The remnants

I’ve been having one of those nights now for about a week. You see, I changed my birth control pill about a month ago, and this has wreaked havoc on my BGs. The ebb and flow of insulin resistance that this new balance of hormones has brought to my life, frankly, sucks. By day, I am living on temporary basal rates of 150% to 200%. And by night, it’s just me and the late night talk shows, stalking low blood sugars with juice, cereal, and cookies.

I was dreaming that my company had restructured and I’d been moved from my home in the development department to a new home in the marketing department. And my new officemates, marketing and sales people, could not understand what I did or how I brought value to the company. So I kept trying to explain why technical writing is important, and what, exactly, I did all day. And they kept saying, “Oh, so you do this?” and I would say, “No, it’s more like this.” And back and forth we went. And the more frustrated I became, the harder it became to explain my worth to them. I woke up sweating, near tears, and dizzy. This low was hard to identify because I have been struggling with similar issues at work. Feeling underappreciated and misunderstood, and struggling to find some like-minded co-workers. But when I finally got that meter case open and the strip in the meter, it turned out that my sugar was down to 35. Wow.

A glass of juice and a bowl of raisin bran later, I was creeping up on 70, so I thought it was safe to turn out the light. But the BG fairies were not in agreement. An hour later I was 52. Another glass of juice, and I was back in bed.

Another hour later and Lukas was crying. He was teething and needed some comfort. I did another test for good measure, and saw a 56 winking back at me. Son of a bitch. I slurped down another glass of juice and set a temp basal of 0% for two hours before running up stairs to comfort Lukas, juice sloshing uncomfortably at the top of my stomach.

Back in bed, I couldn’t believe it when the alarm went off just two hours later. And wouldn’t you know it, my sugar was 187. I corrected and set a temp basal of 200% because I knew that those morning hormones were going to send this number through the roof. Tired, and fighting a low-induced hangover, I tried to swallow that sticky, low aftertaste from my mouth. I jumped in the shower to get ready for another day of roller coasters.

But it’s not until I was on my way out of the house, in the kitchen, that I really stopped and thought about how trying these last couple of nights have been. I’d been on autopilot, testing and treating and testing again. It wasn’t until I saw the remnants that I realize just what I’d been through: an open box of raisin bran spilled on the counter. A trail of juice on the floor from the refrigerator to the cupboard (where I must have spilled it in my 35 mg/dL stupor.) Rings of milk on the counter from the measuring cup where I (tried to) carefully measure out a cup for my raisin bran. Cookie crumbs and plastic wrappers piled high near the sink (where did those come from? I don’t even remember eating those!)

I sighed, grabbed my laptop, and headed out the door. Maybe today will be better.

Making the Low Go: Over the Years

So I’m a day late with this post, but they always say better late than never, right? I spent most of the day in bed yesterday fighting some sort of stomach disturbance. I am on the mend, though, and ready to continue with Diabetes Blog Week

Here’s the topic du jour:

Making the low go. Tell us about your favorite way to treat a low. Juice? Glucose tabs? Secret candy stash? What’s your favorite thing to indulge in when you are low? What do you find brings your blood sugar up fast without spiking it too high?

This topic got me thinking about all of the different ways I’ve treated low over the years. And reminded me of one reason why I have such a weird relationship with food.

Back in my early days of being diabetic, some 25 years ago or so, my lows were much more severe than they are now. Thanks to the peaking effect of NPH insulin and the less-accurate BG testing methods we used, I would sometimes end up passed out, then convulsing. This usually happened in the middle of the night, although I did once have a “reaction” in the cafeteria at school. I was in the fourth grade. My friend told me later that I dropped my lunch tray and that some kid stole my milk. So not cool.

In the beginning, we treated these lows with glucose gel that came in a clear bottle that looked a lot like an Elmer’s glue bottle. It had a twist-open lid that was red and white. The “doses” of glucose were marked on the side of the bottle. Later we upgraded to “Insta-Glucose,” an awful-tasting pink gel that comes in one-serving squeezable tubes, kind of like toothpaste containers. Eventually, we added Glucagon to the mix. This shot was part powder, part liquid, had to be stored in the refrigerator, and could not be mixed in advance. The routine was that my mom would force the pink goo into my mouth, while I kicked and fought and spit, and then she would run to the kitchen to pull the Glucagon shot from the refrigerator and mix it while my dad stood by my bed to make sure I didn’t flop out.

Of course, I remember very little of this seeing as I was unconscious. But the evidence was there when I came to: pink goo all over me – in my hair, on my face, on my pajamas, and an aching sensation in whichever extremity my mom could get a hand on to give me the Glucagon shot.

After I was coherent, she would force Coca-Cola on me. She would beg and plead and finally threaten: “If you don’t drink this Coke, I’m going to have to call an ambulance.”

The Glucagon shot left me with an incredible case of nausea, so if I felt that aching sensation in one of my extremities, I knew that the night would not end without a trip to the toilet to empty the contents of my stomach: mostly Coke.

And then there is orange juice. Whenever I had a close call in public, and needed the help of a friendly waitress or shop clerk, or teacher, I usually ended up with orange juice. Because the general public seems to think that the only thing that helps a low blood sugar is orange juice. Of course I was grateful for the help, but I sure would have appreciated a glass of apple juice every now and again.

