Friday, June 23, 2006

24 hours of being me

Thursday 10:48 am (this "day" is not starting when I wake up because I'm pretty much a zombie then). I'm sitting in front of the computer at work. My pump beeps to remind me it's been 2 hours since my last bolus. I was 277 after breakfast for no discernable reason so I took 1.6 units the pump said I didn't need [3.1 to correct, 3.9 still active]. Sensor says 192 with a single down arrow. Study meter says 145. Val 1, diabetes 0.

10:55 am. Bathroom trip. Check pump tubing from where it enters my leg back to pump, looking for air bubbles. Thought I'd seen a half-unit sized bubble last night near the pump, but now it's nowhere to be found. Maybe that explains the breakfast high, or at least part of it.

11 am Meeting. Bring meter and juice.

11:30 Discretely reach down and hit button on pump to display sensor reading. Glance down. 136. That's 60 points lower than last time I tested, where sensor was about 50 points higher than fingerstick. Even if it's still 50 points off (not likely as things should have slowed down), that would put me at 86, still ok.

11:40 Repeat push and check. 132. OK, we're fine, not moving much at all.

11:55 Meeting ends. Get lunch from cafeteria, whole wheat sandwich (26), salad (0), cookie (16?), and water. Sensor says I'm 120, UltraSmart says 98. Pump bolus estimate is 4.2 units. I usually eat an extra 15g carbs or so and still go low if I'm doing my standard 3-mile walk at lunch, but today I'm running errands. Go for 4.4 units, split half now, half over 30 minutes.

12:15 Heading out to store. Check sensor - 106. But, it hasn't caught up with my food yet. I'm fine.

12:30-1pm During errands, periodically check sensor using same technique as in meeting. 140 with 2 up arrows, 138 level 10 minutes later; 126. Hmm, maybe I should have taken less insulin. Decide I'm OK to drive back to work without testing.

1:55 - my post lunch reminder. Sensor: 114, UltraSmart: 119. Yes! Now, I should be OK for most of the afternoon.

2:15 - cup of tea with milk. No bolus.

2:30 Sensor 120. I typically (but not in the last 2 days) drop between 50-175 points on the way home. Better keep an eye on numbers, since I may have to eat at 3:30 to be able to leave at 4.

2:50 Sensor 128. Great, we're level.

3:09 Sensor 138. Still good.

3:30 I've got my "turnaround" feeling, like I'm in an elevator that's gone down unexpectedly. Sensor: 132. UltraSmart: 101. I don't want to eat too much, but I don't want to go low on the way home either. Break off two squares of my emergency dark chocolate bar, figuring 7 grams of carbs with fat should digest slowly just over the time I normally drop.

3:45 Sensor: 124. Uh, oh. Let's wait a few minutes and use meter.

3:51 Sensor: 116. Nuts! UltraSmart: 101. Still. Decide to drive home without further snacks. School ended today, and my mother in law is watching the kids, so I don't have to pick them up, making my drive less than 25 minutes instead of 90.

4-4:30 Periodic checks of sensor on the drive home show me steady around 120. Val 2, diabetes 0. Go chocolate!

5:20 Supper is ready. Sensor: 114, UltraSmart: 80. Perfect. My mother in law has made us a batch of pasta fagiole, with directions to add the pasta to the beans and sauce at the last minute. I nuke up leftover brown rice instead of pasta for me, and have sauce over that, with a small glass of red wine. Yum. My guess is 48 g carbs, I take pump's recommended 4.0 units, 50/50 split over a half hour.

5:40 Sensor alarms low, 84 with one arrow down (I set it to 100 to catch lows). Ultra smart says 90. I've just finished eating, so I should be fine. Dig up the flyer for the summer camp orientation tonight and discover it starts at 6 and serves food. So I guess we didn't really need that supper, except it was better than hot dogs. For everyone. Pile kids into car and head out. My husband drives, as he usually does when we both go out together, even before diabetes.

6:15 - 7. I have a plate of salad, two oreos, and a cup of diet pepsi at the picnic. Bolus 0.7 units for 16 grams without testing or checking the sensor.

7 pm Back in the car. Sensor says 146. We drive to supermarket with kids.

7:50 In checkout line, better look at sensor. 194, just on the slope down. Fine, no problems. Get kids ready for bed.

8:41 post-bolus alarm. Sensor : 136, StudyMeter: 141. Great!

9:12 Sensor is level at 138. I usually drop at some point before midnight. Let's try 15g dark chocolate again, no bolus. Check tubing for bubbles now because I won't remember in the morning.

11pm. Sensor still level at 140. StudyMeter: 136. Perfect. Go to sleep. Val 3, diabetes 0.

5am Friday. Alarm clock goes off, waking me from a dream that I'm low and can't find any food. Not a good sign. I'm also bathed in sweat, and we have central air: Not a good sign, either. Hit the snooze and reach for the UltraSmart. Pop the cap off in the dark and try to slide a test strip into the little notch in the meter. Can't get it in. Try using the backlight on the pump. Still can't get it in. This, too, is Not A Good Sign. Give up and flip on the bedside lamp, discovering the reason I can't get the strip in is that there's still an old one in there. Sensor says I'm 106. UltraSmart: 119. Did I bounce? Dirty finger? Stress of trying to get the frigging strip in? Or is that the real reading, and dreams of being low were just that, dreams? The cat has curled up on top of my pump. Pull the sheet up and shut off alarm clock.

