pleased precariously

I walked around a lot yesterday (maybe 2-3 hours of walking, up and down hills).  I ate > 60g CHO at every meal, and only injected 2U humalog at each meal.  Before the meals my BG was usually around 120-130, and after 2 hours was in the 90s (a little low.)  Except at dinner.  I ate a largish dinner, and my BG at 2 hours after was 78.  Given that I only injected 2U and ate a lot of carbs, I can only attribute it to the exercise (coupled with the lantus I had injected the night before).  There’s also some interplay with the big meal, which can reduce the speed at which carbs are digested, and so the insulin might have resulted in a short term low.

I ate a snack (18g) at 11pm (when I tested 78).  I probably should have waited a bit longer, since I tested again right before bed (when I was going to inject my 14U lantus) and it had climbed to 200.  I injected my 14U and waited another 20 minutes.  It had gone down to 197 by that point, so I went to bed.

I woke up this morning around 9:30 feeling very shaky.  Checked my BG, and it was 68. Ate two bowls of relatively high carb cereal (around 90g total), injected 3U humalog.  After 2 hours, my BG was back up at 201.

Talk about a roller coaster.  So many variables it hurts to think about.  And let’s not get into the 56 I tested two days ago while at the diabetes center (if you’re going to have a low, that’s the place to do it, I guess.  2 glucose tablets and a little 20 minute freak out later and I was back at 141.)

I can’t wait to see if a pump (and the ability to reduce my basal rate nearly instantaneously) will result in more even BG in the face of exercise.

This happened a few days ago (like 3 days after returning from the hospital), but it’s been an oh wow for me ever since, and I wanted to get it down lest I forget.

But before that: At the beginning of October my eyesight started getting pretty bad, to the point where, when Joelle and I played tennis, I couldn’t make out her face across the court. It was just a featureless flesh-toned blur. Seeing the ball in motion was even harder, with it coming into clear focus maybe 5 or 6 feet from me. Needless to say I lost a lot of matches. I ended up going to an optometrist near my house and coming away with a prescription for near sightedness and some pretty hot glasses.

So anyway, I was sitting at my desk playing around with my guitar, flipping through some iron & wine songs I know, seeing how agile (or not agile, in this case) my fingers were after the weeks in New Jersey, Boston, and the hospital. I looked down, turned on the tuner on the guitar’s body to drop the low E down to D, and found that I was having a lot of trouble focusing on the letters on the tuner. I could, but it required effort. I would relax my eyes only slightly, and it would go completely blurry. With effort, it would return to focus.

On a whim, I let my eyes relax and lifted my glasses off my nose. The tuner was in perfect focus. I took off the glasses and looked across the room, and saw everything clearly. Out my window I could read street signs half a block away. I went for a walk and could make out people’s facial expressions far down the sidewalk. It was glorious.

The geek in me kept thinking “this is just like that scene in Spiderman 2, when he gets his powers back and notices he doesn’t need his glasses anymore.”

So watch out, world.

Just got back from the diabetes center.  They ran an Hemoglobin A1c test, which came back with a result of 12.4 (normal is in the 5-6 range).  This means that over the past 3 months my blood glucose has averaged about 350.  So this has been going on for while.  At least 2 months before I really started feeling off.

I go in to the lab tomorrow to have more blood/urine taken so they can do more tests, the most important (to me, anyway) being the antibody test, so we can have some idea of whether I’m type 1 or type 2.  Another test is the microalbumin ratio, which will give some data on how much (if at all) my kidneys were damaged by my period of hyperglycemia.

Also, talked with the doctor about the Spain trip, and she gave me a prescription for insulin pens to use instead of the syringes and vials (god, they’re so much more convenient), and a travel letter that I can show the airport security people so they’ll let me take the stuff on the plane.  She also made me feel a lot better about the prospect of carb counting in a foreign country (she’s been to Spain several times).  So, it looks like I’ll be seeing everyone at the Mono Summit in Madrid

Sorry for not continuing the story.  Everything about my stay in the hospital is still fresh in my mind, from my first nurse (Sonny, who told me all about his desire to remain single because he puts too much stock in others’ opinions of him) to my last (Heather, who Joelle and I agreed would be cool to hang out with outside of the hospital.  Should really invite her over for dinner sometime). From the odd, ego twiddling experience of peeing into the plastic jug they kept beside the bed to the intense discomfort of typing for the first time after all those painful lancet sticks.  I’ll get around to writing more about it at some point, but I’m more interested in the here and now.

