By the time I made it to work the morning after my sleepless night, having done my midnight to 8am overnight basal fasting test, I was already exhausted and groggy. It didn't help to find a stack of papers on my desk and several emails on my work computer pointing to some urgent matters that needed my immediate attention - and what's worse: immediate action! I made an effort with the attention part having looked over and read the correspondence, but the action would have to wait. At 10am I was to accompany my father to a doctor's appointment at my hospital. He had recently undergone a successful hip replacement surgery and has recovered rather nicely. Today he was coming in to see his internist at one of our clinics for a check up. As much as I was looking forward to seeing my dad I groaned at the thought of having to deal with said clinic and doctor.
People usually have the wrong idea about what it's like to work at a hospital. They think we get special treatment as employees, and though this may be true to some extent, we don't have nearly as much "pull" as it may seem. My family members and friends often come to see doctors here, thinking I have an "in" to get them past the lines and "backstage" quicker. Nope. Even I have to wait to be seen! (I had better luck sneaking backstage at a Scorpions concert than getting an appointment at an eye clinic before the end of the year. Forget skipping the line at said appointment). But since today it was my dad who had the appointment (made well in advance) I did my best to flash my ID badge and my white lab coat to get him to be seen by his internist after only two hours of waiting! And if you've ever been to a city hospital - you know that's not a long time to wait.
I registered my dad at the front desk and left him in the waiting area of the clinic while I ran back to my office and tried to tackle those very important issues I had to deal with. After about an hour I went to check on him as, in addition to being his daughter, I also serve as my dad's interpreter, (English is still a foreign language to my father, even after almost 30 years in the good ol' United States, but seeing as his time has mostly been spent amongst fellow Eastern Europeans at work, his family at home, and Spanish soccer announcers on tv - it's easy to see how his English language skills haven't had much chance to develop further). I was hoping my services would not be needed past 11:30 am as, having had success with my overnight basal test I was now determined to continue it, checking my sugars between the hours of 4pm and midnight. For that, I needed to eat and bolus before noon, as it takes at least four hours for the insulin to finish actively working in your body. And I didn't want it or the food I was about to consume for lunch to interfere with my basal test.
The doctor had just finished with a patient and my dad was next. Perfect timing! I may be able to eat my lunch before noon and go on with my basal testing at 4pm. Or so I thought. The doc then spent 45 minutes in her office, alone....(meditating? Or doing yoga perhaps?), with a waiting room full of patients. I was just about to knock on her door, not caring at this point if I was disturbing her savasana, when she finally came out of her office and called my dad in. We spent the next two minutes in conversation - resulting in several referrals to specialty services and a multitude of prescriptions - and the following 28 minutes in uncomfortable silence, broken only by the sound of the doc's fingers typing on a keyboard and my dad's heavy breathing. After all the paperwork (or perhaps her new best selling novel?) was finished she quickly examined my Dad, asked him to pee in a cup and we were finally free to leave! I gathered all the paperwork (as I am my dad's unofficial secretary as well), walked him out to the exit and leaving him with instructions to "call me when you get home!" I ran downstairs to Au Bon Pain to get me some lunch. Fast! It was almost noon!
At Au Bon Pain I encountered a long line at the sandwich counter. Even in my white lab coat I was forced to wait (behind some other white lab coats as well) so - no special treatment there. Finally I was able to order my Newport turkey sandwich (with avocado! Mmmmmm) vowing to not eat the crust of the country white bread to minimize my carb intake (good luck with that! It's good!) and as soon as the hot little box was in my hands I ran upstairs to my office.
I got to my desk at 11:59. As I have had this meal before I knew the sandwich was supposed to have 75 grams of carbs. I also knew, having eaten it before, that my current ratio of 1 unit of insulin per 9 grams of carbohydrates wasn't gonna cut it in this case, and that I needed more. Much more. This was either due to my ratio being off (which would need to be dealt with after the basal test was fully completed), or the sandwich had some hidden carbs in it that weren't being disclosed on the website. Perhaps a combination of both? Either way I knew I had to take more insulin if I wanted my sugar to be in the right range at 4pm in order for me to continue with the basal test. My sugar reading was 180, so I allowed 2 units for correction (as at this point my ratio is: 1 unit of insulin drops me by 30mg) and took 11 units to cover the 75 grams of carbs in the sandwich. If my current ratios are correct and if the sandwich indeed had 75 grams of carbohydrates I should've only needed 8.3 units. But as I mentioned, experience taught me that this particular yummy turkey/avocado/country white bread/honey mustard meal will definitely need more coverage. So I guesstimated an extra 3 units would be enough (as this is what I usually had to take to correct a high sugar after eating this meal).
