It is a holiday.
But my husband had to work.
So we did the typical barbecue thing as a late lunch/really-early supper. Before he goes in to manage a bunch of teenagers who will inevitably be harassed by the drunken public. Before, during and after the fireworks displays.
Stupidly I neglected to eat breakfast. I had an early morning spike and corrected then waited for them to come down as I nursed a lukewarm coffee. Then I launched into a morning of laundry, baking and food prep. By the time my stomach started rumbling it was so close to our meal that I deemed it pointless to consume anything.
I set the kitchen timer for twenty minutes for the second time. It was my signal to (pre-)bolus for the nearing meal.
I picked up my PDM and plugged in the numbers, waited for it to do the calculations and then pushed all the buttons that would allow it to administer my insulin. Given the carby nature of the meal, I added a hefty increase to my basal rates, and opted for an extended bolus.
The kitchen timer alerts the meal is ready.
We sit down. Dine. And talk politics.
I have an absolute fear of high blood sugars. There’s a part of me that suspects I may have PTSD from the time I went in to DKA, had a heart attack and died for seven minutes.
That plus a couple weeks in the hospital and the parting gift of brain damage.
Even when I negligently allowed my sugars to cruise along in the low-end double digits (sometimes because the anxiety and needle phobia were too much, sometimes to shed a few pounds), I was mindful to not allow them to careen towards the high-teens.
The few times my blood sugars have coasted above 15 mmol/L or 270 mg/dL have resulted in an absolute panic.
Like a full blown panic attack. My anxiety kicks in and my breathing quickens. My chest tightens, my brain enters overdrive, and I am overrun with emotion.
And it was no different today.
Something in the Air
At the time my insulin pump/pod was on my chest.
A few hours before the meal, Otis (my PDM) beeped to let me know that I had three hours until my current pod expired. My plan was to ride it out until the evening. When I could remove it and enjoy a semi-naked shower.
Inside diabetes joke. A “semi-naked” shower means you’re only sporting one of your robot parts. For me, that meant I’d be showering with my CGM. It was not in need of a change, so a completely naked shower (I’m sure you can figure that out) wasn’t in the cards.
After the meal, I thought I may have undershot the carbs. So I picked up Otis and asked him nicely – through the pressing of a few buttons – to give me a little extra insulin. He “beep beeped” and obliged.
Moments later I smelled it.
Insulin smells different to everyone. To me it smells like a hospital: cleaning solutions, soap, bandages, plastic, medicine…
I glance down at my chest.
The pod is leaking.
My phone alarms. The app for my CGM is alerting me: high glucose. It reads 10.5 mmol/L (189 mg/dL) with an arrow straight upwards.
I trudge down to my room. I open the wee cabinet that contains all the parts and paraphernalia that combine to make me a cyborg pancreas, then grudgingly take out what I need to do an early site change.
Technology vs Truth
The CGM is now reading 13.3 mmol/L (239 mg/dL) with an arrow angled upwards. Less than hour ago I was 8.5 mmol/L (153 mg/dL).
I feel nauseated, cotton-mouthed, badly bloated.
And the burps have started.
Side note: I have a lot of gut issues. I’ve been tested for it all via everything from restricted diets to allergy tests to three separate exploratory surgeries. I received confirmation of IBS and a sensitivity to animal proteins. But all the doctors/specialists agree there is something else. What exactly it is eludes us all. Anyways, terrible bloating and guttural belching are signs my sugars are high.
All of this tells me I need to do a finger poke because my blood sugars have to be higher.
And I’m right.
Otis beeps and displays a blood glucose reading of 15.6 mmol/L (280 mg/dL). Immediately I panic. I refill my water bottle (emptied for the second time within an hour) and run to the washroom, Ketostix in hand.
I pee on the stick and it responds by flashing a pink square that tells me there is a small amount of ketones present.
Great. Fucking great.
I guzzle more water. Administer yet another correction dose.