Given how crappy I’m feeling, given how low-blood-sugary I feel, with the headache, mild nausea, lightheaded, cloudy feelings, and given that when I check my BG and see 123..  It makes me wonder just how long I’d been living in a state of hyperglycemia.  Months?

Up until yesterday I’d been injecting 2U humalog for BG levels of  100-150, and 3U for BG levels of 151-200, taken before meals.  My diabetics nurse told me to switch to 3U for the entire range of 100-200, which makes sense because my BG 2 hours after eating always showed a marked increase when I’d injected 2U (this is probably just because I was always feeling hungrier at that level, so I ate more, but anyway).  Also, I’d been injecting 12U lantus before bed, and we upped that to 14U.

Both increases are causing my numbers to drop in a rather large way, and given the tiny range of normal BG that serves as the ultimate target (with a spread of only 50-60 points), it’s nerve wracking forcing myself to not check my blood sugar obsessively every 5 minutes.   It’s been on the high side of that range all of today, from 122 to 134, but god do I feel like ass.

Wonder how long it’ll be until I feel normal at this level.

long story, so I’ll break it up some.

I got back from Boston last week knowing full well that something was wrong with me. Since before I left for New Jersey I’d been drinking water like it was going out of style. Peeing constantly too. 2-3 times a night I would wake up to pee, then find myself thirsty and drink more. Needless to say I wasn’t sleeping well. Also, all through the 15 days I was on the east coast, I was eating an amazing amount. Third helpings at almost every meal where they were offered (Joelle’s mom loved this, I think). I was impressed with my appetite, as was everyone else, but when I saw Nat and he came up and hugged me, he said “you’re looking really skinny.”

I left San Francisco at around 158 pounds. I returned 15 days of almost no exercise and near constant (high calorie) eating later, down to 145 pounds.

I sent email to pals the day I returned asking for GP recommendations so I could make an appointment to get in to see someone. I called my mom to let her know I’d made it home safe and we talked for a bit. She listened to me rattle off the symptoms and suggested “you should have the doctor check you for diabetes.” Screw “diagnose by google”, “diagnose by mom” rules.

I mentioned her suggestion to the hungries on icb and someone said something about a home test, so I googled around to see if they existed, then headed to walgreens where I picked up some glucose diastix. Peed in a cup, stuck the strip in, held it up and watched as it (rather quickly) ran through the color chart all the way from “negative” blue on the left to off-the-chart brown on the right.

I called my insurance’s on-call nurse consultant on Jenny’s recommendation (she also looked up the number for me) and listed the symptoms and the reading from the glucose strip. I told her I was planning to make an appointment, but wasn’t sure if I should wait for it or if I should just go to the emergency room. She said that any tests the doctor was going to do the ER would do as part of my examination, and that I’d be better off finding out now. So, I called a cab and rode over to Davies ER.

I remember filling out the forms and handing them back in along with my card. The nurse came back out and had me fill in the reason for my visit.

Suspicion of Diabetes.

I was called back and the doc checked my blood pressure, pulse, and temperature. He also commented that he could smell ketones on my breath. One of the cooler diagnostic markers (and one that I was already familiar with from hours wasted watching House) is that ketones cause your breath to smell fruity. Given that they promptly moved me to a bed and put an IV catheter in. They brought out their glucometer and tested my blood sugar. The LED display, which normally shows the numeric value, just said “HIGH”. I asked what that meant, and the doctor who put in my IV said “above 400, but we don’t know how high above.”

She drew three vials of blood and started me on an open saline drip. My cell phone was getting signal only sporadically, sometimes long enough for me to send or receive a text, so Jenny and Joelle both knew I was in the ER, but I couldn’t really give them any more info. Eventually they brought me a phone and I called Joelle and she said she’d be over as soon as she got home.

While I was laying there on the bed with the curtain halfway drawn, I heard one doc mention to the other, “You know the possible diabetes? His blood sugar was 562.”

Normal is 70-110.

more later…