It has been 8 days since starting the CGM. For good health and better control I don't know why you wouldn't want CGM with your pump. In one week my Blood Glucose Readings have been better and overall I am able to keep tighter control. I have been able to avoid some highs by seeing that my Sensor Glucose was going up rapidly and avoid some lows by seeing it drop rapidly. Since most of the reports through the online software use a two week basis I will give an update into the change in numbers in another week when I have two weeks of CGM data to compare to two weeks without.
The great thing is I can take a quick sneak peek and see how I am doing without pulling out my meter. If there is a potential glucose reading that needs my attention I can take care of it. If not, I don't have to poke my arm (I test on my arms as my fingers are very sensitive). Granted it isn't always a perfect science but the trends have helped tremendously in this first week with the CGM.
My average sensor readings since May 18th have been 139, while the previous week blood glucose readings averaged approximately 150. Since I can't breakdown a particular time frame of 8 days on the software I will give a more thorough analysis after two weeks to compare sensor glucose averages to blood glucose averages for the time frame as well.
I also think it gives piece of mind when I am sleeping as when there is a high or low predicted I can take care of it instead of waking lethargic and cotton mouthy (highs) or all sweaty, shaky and confused (lows). Plus I hope it helps my wife sleep better and not worry as much about me.
The only issue I still have is the placement of the pump and sensor. I move a lot in my sleep and getting them in line so the signals are reached is a little difficult at times. When I have to move the sensor I am debating where else to put it. I may try just around my right side towards my back area but I am unsure at this point. That placement may help as I sleep on my left side or stomach and usually have the pump on my right hip. It will get figured out eventually.
My question to the manufacturers is, if we can implant GPS or trackers why can't we implant some kind of more accurate glucose sensor?
Thursday, May 26, 2011
Monday, May 23, 2011
Unlocked Set and Sweat
In the last two days two things have happened that have made life a little crazy. I will start with Friday when all things were going well.
It was the first sunny day in a while and I had to get the grass cut and the kids wanted to play outside. Not a real problem just a lot to do. After picking up my son from school we went outside. I worked on cutting the grass while my two kids harassed each other. Since it was nice out I told them when I was done we would cook hamburgers on the grill and eat on the patio. They were both hungry (I was too) and I began to prepare dinner. While preparing dinner I checked my blood sugar and it was 142, not bad but I was a little puzzled that it was high since I just finished mowing the forest my yard had become. Dinner was ready. I ate one and a half hamburgers and twenty tots (a total of 83 grams) plus a 0.4 correction for over 120. I started the bolus started and shortly thereafter started eating. It was our first meal outside in a while and it was good. With the CGM it offers a look into the way my sugars are trending and with this big meal I was wondering how it was all working out, about an hour after my bolus I looked at my pump and my Sensor Glucose has the double up arrows (meaning my blood sugar is rising over 40+ points every 20 minutes). The sensor glucose is 190. I am bit concerned so I check my blood glucose with my meter and it is 221. Now I am panicked, in an hour it raised about 80 points.
I think back to my training and inspect my pump and infusion set. I noticed the quickset connector is not locked into place. Now what? I decide to call my Medtronic CGM trainer and leave a message. It is after 6 pm on a Friday and I am not really sure who to call. While waiting for a return call I decides that I probably didn't get any of that insulin or any basal insulin in a while so I checked my blood glucose again and it is over 330. I did a blous for an amount a little less than the original before dinner because of the exercise. I am not sure where my reading topped out at but slowly enough it started to come down. I checked periodically to make sure it was coming down and to see if I needed additional insulin to make that happen. I had another couple of small boluses and got to under 200 about 11:20 pm. It was a very frustrating day especially since I had been doing very well. The Medtronic rep did get back to me rather quickly and concurred that I took the right action, so I felt good about that. All was well until Saturday.
Saturday I had some some yard work to do. I also needed to change my site and restart my CGM. The morning went well and I laid my daughter down for a nap and I got ready to do some work. Everything was going quite well on this very warm Saturday as I worked in my garden. Then I felt something pulling at my shirt. My CGM with IV 3000 dressing was coming off, and my infusion set was coming off as well. I was in the middle of what I wanted to get done and was sweating, I thought if I stopped and tried to do a new site it would just fall out because I was sweating and working. I decided to try to use additional IV3000 dressings to hold them in while I finished. They stayed but barely. Plus now I wasted some dressings and had to do a new site for each.
