High as a Kite. And Not in a Good Way.

So, last night I saw a blood sugar reading of over 300.

I haven't been that high since I was diagnosed, and I realized it was kind of a 'mental barrier' for me. I guess there was a deep inner dialogue that said "you may be close to 240, but at least you're nowhere near 300. Your pancreas won't ever let you get that high." Apparently, my pancreas will let me soar right up there with Cheech and Chong.

Speaking of the personification of organs, I always picture my pancreas as really really sad that it isn't working. I know others have it sipping pina coladas, or mocking everyone while it collects unemployment, but I always see it as trying really hard, and it keeps getting smacked down. Kind of like Charlie Brown with the football.

(Lucy is my immune system. Too bratty for her own good. Charlie Brown is my pancreas. A hard worker that just can't seem to get it right. Someday, he'll kick that football, which is full of islet cells. You just wait and see. Or, more likely, someone will kick it for him while he stands by and cheers as Lucy is thwarted.)

I have way too much time to think about this.

At least I know what caused the 317, which isn't always the case with highs. I was going low right before yoga class, and I seriously overtreated, thinking what with the exercise, and the tastiness of this particular carby treat, what with the bananas AND the brownies...yeah.

I also learned that 10 days might be too long for the Dex to handle. After yoga, it said 122, so I was congratulating myself on the dealing well with the massive dessert. Oh, but the meter read 252. OK, time to change the sensor. But since I had no idea if that was 252 and *rising*, or if I was coming *down* from an even higher number, I figured I would check again in a half hour before I corrected. And then, well, I forgot, what with the Tivo'd shows to watch, until Dex buzzed that it needed 2 start up bg's, which, of course, was 2 hours later. Whoops. My bad. Well, the bad belongs to Diabetes, but still, I seriously could have handled that better. It also showed me how dependent I've become on the Dex in such a short time.

Again, live and learn. And You're a Good Man, Charlie Brown Pancreas.

High? As it turns out, not really.

4:30 a.m. BUZZ!! I grab the Dex groggily. High. Over 200. Mmmmkay. Since I'm awake anyway, I stumble to the toilet, turn the light on in there, and give myself a shot to bring the sugars down.

As I climb back into bed, my husband asks me if I am low. I tell him no, it's high this time, and settle down. Then it occurs to me. 'This is a new sensor. I should double check that high with my meter.'

119. I just administered enough insulin to drop me 100 points and I'm at 119???? Well, that can't be good. In fact, it could be really, really bad.

So I do what I need to, I eat some carbs. (Doesn't everybody bolus at 4:30 in the morning for a little snack?) I recalibrate the Dex. I remind my husband where the glucagon is in my nightstand, just in case. I settle back in bed, but I know the rest of the night is pretty much shot when it comes to any actual sleeping. My husband tells me "I'm awake with you" and I love him for it.

My friends, it's moments like these that make the FDA balk at the artificial pancreas. My Dex is accurate most of the time. I would guess that it's close to 90%. I mean, there was the time when it said 276 and I was in the 120's, but I knew that one was screwy - it had ??? right before, and while I don't always 'feel high' (insert random drug reference here) I would have noticed a 276. And it's not always accurate on exactly HOW low I am, but it's definitely a warning that I didn't have before, and one that I love. Plus, the fact that I can remember these anomalies shows me how rare they are. If I was saying 'every day this sucker messes up constantly' things would be different.

I've only had it for a month. I reserve the right to change my tune. Your diabetes may vary, of course.

But if an artificial pancreas thought you were at 276 and started dosing enough insulin to drop you over 140 points when you aren't even at 140, the lawsuits are going to pile up like a lazy person's laundry. (Not that I would know anything about those piles.)

So, the question is, is it worth it? How accurate does it have to be before it becomes available? When do the benefits outweigh the risks? Everyone has to answer that for themselves. Again, I reserve the right to change my mind, but at the moment I say, YES it's worth it. Bring it on. Severe lows and highs are ALWAYS a risk for diabetics. We know it. We hate it, but we know it. And while my precious Dex messes with me sometimes, the thought of going back to random finger pricks to manage makes me want to vomit. Increasing our quality of life and our ability to manage is always a good thing. (Of course, if the artificial pancreas kills me, I might feel differently.)(But I would be dead, so I probably wouldn't care.) (My family would, though.)

Plus, I don't see the option of shots or pumps going away. I think the AP would just be another option for patients who want it. Some will be too scared to take it. Others will jump on it. Others will wait and see. Others might go back and forth. We're good that way.

So there you have it. I survived the Dex misreading something, and it got me thinking. I now know why they tell you to double check before you treat. I mean, I knew that before, and I typically do check, but it's very difficult to be responsible for my actions at 4:30 a.m. Live and learn.

I KNEW Mornings Were Evil

So if there's one thing I have learned in the first week with my precious, it's this....

Getting out of bed is bad for diabetes.

I was really excited to see what I did at night. Apparently, I hold steady. (yay!) But the second I wake up and get out of bed, the sugars start slowly climbing. The earlier I get up, the worse it is. And if I have to set the alarm for something especially early, forget it.

Stupid non-girly hormones, working to get me out of bed and spiking my sugars. At least I know my "fasting sugars" don't usually reflect where I've been all night.