Needless to say, as a result of these traumatic memories, there are a lot of ways that I choose NOT to treat lows these days. Despite my doctors’ warnings and reprimands, I do not keep Glucagon in my house. I never treat with Coke unless it is an absolute dire emergency, and I do not treat with anything resembling Insta-Glucose, including those squeezable icing packs and those sports “shots” of dextrose gel. I also avoid orange juice like it’s the plague.

I have hung onto a couple of those early low-treaters, though. When I was a kid, I always carried a bike pouch or make-up bag full of granola bars and lifesavers. By the time I needed them, they were usually smashed and stale, but who really cares when you can hardly think straight? When I was on the soccer team in high school, my water bottle had a false bottom in it. It screwed off to reveal a granola bar, a roll of lifesavers and a couple of quarters. You might think that the quarters were for a pay phone (These were pre-cell phone days, after all,) but they were actually for the nearest vending machine.

These days I’ve abandoned the granola bars because of the slow-digesting fat, but I keep rolls of lifesavers everywhere: in my purse, in the glove box in both my car and my husband’s car, in my laptop bag for work, in my desk, and in all of my coat pockets.

When I’m at home, I use those small, toddler-sized boxes of juice (berry and grape are my favorite,) and Dots (five of them is 15 grams of carb.) When I was in the first trimester, I was low ALL of the time. I treated with Jelly Belly jelly beans because they were just about the only thing I could stomach. When I’m out and about and there’s time, I will order a smoothie, because let’s face it, if you have to go through a low, it’s always nice to end it with a little treat.

Time to Eat the Donuts

This whole eating thing is getting old. It seems that I spend most of my time these days with some sort of snack or meal in my mouth. Every time I turn around, my sugar is low again and I need to eat. And I am just plain full. Full and still low.

This morning was a good example. I woke with a BG of 67. I slurped down a box of juice and adjusted my temp basal rate to 65%. An hour later, I was 74. Another box of juice and another temp basal adjustment.

Breakfast was half of a small bagel with cream cheese and I only bolused for half of the carbs. Before leaving the house I was 93. I tested after arriving at work and I was only 94, even with the bagel still in my system. We are having a kickoff breakfast at work, and I know my BG is on the way down, so I make a small plate.

An hour later I am 122 and that is the highest BG I have had ALL DAY. An hour later: 58. An hour after that: 61. And an hour after that: 57. I am now running at a 35% temp basal and in addition to the breakfast(s) I ate, I have also consumed a fruit cup, two handfuls of cheese popcorn, and a Lean Cuisine. And it’s only 2pm!

If you know me, you know that I like to eat. I enjoy food of all types, both healthy and unhealthy, high-calorie and low-calorie, low-fat and high-fat. So I am usually on the other end of this spectrum, fighting the desire to eat more than is best for my BGs and my waistline.

Boy how things have changed. Between the struggles with ketones and lows, I am always eating something now. And believe it or not, it is not a great as it sounds. I feel overfull and generally NOT hungry. My stomach feels filled to capacity most of the time, which is not helping my other pregnancy-related digestive struggles. On the bright side, it seems that my body is somehow finding a use for all of this food because I really have not gained a whole lot of weight.

I’m sure I will look back on this experience someday and wish that I could go back. But for now, I am just trying to keep up with the energy demands of this baby. Man, he or she must just be growing like crazy in there!

Wouldn’t it be nice if someone would bottle these hormones so that we could use them when we’re not pregnant to reduce our day-to-day insulin needs?

A Rough Evening

Yesterday evening was one of those nights. I had been fighting low blood sugars all day, including a 27 mg/dL mid-afternoon that left me shivering, hazy, and exhausted and I was preparing for my first night of class for the semester.

Side note: I am working on a Masters degree and attend online classes one night per week.

I drug myself out into the cold after work, struggled to hold my eyes open while I drove home, and then collapsed on the couch as soon as I walked in the door. But the blood sugar fairies were not on my side. Even with a 60% temp basal rate, my numbers were still creeping down. After an hour of trying to rest, I finally tested and saw a 45. Crap. Another snack. And thanks to those pesky pregnancy hormones, I was also sporting a pretty significant case of nausea. I choked down two boxes of juice and the shivering started all over again.

Thankfully, my husband came to the rescue. We’ve been talking about this whole ketone thing, so he urged me to think about some dinner. He convinced me to let him make me a box of macaroni and cheese.

Standing in the kitchen slurping on a box of juice and watching helplessly as my husband prepared my dinner, I got an overwhelming feeling of despair. How were my baby and I going to make it through this whole pregnancy and, even worse, how would I be able to give this baby everything he or she needs once he or she is on the outside? Heck, I can hardly keep up with his or her needs while still on the inside!

I’m hoping that it was just the low blood sugar talking, because later, after a lively class with some colleagues that I have not talked to for a while, I felt much better. I was still exhausted, but my mood had improved.

This morning, I am still fighting lows (55% temp basal rates and still the occasional 69 mg/dL) and I am still exhausted, but I’m trying to focus on the positive. I ate my 2 am snack last night and my ketones were negative this morning. Maybe my baby and I will make it through this thing yet.