Friday, January 18, 2008

The low-over

My numbers have been wacky lately. I mean seriously wacky, not just diabetes-wacky. For the longest time, lunch has been my most stable meal. I eat my usual lunch, do a 3-mile walk, and my BG does one of two things: either climbs to 260 or so and drifts gently down to 110 by 3pm, or dips first, meaning an occasional juice on my walk, then climbs to about 180 before back down by 4. I can live with that. That’s about as close as I get to being predictable.

But lately, things have been weird. I always knew if I skipped my walk, I need to add another 0-1.8 units (your guess as good as mine). Lately, even doing that, with or without the walk I hit 300 and stay there. Plus, missing lunch (which I don’t do too often) meant my BG goes up to 350 by 1pm. So, I decided it was time to do some midday basal testing.

Skipping breakfast has never been a big deal, except that as Mr Thyroid finally dies off I find it really tough to miss that a.m. coffee – actually cappuccino (make it myself 4oz milk, 2 oz espresso with our little electric cappuccio maker – best $40 I ever spent). So I decide I will just have my cappuccino at 6:30, then around 10:30 I should be in range to start a lunchtime basal check. I still pack a lunch figuring I’ll eat it around 3pm.

Wake up at 80, look real good overnight, like between 70-120. I’ve been level overnight for two months. Have my drink, bolus the usual amount and head off to work. Waiting for the traffic light two intersections from my office, my Dex’s high alarm goes off, saying I’ve passed 180. This happens almost every morning at the exact same spot, regardless of how long between having breakfast and actually going out the door.

Ten-thirty rolls around, and I check my BG in preparation to starting the basal test. 390. O-kaay, no lunchtime basal checking for me. Plus, thanks to my body’s completely backwards wiring, I am ravenously hungry anyway. Eat my lunch, bolus and correct. BG stays steady a bit, then drops, then back up….basically for the entire rest of the day I’m between 200-250.

At ten pm I’m around 190 and drifting down very gently. I decide not to do any corrections and just fix things tomorrow morning. But, I’m not sleepy yet so I spent forty minutes or so working on my “The Times’ Fiendish Sudoku” book I picked up in London.

After a while, making no progress on my current puzzle, I decide to turn off the light and go to sleep. But, let me just check first and see how out of range I really am. Thirty-one. WTF? Did I do a correction and forget about it? And where the hell are my juice boxes – my bedroom stash is empty.

I go downstairs, pour myself a glass of milk, and chug it. And interrupt my husband’s piano practice to tell him I’m low. I should be using something quicker, but I don’t have my little green juicy-juice boxes and stubbornly wont consider those darn sidewalk chalk glucose tablets. After about 5 minutes, I have a second glass of milk. And one of my homemade molasses cookies. So I don’t go low again. Then, because they’re tasty, I have another. And another.

OK, I’ve just gobbled down like 50 g of carbs. Now I’m tired. My husband comes up and reads to me, to make sure I’m going up before going back to sleep. It takes an hour for me to break 60. At this point I assure my husband that I’m most likely headed for 400 but that I really just want to sleep now and I’ll fix it tomorrow.

The alarm goes off. I hit the snooze, grab the meter, and test. 74. WTF x 2??? I pull Dex from under the pillow. According to him, I never went above 100 all night. Unhook pump, shower, get ready for work, sit down for breakfast, retest. 78. Hmm. Have a real breakfast – toast and cappucino. Low alarm goes off. Hang out for half an hour until fingerstick shows my bg hitting 78 again, then go in to work.

At work, I feel like I am completely wrapped in blankets. Muscles ache, brain hurts, and I bumble through the day, feeling as though I’ve switched brains with the dog. At least, maybe the dog could make more sense of the code I’m supposed to be working on today.

At lunchtime I’m 94. I eat, bolus lightly, and take a walk, hoping to clear my head. Nope. All I can think about is going back to bed, lying down, and sleeping.

Somehow I make it through the day – with a juice box at 3:30 as I dip down to 64 – and head home. Bed. Bed. Bed.

I call Number One Son over, explain to him what needs to get done for dinner, and go upstairs. Bed. Bed. Bed. I check my BG – 96 – and fall asleep instantly.

45 minutes later, my husband wakes me up for dinner. I feel about one thousand percent better. I can keep my eyes open. I go down to eat, do a fingerstick. 46. Hoo, boy.

By the time dinner is over (juice, wait for BG to come up, dinner + extra 35g carbs so I don’t dip again) I am back wrapped in my metaphorical blanket, too dull to think of anything. I stand up. “I’m going back to bed.” It’s barely eight. BG 220.

Dex beeps at 1am. I’m 46 and drink juice (bedside stash has been restocked). Back to sleep, wake up at 90, go to work. Once again, high all afternoon and evening. I do no corrections, only bolus for the carb contents of meals. 224 at 11pm. Ignore it and go to sleep – last bolus 5:15.

I wake in the middle of the night, drenched with sweat and shivvering like mad. Check Dex; he says “LOW”. It’s 3:30, and I’ve been LOW for an hour. Flip to the 3 hour screen and see that BG went into free fall about 1am. I must have slapped the “below 90” and “below 55” alarms in my sleep. Wonderful. I feel much, much worse than the 31 two days ago. I know I should wake my husband, but all I can think of is that he’ll turn on the light, and I don’t want the light on. Poke straw into juice box in the dark, slurp, toss, roll over, sleep.
When the alarm goes off this morning I’m 46. Great. Another juice. Wait. Shower. Get ready. No way am I driving in to work this morning. I feel like I’ve been beaten with sticks, then taken a few turns in one of those witch dunker things, into ice water. I’m achy and tired and miserable and not able to think.

I try to log in from home, but after about 90 minutes of bumbling around in the code, doing things like spending fifteen minutes trying to figure out where I can find the script that updates the version info file, giving up and emailing a co-worker to ask where to look for it, then getting the sudden brainstorm that maybe the code is inside the file named “update_version_info.bat”. That sort of thing. A menace to myself and any poor sucker stuck working on the same code base. And my brain is running through the same loop, over and over : “I’m tired. I’m cold. I want to lay down. I don’t like these lights. I’m tired…”

I check out Dex's nine hour graph and see a perfect "W" 220 - LOW - 55 (after 3am juice) - LOW - 220.

I give up, email my boss that I’m sick, and go upstairs, proceeding to lie in bed for two hours with my brain going “I’m bored. I’m cold. This bed isn’t comfortable. Too much light….”

At least it’s Friday.


Scott K. Johnson said...

Oh Val,

You have been on one hell of a rough ride!

While I don't have any real practical advice to offer, I wanted to let you know I'm thinking of you and hoping that the weekend treats you better.

Keep us posted!

Gcavanaugh said...

I am just finding your blog. I have read many of them. and I just want to say that I am so glad you write them. I have a seven year old with type one, so I can totally relate to the chaos of this disease. but it is comforting to hear your experiences as an adult. even though it is my son who has T1 , I feel like I have it. So hearing your stories makes me feel like someone else gets it. gets how frustrating it is. how absurd, and how this absurdity just makes you laugh.