No, its not a reference to the UK. Its about infusion sites for insulin pump users. I should have learned my lesson the first time, but I repeated my mistake and paid for it... I thought I would share.
When I put on my new infusion set, I noticed a little blood in the catheter. No problem, I needed a morning Bolus and it went away instantly. However, in my personal case, I SHOULD have changed it right away. The site look progressively worse over days time and I took it out this morning (only 2 days in). Blood instantly started coming out. Bright red and quickly streaming down my side. I scrambled for a napkin to sop up the mess and as quickly as I could I covered the hole. I had to hold pressure on the wound for 2-3min before it clotted and stopped.
This is the second time this has happened within a year's time. It really freaked me out the first time. A steady stream of blood coming from a small hole in your stomach would do that I guess. What I'm left with is a very sore and bruised area about 1/2 inch (1cm) in diameter. I put Neosporin on it and went on with my life.
I just wanted to write it down because that blood in the catheter should have been a strong warming that the site was not good for me. I had crazy high BG readings for nearly 3 days and I'm very high this morning. I just HATE wasting all that insulin and having to take another shot to put on a new infusion set. But in the long run, I felt much worse when I kept it on and should have changed it right away. It just wasn't worth it.
Lesson learned.
Friday, March 26, 2010
Wednesday, March 3, 2010
Dropping BG and Diarrhea, cha cha cha
For younger people, you might not know that the title is a throwback to an old MTV cartoon called, "Beavis and Butthead".
Anyways, I'm writing about a gross topic today. As the title suggests, I'm talking about diarrhea. This info here is completely anecdotal so please that all the suggestions here as a strictly individual case. Although, if you happen to pass by this page and have a similar story, I'd love to know.
Yesterday, I went very very low. Down to 39mg/dL. Before I had very good control I would sweat profusely and shake and get dizzy rapidly because I was starting at 200-300mg/dL and dropping to 40mg/dL. It was quite tramatic and scary and typically ended with a deep pain in my stomach followed by a single strong bout of diarrhea (nearly entirely water). Afterward, I would start to feel human again. The entire process from the start of crashing to final relief was about 30min-2h depending on severity but it always ended the same way.
These days I have much better control. I do still go low, however, the symptoms are not nearly as dramatic. Typically I'm starting at 100-160mg/dL and I'm slooooowly dropping to 50mg/dL or even 39mg/dL as was the case yesterday. And the major joy is that the harsh projectile diarrhea isn't a standard event! I'm happy about that, but sometimes I still get a more mild and delayed response.
Last night, after a nice and normal meal, I had a gentle but definite urge and finally a run with the runs. As mentioned, earlier n the day I dropped to 39mg/dL and didn't check my recovery until dinner-time. I was at 190mg/dL... not bad considering I drank a coke to help the recovery and didn't correct for it. Then, after dinner and my brown belt bout, I shot up to 280! I went to bed thinking this stress and internal issues with the muddy super-soaker had caused the jump. But again this morning I found that my BG was up to 300mg/dL.
SO I think back and I don't remember what happened after my bouts before. I was always high, but I also had always assumed it was the sugar I ate to stop from crashing. Maybe the resulting diarrhea is actually the source of the higher BG?
So now my current hypothesis is something like this...
The low low BG causes a natural reaction to encourage eating.
I eat to stop from crashing, but the ball is in motion to finish the deal with a bout of diarrhea.
Once the body has flushed, a new issue arises with the bodies response to evacuating that much water in one sitting, and so the BG rises.
If the urge continues or the feeling at least continues (and it does) so will the rise in BG.
Its a pretty awful circle if I'm right. I'll have to really apy close attention when this happens again, and I KNOW it will happen again.
Anyways, I'm writing about a gross topic today. As the title suggests, I'm talking about diarrhea. This info here is completely anecdotal so please that all the suggestions here as a strictly individual case. Although, if you happen to pass by this page and have a similar story, I'd love to know.
Yesterday, I went very very low. Down to 39mg/dL. Before I had very good control I would sweat profusely and shake and get dizzy rapidly because I was starting at 200-300mg/dL and dropping to 40mg/dL. It was quite tramatic and scary and typically ended with a deep pain in my stomach followed by a single strong bout of diarrhea (nearly entirely water). Afterward, I would start to feel human again. The entire process from the start of crashing to final relief was about 30min-2h depending on severity but it always ended the same way.
These days I have much better control. I do still go low, however, the symptoms are not nearly as dramatic. Typically I'm starting at 100-160mg/dL and I'm slooooowly dropping to 50mg/dL or even 39mg/dL as was the case yesterday. And the major joy is that the harsh projectile diarrhea isn't a standard event! I'm happy about that, but sometimes I still get a more mild and delayed response.
