LifeAfterDx--Diabetes Uncensored

A internet journal from one of the first T1 Diabetics to use continuous glucose monitoring. Copyright 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014

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Location: New Mexico, United States

Hi! I’m William “Lee” Dubois (called either Wil or Lee, depending what part of the internet you’re on). I’m a diabetes columnist and the author of four books about diabetes that have collectively won 16 national and international book awards. (Hey, if you can’t brag about yourself on your own blog, where can you??) I have the great good fortune to pen the edgy Dear Abby-style advice column every Saturday at Diabetes Mine; write the Diabetes Simplified column for dLife; and am one of the ShareCare diabetes experts. My work also appears in Diabetic Living and Diabetes Self-Management magazines. In addition to writing, I’ve spent the last half-dozen years running the diabetes education program for a rural non-profit clinic in the mountains of New Mexico. Don’t worry, I’ll get some rest after the cure. LifeAfterDx is my personal home base, where I get to say what and how I feel about diabetes and… you know… life, free from the red pens of editors (all of whom I adore, of course!).

Monday, December 26, 2005

Blue Christmas

Chapter 1: Carb City. New discovery: diabetes sucks worse at Christmas than it does the rest of the year.

The rest of you probably already know this and are wondering why I'm late to the party. Well I'll tell you why. Last year was my first diabetic Christmas. I was so frail, week, and sick from all the medical adventures and miss-adventures that surrounded my Dx, subsequent re-Dx, and my final Dx that I spent the entire holiday at home in a heap on the couch. And sometimes in bed. Or on the floor mid-way between the couch and the bed. Deb and Rio made the rounds of the various parties and extended my regrets.

Both sides of the family and various friends showered me in sugar-free sweets and I rode the season out in style.

Now most of the time I'd don't find diabetes to be all that big of a pain in the ass. I give in to temptation now and again in a controlled fashion and otherwise avoid putting myself into situations I know will be bad for my BG.

But this year I'm back to OK health and I'm out and about. And no one had any mercy on me. At the first stop, at which I arrived starving, there was not one diabetic friendly thing on the over-flowing table.

Carb chips and salsa. Biscochitos, the state cookie, literally covered in sugar. Fudge. Zucchini bread with raisins. Banana bread with chocolate chips. Fresh breads and jams. It was a fucking disaster. At least there was one diet soda in the cooler. Of course it had caffeine, which generally makes me sick to my stomach.

I had expected trouble, but... I’m standing at the table with concerned family members looking on, "Aren't you hungry?" asks my hostess earnestly. Well, shit.

So I SWAG Bloused (scientific wild assed guess--really nothing scientific about it at all). I am holding a plate of food. Full of unknown and imponderable carbs. 50? 100? Who the hell knows? So I just stacked up the insulin. Each time I put something in my mouth I chased it down with a slug of insulin. Doing my best to guess what the plates might hold.

I’ve got an unstable cocktail of insulin, fast acting carbs, and slow acting carbs coursing through my body.

Now this is where the Guardian came in real handy. I changed the alarm thresholds for the weekend, making them much more conservative to head off trouble at the pass at the risk of more false alarms. But it was really nice, that every 20 minutes or so I could discretely open the cover, Click, and check my BG. No finger sticks, no "oh my God, do you feel OK," from family members.

I was also able to use the monitor to keep my mate in the loop. A high tech form of non-verbal communication. I hold the monitor up for Deb to see. 147.

She frowns. "How much insulin on board?" she asks me.

10.5 units.

A flash of anger in those beautiful dark brown eyes, "You're going to crash!"

Very likely. But we’ll see it coming. No point in rushing the sugar infusion. I keep my eye on the trend. Every ten minutes I check. I can flip back in time with a few button clicks. It is a hypo-speed drop. 182. 167. 130. 115. 103.

And I thought all was OK, and that I was in control of the situation, but I was mistaken. When we were ready to leave, with Rio’s presents loaded into “Momma’s truck” (our old Honda CRV), and Rio safely belted in and me in the driver’s seat we decide a finger stick is in order. Guardian shows me dropping but still at 97. The Cozmo clocks me in at 66. Damn. We look at each other and each get out. A quick Chinese fire drill and we change drivers. I find my self sulking in the passenger seat eating cherry slices.

Later in the night the slow acting carbs kick in and I find my self taking correction boluses of insulin every two hours all night long and spending the better part of the time north of 200 BG.

Chapter 2: Joy and Guilt. So Anita had English Trifle, a three layer Chocolate Mousse Cake with a candy crust bottom (think Nestlé Crunch Bar on bottom, a moist rich layer of chocolate cake in the middle, and dreamy fly-away mouse on the top, all dusted with coco powder), and sugar-free Pumpkin Pie. All served with champagne cocktails and de-calf coffee. After sampling all three and having a second helping of the mouse cake I said to Anita, who was abstaining but enjoying all the feedback of contented groans and orgasmic moans, "boy, I sure admire your will power." To which she replies, "it has nothing to do with will power. I want to keep both my feet and my eyes."

