Next time ask for a side salad
I probably need to be more clear about that. What I'm saying is that when the girl and I were first together I'd click and look at A reading. I was using her like a finger stick. OK, a fast and painless one; but a finger stick none the less. I was looking at a moment in time. A single piece of information.
Now, I never look at a single reading. I check my NOW number and then quickly scroll back in time using the down arrow button. Five minutes per click. I usually glace at a half an hour. Then, instead of just being pleased with the simplicity, I think about what I'm looking at. Direction? Is the BG going up or down? Or is it fairly stable? Speed? Speed I'm not always so good at, 'cause that takes mental mathematics, which is my weak spot. That said I can get a rough idea of how fast things are moving.
On the way up to Denver we stopped at Denney's in Raton. OK, Denney's isn't the best food in the world, but its pretty good. They also have one of the better kids menus. Very flexible. Choose an entree from the list. Choose a side from the list. Would you like another side? Nice vibrant color photos of all the options. Easy for little ones to study the possibilities. Rio's choice, Mac and Cheese (no surprise) and a firm announcement that he wants the cheese pizza the next time we come. It'll be month from now, but he'll remember.
What I personally like about Denney's is that they have extensively published carb data on their menu items. Not just a few here and there, but everything---even deserts (although I refrained today).
I ordered a Philly Beef & Cheese hogie-type sandwich on chiabatta bread, hold the mushrooms. No fungus for me, thank you very much. Good thing, my waitress informs me, as we are out of mushrooms today. It comes with fries. I hesitate a moment, knowing that fries are likely to give me trouble but my brain locks up and I can't come up with any alternatives. Twelve hours later it occurs to me that they would have subbed a side salad for me with no quibbles. Had I done that my day might have been very different. But that's Monday morning quarterbacking.
By the way, the Printcrafter rating on the sandwich: Five stars. Yum.
Sandwich: 53 carbs
Side of fries: 57 carbs
Diet Coke: 0 carbs
Bolus: 5.5 units of insulin. Let's eat! The damn fries are wonderful and I eat every last one, being careful to use minimal ketchup, the stuff is packed with sugar.
Following the meal I keep an eye on the BG as we snake our way up Raton pass and over the New Mexico / Colorado line. Unlike the terrain we're cruising through, my BG is staying really, really flat. I'm thinking there's gonna be hypo in my future.
Quite the contrary. As we near Colorado city a steep rise kicks in. We're about two hours post bolus at this point. We stop at the Cuerno Verde rest area at Colorado City. Rio has important business here. First we play on the rocks. On the West side of the rest area, between the overflow parking and the restrooms, are eight BIG rocks laid out Zen garden style on a bed of sand. It is our tradition to stop here both coming and going. Rio scrambles to the top of each. Two of them are designated jumping rocks. He always does them in the same order, over and over and over and over and over as many times as I'll let him. Today we have an advanced pact. It is dark, very cold, very windy. One time is the deal. He keeps up his end of the bargain then runs to the bathrooms as fast as his little legs can carry him to see the map.
Inside the building that houses the woman's room, handicapped restroom, and men's room is also a generous lobby with a magnificent two story bank of curving windows. In the center is a large rack of brochures for various sights and things to visit. And on the wall is a giant map of the state, including a wee bit of our home state.
Rio points to the map. This is were we ate lunch. And this is were we are now, and this is Grandma Jean's house. And these are the mountains. And what's this? I bend over and squint at the large purple splotch on the map. Ft. Carson, I tell him. Where the army practices with their tanks.
So while Rio studies the map of our Journey, I study the map of my BG. Rio's looking at were we've been, where we are, and where we are going. Likewise, I can see where I've been, and where I am. Where I'm going is trickier. So I've got a quickly rising BG. In an hour I've jumped from 125 to 237 and I know a correction bolus is in order but I've got a radical new theory to test. Well, radical for me anyway.
