Tag: BG

Day 21-

One of my favorite Regina Spector songs starts like this, “ Some days aren’t yours at all, they come and go as if they are some one else’s days”. If you have never heard of her you need to, she is an amazing talented singer/pianist/percussionist/ songwriter. Today I am going to talk about bad days. Not just your regular bad days, T1D bad days. I am going to keep things real, so just a heads up. So a bad T1D day may go something like this, getting ready to do some sort of activity like running, walking, swimming, biking, or even going to a museum or zoo where you are going to walk around a lot and your BG goes low before you get there, then 30 minutes later it goes low, then 30 minutes later it goes low again. Then you finally get it stable and go out to do your thing and then when you get there and get started it goes so low you think you are going to pass out. There goes your whole day. That’s it. It doesn’t matter how much you want to do something if you are going to pass out doing it then it is a no-go. I have gotten ready for a bike ride and started out only to get 1 mile away and then have to ride home, or sometimes not start at all. Or get to a Dr. appointment or work and have by BG so low I am even afraid to get out of the car. This is extremely frustrating because you can see the building; it isn’t that far at all, yet you have to wait for your BG to come up so you don’t pass out on your way in. Also, then you are 10 minutes late for your appointment or work. A bad day is getting out in the middle of the woods alone, have repeated lows, running out of food to treat it with, turning off your pump because you are hoping to hell if you pass out you will eventually wake up because you stopped your pump and are so full of sugar you feel like a gummy bear. You know shit is bad when your dog won’t leave your side. All the exercise things apply to high BG too because, again, if you aren’t getting insulin for some reason, when your BG is high you are at risk of DKA and exercise can push you into DKA quicker in that instance. A bad day is having a crazy morning and forgetting to change your pump site and reservoir, to get out the door and then run out of insulin and then to have to immediately return back home, OR forget to put your pump back on after taking a shower, which does happen occasionally, and then realize an hour later and then return home from where ever you are and feel really, really stupid. A reminder, we are all human. A really bad day is putting a new infusion set in and hitting a vein, because our bodies are full of them, having to pull out the new site because insulin cannot be injected into blood (it will act to fast) and also the new site hurts like a SOB to have it bleed, and bleed, and how the hell can so much blood come out of a tiny hole, and then lay down with a blood soaked towel until it stops (which it does) and then get to put yet another infusion set in. We T1D actually have a name for these vein sites; we call them “gushers”. A bad day is to have an infusion set needles bend as it goes in, it kind of glances off of your skin but still goes in off to the side. Those leave a hell of a bruise. Human skin is amazingly tough, you would be surprised how tough. A bad day is an infusion set leaking due to scar tissue and not knowing exactly how much insulin you missed, was it 2 units, or was it 10? Then having to wait hours to see if you added to correct correction dose. A bad day is having your infusion site or tubing pull out and not know, or have half hanging so again you haven’t been getting insulin and have no idea for how long. Again you have to wait hours to see if you gave yourself enough insulin to correct for the leakage. A bad day is having low BG all night which leads to highs, you conservatively correct the highs, because you’ve been here before, only to go low again and this keeps happening all night into the next day. We call those rollercoaster days. Then you feel like you got hit by a bus and you still have to function all day. A bad day is accidentally sticking your 18g reservoir needle, which is used to get insulin from the bottle to the reservoir through your finger because you slipped. A bad day is having high BG all day and feeling like you have the flu only to have it come crashing down later multiple times. A bad day is having the flu because as you are figuring out now, vomiting and T1D don’t really go well together. If you give yourself insulin for a meal and then throw it all up, well you better get some juice in you so you don’t pass out from a low BG. A bad day is passing out from a low BG, ending up in an ambulance, and at the hospital. The thing about the Glucagon shot is yes it keeps you from dying, but when your BG starts coming back up it is very common for the T1D to start vomiting and also have seizures. I could go on, but I think you all get the point. Regardless of bad T1D days the world keeps turning and we have to keep moving. Most of the time, we suck it up, are glad we are alive, and just keep moving. There are sometimes though that when I am having a really, really hard time I choose to stay home because I am a little unsympathetic to common complaints and would not be proud of what would come out of my mouth. I know this must be all hard to hear and ready, but this is how our lives go, this is how it is. Most days though, we are fine, because please remember this is our “normal” as fucked up as it may be.