Yesterday, I had lunch, and I swear to you, my sugars did not budge for about 4 hours from the minute I bolused. I started at 110 and didn't go above 116 (cured!). I took a nap - hey, don't judge, it was a rough emotional day. Getting up from that nap sent me climbing, and even through dinner and correction boluses, I never fully recovered from that climb.

Clearly the best option is to stay in bed all day.

I knew it.

First day with My Precious

Ah, my precious. I have been trained, I have been stabbed, and now I can tell you at any given time what's going on with my blood sugar. I can be cool and post pictures of my Dexcom. (But I won't, not just yet). (I can't find my camera, and I'm lazy).

I went low that afternoon. My Precious buzzed and booped. Ooh, the first buzz. What does it mean. Under 80! Meter says no. Under 55! DEXCOM NO-LIKEY UNDER 55! Meter said 68, so I treated. I kind of love peppermint bark, btw.

Then I had a lovely dinner and watched my sugars climb. It almost hit that high threshold, but not quite. I was fascinated, and I think I am easily amused. However, going to bed at 175, I decided to take a half unit of insulin. My correction value has been changing, and I decided that half would probably get me to around 140-120, which is all well and good. (Sometimes 1 unit drops me 80, sometimes 50. Consistency, thy name isn't diabetes.)

ALL NIGHT LONG. (Cue the Lionel Richie soundtrack).
Buzz. Buzz. BUZZ. LOW!!! UNDER 80!!! LOW!! UNDER 80!!! 3 times it did this, and I checked my meter. 97. 102. 96. Please be quiet, my precious. I'm fine. I'm sleeping.

LOW!!! UNDER 55!!!! At that point, I just grabbed a candy and popped it, figuring I probably was low, and maybe it would make precious be quiet. LOW! UNDER 80!

My husband "Did something beep? What's going on?"

Sorry, babe. Diabetes apparently is a loud disease.

And on it went, until I was coherent enough in the morning to change the low alert from 80 to 70.

I have been longing to know what my blood sugars do during the night. Spot checking isn't really helpful. Why would I go to bed at 90 and wake up at 140? When did that rise happen? Right in the morning, or have I been rollercoasting all night? Going to bed at 160? Waking at 160? Did I really do NOTHING at night? So I was longing for that lovely graph, that lovely telling of what my body was going through while I was unconscious. Apparently, I have to be conscious to see it. It stayed pretty consistent...ly low. And it did start to rise around 7:30 in the a.m. So that's good to know.

It seems to be more accurate if I'm above 100. Otherwise, my precious runs a little lower than the meter. It's in my abdomen right now. I will try my arm as the next site, see how that goes.

And despite the buzzing, I love it. I love it very much.

One More Thing

Get training on the Dexcom on Jan. 4. Hee hee.

I forgot to mention last time that my doctor has contnued to use me as a guinea pig. He put me on some heartburn medication to see if a ppi (proton pump inhibitor) response would help me. He says there is data that a ppi response can stimulate beta cells.

It took a week or so, but now I am having more lows than usual. He may be right. It's kind of exciting. I definitely need to lower my bolus rate a tad. So we'll see about that. In the meantime, "my precious" (dexcom) will help notify me of those lows.

Fun times at the endo. Plus CAPS. LOTS OF CAPS.

So, I went to the endocrinologist last week. He still loves me, thinks my attitude of "I want more beta cells and I don't care what I have to do to get them" is great. My a1c is still 6.3.

It's a nice rhyming number. (A1C! 6.3! There's a cheer in there somewhere.)

My LDL is also down to the 150's, so that's better, but we're still treating it. HDL still high, so that's good.

He also did some kind of sensitivity test, and my cardiac risk is low. I'm not sure what the test is called, because they DIDN'T SEND ME A COPY OF MY RESULTS, even though I ask every time.

I swear that nurse/tech/whatever her title is doesn't like me. I also left without a follow up appointment. It was weird.

"OK, I think I need to make an appointment for 3 or 6 months out."
"He didn't say. When you get your lab work then he'll tell you."
"It's never worked like that before. Can I just make an appointment now?"
"No."

OK, I'll leave now.

So, the real question I had for my doc was regarding my Dexcom. CGM. The Golden Ticket. WHY didn't I get one last time? Denied? What can I do now?

"Huh, I never heard back. Let me check on that."

Then he said he could trial me for a week, but they one they have cost him $800 out of his own pocket, and it wasn't charged, and I would have to BRING IT BACK because it cost him so much money, and I would have to be careful, and the nurse that usually educates on it isn't here, and it was pretty clear he didn't want to hand it over.

And...as it turns out, they never sent the request. That could be why I didn't get one. If my insurance or the Dexcom people don't know I want one, they don't magically send one out randomly. Funny how that works. So this time I stayed there until the request was faxed.

Then I went to lunch with my husband, after being scolded for wanting follow up care.

At lunch the Dexcom people called me. YES. They aren't in-network, but they know people who are, they will be calling me in the next couple of days.

Yada yada yada.....a bunch of phone calls and nagging of my doctor's office later.....IT'S HERE. TODAY. I AM JUMPING UP AND DOWN.

Did I mention that my deductible is met and it didn't cost me anything? 2 weeks later, that would have been quite the different story.

Did I also mention I don't have a clue as to what I'm doing? I guess I will be calling tomorrow to go meet with the nurse to have her show me what to do. While there, I'm going to schedule a follow up appt. You know, if they let me.

"Cause I've got a Golden Ticket...."