Wow. Well that's perspective, isn't it? What a bummer. The 100 carbs of sweets in my stomach turns to lead.

In her youth she and her husband ran an photo lab in the Virgin Islands; and in her retirement she worked for me. But in between she was an RN for years, and years, and years. She saw all the wreckage left after years of uncontrolled diabetes time and time again.

Again, the Girl shows a steady and sharp drop. It looks like Anita’s guilty pleasures had less sugar than I guessed. I’m on the ball tonight. I’m expecting the BG to be ahead of the Guardian. I watch warily. By the time we are getting ready to load up and head home she shows me in the 120s. I’m thinking we are probably closing in on the intervention threshold. I take a finger stick to get the real story.

171.

I cannot get a break this weekend.

We load up Rio and his new constant companion: Mr. Potato Head, and make the 20 minute drive across the dark emptiness to home. The Red and White Christmas-light star that was my Dad’s pride and joy for my entire lifetime greets us home and lights the way up the porch steps to the front door. Once in and unpacked I check sugar and Guardian.

The Girl has me at 94 and the Cozmo at 74. They’ve flip-flopped again. I guess the girl had the trend right, but the numbers came down strange. First she was ahead, now she’s behind. Lucky for me Anita’s daughter (a super custom printer and very good friend who also worked at the lab in the old days) has sent us with a box of Rugula. Well if you gotta take on sugar, it might as well be something fun. It is delicious, but I’m sugared out. I’m sick to death of sweets.

I need something salty. I rummage in the pantry and come up with big bag of peppered beef jerky, my Christmas present from my mother-in-law. I’m sure glad it was Christmas, but I’m sure glad it is over. At least for this year.....Will I be more courageous next year and just say “no,” or will I indulge like a modern day Roman sugar-alcoholic and be satisfied with ending the week with not being in a coma?

6 Comments:

Anonymous Anonymous said...

I'm starting to think the chance of the Guardian being released nationwide is not very good. It's too expensive and it basically tells you what you already know. If you eat too much, your bloodsugar will go too high, but *oops* the Guardian doesn't know how high right now. Check back later. If you take too much insulin, your bloodsugar will go low, but *oops again* the Guardian only knows it's trending lower, not that it's actually low yet.

5:43 PM  
Blogger JustLinda said...

Routine is a diabetics best friend. I know that with my diabetic husband, it's always the holidays, vacations, traveling, etc that screw us up.

I'm anxious about the Guardian because it's always the fast drops that catch us way off guard. The trend is really, really important to us for that purpose, so I'll have to disagree with the last commenter. My husband has hypoglycemic insensitivity and does not feel them coming at all anymore. We'll take whatever help we can and right now there isn't much of it out there. The Guardian appears to hold our biggest hope...

6:05 PM  
Blogger Ellen said...

My son loves the pump so he doesn't have to have "routine" in his life. He loves your "SWAG" term. Tonight at the cousin's house he had insulin he estimated for about 300 grams of carbs. YIKES. He treated one low there (in the 60s). Sometimes you just have to wing it and enjoy the party. :-)

I was taken aback by her comment re the feet and eyes. Blood glucose can go up and down even when you don't eat "sweets". Sheesh. She prepared all that on the table and then made that comment to you? That hurts.

You're doing a great job with the diabetes Wil. Keep up the fine work. You're an inspiration.

6:46 PM  
Blogger Kerri. said...

Congratulations on effectively navigating the holidays without too much distress. (And without too many cherry slices!)

I also spent the holidays chasing my food with insulin ... made for a lot of blood sugar checking but it's only once a year and I didn't spiral the least bit out of control, so no harm, no foul.

Maybe "the girl's" New Year's Resolution can be to sync up with your meter and make your life a little easier!

7:54 PM  
Blogger maureen said...

Ah, the party. After much experimentation, I've discovered the way I get the best result is a square bolus or a temporary basal rate. I'm a grazer, and when I bolus on top of bolus, I always wind up low. My philospophy when I first got my pump and my first few parties were complete disasters with lows and highs, was if you don't get it right, try it again. I will love to see how a continous blood glucose monitor will effect this for me. Hopefully it will be more reasonable finiancially soon... and more available.

3:52 PM  
Blogger Scott K. Johnson said...

I just love the SWAG Bolus term! That's great - and sooo true. Sometimes we just have to give it our best shot and go from there.

I know I have all kinds of mental trauma when I get all obessive about things and count every last gram. It's just not always possible. Like Ellen said, sometimes you have to just wing it and enjoy the party.

I think you did pretty good with everything and it sure sounds like you had a pretty good time.

4:25 PM  

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