Day 5-

Ok, so today we talk about Blood Glucose, aka blood sugar, or just plain BG. Your BG is the level of glucose in your blood…. yes blood. It is measured here in the US mg/Dl. So it gets complicated from the get-go. The standard of a normal BG reading differs from organization to organization. Some organizations say a FASTING BG should be 80-120, others claim 60-110 or 70-100, or, or, or. When you have T1D you use something called a glucose meter to check your BG 8-10 times a day by poking your finger with a tiny needle called a lancet. Yes, I said 8-10 times a day, sometimes it is actually more if you are having a bad BG day or it can be less, but is rarely less. I see you have added up how many holes you can create in your fingers within a week… up to 70… yup that is correct. That is why if I cut myself you bet I get my meter out and check my BG! So, back to the “normal range of fasting BG”. So one of the issues with this is every glucose meter has a range of accuracy. Two different meters can be within 30 points of each other. 30!!!!!!! There goes your whole range. Also every T1D is different. For me, as an example, if my BG is 80 that means it is going down, sinking, man overboard. Very, very rarely do I go up after an 85 or below reading. So if my BG says 70 then I have to treat it as a low BG and have to have some carbohydrates, like juice or I like to use Honey Stinger Gels. But I only have 20-25 carbs to treat it… not a ton or it will go up to much and then my BG will be high. Another problem with having BG on the lower side of normal say 60-80 is you develop something called hypoglycemic unawareness. This is where your BG can be low, very, very low, say 30 and you can’t feel it and you don’t have any symptoms and you can pass out and if no one is there to give you something called a glucagon shot to revive you, you die. Yes, if you become unconscious from low BG and you are not administered glucose in some way you die. Fun times right? Ok, so back to BG target range. After you eat every person’s BG rises as you digest your food. It is only supposed to go up so much, a T1D target range for 2 hours post meal is 150-170 max…. ha ha haaaaaaa they are HILARIOUS! In a perfect world that would work, but something I forgot to mention is EVERYTHING IN THE ENTIRE UNIVERSE AFFECTS YOUR BG if you have T1D… well may be not everything, but pretty damn close! Illnesses, stress, hormones, the weather… yes the weather, sleep, food, exercise, the time of day and what you are doing, any sort of movement, just to name a few. If your heart rate is up your BG is going down, stress can make it either go up or deep seated stress and make it drop or maybe go up or who the F@ck knows.. Also a fun fact, when your BG goes low your liver automatically releases stored glucose to compensate for the low, so if you have T1D then your BG goes up and depending on how much extra glucose you have stored it can go wayyyyyy up, then you wait and give your self insulin to make it come down and then it is low again and you treat it and then we go back up the rollercoaster… so sometimes when you see me and I tell you I am having a bad day, believe me. Having BG all over makes you feel like you are hung over and got hit by a bus, plus if it is at night, say goodbye to any sleep. Oh and the low symptoms are super fun too, dizziness, shortness of breath, brain fuzziness, sensory overload -the frontal lobe of your brain that filters everything shuts down so now you are feeling and hearing every single thing going on around you… lights, noises, wind…. all at once at a high intensity. For a while when I woke up at night with a low BG my legs were cold from the inside out because one of your bodies defense mechanisms when your BG is low is to protect it’s organs and your brain so in return your body shuts down circulation to your extremities. Fortunately, that symptom was short lived. And now we move on to high BG. For a T1D anything over 250 mg/DL is high, meaning that is when organ damage starts happening. You see when you BG is high it actually makes your blood in your veins and arteries thicker, like sludge, so you whole body has to work harder. That is why you hear of Diabetics, T1D and T2D who have had continuously high BGs having serious complications, such as heart disease, eye damage, neuropathy, just to name a few. When your BG is high you heart has to work very hard to pump that sludge. It is no good, no good at all. Also you can end up in DKA, which, I have talked about a lot and the end result can be death. Symptoms of high BG is shortness of breath, thirst, dehydration, brain fogginess, exhaustion, and blurred eye-site because when your BG is high it actually makes the fluid in your eyes behind the lenses thicker and then in-turn pushes on your lenses creating kind of a fish bowl effect. It also affects your depth perception and can take hours to clear up. Just a reminder if you have T1D you use insulin to bring your BG down. So a review Low BG can equal death and high BG can equal death. I am not saying this to be dramatic I am telling you all this because it is a fact and my reality… fun stuff right?! Everyday my number one goal, no joke, is “don’t die”.