Friday, June 09, 2006

Yesterday was a beautiful blood sugar day. The highest I was was 118, the lowest, 64. Overall I averaged a lovely 102. I wasn't sure why, but I was happy to accept the numbers.

Today: wake up at 205. Two hours later I'm in the 300s. I take a shot and begin to drop. 204. After lunch, 254. Then, just now, 384. I notice an air bubble that is more than half the pump tubes' length. The kind that alternates with insulin a bit, and then, air. I guess my resovoir has just been full of air, and I've missed it, because that is the only way I can account for the air bubble and my general sense of ickiness.

I even tested for keytones, just to see, and because I wondered if "general sense of ickiness" = protein in urine. This time around, it does not. And anyway, I wouldn't know what to do if it did. I've called the doctor in the past and they just said to drink water and not to worry. Okay.

What do other diabetics do?

And since I'm wondering about other diabetics...a couple of health-related/pump-related questions.

  • I used to wear my pump in my abdomen until it stopped absorbing. That didn't take long at all. I can make it last about 12 hours before my blood sugars creep up for no obvious reason. I never get a warning signal, it just quits working. My doctor thought it was becuase I didn't have enough fat on my stomach, but I don't think that's the case (having grown some since I got married!)I am now wearing my pump in my arm because my thighs were getting gross and it never lasts anywhere else. My doctor said I could wear it anywhere on my arm, but it hurts like heck in the muscle. Any suggestions about how high/low, how far around to go? Or how to make the thing work in my abdomen?
  • About three months ago on a totally normal blood sugar day my right eye seemed kind of fuzzy. The fuzzyness comes back on and off and scared me so much that I made an emergencing eye doctor appointment. He gave me a full workup and checked for all the usual suspects, and everything was fine. He suggested maybe it gets fuzzy when I'm having highs, and sometimes that's the case but not always. Has anyone else experienced this?

Thanks for the feedback!

12 comments:

Scott K. Johnson said...

Hi Nic,

Super blood sugars the other day! Don't you love those?!

Air in the cartridge or tubing will throw you off big time. I also find that when I run longer than three days on a set/cartridge, I'm running high (200's) almost all day. I think the insulin starts to degrade or something, or maybe my site itself is just worn out. Either way, I know that I need to change my site/cartridge on a pretty strict three day schedule.

With the ketones, the first thing to check is your insulin delivery. Make sure you are getting your insulin.

If the cause of your ketones turns out to be lack of insulin delivery, you've then figured out what caused it, and fixed it. You then should drink tons of water to flush the ketones out. You will also need to eat, even if your BG's are high, to get some fuel into your body. Bolus for the food, and the highs, and just watch things. It takes time, but you should start to come down and reduce your ketones.

The only time you will really need medical attention is if you are unable to hold down water. If you drink water, then puke it all up, your chemical balance is off and you will need to go into the hospital to get IV's. They will re-hydrate you, get your BG's down, and straighten things out.

If you're not puking, just keep slamming the water, flushing those ketones out, and treating the highs and food. You'll be a bit resistant to the insulin, so you may need a bit more than usual - but be careful, don't rush to get back down. It takes time.

As far as the site placements - can't help much. I've used my stomach, lower back and upper butt/hip areas. Not tried legs or arms at all.

Hope my comment made a bit of sense. And as you saw I also just posted something on ketones too - maybe that helped a little. Feel free to ask more questions if you have any!

All the best!

Nic said...

Thanks! I didn't think about the food thinkg with keytones. It makes a lot of sense. And I do tend to overcorrect...sigh.

As for the insuling degrading, I've noticed that too. But I'm so stubborn. My thinking goes: well, if there's still insuling in there and the site is holding up, then I'm really getting my monies' worth. Never mind the 200s. Silly, isn't it?

Scott K. Johnson said...

You know what I did last night? I was supposed to change my set yesterday morning, but I had over 100 units in the cartridge (I use around 75-80/day), and I just didn't feel like changing yet.

I ran a bit high through the day, but last night I set a temp rate to deliver 125% of my normal basal rate (increase the insulin because it's less effective).

I woke up at 74 (oops, over did it a little bit I guess) which is a bit low, but tolerable in safe conditions (at home, plenty of quick food around and family to help if I need it).

The things we do sometimes!

I was pretty proud of myself for fighting off the highs overnight by getting creative with my pump, but it's still not great to leave the set in so long. I am a believer that you build up more scar tissue when you leave the site in longer than you are supposed to.

Bundle of Contradictions for sure! :-)

julia said...

I put O's infusion sites in the backs of her arms, her stomach, all the way over to her sides, and (finally!!) her thighs. She won't let me do a butt site. Can't say I blame her, it doesn't sound pleasant.

If you don't have one already, ask your endo for a Precision Extra Ketone meter. It will measure ketones in the blood, which are a lot more accurate than urine ketones. Urine ketones lag behind by up to 12 hours. The strips for that meter are expensive, so see if the doctor will give you samples of those, too. I've never had to pay for a ketone (or bg) meter.

Nic said...

Dear Scott -- that's brilliant! It's so good to hear about these ideas. I borrowed your idea and dialed down today when I knew I'd be plummeting. It worked -- I maintained a nice, level 140. Thanks for the inspiration.

Dear Julia -- thanks for the info on the blood keytone meter. I've been hearing more and more about blood keytones. I understand O's aversion to the butt site. It does seem weird; and, it's easy to pull out the tubing. I've gotten over that aversion but I can't imagine having a site on my side. Funny how these preferences exist.

Tiffany said...

Hi Nic,

You are talking to an infusion site afficionado. Damn, did I spell that right???

What sets do you use in your arms? I have very slender arms and anything over a 6 mm cannula hurts; if you find that even the 6 mm's are bothering you, then your best bet is to try the angled sets. I generally go to the backs of my arms (if you hold your arm flush against your body, the back is literally the back), mid-way but erring toward the shoulder. I've also noticed that it helps to 'pinch' before inserting the arm set, so if you aren't yet, try propping your arm up on a chair while you insert, so that it pushes the flesh over (what's there, anyway).

Abdomen wise, it sounds like hypertrophy (or any of its family members) to me. How long has it been since you stopped using your abdomen? Were you using upper and lower quadrants?

Ever tried inserting your sets in your breasts? (no flinching, please, I do this regularly)

As for Ketones, I second what Scott says but add that water and Gatorade are great ways to bring these buggers down. Lots of water, and a bottle of gatorade, until the Ketones are gone. Gatorade will balance any diminished electrolytes (the evil counterpart of DKA) while also providing necessary fuel, and water keeps you hydrated (mucho importante) and flushes out the bad stuff.

But, if you're ever feeling overwhelmed by ketones, get you to the Emergency Room (puking or not puking)!

The eye thing is called Diabetic Lens Osmosis. It occurs when BG's go high, which causes the occular lenses to fill with fluid, which then changes how the lens refracts light. The end result: blurred vision. It is generally harmless and easily treated simply by normalizing blood sugar levels. No harm from this one, and it is quite ordinary, so rest easy.

Nic said...

Dear Tiffany,

Wow! What a great bunch of information. I'm so glad to know that my eye issue has a name! I will tuck that away in my memory.

I use the 6 mm canula. I've tried to use the angled sets (in my abdomen), but it takes too much coordination (seriously). And I don't think it worked, but I can't remember. I do try to use upper and lower quadrants but I find that I like "a" spot or spots more than others; especially because my jeans always seem to hit right where my site is and it peels itself off.

I have not tried my breasts, but I might have to. Not sure how my hubby would feel about that... :-)

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