After I cool off and stop sweating I clean up some and start a new sensor site. First time applying one by myself and it didn't take much for me to mess up. I got the sensor in fine and everything else went smoothly except I forgot to take the clear tape off the sensor. I found it impossible to remove the clear tape off the sensor without removing it. I was not very happy about it because getting the CGM was a hassle I didn't want to waste the sensors. I started over and get the sensor in no problem and even remembered to take off the clear tape. While I waited for the transmitter to charge I started my new site for the infusion set. This went goes fairly well but I felt like a pin cushion since I have had four insertions in a matter of a few hours. Live and learn. It is still way better than injections 4-5 times a day.
As the day wore on I needed to do my 2 hour check for the sensor. My reading was 263 and I couldn't use that as you need to have a stable reading near or int he normal range. I took another 5 hours to get to 150 so I used that and moved on.
I did do something different from the first time of setting the sensor, I taped differently. There was a tip in one of the learning guides for the CGM that talked about using half of a IV3000 to go over the sensor and part of the transmitter. That has worked great so far as it allows air to pass through keeping the area dry, especially when sweating.
It was the first sunny day in a while and I had to get the grass cut and the kids wanted to play outside. Not a real problem just a lot to do. After picking up my son from school we went outside. I worked on cutting the grass while my two kids harassed each other. Since it was nice out I told them when I was done we would cook hamburgers on the grill and eat on the patio. They were both hungry (I was too) and I began to prepare dinner. While preparing dinner I checked my blood sugar and it was 142, not bad but I was a little puzzled that it was high since I just finished mowing the forest my yard had become. Dinner was ready. I ate one and a half hamburgers and twenty tots (a total of 83 grams) plus a 0.4 correction for over 120. I started the bolus started and shortly thereafter started eating. It was our first meal outside in a while and it was good. With the CGM it offers a look into the way my sugars are trending and with this big meal I was wondering how it was all working out, about an hour after my bolus I looked at my pump and my Sensor Glucose has the double up arrows (meaning my blood sugar is rising over 40+ points every 20 minutes). The sensor glucose is 190. I am bit concerned so I check my blood glucose with my meter and it is 221. Now I am panicked, in an hour it raised about 80 points.
I think back to my training and inspect my pump and infusion set. I noticed the quickset connector is not locked into place. Now what? I decide to call my Medtronic CGM trainer and leave a message. It is after 6 pm on a Friday and I am not really sure who to call. While waiting for a return call I decides that I probably didn't get any of that insulin or any basal insulin in a while so I checked my blood glucose again and it is over 330. I did a blous for an amount a little less than the original before dinner because of the exercise. I am not sure where my reading topped out at but slowly enough it started to come down. I checked periodically to make sure it was coming down and to see if I needed additional insulin to make that happen. I had another couple of small boluses and got to under 200 about 11:20 pm. It was a very frustrating day especially since I had been doing very well. The Medtronic rep did get back to me rather quickly and concurred that I took the right action, so I felt good about that. All was well until Saturday.
Saturday I had some some yard work to do. I also needed to change my site and restart my CGM. The morning went well and I laid my daughter down for a nap and I got ready to do some work. Everything was going quite well on this very warm Saturday as I worked in my garden. Then I felt something pulling at my shirt. My CGM with IV 3000 dressing was coming off, and my infusion set was coming off as well. I was in the middle of what I wanted to get done and was sweating, I thought if I stopped and tried to do a new site it would just fall out because I was sweating and working. I decided to try to use additional IV3000 dressings to hold them in while I finished. They stayed but barely. Plus now I wasted some dressings and had to do a new site for each.
After I cool off and stop sweating I clean up some and start a new sensor site. First time applying one by myself and it didn't take much for me to mess up. I got the sensor in fine and everything else went smoothly except I forgot to take the clear tape off the sensor. I found it impossible to remove the clear tape off the sensor without removing it. I was not very happy about it because getting the CGM was a hassle I didn't want to waste the sensors. I started over and get the sensor in no problem and even remembered to take off the clear tape. While I waited for the transmitter to charge I started my new site for the infusion set. This went goes fairly well but I felt like a pin cushion since I have had four insertions in a matter of a few hours. Live and learn. It is still way better than injections 4-5 times a day.
