugar at 70 all night, despite consuming (and then erhh un-consuming)  about 80g of carbohydrate. Around 4 am, a Capri Sun and a whole Vitamin water later, I crawled up to 150 mg/dL and stayed there for half of the next day in fear of plaguing lows. It is times like this that I wish I was on pump therapy. What I would have given in those moments to be able to “untake” (suspend) insulin…

The story does not end there, however. Still feeling like total crap, now with what felt like excessive dehydration and pronounced body aches, I was questioning my abilities to travel the following morning. Of course these things always happen on the weekends, so I found myself in the emergency room in order to be assessed/ possibly treated for dehydration. In the end, I had some ketones (nothing horrible, just consistent with excessive vomiting, etc.) and low sodium. After an afternoon of drinking nothing but chicken noodle soup, chicken broth, chamomile tea, and eating some saltines and pretzels (which is about all I could eat), I pulled it together just in time to make my early morning flight on Sunday. 

The story does not end there, however. My GI system still did not feel back to normal, and as I attempted to resume “normal” eating habits and insulin dosing, I failed miserably. It seemed that although I was keeping food down now, it just wasn’t absorbing the way it was supposed to, and I found myself having to chase the impending lows yet again. Seriously, I can’t even look at Starburst and Smarties without gagging right now. The issues were compounded by weird travel food, carb over-estimation, presentation stress, and a ton of walking around the Seattle hills. Monday night was scary. I should have in retrospect just reduced my basal doses. But I didn’t. And after hours of walking around the city, together with the aforementioned resolving GI issues, I had to stay up alone in my hotel room for hours, afraid to go to sleep, because no matter what I ate (without taking any fast-acting insulin whatsoever) I could not get up to 100 mg/dL. Luckily I found a dollar, the only one I had, and purchased a Sprite from the hotel vending machine. Otherwise, I was running out of food, and was so close to giving up, putting on my shoes, and walking a block up the street to the hospital to ask for a dextrose drip. After half the Sprite, on top of all the other food I consumed (totaling maybe 50g of carbs, and that was on top of my dinner of salmon, rice, and asparagus that I didn’t even bolus for!) my BG was finally crawling up slightly enough for me to go to sleep. I woke up in the 140s, afraid to correct. That morning, I finally reduced my basal dose. I was still afraid to bolus for breakfast, and it wasn’t until I was in the 170s that I started nudging it down. 

The story does not end there, however. That same day, I spiked to 200 mg/dL about three times. I blame it fully on overly-conservative bolusing coupled with presentation stress. By Tuesday night, the day before my return flight home, I was staying up to wait for my BG to come down reasonably so I could have decent numbers over-night. The next day was travel day, and I had one more scare, where I once again over-estimated my breakfast carbs, and ended up chugging about 30g of juice right before boarding my airplane (because really, the last thing I wanted to do was pass out boarding a plane.)

Through all this, I have to say I feel that Dexcom was my saving grace, even though I still went through about 100 test strips. And to think I almost didn’t bring it on this trip because I didn’t really want to deal with the TSA. I opt for a pat-down as I do not want to take Dex through the scanner, nor    do I myself want additional radiation exposure, and I wasn’t sure how they would handle the Dex. But I am happy to report that both screenings went smoothly (well with the exception of the guy rolling his eyes at me and saying that he hoped I wasn’t planning on flying or using my cell phone, because don’t I know that those produce radiation, queuing my rant about the additive effects of radiation and people having their rights and reasons based on cumulative radiation exposures, such as from frequent flying or employment exposure, health conditions, or any other number of reasons).

Ugh, what a week. I am still on pacific time and dragging myself out of bed at 5 am this morning was not pleasant, but I have to say, I was happy that my stomach was feeling more normal, and that I woke up with a blood sugar of 82 (although I did require about 6g of carbs overnight not to go low). Amazingly, I lost like 5 lbs this week, and have kept my basal doses reduced, and decreased my I:C from 1:8 to 1:10. We shall see what happens next! I am trying to take my own advice from my last post and shake this off, I am. I am just so ready for predictable, please.