Pushed to the breaking point this week

Type 1 and LADA
1

Those who have followed anything I've posted in the past know my struggles with highs.
I've been on the pump since May of 2011 and a CGM for a few months now.
Since then, my A1Cs have come down almost 3% and overall I've changed. I am being more active and eating considerably lower carb.
With all these positive changes, I've quickly gone back to hypo unaware, which is what caused my years of highs out of fear to begin with.
I've only been waking up or catching the lows last second when the CGM alerts that I'm dropping too fast or hit my low range.
I had the paramedics called for a 41 out of nowhere on Tuesday.
Tonight, I had a mid 300s drop to 80 in a matter of 90 minutes and had to race to the ER because even glucose gel didn't stop the plummet.
The ER doctor was kind. She simply stated the obvious, that my lifestyle choices require me to turn down my basals. I get it. I know it. But I have a massive guilt/fear complex of turning them down because I don't want to return to the high A1Cs.
To complicate matters more, I'm in a fairly new relationship and this week we moved in together. He's not taking it well. He had an angry/blaming reaction Tuesday night. And a "I wasn't prepared for this/scared" reaction tonight. I fear losing him because I'm such a burden as usual in my relationships.
I feel like I'm doing everything I'm supposed to and despite this, feel like a failure and completely defeated.

That's all. Needed to share.

2

I hope you know, we are all really proud of the progress you have made. All those feelings which drove you to keep your blood sugars high, the fear and anxiety, they don't just turn off. It takes time and effort to bring all of those feelings under control and make rational and logical decisions about these things. It is important to take life as a journey. We take one step at a time and only by looking back can we see what progress we have made. Anytime you have a setback, it can really help to look back and see how far you have come. In the scope of things, one step back doesn't reverse how far you have come. Think about it.

3

A 3% improvement is fantastic and you should pat yourself on the back for being proactive and accomplishing it.

As for the rapid drops, it may help to try to set the emotions and frustration aside for a moment, look at the data, and try to analyze what caused it in each case. Logging and perhaps a 3rd party's help (a CDE or another PWD ?) may help figure out whether there are some adjustments that need to be made to stabilize things. Look for patterns.... was it an over bolus (off carb count, wrong ratio ?) , too much physical activity without a corresponding adjustment to basals or a snack ? , etc...

All of us have mysterious things happen we can't explain once in a while, but if it happens a lot, there may be a pattern that can be discovered and an adjustment made to stabilize things.

The good thing is you now have the technology to help you discover what is going on and reach a point where less work is required day by day.

You've made so much progress... focus on the positives. You are not a failure.

4

3% rocks!! Way to go!! Sorry about the paramedics' visit though, I know that's no fun. I haven't had one for a couple of years but they are always a drag.

If the 41 "came out of nowhere" in that it was fasting, I'd agree w/ the doc and turn the basals down. The thing that still amazes me about the pump is how much small adustments to basal or bolus ratios will change numbers. If you hit 41 and had a very small amount less insulin, you'd have been at 80-90 and probably "fine" or close to it!

To figure out where to make adjustments, particularly when things seem out of whack, I look at the CareLink "pie charts" that show the time of day (I think they are "modal" reports...) and what %age of numbers are within range and make adjustments to maybe an area or two that seem to have the most lows (or highs for that matter...). Sometimes, there's what I refer to as "spillover" in my head, where an off basal can "pollute" a bolus or an off bolus ratio can push down what may look like a basal issue. In your scenario, while the low was the "big problem", the solution might lie with getting rid of the 300. I am much more inclined to take risks to get rid of a high since, if my BG runs down, I will eat some jellybeans which doesn't bother me all that much.

While it's alarming, the 41 isn't that far off and may have stemmed from "attacking" the 300 a shade too much. Neither result is a total disaster and, by nudging it a bit in the right direction, perhaps you can continue your efforts to feel better while knocking your A1C down a couple more points.

5

Good work on lowing the A1C!

Could this be emotional? It is almost Christmas, the most stressful holiday. Plus you are entering a new relationship, which has a whole nother group of emotions tied to it. If you are taking leave next week, there is the stress ofgetting things done, so you can be off.

I would make one suggestion. See if you can talk to a psyhcologist about your fears, problems, etc. There are some out there who only work with people with chronic illness, and if you can find someone who specializes in diabetes, even better. Talk to your doctor about a referral, or better yet, a CDE.

I did this a few years back. I found it really helped me see the reality of what was going on.

6

When my boyfriend and I moved in together, he knew very little about diabetes and even though I thought I prepared him whe. I had my first low and needed help, he freaked out. Very upset.