As the day wore on I needed to do my 2 hour check for the sensor. My reading was 263 and I couldn't use that as you need to have a stable reading near or int he normal range. I took another 5 hours to get to 150 so I used that and moved on.
I did do something different from the first time of setting the sensor, I taped differently. There was a tip in one of the learning guides for the CGM that talked about using half of a IV3000 to go over the sensor and part of the transmitter. That has worked great so far as it allows air to pass through keeping the area dry, especially when sweating.
Thursday, May 19, 2011
The Beginning of Robot Dude
My daughter used to call robots "Robot Dude". With the CGM (Continuous Glucose Monitor) now attached to me I am feeling a little more like a robot. The training was very good, the only issues were the husband of one trainee and the other trainee told stories. I understand that you may want your significant other to learn this as well, but turn off the cell phone or if you answer it leave the room. The other trainee was nice but when she started to tell a story it took a while, I am all for stories and sharing life experiences but there is a time and place and show up on time. Part of my frustration with this was the fact that I knew from reading the materials I had to do checks with the blood sugar in two hours from the start and then again two more times that day before bed to calibrate the CGM.
I will admit when first seeing the sensor and the needle used to insert it, it is very intimidating. They say it is painless and I believe it, I think I just hit a tender spot. The sensor must be on the same side of the body as the pump and this caused a little thinking for me as I usually have my pump on the front of me as I keep it in a front pocket (and the clothes I wear sometimes don't have a back pocket) and when I sleep I put in on or just around my hip because I sleep on my stomach a lot. The trainer helped me decide to put the sensor on my side a little so it can work from the front and hip. It didn't miss a beat all night. I did have slight bleeding where it was attached but it was minimal and stopped very quickly. The whole process of setting the sensor was a little involved. You have to pick it up in a certain way so you don't pull the needle out and when inserting you have to follow steps pretty well to do it right. Angles and the way you remove things when placing the sensor have to be done right. It is still all worth all the trouble to give that added help in controlling diabetes in my opinion.
Due to the fact that I like instant gratification it was tough to wait for the first calibration time of two hours to start seeing information on my pump regarding the CGM. Being a nerd of sorts I love things like this and it is very interesting to see the graph populate itself. I am trying to wait another day to upload the data to look at reports.
The downside right now is getting used to having something else attached to me. I am going to have to try different spots to find what works best and is comfortable. Right now on my side above my waist is alright but it is slightly uncomfortable which may be the tape holding the sensor and transmitter or just the area. It is not painful, I am just always aware it is there.
This is going to be a great addition to controlling my diabetes as it will give me a good idea what is going in between Blood Glucose readings. The thing I am looking forward to the most are the predictive alerts to help prevent the highs and lows. In addition I think it will help figure out the best basal rates. I realize it is a process of always fine tuning as seasons and activities change along with my body but I can't wait to see my a1C in August as my most current from a couple of weeks ago was done from 7.1 to 6.6.
I will admit when first seeing the sensor and the needle used to insert it, it is very intimidating. They say it is painless and I believe it, I think I just hit a tender spot. The sensor must be on the same side of the body as the pump and this caused a little thinking for me as I usually have my pump on the front of me as I keep it in a front pocket (and the clothes I wear sometimes don't have a back pocket) and when I sleep I put in on or just around my hip because I sleep on my stomach a lot. The trainer helped me decide to put the sensor on my side a little so it can work from the front and hip. It didn't miss a beat all night. I did have slight bleeding where it was attached but it was minimal and stopped very quickly. The whole process of setting the sensor was a little involved. You have to pick it up in a certain way so you don't pull the needle out and when inserting you have to follow steps pretty well to do it right. Angles and the way you remove things when placing the sensor have to be done right. It is still all worth all the trouble to give that added help in controlling diabetes in my opinion.
