Help TuFriends. Need some ideas, please. Sorry it's long

Diabetes Technology Insulin Pumps
#1

Took a two day road trip: Thursday was a concert in one city and Friday a rodeo in another, all near enough to home, but we made it an early weekend.

Doing great all week prior, readings even a little low. Had pre concert dinner(not the best choice, but fish and chips. Bolused square over 1.5 hours to cover known carbs and tested at 57,) went to the concert, walked, moved, had a great time. About an hour into the concert, sensor alarm at 72, BG check was 63. Had a small glucose lifter, after the concert at the hotel tested at 253. Figured it was the food. Corrected with a shot, went to sleep. Every 2 hours that night I was alarmed for a high BG (mine is set at 200,) got up tested (usually higher than sensor)and corrected took over 9 units between 12:30am and 7:30 am, which is an astonishing amount of insulin for me. (My normal basal/bolus total are about 12)

Friday morning, still got up at 226, took a shot and changed pump kit. Easy lovely day touring the by ways of Virginia, small smart dinner, rodeo, lots of walking, cheering, etc. Again had a low at the rodeo but did NOT treat, but tested at 59. Back at hotel couple of hours later tested at 223. HUGE rise. Set temp basal at 125%, took another correction using the same syringe, and had a low reading about 2am. Shut off temp basal, no corrective action. Woke up at 219. Corrected with the third shot from the used syringe. Upped temp basal to 125%. No breakfast, corrected via pump about mid-morning at 165. Landed at home, starvingly hungry at 151. Changed kit, new bottle if insulin, had a tomato and bread sandwich at 12:30. Bolused appropriately. At 2:30 tested 196, corrected and went back to 125% temp bolus.

Not sick, no UTIs, but overly stressed by this weirdness. Not overly stressed. OUTRAGEOUSLY stressed. Trying to calm down.

I HATE THIS DISEASE. So tired of all the problems. Ideas?

#2

Nature of the beast, Spock. I have had weekends like that where there is no rhyme of reason to my basals or my bolusses. Sometimes it is the stress of changes in routine, even pleasant changes, like your vacation/road trip. The roller coaster ride of blood glucose management is frustrating, but it is sometimes just like that. You were out of town, away from your normal routine. Maybe there were unknown carbs in the " smart dinner" that did not hit you until hours after the low of 59.. that combined with a reactive high from the untreated low could have given you the 219.. Sometimess I just cannot figure out the why?s. I just treat, and keep going.
God bless,
Brunetta

#3

Thanks. Yea..low to high, but I rarely have that. My husband believes that restaurants sprinkle carb powder on food and restaurants are tricky. You would think that after 52 years, I could get a handle on this. Still remaining high, currently 177 after known lunch at home, 3.5 hours of correction and increased basal.

It all just gets me so down in the dumps.

#4

Hi, Spock. I would be frustrated, too. I believe, however, that most blood glucose changes are explainable, but not all.

You were low (53) when you ate the fish and chips and low (63) after. That is a sustained period (a couple of hours?) of hypoglycemia and as you well know the counter-regulatory hormones and the liver can all gang up to produce a multi-hour rebound high.

In addition, the fat and the protein in the fish and chips metabolized for several hours post-meal. I am surprised that the 9 correction units didn't bring you back to normal. Did you take those with a syringe or via the pump?

The next day you seemed to follow a similar BG trace. Is there a reason you didn't treat the 59 at the rodeo. The subsequent 223 could easily be explained by a low-BG counter-regulatory/liver bounce.

For a while, I was treating trending lows with +200% basal. I had some limited success with that but stopped when Gary Scheiner (at one of the TuD live videos) said that that wasn't a good way to treat a high. I like to use a syringe intra-muscular shot and then rub the injection site vigorously with my hand. It seems to bring the high down more quickly.

Perhaps your basal rates need resetting. Your post-tomato sandwich BG of 196 may mean that your basal is too low. Just a thought.

Have you been getting your normal exercise? I find that walking for 30 minutes 1-2 hours post-correction is a potent way to bring down BGs.

I hate this disease, too! Don't get mad, get even. When the old tricks don't work, find some new ones. The most important thing is to develop a plan and execute it. Then go on from there. Hope dies last!

