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, 2015, 2016

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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!).

Friday, October 03, 2008

She shopped until I dropped

I really wanted to die at home. Not at Sam’s Club.

I’m not doing too well, babe, I told my wife. Of course, this was a self-inflected injury. We’d taken Rio to the dentist in Santa Fe for two fillings, poor thing. He was an absolute trooper. No fussing. No complaining. Staying calm and still while the barbarous dentist and his assistant prodded, drilled, scrapped, suctioned, and sprayed.

I was very proud of him, so when we were done it was off to Target for a reward. He choose a build-your-own-light-saber kit. My BGL was coasting around 100 so I set the OmniPod to deliver a 50% reduced basal rate for the hike around the superstore.

It worked like a charm; when we arrived at Applebee’s, the dental-victim’s choice for lunch, I was at 104. No crash, no spike. Then I got cocky.

Rio selected Kraft Mac and Cheese. What nerve these restaurants have charging four bucks for a third of a 75-cent box of pseudo-food! Oh well. Deb and I chose Quesada burgers. Yum. I forgot to order side-salad instead of fries and made the mistake of eating just one fry when my food arrived….

Potatoes turn to sugar in your blood fasting than pure cane sugar. I think they must also trigger endorphins or something. It is true: you can’t have just one. Well, whatthefuck. I’ve got a pump. I’ll just bolus for those puppies. As I was thumbing through Calorie King’s pocket guide (courtesy my friends at Roche Diagnostics) to get an estimate on Applebee’s fries when the Blue Ribbon Brownie caught my eye, all 107 carbs of it. Hmmmmmmm…the exact carb count for a huge desert. I fingered the pod on my bicep. Hmmmmmmmmm…

Of course, like the idiot I am, I ordered and ate the whole thing. Both brownies. Both scoops of ice cream. All of the fudge sauce. I even licked the plate. I think I’ve mentioned before that I’m a poor role model. My arm ached from the volume of insulin the pod forced into the limited subcutaneous fat on my arm.

Everything was fine. For 15 minutes. Then the excursion started. The thirst set in. My head was pounding. The Guardian alarmed. Then the stomach cramps set in.

“OK,” said my mate of 20 years and partner in diabetes since the beginning, “let me just grab a few quick things and we’ll go.”

I sat in a Serta desk chair on display at the end of the long aisle of office supplies. I had a commanding view of the produce and wine sections. I felt like crap. Rio hovered over me, his dark-brown eyes filled with worry. “Do you need candy, Daddy?” He reached out and gently stroked my cheek with his finger.

No baby, I’m high, not low.

“Maybe you should take some more insulin,” he suggested.

The stomach cramps are really bad now. I unzip the front of my go-bag and pull out the Abbott Precision Extra meter that is stowed there. Break glass incase of emergency. I break the glass. This could be an emergency.

I unwrap one of the purple-foiled strips that cost $8 each. I set the lancing device deep. Snap! Squeeze. Darn it, my vision is getting blurry. BIG blood drop for the thirsty ketone strip.

“Where is that mother of ours?” asks Rio, looking frantically left-then-right-then-left again—still murky on the difference between wives and mothers and where everyone is supposed to fit into the family tree.

The count down starts. I close my eyes for a minute. Even when my sugar is really high, I rarely clock ketones at all. But this feels different.

15...
14...
13…

These blood ketone meters take a while, but it tells you how acidic your blood is right now.

8…
7…
6…

So much better than the old way: peeing on a strip and comparing to color to the chart on the bottle that tells you where you were at two hours ago.

4…
3…
2…

If you are a T-1 you should have one of these, even if you have to pay for it. And you probably will, insurance companies being what they are.

1…

Positive for ketones. Big time positive. Not enough to kill me. Not yet. But double the amount I’d ever seen on my ketone meter before. The highest I’ve ever been. Ever. I hold the meter in my hand, trying to make sense out of the number. Trying to process in my mind. Like a cold wind from the north fear sweeps down on me.

It’s OK, I tell myself. Takes hours and hours and hours to go into DKA. I’ve got time. Take more insulin. Stay calm. Let it work. If the ice doesn’t break you’ll take an IM shot straight into the muscle. You’ve got two deep-needle syringes in your bag just for such emergencies.

An hour later Deb returns with a basket full of “necessities.” You’re going to have to drive, I tell her.

It takes forever to check out. Then Rio is hungry again. I collapse at the food court to wait. To my surprise one of our nurses comes by. She comes over and gives me a quick hug. “I saw Deb and she said you aren’t feeling well, hope you feel better soon, sweetie.”

Thanks, I’ll be OK.

The next person who comes by is our medical director. I can’t fucking believe this. I guess the whole staff is a Sam’s Club today.

Rio tells him, “Daddy has a stomach ache.”

Our head Doc pauses, steps forward, then back, and frowns. “I left my wife in a hot car,” he tells me sheepishly. He has a huge sack of dog food and a huge sack of bird seed in his cart. I didn’t know he had a dog.

Don’t worry about me, sir, I’ll be fine. Damn if I’m going to tell him his insulin pump enabled Diabetic Educator is ketonic from eating French-fries, two brownies, two scoops of ice cream, and hot fudge sauce.

I don’t remember much after that. In the car I drank all of the water in my traveling cup. And all of the water in Deb’s traveling cup. And all of the water in the back-up bottle we use to refill the traveling cups. Then I passed out. Not a coma, just exhaustion.

The next six hours are a blur of fluids, correction boli, and finger sticks. I got it down from nearly 400 into the low 200s and there my sugar stuck. For hours. Bolus after bolus hammered away at the sugar with little effect.

I sat on our back porch where the monsoon rain-bread mosquitoes that had been plaguing us the last few weeks paid no attention to me; my blood too acidic for their taste, I guess.

I pissed away another 8 bucks and found the ketones had been cut in half. This would end OK.

The sun setting over distant mesa tops drained my stress away. I puffed on my pipe and relished the feeling of my body recovering. Cramps fading, vision sharpening, mind clearing.

Every once in a while I entertain the fantasy that the doctors got it all wrong. That I’m not really diabetic. But it is just a passing fantasy, and when I push the limits I pay.

They did get it right.

3 Comments:

Blogger Colleen said...

Sounds like a truly crummy day. How's school going??

5:41 PM  
Blogger Scott K. Johnson said...

Yuck man!

What do you think happened? I mean, I always thought ketones were from lack of insulin for longer periods of time than just a single post-meal high? WTF?

9:05 AM  
Blogger josl said...

ditto what scott said!! you're shattering my false sense of security!

what's the scoop?

11:04 PM  

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