Due to the fact that I like instant gratification it was tough to wait for the first calibration time of two hours to start seeing information on my pump regarding the CGM. Being a nerd of sorts I love things like this and it is very interesting to see the graph populate itself. I am trying to wait another day to upload the data to look at reports.
The downside right now is getting used to having something else attached to me. I am going to have to try different spots to find what works best and is comfortable. Right now on my side above my waist is alright but it is slightly uncomfortable which may be the tape holding the sensor and transmitter or just the area. It is not painful, I am just always aware it is there.
This is going to be a great addition to controlling my diabetes as it will give me a good idea what is going in between Blood Glucose readings. The thing I am looking forward to the most are the predictive alerts to help prevent the highs and lows. In addition I think it will help figure out the best basal rates. I realize it is a process of always fine tuning as seasons and activities change along with my body but I can't wait to see my a1C in August as my most current from a couple of weeks ago was done from 7.1 to 6.6.
Wednesday, May 18, 2011
The 3 Day Dilemma
With wearing the pump I have found that sometimes I have a dilemma when it comes to infusion set changes. I was taught to change the infusion set every 3 days and if it is sometime after a full three days that is alright. Well in the process of taking longer for site changes to not waste insulin and to not go too long to avoid an infection I have come across my dilemma, what to do when the full three days is up at 8 pm.
What do I do? I go to bed generally around 10 pm so a site change at 8 pm is not bad because I test before bed anyways. The issue comes in it is exactly three days form the last change which probably was about 3 days and 8 hours from the previous change. As of 8 pm last night I had 39 units of insulin left in my pump, enough for another full day. I inquired to the Facebook group of diabetics I am a part of and received a whole range of answers. Granted everyone is different and their bodies react differently, but being only about a month into being on the pump I needed some guidance.
The advice that I received was basically the same from most. 3 Days and no more! Although there was agreement it is OK to occasionally go over the three days but the risk of infection and scar tissue builds up. Some have gone over three days but never four so at least from my small sample of pumpers I have a better idea what some of them do.
I decided to go overnight without changing the site as it was too much insulin to waste and for my cost of insulin of over $500 per three months I wasn't going to throw that much away. When I woke up and tested I was 155 so all worked out this time. I did my breakfast bolus, ate and then changed my site. If I stay vigilant and get my amount used a little better under control I will be able to more precisely fill the reservoir to not waste or be in that predicament too often.
All of the Facebook group suggested filling the reservoir more to the average used for three days, which I am working on but being new and with the illness I had a little over a week ago it has been tough to calculate. When you don't want to eat due to the illness and blood sugar readings are fine it makes it tough to find a true average as I was down around 20-25 units when some regular days I have ranged from 33-40 units a day. This reservoir fill I went to my most recent 7 day average to see how I do and have lowered my fill from 160 down to 140 units. Hopefully this way I won't have as much unused insulin after three days.
What do I do? I go to bed generally around 10 pm so a site change at 8 pm is not bad because I test before bed anyways. The issue comes in it is exactly three days form the last change which probably was about 3 days and 8 hours from the previous change. As of 8 pm last night I had 39 units of insulin left in my pump, enough for another full day. I inquired to the Facebook group of diabetics I am a part of and received a whole range of answers. Granted everyone is different and their bodies react differently, but being only about a month into being on the pump I needed some guidance.
The advice that I received was basically the same from most. 3 Days and no more! Although there was agreement it is OK to occasionally go over the three days but the risk of infection and scar tissue builds up. Some have gone over three days but never four so at least from my small sample of pumpers I have a better idea what some of them do.
I decided to go overnight without changing the site as it was too much insulin to waste and for my cost of insulin of over $500 per three months I wasn't going to throw that much away. When I woke up and tested I was 155 so all worked out this time. I did my breakfast bolus, ate and then changed my site. If I stay vigilant and get my amount used a little better under control I will be able to more precisely fill the reservoir to not waste or be in that predicament too often.
All of the Facebook group suggested filling the reservoir more to the average used for three days, which I am working on but being new and with the illness I had a little over a week ago it has been tough to calculate. When you don't want to eat due to the illness and blood sugar readings are fine it makes it tough to find a true average as I was down around 20-25 units when some regular days I have ranged from 33-40 units a day. This reservoir fill I went to my most recent 7 day average to see how I do and have lowered my fill from 160 down to 140 units. Hopefully this way I won't have as much unused insulin after three days.