So to help him feel better and help me feel safer, I made a little diagram on paper. It basically says, if this happens do this. Example, if I am not making sense, you need to haver eat or drink one of the following (and I listed them). If I won’t then move to step 2 which was oral glucose or frosting and if I refuse or am unconscious, the. Glucagon it is.
This has helped tremendously. He carries it around in his wallet and knows exactly what to do. And I even included the phone number of my sister to call to help him if need be. That way he will have support and feel empowered instead of scared.

7

I was talking about that same stuff to my brother yesterday. When we were in our twenties we were so much healthier and the highs didn't make us feel so crappy so we tested less and stayed higher.
Now the highs make me feel sooo poluted. I try hard to stay in range and commend anyone else that does it too. It is tough; I can't sleep deep when I'm high and a low in the night can be catastrophic; the CGM helps but is not always accurate.
All I can say is keep fighting. Maybe your significant other sees things that you don't or maybe he doesn't understand; if he's worth being with he will love you and stand beside you.
It can get frustrating watching a significant other that doesn't take care of themselves, hopefully you don't fit that category.

8

The only comment I would offer is not to overcorrect on the insulin/food too fast.

The body is dang slow and better to undercorrect a bit and slowly.

When one over corrects and too fast; one ends up cycling low and high from overdriving things too fast.

I was there before - most painful.

9

Until retirement, I was an adult educator (trainer). When I first got my pump, I created a Quick Reference Card for my husband that tells him how to quiet alarms, suspend the pump, even turn it off. He keeps one in the nightstand and carries one in his wallet.

I had some foot surgery and a sedated dental procedure and gave both docs the QR card, just in case. The dentist actually used it, as my glucose level when high during the procedure, so he could turn the CGM alarm off.

It actually helps others, as well as protects me.

We have been maried 47 years, so he is well versed on how to treat lows.

10

How low carb are you? When I eat carbs, almost at all, my blood sugar is so much more unpredictable. When I start feeling out of control -- like I'm bouncing back and forth between correcting for highs and then go to low -- I can usually pull things back into balance by going way down in my carbs, like between 10 and 20 g a day (usual just from green leafies, cheese, eggs, cream). Dr. Bernstein talks about the law of small inputs: big inputs make big mistakes, small inputs make small mistakes. And I've found this to be so true. If you're only eating tiny bits of carb, you only need to do tiny bits of insulin and you end up staying within a fairly small blood sugar window.

The other thing about eating this way is that I can protect so much better against lows, if that is my priority. There have been times that I've decided it is more important to avoid lows than to keep my blood sugar in some small range, and when I've done this, I've been amazed to go weeks at a time without lows, which I hadn't thought would be possible. My b/s also doesn't tend to go very high either, though, since I'm doing the small inputs thing.

I'm sorry about your guy feeling freaked. I can't imagine that made you feel great. I've been with my husband now for 23 1/2 years (20 with diabetes) and he has had a few moments of freaking, but truthfully, it is such a small thing in his life. It really has hardly been a blip on his radar (let's hope I can say this in another 20 years!). I'm sure there're a dozen things about me that bother him more than my diabetes. I think your bf will adjust and be okay with it.

ETA: This is just out of curiosity... I'm sure that everyone's experience of blood sugar is different, and even my experience of a 60 on one day can be very different from how I'll feel at 60 on another day, especially if it's plummeting. But I'm wondering what was going on for you when you needed the paramedics at 41. Were you conscious? Do you have times when your body just can't absorb sugar fast enough? Were you alone and scared that your self-treatment wouldn't work?

11

Wow! A 3% improvement is phenomenal! I had to do a lot of trial and error when starting back on the pump a couple of years ago to figure out how much my basal rates had to be turned down during exercise. I had quite a few sudden drops as a result of not decreasing it enough, and a few highs because I decreased too much. Just be systematic about it and find what works. A few highs here and there are not going to ruin all your hard work. Believe me.

As for the relationship, the only advice I can give there is to educate your boyfriend in as matter-of-fact a way as possible. Don't expect any immediate turnarounds. He has to want to be a supportive partner. If he can't be that, then he's not the person for you. I've dated a lot of people and for every person out there who sees T1D as a huge burden, there's another person who is supportive and understanding.

12

Alone and scared and in the storefront business that I run in a rough neighborhood. I was 41 with double down arrows on my CGM and active insulin on board. I've since changed my ISF from 65 to 70 and so far it's helped a little.

13

Thank you. He's trying :)

14

I have been diabetic for 38 years and married for 35. I realize I am an old fart but here are my observations on the relationship for what it is worth. First Diabetes is not you but it is your passenger. When you move in so does diabetes. Rotten deal, inconvenient you get, but it packed its bags as well. You are inseparable.