Last night, after a nice and normal meal, I had a gentle but definite urge and finally a run with the runs. As mentioned, earlier n the day I dropped to 39mg/dL and didn't check my recovery until dinner-time. I was at 190mg/dL... not bad considering I drank a coke to help the recovery and didn't correct for it. Then, after dinner and my brown belt bout, I shot up to 280! I went to bed thinking this stress and internal issues with the muddy super-soaker had caused the jump. But again this morning I found that my BG was up to 300mg/dL.
SO I think back and I don't remember what happened after my bouts before. I was always high, but I also had always assumed it was the sugar I ate to stop from crashing. Maybe the resulting diarrhea is actually the source of the higher BG?
So now my current hypothesis is something like this...
The low low BG causes a natural reaction to encourage eating.
I eat to stop from crashing, but the ball is in motion to finish the deal with a bout of diarrhea.
Once the body has flushed, a new issue arises with the bodies response to evacuating that much water in one sitting, and so the BG rises.
If the urge continues or the feeling at least continues (and it does) so will the rise in BG.
Its a pretty awful circle if I'm right. I'll have to really apy close attention when this happens again, and I KNOW it will happen again.
Tuesday, February 16, 2010
Sick and Tired
I've been feeling worn down and sick for a little over a week. Moreover, I've been staying up late and having trouble staying asleep. I feel like when I'm sick and/or tired, I get unusually high BG readings. I don't think this is "in my mind" as a couple doctors have told me. And, in fact, being sick does make your BG rise. Being under stress can do the same and in some people, taking antibiotics also can make you go high (see comments http://www.tudiabetes.org/forum/topics/being-sick-high-blood-sugar)
Truth is, there's more things that can raise your BG than can lower it. The fact that a major treatment of illness (antibiotics) adds to the problem by raising your BG is really irritating to me. But sometimes its necessary and the only answer is MORE FREQUENT CHECKING. Plain and simple. MORE CHECKING followed by MORE CORRECTING.
I try to avoid making changes in my basal and correction and bolus ratios until I am feeling well again and not taking antibiotics because it can cause problems later. The better solution for myself is to correct for the highs and just check more often. The problem is that I've been slacking these past few days and my BG is going high without correction, which adds to my sick feeling and sleepless nights.
Throughout most of the winter I have this on and off again sick feeling which really messes with my health for several months. I don't know that warmer climates would help me throughout the year, but staying inside for 3-4 days in a row because of massive Balitmore blizzards has certainly kept me feeling awful.
Truth is, there's more things that can raise your BG than can lower it. The fact that a major treatment of illness (antibiotics) adds to the problem by raising your BG is really irritating to me. But sometimes its necessary and the only answer is MORE FREQUENT CHECKING. Plain and simple. MORE CHECKING followed by MORE CORRECTING.
I try to avoid making changes in my basal and correction and bolus ratios until I am feeling well again and not taking antibiotics because it can cause problems later. The better solution for myself is to correct for the highs and just check more often. The problem is that I've been slacking these past few days and my BG is going high without correction, which adds to my sick feeling and sleepless nights.
Throughout most of the winter I have this on and off again sick feeling which really messes with my health for several months. I don't know that warmer climates would help me throughout the year, but staying inside for 3-4 days in a row because of massive Balitmore blizzards has certainly kept me feeling awful.
Tuesday, February 9, 2010
Changing my set changes the effect
This happens every so often. I change my infusion set and my BG readings go high for no apparent reason. Sometimes for up to 1 day. What I do is to check more frequently and correct as needed. I used to change my basal, bolus, or correction depending on when I saw it and how I came to notice high BG, but by the time I changed it, the problem had already resolved and I ended up causing low BG crashes.
SOooo... what is it? Well, I've told my doctor this before and he believes my basal needed adjusting. See previous posts for the list of reasons why he is wrong. The nurse practitioner, however, listens and agrees that changing sites can cause this problem. Check out these other blogs
http://www.insulin-pumpers.org.uk/badsite/
http://www.diabetes-insulin-pump-therapy.com/high-blood-sugar.html
I really like the first one. So much useful info that I can't seem to find anywhere except from people's personal experience. Why would you get high BG from changing your site? LOTS of reasons...
First, they go down a checklist of performing a Pump Self-test; make sure your tubing isn't tangled or leaking; make sure you have correct basal and bolus levels, and describe the condition of your infusion site. Is it red? swollen? do you see blood in your infusion set line? did you prime it correctly or do you see air bubbles? These are important questions, but if the final answer is that the site hurts, its hard, its red, or isn't responding to correction... CHANGE THE SITE!!! I can't emphasize that enough. If its a continuing problem, you should change the site. For myself, its not hardened, it is irritated, but it goes away after a day. I pay a lot for supplies and throwing out 3ml of insulin, an infusion set and reservoir (I don't mess around with reusing reservoir because of sterility concerns). I know that most all times my BG will go back to normal within a day (sometimes less).