Monday, May 16, 2011
Continuous Glucose Monitoring (CGM) Training
In a couple of days I will doing my CGM training and getting hooked up. I am pretty excited about this. I am a guy so therefore I have a love for technology. It will be interesting to me to see how this all works. The biggest interest to me are the predictive alerts so that I can head off those highs and lows.
I do think about having something else attached to me but in the grand scheme of life it is only to help me live a better healthier life. Although my kids might start to think I am a "robot dude" (as my daughter calls robots).
The training is two hours and this one is in a group setting, so it will be interesting to see and hear other peoples thoughts and opinions. When I did my pump training there was another person being trained at the same time, I found it very interesting to hear their questions and concerns. The other trainee was a female so some things didn't pertain to me, like using a bra to hold the pump. Although, from this and the Facebook group where I ask them many questions I am finding that a bra may come in very handy. It would certainly help make changing clothes easier as I seem to not know what to do with the pump each day. It is a crude balance and holding system that really needs some refinement.
To me the CGM with the pump seems like a necessity, even though I don't have it started yet. It all seems so close to a better system of almost having a pancreas replacement. At some point I believe technology will be good enough that I will be to stop testing via finger sticks (or in my case alternate site (forearm)) and just have the pump site and CGM site.
I do think about having something else attached to me but in the grand scheme of life it is only to help me live a better healthier life. Although my kids might start to think I am a "robot dude" (as my daughter calls robots).
The training is two hours and this one is in a group setting, so it will be interesting to see and hear other peoples thoughts and opinions. When I did my pump training there was another person being trained at the same time, I found it very interesting to hear their questions and concerns. The other trainee was a female so some things didn't pertain to me, like using a bra to hold the pump. Although, from this and the Facebook group where I ask them many questions I am finding that a bra may come in very handy. It would certainly help make changing clothes easier as I seem to not know what to do with the pump each day. It is a crude balance and holding system that really needs some refinement.
To me the CGM with the pump seems like a necessity, even though I don't have it started yet. It all seems so close to a better system of almost having a pancreas replacement. At some point I believe technology will be good enough that I will be to stop testing via finger sticks (or in my case alternate site (forearm)) and just have the pump site and CGM site.
Thursday, May 12, 2011
The Shaving Decision
After some contemplation, site selection was getting difficult so I decided to shave the abdomen. Lots of thoughts raced through my head: what if it itches, what if I look like a dork, how much to take off, what will the wife think, etc. A lot of my decision was based on the fact that I would like to keep sites on my abdomen for now and I haven't had a lot of luck with the hairy areas.
I started with a smaller area and quickly decided that I looked ridiculous. I was trying to achieve the best of both worlds of being practical for the site placement of my infusion sets while trying to look good at the same time. From there I shaved off more and more up to my chest. I wasn't sure if it was the best idea but it looked better than having some hair in areas I know I wouldn't be placing a site and maybe it would help my swimming time in a 100 meter race.
When my wife got home I asked her thoughts, she gave some advice that maybe I should do the upper part in more of a "V" shape from the bottom of my chest. So as I am continuing in this journey I am taking that advice and trying to maintain it differently. I am still not sure what she actually thinks.
Since shaving my abdomen the site placement has been much easier, sticks far better and the removal does not hurt as much, although it is a little more difficult to remove but that is a good thing. Even at this point I am trying the sites with out using the extra IV Hand 3000 clear film pieces around the edge of the site to be sure the pad on the infusion stays in. Plus in that vain as I have mentioned earlier it helps me rock the look of the pump a little better, although in the summer when it is hot or I plan on being in a pool more often I will probably go back to using the extra protection.
I started with a smaller area and quickly decided that I looked ridiculous. I was trying to achieve the best of both worlds of being practical for the site placement of my infusion sets while trying to look good at the same time. From there I shaved off more and more up to my chest. I wasn't sure if it was the best idea but it looked better than having some hair in areas I know I wouldn't be placing a site and maybe it would help my swimming time in a 100 meter race.