When i got married my wife and I had not lived together, but we had been through several lows and she was still ill equipped to handle the lows. She felt constrained, embarrassed and inept in the face of the lows. We had to figure it out and it was not perfect. As we lived more and more together She took a more stepped up active role in my management. Today she handles the lows if she is home, calls 911 if needed, and scolds me for highs and lows.

My point is it does not occur overnight. Both of you have to hit a stride. You have to show your vulnerability, and frankly he needs to step up and say yeah I get it we can figure this out. If he does not see himself in this role and you cant blame him if he don't, he needs to move down the pike. I hate saying that, I know you have high hopes, and I have high hopes for you. But lets face it, you did not choose insulin, neither did I. I suggest a frank conversation and cut it off if it will not work.

It worked for me but not ever time. I dated a girl once who was appalled by my diabetes. She wanted nothing to do with it. I broached it on the first date, and we never went out again. She did not wish to be part of it. I get it, hell I didn't want to be part of it. I grew up with the disease, (my mom had it) so to me it was like second nature. But I also saw people who would not take care of diabetic children because they were scared, and invariably some of those people ended up at my house and my mom watched them.

Now none of those people were bad, none lacked courage, but all of them washed their hands of people who used insulin. Chances are this is your first serious relationship that might be ruined because of diabetes. Talk it out, be frank and tell him you understand if he needs to drop it.

Then consider something else, think abut some therapy, I always say this and people say hey I don't need therapy, well neither did I until it nearly broke me 20 years into my marriage. I was angry, in denial and just plain mean about the disease. I wish i had those years back, I would be better off today.

Finally, if your current BF walks, I will promise you 100% someone out there is looking for you. He will learn about the disease, learn what to do and put your health front and center. I found that and I told my wife before we got married I did not think we could because I was not sure she was strong enough. That shows how dumb I am, because she is tough. I mean really tough. I wish you the very best.

Rick Phillips

15

Great job getting your A1C down! I wanted to address the boyfriend thing - I have been with my fiancé for over 2 years now and he couldn’t be more supportive. That doesn’t mean babying me or feeling sorry for me, but it means being strict and telling me to check all the time, almost incessantly. I’ve had a lot of trouble with highs in the past and I am just now regulating myself to the point where I am in the 6s. Because of him, I am in better control and we want to make sure that I don’t have complications so that we can see as many anniversaries as possible. I believe he is probably the best type of partner to be with, but it takes a lot of time to get there. Before him, I dated guys who didn’t understand at all and made me feel like such a burden. Of course diabetes is a scary thing for those who don’t understand it (and even for those that do) but there has got to be a better way for your boyfriend to handle your diabetes. He should be reading about it, asking people about it and wanting to know as much as possible so that you both are as healthy and happy as possible. Personally, I think it is impossible for “normal” people (and most type 2s for that matter) to understand what we go through, but for those who are close to you, it needs to be a matter of importance to try and learn as much as possible. It will make both of your lives easier and one day, diabetes won’t have to dictate your conversations or your relationship. I once was dating a guy who said that diabetes is too much trouble to deal with for the significant other (I dumped him shortly thereafter). I went home, straight to my laptop with tears in my eyes to google “dating a diabetic.” You can find everything on the Internet these days, even a forum for people who date diabetics. Don’t wander over there through because most of the posts say that it’s too much trouble to get involved with a type 1 diabetic. What I gathered from that site was that it is ok to date a woman with 8 kids and another boyfriend, but type 1s are waaaay too scary to be with. If your boyfriend continues to give you a hard time about even having diabetes, he needs to find Octomom and see how much of a burden diabetes is then. Just like MyBustedPancreas said, for every man out there who thinks type 1s are a burden, there is at least one person who would love to help you both make it to live to 100 so you can hold hands on your front porch in your rocking chairs with your meter nearby and your pump tucked into your bra and your CGM beeping like there’s a burglar in your bloodstream. When your significant other finds that romantic, you’ll know he’s a keeper.

16

What I do, since I live alone, is keep my favorite hypo foods (pixie sticks, oatmeal bars, grapes, and kool aid) right by my bed. I usually wake right up when I feel myself going down. Just so I don't have to go tearing through the fridge.
That is the only thing I hate about night time.
Anyway, 3% is awesome. You are doing really good I think. Don't give up. :0)
Also, don't be down on yourself. Just teach your boyfriend about your condition and what he should expect.

17

I can relate to that same feeling of being a burden on your partner, I have been married for about 4 years now and it has been a roller coaster for us due to my uncontrolled diabetes at time. I feel like I can really relate to your feelings and issues that you are coping with. I want to start utilizing this site more often for support and advice.

18

See if you agree with the the original post ???

http://www.tudiabetes.org/group/diabetesvets/forum/topics/583967:Topic:154565