Thursday, February 28, 2013

3 days in the life of a T1D brain

So last week a friend and I inundated facebook with some hourly diabetes updates. We were trying to prove a point that diabetes is certainly not all lollipops and rainbows. It’s not even cupcakes and unicorns – like where did those icons even come from to represent the DOC anyway?!

I thought it would be a boring nerdy experiment that would have some people simply unfriending me. It turns out I got some really amazingly positive feedback at what we were doing. People started asking questions. Some folks were getting educated while others were offering advice. Advice which I actually took from another T1D and it worked out splendid.

This all made me want to document a few days of diabetes for you.
I’d like to add that my glucose meter of choice has been the new iBGStar which, sadly, I’ve been rather disappointed with. After the next bottle of strips is done I’ll be heading back to my trusty Freestyle (AGAIN!).

So here we go.  I tried not to write essays with each and every BG check even though there is SO much thinking involved with every decision. It's long and quite monotonous but hey, that's how we LIVE with type 1 diabetes. Every day, to stay alive. Please remember that I am not perfect. I wish my BG never left the 4-7mmol/l range but that is FUCKING IMPOSSIBLE. Please don't judge.

This is our life. Here’s 3 days (in a row) of the life and brain of a Type 1 Diabetic….

Day 1
2:00am – I awake to my body trying to send me a message. 3.3mmol/l (60mg/dl) low. Drink back a juice box and go back to bed.
5:30am – BG is 6.2mmol/l (112mg/dl)
6:30am – Bolus my usual 6 units of Novorapid for my 30g carb breakfast of oatmeal and PB (very insulin resistant at this time of day)
9:30am – BG is 5.7mmol/l (102mg/dl). A little low for 3 hours post breakfast and an early morning low. Insulin in my system still has an hour left of active time. Snack of a couple left-over pancakes from the night before (I love left-over pancakes). SWAG 2u for about 25g carbs. I also injected my usual 24 units of lantus (an hour late-oops).
12:00pm – I had a sneaky suspicion that I under bolused for the pancakes. I have a very low insulin to carb ratio in the morning and at 9:30am I am still quite insulin resistant I guess.  BG 16.1mmol/l (290mg/dl). I retest 1  more time to confirm the high. Subtly curse. I wonder if the hour late on Lantus had an effect too? Take charge and inject 6 units of Novorapid which is probably too much but it means I come down faster.
1:30pm – BG 9.2mmol/l (165mg/dl). Quite the drop for only 1.5 hours but better low than high I say. I eat a banana with no bolus.
2:30pm – one hour later BG is at 7.3mmol/l (131mg/dl) good call on the banana-no-bolus Scully.
Ate an apple somewhere after and started to not feel well.
3:30pm – BG is 8.3mmol/l (150mg/dl) Okay the apple pushed us over the edge a bit. Inject 4 units of Novorapid and eat a Clif Luna bar (25g carbs). I still wasn’t feeling well.
6:00pm – BG is 8.3mmol/l (150mg/dl) again. Hmm? The 4 units should have been more than enough. Another 4 units injected and a very tiny ½ PB and honey sandwich on gluten free bread. I still wasn’t feeling well.
8:00pm – BG is 7.3mmol/l (131mg/dl) Have a tiny bit of Quinoa salad I just made, still not feeling well. Quinoa salad was superb though. There was virtually no carbs so I forewent an injection.
8:30pm – alarm goes off and I take 10 unit Lantus injection. I was asleep like the dead by 9:30pm because, you guessed it – I wasn’t feeling well.

What did I learn this day? I don't eat very much on a daily basis. I tested 9 times.

Day 2
2:00am – BG is 5.9mmol/l (106mg/dl) good call Scully! I wake up randomly during the night at this time from so many years of setting an alarm.
5:30am – BG is 3.9mmol/l (70mg/dl) I felt MUCH lower than that so I had 2 Dex glucose tablets. Again, my issues with the iBGStar.
6:30am – inject the same 6 units of Novorapid for my (same) 30g carb breakfast of oatmeal and PB
8:30am – 24 units of Lantus. BG is 10.2mmol/l (184mg/dl) Weird. Same bolus, same breakfast, same time, same everything as yesterday. This 10.2 requires a correction injection but for some reason (stupidity) I didn’t correct. I know the insulin still has 2 hours left in my body but I also know that 10.2 is too high for 2 hours post meal.
10:00am – Lets check on that mistake, BG is 9.2mmol/l (165mg/l) Yup. Totally should have corrected that at 8:30am. Inject 2 units of Novorapid and munch on some raw cucumber and celery (no carbs).
12:00pm - BG 7.9mmol/l (142mg/dl) Good enough for me
2:00pm - BG 7.4mmol/l (133mg/dl) still good


3:00pm - BG 7.7mmol/l (139mg/dl) Ate a bowl of quinoa salad I made the night before. Injected 3 units of Novorapid but don't remember my reasoning behind the 3 units (I didn't write it down). I was heading to the gym in a couple hours so one would think I would ease back on the insulin.
4:30pm - BG 9.2mmol/l (166mg/dl) Okay it's been an hour and a half since the 3u and the quinoa. I ate a SMALL handful of Skittles on my way to the gym from work. PS: I love skittles. I thought it was a small handful. I just wanted to get my BG up a bit before the gym.
5:00pm - BG 14.2mmol/l (256mg/dl) NOT what I was expecting. Also surprising considering the insulin I had for the quinoa which has very few carbs. What's going on here? Oh well, go sweat some of it off assuming that'll do the trick. Workout was okay but felt a little sluggish I guess because of the high.
7:00pm - Post exercise and BG was still 12.6mmol/l (227mg/dl). I immediately injected 3 units of Novorapid a bit pissed and ate nothing.
8:30pm - checking in with a 10.6mmol/l (190mg/dl) Heading in the right direction. Lantus alarm goes off and I ignore it.
9:30pm - late dinner with Ryan of a tasty delightful stir fry and a small amount of rice noodles. BG is 5.2mmol/l (94mg/dl) which is great. It's 2.5 hours post 3 unit correction so I don't bother injecting for the dinner because there are very few carbs. Plus there was some exercise earlier which could drop my BG. Still forgetting to take my Lantus apparently.