When my wife got home I asked her thoughts, she gave some advice that maybe I should do the upper part in more of a "V" shape from the bottom of my chest. So as I am continuing in this journey I am taking that advice and trying to maintain it differently. I am still not sure what she actually thinks.
Since shaving my abdomen the site placement has been much easier, sticks far better and the removal does not hurt as much, although it is a little more difficult to remove but that is a good thing. Even at this point I am trying the sites with out using the extra IV Hand 3000 clear film pieces around the edge of the site to be sure the pad on the infusion stays in. Plus in that vain as I have mentioned earlier it helps me rock the look of the pump a little better, although in the summer when it is hot or I plan on being in a pool more often I will probably go back to using the extra protection.
Thursday, May 5, 2011
To Shave or Not To Shave?
Saturday rolls around and I am going to be gone most of the day. I need to a do a site change before I go. I have my first painful "KELLY CLARKSON" moment of removing a site. The last placement was a little more into the dense area of hair and it hurt when it was time to remove. After avoiding the center area (or most densely hairy area) I decide to give it a try and to see how it works out.
After first placing the site a couple of inches above my belly button all is good at first. I have the clear sticky patches to put over the site to help make sure it stays in place and use one. I have been using them all along as I want to be sure I don't issues while I get used to sleeping with it among other things, plus I sweat a lot when I get hot.
I go to take a shower and the problems begin. As I get out of the shower the clear sticky patch is coming off and pulling on the site. The hair in the area is making it hard to stick to the skin. As I get dressed I realize this is not going to work out. I noticed some red on the infusion set adhesive pad and figure I need to redo the site, plus it is painful. Both kids decide they need to use the bathrooms at the same time. So I grab an electric razor and head to the kitchen, sure would be nice to have a little privacy.
Since I am in a hurry I just shave an area that I am going to use for the next site. I pull out the old one and now I am bleeding as I try to get the new site in the newly prepped site. I get infusion set set up and get it on and clean up the other site that doesn't want to stop bleeding. Finally get it taken care of and wonder if the other bolus actually made it since I had such an issue.
I test every hour after to be sure I got the insulin bolus for breakfast as I need to be ready as I have 12 young kids I am coaching at a track meet that day and want to be make sure I am in good shape to do so. Everything checks out at every check so I am able to relax and be there for the kids. They had a great track meet by the way and turned my bad morning into a great day.
Now I have some thinking to do, do I shave as I go or just shave it all? I am still not sure what I am going to do. I don't think my wife will care either way as long as I am healthy and happy but I want her to have a say in the choice as well. Plus I wonder how the brochures make the pump set look so good. I want to be able to rock the pump out like that but I fear it make take a lot of crunches or maybe one of Tony Little's programs or devices I see on infomercials.
After first placing the site a couple of inches above my belly button all is good at first. I have the clear sticky patches to put over the site to help make sure it stays in place and use one. I have been using them all along as I want to be sure I don't issues while I get used to sleeping with it among other things, plus I sweat a lot when I get hot.
I go to take a shower and the problems begin. As I get out of the shower the clear sticky patch is coming off and pulling on the site. The hair in the area is making it hard to stick to the skin. As I get dressed I realize this is not going to work out. I noticed some red on the infusion set adhesive pad and figure I need to redo the site, plus it is painful. Both kids decide they need to use the bathrooms at the same time. So I grab an electric razor and head to the kitchen, sure would be nice to have a little privacy.
Since I am in a hurry I just shave an area that I am going to use for the next site. I pull out the old one and now I am bleeding as I try to get the new site in the newly prepped site. I get infusion set set up and get it on and clean up the other site that doesn't want to stop bleeding. Finally get it taken care of and wonder if the other bolus actually made it since I had such an issue.
I test every hour after to be sure I got the insulin bolus for breakfast as I need to be ready as I have 12 young kids I am coaching at a track meet that day and want to be make sure I am in good shape to do so. Everything checks out at every check so I am able to relax and be there for the kids. They had a great track meet by the way and turned my bad morning into a great day.