5:30 am pump low alarm (cat has moved): 96. UltraSmart: 97. Get up, decide to unplug for the shower. Feed cat. Usually I wrap the pump in a ziploc freezer bag and take it in with me, but usually I'm a lot higher than 97 too. Val 4, diabetes 0. Shampoo, removing AUTS (another used test strip) that has somehow entangled in my hair.

5:50 shower over, hook pump back on and get dressed. Sensor did not lose signal when I showered, says I'm 90.

6am sensor low alarm. Turn it off but don't check.

6:15 make breakfast. Sensor: 98, StudyMeter: 121, UltraSmart: 114. We're all in sync, good. Have a Thomas' mini-bagel (24), milk(13), and cream cheese (let's try 5). Take pump's recommended 7.0 units, split 50/50 over half an hour as usual. Feed dog and kids, or at least perky, cheerful Number 3 Son, who wakes up at 6 with no alarm. Definitely not my genes there. Make decaf coffee to take with me.

6:30 ready to leave for work. Sensor: 122 with an up arrow. Fine.

7:05 am Arrive at work. I have my "turnaround" feeling. Sensor: 166, one up arrow.

8am. Bathroom, tubing check, look at sensor. 164. No arrows. Perfect. This was the same breakfast that took me to 277 yesterday, by the way.

8:10. Feeling a little sweaty. Could be the a/c. Low? After breakfast? Not likely. Check sensor: 170. It's the a/c then.

8:15 pump reminder. Sensor: 168. StudyMeter: 171. For breakfast, this is success.

8:40 Walk to cafeteria with my office mate. They do not have apple turnovers, my real weakness, so I just refill my decaf coffee and head back. Sensor: level at 170.

9:15 Sensor 134, two down arrows. Huh? I'll check with meter later..

9:30 Sensor 120. No more arrows. Probably fine, check later.

10am Sensor 102. Hmm. UltraSmart: 90. An hour and a half until lunchtime. Snack, or wait? I'll wait a bit and see what happens.

10:15 Sensor low alarm 94. So that's what happens. Don't bother with the meter, just eat a bit of lunch early. Except, didn't make a lunch today. Break into the pack of PB crackers, eat 2 (7g). Should be OK until lunch.

10:30 Sensor 90.

10:45am Sensor low alarm 78. Huh? UltraSmart 96. Crackers worked after all. I'm OK until lunch. Low successfully averted; Val 5, diabetes 0.

This was a good day. In fact, this was an extremely good day, the kind of day I only have every couple of weeks. The sensor and meters were in agreement, unlike last week, when the sensor said 160 and a finger stick said 30 (sensor never went below 85 that day). Or the night before last, when my BG wouldn't go below 350 for four hours, despite all the corrections.

This was the kind of day I hope I have more of. And that I probably will have more of, because although I hope and pray for a cure, realistically I know that when and if it comes, it will probably be for people who've just been diagnosed, who still have some beta cells left. That I may go the rest of my life like this, hoping for days when I "only" have to think about diabetes 46 times in 24 hours. Because I can deal with that, I really can.

But no little kid should have to.


Kevin said...


That was amazing. The whole thing. How well controlled your readings are with the sensor to help out, the detailed logging of readings, carbs, boluses, activities, thoughts, and concerns. I keep detailed records, but they can't hold a candle to this. But even without it all being written out, it is an EXCELLENT representation of what we all go through -- 46+ times/day.

And I think you're right on the cure front. It may come someday, but we can't hope and wait idly. And this, this constant work, is something we can do.

Major Bedhead said...

Definitely wow. That was great to read. Do you do that kind of detail daily or was this a one-off for the blog? Because if you do that daily, I will be highly impressed.

Every endo appointment, I bug for one of these for O. She wants one badly. I want her to have one, badly. I keep hoping they'll approve them for kids under 18 and that the insurance company will cover them.

Scott K. Johnson said...

Super great post - an excellent look at what goes on in our heads.

I (of course) got a kick out of the AUTS in your hair. :-)

Anonymous said...

that is so cobnfusing. how did you get a continuos montior

Val said...

Hi all, and thanks for the comments. In answer to your questions:

No, I do not keep records like this all the time (if I did, I'd do nothing else). But, for a long time I've been wanting to capture ths, everything that goes through my head in a typical day.

Actually, this turned out to be a rare good day. Maybe another time I'll do this again and capture a bad day (rage bolus, 4.5 units, BG check 311, diabetes 12, val 0). Even with the sensor.

And I have to admit I cheated a bit - I did look at the sensor a few more times then that, and I resisted looking at it another 25 times or so, because I didn't want to have to write it down.

And I had the pump-with-monitor thingy because I was part of the FDA approval study for it. I have to turn it in on Tuesday, though, after using it for six months. But, Tuesday I start the DexCom (wishing insurance would cover it, but unfortunately, it's looking more like my lunch-and-vacation-budget for the next several years. Thank goodness we're finishing up daycare, so instead of freeing up that $$$, we're just mailing it to DexCom...

Anyway, I plan to do a comparison post once I've been using the DexCom for a few weeks...

Kelsey said...

Wow, I'm exhasted just reading this... though I relate! It's amazing all the thinking and planning that goes into diabetes management. Truly amazing.