Saturday, December 16, 2006

Quick, bring me an orange!

My in-laws took the boys overnight last night, and we decided to go out to dinner. It was a spur-of-the-moment thing; we didn’t have much in the way of leftovers and were both frazzled from the long week at work.

I wasn’t worried; I had changed my site the day before, had a ton of insulin in my pump, had my meter and juice and all in my purse. Decided, in the light of recent news, to go eat something with chili peppers in it as a sort of salute to capsaicin.

I had been running in the low 200s all afternoon despite corrections, but wasn’t too concerned. This was just my thyroid getting jealous since the pancreas was getting all the attention. I’ve noticed before I work backwards to most “typical” Type 1’s – this apparently includes being hyper- not hypo- thyroid. So when things act up, it just randomly spits out some extra hormones and keeps my around 250 for 4 or 5 hours. My 4 hours was just about up, the latest correction would work, and I’d be back to normal by the time our food arrived.

Alas, wrong again. Still 250 when we sat down. Ordered a Pilsner Urquels on tap and nibbled a bit of bread, bolused 4 units and doubled my basal for 4 hours. Dinner arrives: 300. Eat the Cajun fish and a few tablespoons of spicy risotto. Despite the menu, this is an Irish pub; my beer comes in a pint, about 4 times as much as I normally have at one sitting, and I’m pleasantly buzzed. Maybe my site’s clogged. No problem, we’ll just finish eating and head home and I’ll take care of it there. Bolus another 5 units.

I check my Dexcom. 390. Yeah, like it climbed that fast in ten minutes. Restaurant is pretty tight quarters; I’ll just nip into the ladies’ room and swap out my site with the spare from my purse. Once in the ladies’ I test again. 390. Damn! OK, lets swap out that…site…Damn again. I’d transferred the spare infusion set to my evening bag for last weekend’s Xmas party, and hadn’t put it back. OK, another 6 units, and I’ll just ask for a doggie bag for that lobster risotto.

We head home. I run upstairs to check. 372. OK, forget the stupid site, let’s just inject 5 units and then change. Rip out the old set and inspect it carefully. No kinks or bends, nothing to show why it didn’t work. Which means I may actually have like 15 units of insulin on board. Probably not though. I check Dexcom; it shows me dropping. Sharply.

Oh, shit.

“Honey, you remember how to use the glucagon, don’t you? Just in case?” We’d done a practice with an expired set last year and he’d been nervous just injecting an orange – but since then I’d made him do my site change or Symlin a few times so he’d be used to sticking me (I’m snickering here) just in case he ever had to.

I dig out the glucagon kit from the bedside table. It expired in June. But wait, I know I picked up a new one; must be downstairs. We take out both kits, set the good one aside and take the expired kit and a Clementine from the fruitbowl. Practice time again.

“All right, you need to figure out what to do. I’m not going to be telling you if you really need to use it.” He flips over the kit and begins studying the label on the bottom. “The instructions are inside.”

He opens it up, takes out the folded glucagon-for-dummies sheet and starts reading.

“Um, honey? I don’t think you need to shake the bottle until you add the liquid – it’s just a tablet in there now.”

He growls just a bit and returns to reading the sheet. Needle in the bottle, squirt and shake, draw it up into the syringe.

OK, that takes a few tries, he keeps sticking the needle too far in and sucking up air. My tipsy self is finding this incredibly humorous.

Finally, the moment of truth. He pins the orange firmly against the counter with one hand, needle in the other.

“Throw it in like a dart, don’t hang on to the plunger. Great. Now just wait ten seconds or so, you don’t want to let it dribble out if you pull out too soon…” Yeah, I know I said I wouldn’t help him. I also promise not to back seat drive.

He waits, then pulls out the syringe. The orange erupts like a mini geyser, like a garden fountain with its single perfect arc three inches into the air. Our own personal “Citrusken Pis”, taking a leak on the kitchen counter.

I lose it. We laugh so hard we can barely stand up. We can’t even look at the real kit without giggling.

“Okay, honey, if my BG keeps dropping, just dial 911 tonight, all right?”

But we don’t need to. It levels out at a great 150, stays that way most of the night.