Now I have some thinking to do, do I shave as I go or just shave it all? I am still not sure what I am going to do. I don't think my wife will care either way as long as I am healthy and happy but I want her to have a say in the choice as well. Plus I wonder how the brochures make the pump set look so good. I want to be able to rock the pump out like that but I fear it make take a lot of crunches or maybe one of Tony Little's programs or devices I see on infomercials.
Wednesday, May 4, 2011
The Bad Site
Being new to the pump is a learning process each and every day. I was officially on the pump one week as of Tuesday and feeling pretty good about it. Tuesday was an odd a day. It started out with a high after breakfast and with no correction a low mid morning. Pre-lunch was good then the difficulty started post-lunch, 193.
I had track practice that day and was fairly active so I tested after to see where I was at - 214. This was frustrating so I went back and made sure I counted carbs correctly for lunch and after recounting three times I did so I did a correction. Pre-dinner then I was 202. In my mind I was thinking, "What the heck is going on?" I was over my illness, still on the antibiotic but it didn't make sense to me. Post dinner I was 186 and at least happy to be under 200.
Before bed I tested several times while giving small corrections. I couldn't get under 200 and was questioning changing my site. Bedtime I was 177 so I thought things were getting back to normal although my site was bothersome, it was hurting a little. At 3:00 am I wake for my check feeling awful, I check and I am 325. I was very confused, pissed off and not sure what to do. Should I do a correction or site change? I didn't do a site change because I didn't know if I would be able to get up and test an hour or so later. A small correction (one unit) was the way I went. Unfortunately I could not get back to sleep as when I get high I usually don't feel well and the cotton mouth I feel is the worst. I struggled in bed for a while and eventually feel asleep.
On Wednesday morning I test and I am 355. I freak out. I decide before anything t change sites and do a bolus. I pick a new site and bolus to correct my blood sugar. After I do that I realize I should check for keytones. Keytones come back moderate and now the panic turns into a serious panic. I start guzzling water, checking my blood sugar every half hour and checking keytones as well. Initially the blood sugar starts to drop (319) then goes higher than where it was (371) I listen to the pump and bolus more but fear over correcting. Keytones are a least starting to correct to small. I call the nurse at my doctors office as they just open. I keep checking and wonder if my pump is having a problem as I it is taking what seems like forever to come back to reality. Here are the times and numbers through the morning:
7:25 am 319
7:52 am 371 Keytones still Moderate
8:23 am 373 Correction Bolus
9:18 am 273 Correction Bolus, Keytones Small
9:45 am 273 Correction Bolus
10:15 am 246 Keytones down to a trace
10:49 am 171 Keytones Negative
11:50 am Pre Lunch 101
FINALLY! Back to normal, now just waiting for the crash. Meanwhile I put my daughter down for a nap and jump in the shower. The phone rings, thinking it is the Doctor I get out of the shower with soapy hair and face and search for the phone - it is not the doctor but wife finding out what is going on as Tornado Sirens are going off. I get as dried as I can scoop up my daughter and get to my basement and check the weather. Unfortunately this storm was moving fast, maybe even faster than the sirens. Fortunately there were no tornadoes. So I get my daughter back to bed an wait for the doctor's office to call.
Then finally call and confirm that I had a bad site. I apparently did alright handling it, should have checked for keytones before changing the site but I was in crazy mode at that point and just wanted to get a correction right away. We made a small basal rate change to my 10 am and bumped it up to 0.7 and my 4 am to 0.9.
Having my confidence shaken I am back to unsure about this a bit, but it turns out bad sites happen and since that time for the next few days I did very, very, very well. Through Saturday of that week I had one high over 200 which was totally my greedy eating fault. and a few lows that I just had a small snack to correct. Things are going well at least until the next site change Saturday morning.
Tuesday, May 3, 2011
The First Meal Without Labels
Everything was going alright and this new pump thing seemed pretty good. Saturday was a pretty good day and my confidence was growing and life seemed to be moving along and I was sure happy to not have to use a needle since Tuesday, although my arms were getting a bit sore from all the testing but I knew it would get better.