What did I learn this day? A LOT! Don't forget Lantus first of all. Trust my gut when I think I should correct. Don't trust my gut when I think I should correct. Skittles can lie. I tested 11 times today.

Day 3
4:00am - I wake up for no apparent reason. BG is 9.6mmol/l (173mg/dl) and THAT'S when I realize I forgot to take my Lantus. Swear first, then inject 2 units of Novorapid to ward off the high and fail at trying to get back to sleep. Alarm goes off at 5:10am. Curse some more.
6:00am - Get ready to leave for work BG is 3.6mmol/l (65mg/dl) Huh?! I test again, 3.4mmol/l. wtf? it's only been 2 hours. I eat a date and leave the house.
6:30am - BG 7.1mmol/l (128mg/dl). Inject the same as usual. 6 units for my 30g carb oatmeal and PB. Eat oatmeal while driving. Yup, that's me. I also injected my 24 units of Lantus instead of waiting until 8:30am because I forgot (stupidly ignored alarm) my Lantus the night before.
8:30am - I feel low. BG is 4.3mmol/l (77mg/dl) and I can tell it's dropping. It's only 2 hours post breakfast and this is too low. I eat a banana. Wonder if it was the exercise the night before. Yesterday I was a bit high at this time, the day before I was a little low. Same breakfast, same time, same carbs, same injection all three days in a row but different results.
12:30pm - Somewhere before noon I munched on a big bag of celery and a few handfuls of pistachio nuts (no carbs). BG is 8.2mmol/l (148mg/dl) I do nothing. PS: celery is my favourite.
3:30pm - BG 8.6mmol/l (157mg/dl). Not happy with that number at all. I haven't eaten most of the day so clearly I'm running on empty. I had a big fat coffee for lunch - so totally healthy right? On one hand it means my basal rate is steady (and perhaps needing an increase) because there is very little change in the past 3 hours. I was headed for the gym after work and I didn't want a repeat of yesterday. NO SKITTLES! I injected 4 units and ate an apple and some cucumber.
5:30pm - pre workout BG 6.8mmol/l (122mg/dl) great number! eat half a protein bar for the carbs
7:30pm - post workout and hard spin class BG 6.5mmol/l (117mg/dl) eat other half of protein bar, no injection. I call that a WIN! (this time)
8:40pm - post egg and veggie dinner (no carbs so no injection) BG 6.1mmol/l (110mg/dl) Still winning! inject 10 units of Lantus

End of day. Tested BG 9 times.

1:30am - BG 4.1mmol/l (74mg/dl) Oops, too low for this time of night. Drink a juice box.
5:00am - BG 2.4mmol/l (43mg/dl) There's that post exercise effect. Drink another juice box and carry on with starting my day. Just like yesterday and the day before that...

And this is where we end. Could I do this endlessly? Well I DO do this endlessly but rarely write it all down.

Diabetes... it's forever and endless and all-consuming. Some days I swing from 2.0-18.0mmol/l (18-325mg/dl). Some days it makes sense, other days it doesn't. Diabetes is fluid, rarely "controllable" but somewhat "manageable". It has me up at some point during the night every night, often twice. It doesn't sleep and sometimes neither do I.

Someone (hi Pat!) came up with the idea that one day all of us social media type 1 diabetics should inundate the internet posting every little minutia of diabetes. From the highs to the lows to the exercise to the BG checks and insulin doses. Write about our thought processes and what goes through our minds. Just one day. I thought it was a great idea and a wonderful way to annoy a whole shit ton of people ;).

Thank you for having the patience to get to the end of this post.

7 comments:

  1. Sounds like my life except that I don't use Lantus and I apparently eat way more than you do.

    The ups and downs. The same breakfast every day with different results - yup. Sounds eerily familiar.

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  2. I loved this post! To read how other T1D go through day is somewhat of a comfort for me as I get so frustrated with the swings in BS's despite usually eating similar things. If you don't mind I may copy your post and track three days of my own BS's and foods eaten to share with the DOC. Thanks for sharing!!

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  3. It's weird to see that because it's like reading my own BG diary LOL. Your correction doses are awesome, too! all in all, you learn a lot about the way -your- body works by keeping charts like those.

    Oh, and the iBGStar? I was amazed at first. I'm back on my OneTouch. Too many bugs. xD

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  4. Thanks for sharing :) It's interesting seeing into others daily lives with type 1. My youngest son was diagnosed with type 1 a little over two years ago. He just turned 13.

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  5. I think this inundating is a good idea. I'm so tired of the variety of comments that I would like people to have a front row seat to our lives. I'm glad you found you didn't totally annoy your readers.

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  6. i loved reading this! so educational, and totally engrossing/entertaining. i would like to read an entire book of just this stuff.

    you brilliant!

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  7. Girl I don't know how u function all day at work when u have to wake up at those crazy times to check bg. U are a better diabetic than me. If I test in the night because I think I'm low, and test confirms I'm low, I am sometimes too tired to treat it and I say "f it" and roll back over. Most nights I don't check at all. Livin'on the edge! Lol

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