I’ve been on a blogging vacation. It wasn’t intentional, but one missed post turned into another missed post. And another missed post. Before I knew it, my twice weekly postings had turned into none. Blogs aren’t supposed to be a burden, so I’m not feeling too guilty. Unfortunately my blogging vacation has been accompanied by a lapse in my diabetes care. A few (well, maybe a lot of) bad decisions along with infusion set problems have resulted in a series of days (weeks?) with less than optimal numbers.
My diabetes care is never perfect, but for the most part I do pretty well and spend a lot of time in my “target range”. For much of the last year I have had success with a low carb diet (most of the time) and an insulin regimen that has controlled my morning blood sugar spikes (most of the time). So what has thrown everything out of balance?
A little bit of this and a little bit of that.
Balance is the hardest part of Type 1 diabetes. Without a functioning pancreas, our bodies have no sense of equilibrium. We live on a tightrope where good numbers are a small step from catastrophic lows and higher numbers seem to send the glucocoaster spiraling out of control. It’s the reality that everything today is connected to everything yesterday and will influence everything tomorrow.
I eat a couple of chocolate chunk cookies. Okay, they are the (huge!) chocolate chunk cookies (delicious!) from Costco. I take a boatload of insulin and my BG numbers seem to stay in check. But at 2:00AM my Dexcom screams that my BG is high and rising quickly. I program a correction dose into my pump and unfortunately wake up with a low at 6:00AM. Two glucose tabs and before I know it, I’m back to 180 and rising quickly. I test frequently and take enough insulin to vanquish two plates of pancakes, a banana split, and half a loaf of Wonder Bread. But wait, I didn’t eat any of those things. I either ate nothing or my normal 17 carb breakfast of Greek yogurt and apple or blueberries. The dog walk that usually prevents huge post-breakfast BG spikes is rewarded with numbers in the 200’s.
My endocrinologist claims that overnight lows result in hormones that ultimately cause highs. I think she’s right because the more overnight lows I have, the more daytime highs I see. The more I correct the highs, the more I end up low. Dexcom tracings that resemble the Himalayas multiply rapidly and refuse to give way to somewhat gentler blood glucose slopes.
The cookies are long gone and the sweet, yummy, chocolaty taste is a pleasant guilt-laden memory. The problem is that my diabetes remembers the indiscretions and even when I’m eating a judiciously low-carb meal, my body is quick to spike and quick to crash. Add frustration and diabetes burnout to the mix and it’s hard to get back on the straight and narrow.
Mixed in with things I can control are things like infusion set failures. I have used angled sets (Silhouettes and Comfort Shorts) successfully for most of my pumping life. Skin problems, inflammation at pump sites, and insertion pain have motivated me to explore other types of sets. In my last supply order, I included a box of Insets and a box of Cleos. I started with the Insets and loved the pain-free insertion. Since I weigh a little more than the last time I used 90-degree sets, I was encouraged by the performance of the first 9 sets with no pain, no failures, and all of them lasting 3 days. Then came #10. It was a blast from the past with an absolute failure five hours after insertion. I rarely get insulin blockages with angled sets. This site failure reminded me why I had quit using Quick Sets ten years ago and learned to live with the horrible insertion needles of angled sets. I’ll use the box of Cleo’s and probably go back to Comfort Shorts. I can stand a little pain and inflammation to have reliable insulin delivery.
After covering a lot of subjects here without much sense of direction, I’ll wrap up by saying that I’m back to blogging after a brief hiatus. Judging from the last two days, I think my diabetes care is back on track. In many ways these two things go hand-in-hand because they are reflections of how much diabetes is like a spoiled child who demands all of our attention and won’t settle for less than 100%. Not even when you want a vacation….
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I encourage anyone having issues with sets to try the Contact Detach sets, they are awesome. We had previously used Quicksets and Inset 90, never had luck with the angled sets before Omnipod. Melissa just started on her Tslim, and I asked for samples of the Contact Detach after reading some people rave about them. I put the first one on her on Friday when she started on the pump and it was super easy to insert manually. The thing that might hold people back is that the disconnect is not at the site, which means you have what looks like two sites on, but one is actually just the disconnect. Her skin looks awesome after removing it today, much better than ever before with a teflon cannula! She is also using 20% less insulin on this pump with this set, which is unreal. Her basals are just over 10 units per day, which they haven’t been in years.
I’ve never tried the metal sets, Mary, but I know some people think they’re the best. So maybe I’ll get a box next time. Or I suppose I could call Animas for samples. I’m glad to hear that the t:slim is going well for Melissa! I still wish that I had ordered that instead of the Ping, especially since I wonder if the Vibe will ever be approved….
Mary, I’m happy to hear that Melissa is doing so well on the Tslim!
Welcome back to your blog and those cookies sound wonderful and worth it! No beating yourself up for living foot loose and fancy free once in a while.
The problem with cookies is that I can never stop at one…. Looking forward to seeing you at the April JDRF AWT1.
Laddie, I loved the blog, but especially the last two sentences-so true! All those insets confuse me, because I’ve only used the OmniPods since starting pumping. But next year I’ll be on Medicare, so if I’m forced to go the route of a tubed pump I’ll be consulting you on pumps, tubing and insets.
Since you loved your Omnipod, I suppose a tubed pump will be a disappointment for you. I’ve never minded tubing and always thought the lumpiness of the Omnipod would bother me more. It will be an interesting change for you….
Laddie and Sue, We really like the Omnipod too, and I was not happy about the forced change for sure. When I researched the Tslim I knew it was the only pump that made sense for her. Once I saw how tiny it was and joined the Facebook group, I was quickly excited to move forward with it. It is tiny, and some of the features are great for Melissa’s disability. Sue, it is smaller and thinner than the other pumps, and will actually fit into a Vera Bradley case with the Dexcom in it as well. Laddie, you might want to get the 6mm cannula and possibly 32 inch tubing even if you are used to 23 because of how these go on. There are a couple of Youtube videos on the insertion that you could watch. Some people seem certain that the Vibe will be the first pump to integrate with Dexcom, but I am not so sure about that since the new stricter rules for FDA and pumps. I had called Animas for samples before and was given a total run around including charging something like 20 dollars for a couple of samples. That was a few years ago, so hopefully they have changed and you are using their pump, so maybe that makes a difference. I wouldn’t want you to get an entire box and then not like them!
It’s no big deal for me to get a whole box because even if I don’t love them, I would be able to use them. I’ve been through so many different products in my diabetes career that I don’t expect anything to be perfect. And if you never try anything new, you might miss out on something that is much better than what you’re currently using. At the end of the day, it’s just diabetes and you have to make it work.
We are so similar. People are often surprised that I have just cut out entire groups of food from my diet, but for me I can’t do “moderation” well. With my diabetes management I’m either on or I’m WAY OFF.
Glad you’re back! You were missed! (And I hear you about the spikes and lows… I think low carb is in my future…)
Ugh, sorry to hear you’ve been going through a bit of a slump. I totally get it though, and have been there myself. I think it’s good to take a bit of a break when we need it, so we can come back stronger than ever (both blogging and diabetes!!).
Happy to see you are back and doing better. Love what you said: “At the end of the day, it’s just diabetes and you have to make it work.” I’ve been on a MDT pump since July 1995 and that’s what I have learned, too. My hope is that we soon get a faster-acting insulin than what we currently have. My endo says it’s coming but not for a while.
I’m glad you’re back and am definitely seeing a correlation between what your doctor said and issues I was having a few months ago with days of yo-yo bloodsugars after an overnight low. This whole balance thing can truly be exhausting. I definitely hear ya sistah! xoxo
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