Saturday night I made my first dive into candy as Easter was the next day and we were getting the kids Easter baskets ready. Who can really resist a Cadbury Cream Egg or a Reese's Peanut Butter Egg. Two of my favorite things beyond the Sweet Tart Jelly Beans. Well I ate some candy, counted the carbs and used the bolus wizard and was feeling pretty good until the 3:00 am check. I was 232, not surprised as a few jelly beans or a little Butterfinger egg may have slipped into my mouth on accident. It wasn't too bad but I was a little concerned.
Easter morning I woke up at 212 and was ok but a little upset that it seemed like another step backwards. We went to church and then over to my wife's family's house and celebrated Easter. This would be my first meal with no labels and just my knowledge of carbs to figure out how much to bolus for what I was eating. Before Lunch check was 169 and I was hungry. I had some coffee cake, kielbasa, bacon, sausage, and corned beef hash. I don't recall what I guesstimated the carbs to be but I didn't do as well as I though as I was 244 two hours after lunch.
It was time to do a site change for my pump. I picked a new site, still avoiding the hairy parts of my abdomen as much as possible and got everything rolling pretty good for my first site change on my own not at home. I get done and wait about an hour and test and my blood sugar is up to 261, I do a bolus and I am a little worried as I don't know if it was a bad miscalculation on the food or if I didn't pick a great site. I check about every 45 minutes to and hour after that and the readings go 252, 215, 193 down to 176 on my pre dinner check. I eat a little dinner even though I am not hungry and my 2 hour post dinner check is 104. Whew, back on track! The 3:00 am check was even good, maybe a little low at 107 but I was able to get some rest and stop worrying.
The next day, Monday (close to one week on the pump), I was to call in my blood sugars to see how I was doing and potential make some basal rates adjustments. I called in and we made some changes to my basal rates as my mornings were still a tough one as I would always be higher than I should after breakfast and we raised my evening rate a little as well. I started out at 0.5 Basal rate and now it goes: 12:00 am 0.5, 4:00 am 0.8, 10:00 am 0.6, 6:00 pm 0.7, then it restarts at midnight again.
From here I am pretty excited as it seems like the adjustments are getting smaller so I must be on the right path, then I have my first bad site.
Saturday night I made my first dive into candy as Easter was the next day and we were getting the kids Easter baskets ready. Who can really resist a Cadbury Cream Egg or a Reese's Peanut Butter Egg. Two of my favorite things beyond the Sweet Tart Jelly Beans. Well I ate some candy, counted the carbs and used the bolus wizard and was feeling pretty good until the 3:00 am check. I was 232, not surprised as a few jelly beans or a little Butterfinger egg may have slipped into my mouth on accident. It wasn't too bad but I was a little concerned.
Easter morning I woke up at 212 and was ok but a little upset that it seemed like another step backwards. We went to church and then over to my wife's family's house and celebrated Easter. This would be my first meal with no labels and just my knowledge of carbs to figure out how much to bolus for what I was eating. Before Lunch check was 169 and I was hungry. I had some coffee cake, kielbasa, bacon, sausage, and corned beef hash. I don't recall what I guesstimated the carbs to be but I didn't do as well as I though as I was 244 two hours after lunch.
It was time to do a site change for my pump. I picked a new site, still avoiding the hairy parts of my abdomen as much as possible and got everything rolling pretty good for my first site change on my own not at home. I get done and wait about an hour and test and my blood sugar is up to 261, I do a bolus and I am a little worried as I don't know if it was a bad miscalculation on the food or if I didn't pick a great site. I check about every 45 minutes to and hour after that and the readings go 252, 215, 193 down to 176 on my pre dinner check. I eat a little dinner even though I am not hungry and my 2 hour post dinner check is 104. Whew, back on track! The 3:00 am check was even good, maybe a little low at 107 but I was able to get some rest and stop worrying.
The next day, Monday (close to one week on the pump), I was to call in my blood sugars to see how I was doing and potential make some basal rates adjustments. I called in and we made some changes to my basal rates as my mornings were still a tough one as I would always be higher than I should after breakfast and we raised my evening rate a little as well. I started out at 0.5 Basal rate and now it goes: 12:00 am 0.5, 4:00 am 0.8, 10:00 am 0.6, 6:00 pm 0.7, then it restarts at midnight again.
From here I am pretty excited as it seems like the adjustments are getting smaller so I must be on the right path, then I have my first bad site.
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