I bolused and got ready to eat my lunch, but before I could take a bite of my turkey sandwich I hear the all-too-familiar beep-BEEP-beep coming from my pocket where I kept my pump. I looked at the screen, which was now lit up in green and telling me my reservoir was low. I quickly checked to discover I had under one unit left. Ah well - it's no problem - I'll change my tubes after I eat...Wait!...My tubes...Suddenly I got that feeling in the pit of my stomach - the one that tells you it may be time to start worrying. I didn't have an extra infusion set with me! I used it the other day at work as my sugar was unusually high, which I attributed to my set being inserted in the "wrong" area on my stomach - one where the absorption wasn't as good. I was right because as soon as I changed the spot my sugars were ok again. But I had used the infusion set I carry around in my purse and totally forgot to replace it when I got home. This was not good. But wait! What day was it? Oh yes - the day my 3-month-supply of diabetes paraphernalia was scheduled to be delivered to my work (it's easier than having to take a day off to wait for UPS at home!) I was saved! I quickly thumbed through my little notebook (that tells me what I have to do and when) where I had jotted down the UPS tracking number I got from the company. I checked online and there it was - delivered! And waiting for me downstairs at the loading dock.
I ran to the basement as fast as I could. My heart sank as I found the place practically desolate, save for a few boxes that certainly didn't contain my supplies. "Hello!" I yelled as there was no soul in sight. "I need help! Having an emergency here!" I heard some noises in the back office so I made my way there. A couple of Receiving guys were having lunch and clearly weren't happy to see me. Especially since they deal with me enough on a regular basis due to the nature of my job. But all I wanted was my supplies. Time was running out! "I need my box - medical equipment - UPS - this morning - delivered - need it now - emergency - personal delivery", I blurted out. The guys looked at each other over their sandwiches, sighed and got up to help me. Bless their little hearts. They said they remembered the box this morning but that they delivered it upstairs to my area. Thinking it may have been brought to the OR workroom next door I called the technician there who assured me no such package was in his possession. Receiving guys wouldn't budge. "It's up there! We brought it up ourselves! Go check!" So I ran up to the second floor but, as the tech said: no box. Frantic I ran back downstairs again. All I kept thinking is: "I need to change those tubes! I don't want to run home a mile to get a new set! I need to eat right now! It's past noon! I want to do my basal test! And what if they lost my box and I won't get my supplies!!" Downstairs one of the Receiving guys was still adamant that the box was safely brought upstairs, however he just remembered it may have been left in someone else's office. All right then! A quick call up to the tech resulted in him finding my box and delivering it to my desk. It was now almost 12:30, I was hungry, tired, frustrated, and no doubt this didn't help my sugar, which was already out of range to start with.
I opted to eat first as I wanted to make sure those darn carbs wouldn't bother my blood sugar from 4pm onwards. I swallowed my sandwich and ran to the bathroom to change my tubes. All went well and I was about to open the door to leave when I dropped my insulin bottle. It broke. The smelly insulin oozed out of the little vial onto the tiled floor. It smelled like glue. I hate that smell! I quickly cleaned up, threw away the bottle (with a heavy heart - that's my life support after all!) and sneaked back to my desk hoping no one would get high off the smell in the small windowless bathroom.
I was about to finally do some work when my cell phone rang. It was my cousin. He just got to the hospital, a few minutes late for his 1pm appointment I managed to book for him at one of the clinics. (See what I mean?) As he doesn't know where to go I meet him on the clinic's floor and take him to his appointment. I chat briefly, then, remembering I left the office unmanned as my co-worker went out to lunch, I hurried back to my desk.
By now it's been an hour since I ate, so I checked my sugar hoping all was well since, despite all the obstacles, I didn't want to postpone my basal test. My meter showed a reading of 135. I was happy! I figured my guesstimate was correct. I went on to finally do my work and looked forward to 4 o'clock when I was to begin my basal test (and soon after that go home!) When 4pm rolled around I confidently took my meter out and checked my sugar. I couldn't believe the reading: 242! What happened? I was lost! And more importantly - I couldn't do my basal test. I didn't want to walk around with my sugars in the mid 200's until midnight. To say I was bummed is an understatement. All that craziness for nothing! All the rushing to make sure I eat and bolus by noon (or shortly after)! And on top of that my calculations and guesstimates were waaaaay off! Unless it was the added stress of the missing box and spilled insulin that propelled my sugar to these heights?! I didn't know. All I could do was try again tomorrow. Was I able to do it? Find out next time on My Battle with Basals!