I did my site change right after my husband left for work.
Placing the new pod on my arm so I can obsessively watch and smell for leaks.
That was nearly four hours ago. My CGM is still slightly off. My most recent blood glucose reading is 17.1 mmol/L (308 mg/dL). I feel ill.
And I’m a fucking mess.
NONE of the correction doses seem to be working. My blood sugars are still high. I have literally downed almost 36-ounces of water. I have done 150 squats (because it’s way too hot outside for me to walk it off). I have an increased temp basal running. And I still haven’t showered because that always makes my glucose levels rise.
Don’t fucking need that right now.
I have pricked my finger over two dozen times in these four hours.
And I am fucking horrified at the idea that I may have to inject insulin. The very idea of it feels me with fear. Makes me go cold. And sweat a little. My heart is racing. I feel tense. I need to do something to take my mind of it all if only for a moment.
I desperately want my levels down but the notion that it may take a syringe to do that is my worst nightmare. I haven’t injected since I started pump therapy. And I haven’t used a syringe in ages as I was using pens before I made the long-awaited switch.
When my husband calls to check in, our son finds me in the basement folding laundry and crying. I’m about to embark on a full blown anxiety attack…
We chat briefly.
I am freaking the fuck out. I tell him how scared I am, that there are ketones present. That the CGM is off so he should know my bloods are actually higher than what the app says. That I’m petrified I may have to inject. That I’m worried if I do it will compound the situation and cause me to go dangerously low.
Unfortunately he cannot leave. I can hear the worry in his voice and try to reassure him, through the tears, that I will be okay. But I also swear a lot and express my fear of potentially having to inject myself. While his presence isn’t likely to reign my blood sugars in to range, it would bring me a tremendous amount of comfort to have him home.
Logic gives me a quick boost somewhere in it all – my lunch bolus likely didn’t all go through, some of that leakage could have been from that.
Not receiving that full dose would certainly be enough to cause this mayhem.
But I can’t help but feel responsible.
Years of admonishment from the medical sphere and uneducated folx have left me bearing the brunt of all things negative when it comes to diabetes. Any success is obviously thanks to the wonder of medicine and those folx with all the fancy certificates up on the wall. Right?
Because I certainly do not deserve the credit for showing up and choosing to save my own fucking life every single fucking day. Right!?
My last finger poke said my blood sugars are 14.2 mmol/L (254 mg/dL) and the PDM suggests another correction dose. I obliged.
I still feel horrific. I just want to have a shower, put my pajamas on and call it day.
I’m so fucking over it. All of it. And I’m so fucking tired.
In four and a half hours I have checked my CGM more than 75 times (I’ve been keeping track). I have pricked my fingers over two dozen times (Otis informed me). And I have now administered 5.55 units of insulin.
Around 9:15 pm, things started to improve.
I was no longer in double digits but that 9.5 mmol/L (171 mg/dL) came with an arrow pointing straight down. I rolled with it and took that shower I wanted so badly. Figuring I was “safe” because showers typically cause my shugs to creep up a little.
Looks like I had in fact stacked. Panicked. What-fucking-ever. Because now I was low, and shit was about to get serious…
There was a time, shortly after my shower, where I felt somewhat okay. I gambled and took the kiddo out to watch some fireworks and light an sparkler. That Dexcom alert (sounding somewhat like a Pole Position announcement from that old Atari game!) went off and suggested I tend to my suddenly low blood sugars.
Bean was over it too, he doesn’t love the loud bang of fireworks and they were obnoxiously loud, ear-bursting and heart stoppingly loud.
Half a cupcake, suspended insulin and eventually a juice box managed to join forces and pull me from the pit of death. Physically, mentally and emotionally exhausted, I said “FUCK IT” and went to bed. Ridding the back of that unicorn right into a 4.8 mmol/L (86.4 mg/dL) as I turned in…
Good news: I woke up this morning.
And for that I am grateful.