#5

....and we have to "Keep Hope Alive!!" 80's or 90"s quote from Jesse Jackson:
Thanks Terry. You will make it over this bump in the road, Spock.

#6

You are good, Terry and your input is excellent. I can usually handle the up and downs. I understand D and my body, but everything that normally works has failed. Normally, I get even with a vengeance, but this go round is just killing the hope.

It was just a simple lovely weekend away with my wonderful husband. And D just transformed it.

#7

Thanks

#8
everything that normally works has failed

When this feeling overtook me many years ago, I needed several years to figure it out -- way too long. I reached out to doctors, nurses, and CDEs for relief. They didn't have the answers. I had to figure it out for myself, and I did. My only regret is that it took me so long.

Spock, you are smart and persistent. You will solve this rough patch, if only simply by making it through to a better day.

Sorry your weekend was spoiled. Try, at least, to salvage some D-lessons that will help you in the future.

#9

Spock! You are a genius! I did not know that restaurants sprinkled carb powder on food! That explains EVERYTHING! :slight_smile: Seriously, I am new to this at 59 years old, but it is my understanding that there are 122 metabolic functions that impact BG, and we have control over 2–what we eat and the insulin we take. Everything else is a crap shoot. Don’t aim for perfect, aim for better and never let D win!

#10

Lots of bad, but James Taylor followed by cowboys were still fun.

#11

I just needed support and knew where to come for it. THANKS. I need the support!

#12

When I have had consistently high BG it is because of the insulin.

#13

Hi Spock. Everyone gave good logical input so I'll just focus on the emotional. I can relate because I got back yesterday from a week in the Bay Area. Lots of walking which I never do at home but love to do in Berkeley.More drinking than I do at home (though nothing extreme, I'm too old for that). Lots of cappuccinos out without the benefit of my carb-free almond milk, and of course, forgetting I'm drinking milk I need to bolus for! LOTS of meals out with friends which for me more often not includes the sentence at or shortly before the food arrives..."Oh ■■■■, I've been talking and forgot to bolus ahead!"

I had some reasonable BG spells, but several highs and lows my records being a 318 (knew why) and a 25 (no clue). Just to clarify other than eating higher carb than normal, no super splurges/binges as I just don't eat like that anymore.

All pretty par for the course for me for a week away from home. What was different than previous trips was my attitude towards it all. In the earlier years of my dx (I know compared to you mine are all early years!) I was very rigid about when I ate and tried to marshall groups of people to eat places that worked for my D (and my vegetarianism which are often opposite things). I complained and obsessed about my variable blood sugars. This trip I pretty much went with the flow, ate what was available - low carb if possible, higher if not. (The vegetarianism is non-negotiable). Used perhaps poor judgment by driving with very low blood sugar because I was due to meet a friend and I already try people's patience by not having a cell phone. In short, I was good company, for others and FOR MYSELF! None of my blood sugar problems ruined my trip. I had a great time. I sort of accepted ahead of time that things would be wonky and damage control was sufficient. I'm not saying you had a bad attitude, Spock, not at all; it sounds very trying! I'm just sharing my own difference in approach compared to other trips - both in terms of expectations and reactions when things went screwy. For me that difference was huge!

#14

I don't change my pump when having those problems like your explaining. I correct with shots & boluses. Just a question are you wearing your pump near your sensor????

#15

Hi Spock -

Hope things have calmed down for you. Only two random ideas.

When I'm getting sticky highs over 200, I need a temp basal of 160-180% on top of the normal correction. I usually end up a little low at the tail end of the experience but that tends to be easy to deal with.

When I was regularly having sticky highs, part of the problem turned out to be problems with air bubbles. I doubt if that was your issue this time, but just in case....

Take care,

Maurie

#16

Thanks to all. You are great and your input is welcomed.

A lot of my concern wraps around an odd problem. My husband and I were overseas last year for three weeks and I had the same problems. For the first time in 17 years we are not going to Europe in 2014. Additionally, we may have a chance to spend a lot of time volunteering in France for the 100th WWI anniversary. If I can't make it through three days in Richmond, how can I convince my husband that I can handle the long term volunteering in France? So, it double stressed me.

All seems well today, still went to 223 this AM, but even the correction worked well.

Terry: I do find that the increased temp basal works really well for me when my BG has long periods of untreatable highs. Mixed with the syringe injection, it seems to work.