To be honest, I can't claim full credit for this idea, but I can't recall either if there is just one person who deserves the credit or if this is something I synthesized from various conversations and readings. So if I stole someone's pet theory, I apologize. But here is my own personal take on it.
Ride the wave. That's right, I'm going to try to let this spike reach it's apex before I do anything about it. Before I tell you why, a quick comment that is important. Most of the time my high BGs are below the mid 250s. High BG is not really where I have trouble. I do spike into the 300's sometimes; and I've clocked a 400 or two in my life, but it is not common. The two times recently that I've spent considerable time in the stratosphere didn't even rate me one tenth of a blood ketone. Not that I'm complaining. I'm just pointing out that riding a high wave to its crest is less dangerous for me than bunging jumping off a bridge. Which I've never done. Why survive something that will scare the hell out of you only to be killed by your wife for doing it?
Obviously, if you are ketone prone you should not try my new approach.
This is why I want to ride the wave: I'm trying to avoid Serial Correction Boluses. (there's a new one for Kerri's diabetic dictionary). SCB's always happen to me. When I get a wild sugar ride I find I'm taking correction insulin every two hours. The reason I now realize is this: I'm taking them on the up-slope. The sugar on board has not run its course. That being the case, the various magic formulas in the pump software can't work.
Third grade math example: let us say that we've got a spike that will top out at 300. If I intercept it at 200 and take insulin, the pump is not going to give me enough juice to knock down a 300. Instead, it will flatten out the curve. I'm still going up, but just not as steeply. When it hits 250 the same thing will happen again. Eventually, four or five boluses later I may end up over correcting and end up in the basement.
On the other hand, if I wait until the spike reaches it's high, where it will stay unless I do something about it, then I have some simple facts to deal with. It takes "X" units of insulin to Lower "Y" points of BG to target level of 115. OK, maybe that is more seventh grade than third grade, but waiting maximizes the efficiently and effectiveness of the correction bolus. In theory at least. This little experiment can also serve to help nail down a precise correction bolus ratio.
Point is, if I let it ride to the peak I should be able to knock it down with one correction not five. And that, again, in theory, should leave me high for a shorter period of time. Minimizing your high time is the name of the game for a A1C that will make your heart glow.
Now determining the peak of a spike with finger sticks would be a pain in the finger tip. But with continuous monitoring, this is very easy indeed. It doesn't even matter that much if the Guardian and the BG are not quite in sync, and they probably won't be with a fast rise. You'll still need the finger stick for the insulin, but you can use the Guardian by herself to tell when you've reached the top and leveled off. At that point you take your finger stick and figure out how much insulin is needed.
I get two readings in a row that are the same before we leave the rest stop. I know the peak is near, but I'm not sure we're really there yet. We drive on and I stop near Pueblo, once I'm sure we've leveled off. My readings show: 273, 277, 279, 279, 279. Looks like the crest of the wave to me. I take a finger stick and get a reading of 348. I don't trust freestyle readings over 300 so I do a second stick and get 327. I diecide to split the difference and correct for 337. Furstratingly, the pump stubbornly refuses to let me over ride the most recent finger stick so I correct for 327. Oh well, that's erring on the side of caution.
We hit the road again. I periodically check to progress of my therapy by balancing the monitor on top of the steering wheel, scrolling with my right thumb, driving with my left hand, and keeping one eye on the road and one eye on the monitor.
Damn, she's going up again. So much for science.
The BG keeps going up until Colorado Springs, then noses over nicely. 294, 291, 286, 278, 270, 265, 262, 260.
When we get to the Colorado Blvd. exit of I-25 in Denver I'm at 252.
Very cool. At this point we stop at Noodles, where we've arranged to meet my mom for a late dinner. So we'll never know if this correction would have been picture perfect, but it sure looked good for the home team. By three hours after the meal I'm below 100.
For me, for now at least, I'm going to ride the waves.