Last night my site hurt when I set it up. This morning my BG was high. It wasn't a surprise, just an average bad start to a good day. If you have questions, I actually found the MiniMed site helpful.
http://www.minimed.com/help/sitemanagement/index.html#a6
And there are also the National Institutes of Health and Center for Disease Control with useful sites too.
http://www.cdc.gov/diabetes/ndep/index.htm
http://www.ndep.nih.gov/partners-community-organization/index.aspx
And I really like this book called "Insulin Pumping"... here's the website founded by the authors.
http://www.diabetesnet.com/pibook.php
Everything is going well now.
SOooo... what is it? Well, I've told my doctor this before and he believes my basal needed adjusting. See previous posts for the list of reasons why he is wrong. The nurse practitioner, however, listens and agrees that changing sites can cause this problem. Check out these other blogs
http://www.insulin-pumpers.org.uk/badsite/
http://www.diabetes-insulin-pump-therapy.com/high-blood-sugar.html
I really like the first one. So much useful info that I can't seem to find anywhere except from people's personal experience. Why would you get high BG from changing your site? LOTS of reasons...
- The site is close to muscle or the infusion set slope is angled to steep and is close to muscle causing higher BG (absorption is hindered).
- The site becomes swollen or irritated or at worst, infected, which causes inflammation and hinders your insulin activity and absorption.
- The site has hardened fat tissue, which hinders absorption.
- Site isn't taken very well and your body reacts to it negatively for a number of immune response reasons, which leads to inflammation...
First, they go down a checklist of performing a Pump Self-test; make sure your tubing isn't tangled or leaking; make sure you have correct basal and bolus levels, and describe the condition of your infusion site. Is it red? swollen? do you see blood in your infusion set line? did you prime it correctly or do you see air bubbles? These are important questions, but if the final answer is that the site hurts, its hard, its red, or isn't responding to correction... CHANGE THE SITE!!! I can't emphasize that enough. If its a continuing problem, you should change the site. For myself, its not hardened, it is irritated, but it goes away after a day. I pay a lot for supplies and throwing out 3ml of insulin, an infusion set and reservoir (I don't mess around with reusing reservoir because of sterility concerns). I know that most all times my BG will go back to normal within a day (sometimes less).
Last night my site hurt when I set it up. This morning my BG was high. It wasn't a surprise, just an average bad start to a good day. If you have questions, I actually found the MiniMed site helpful.
http://www.minimed.com/help/sitemanagement/index.html#a6
And there are also the National Institutes of Health and Center for Disease Control with useful sites too.
http://www.cdc.gov/diabetes/ndep/index.htm
http://www.ndep.nih.gov/partners-community-organization/index.aspx
And I really like this book called "Insulin Pumping"... here's the website founded by the authors.
http://www.diabetesnet.com/pibook.php
Everything is going well now.
Thursday, February 4, 2010
Mid-Day Downer
So I haven't been posting daily because... well.... that takes a bunch of time and putting all my numbers up hasn't been 'helping' a lot. But reviewing trends and giving tips to myself has.
For the past 3 days, I've been eating a sandwich, chips (weighed on a scale) and an apple for lunch. Each day I'm somewhere between 100-150mg/dL before eating. I keep dropping to a point where I almost crash and the nagging feeling of low BG is very distracting to my work. SO I'm trying the square bolus option, which seems to help out quite a bit. I've been doing 30min release.
Now today specifically, it dropped to 50mg/dL 1hr after eating/taking insulin. This concerns me because its a pretty accurate carb amount and I did a square bolus and started at 96mg/dL. Thank goodness there was 4-day old Birthday cake (which seems to never spoil... that can't be a healthy sign). I wonder if the increased sunlight/full-spectrum light bulbs at home (a new purchase) have actually had a positive effect already.
I'll keep monitoring and see.
For the past 3 days, I've been eating a sandwich, chips (weighed on a scale) and an apple for lunch. Each day I'm somewhere between 100-150mg/dL before eating. I keep dropping to a point where I almost crash and the nagging feeling of low BG is very distracting to my work. SO I'm trying the square bolus option, which seems to help out quite a bit. I've been doing 30min release.
Now today specifically, it dropped to 50mg/dL 1hr after eating/taking insulin. This concerns me because its a pretty accurate carb amount and I did a square bolus and started at 96mg/dL. Thank goodness there was 4-day old Birthday cake (which seems to never spoil... that can't be a healthy sign). I wonder if the increased sunlight/full-spectrum light bulbs at home (a new purchase) have actually had a positive effect already.
I'll keep monitoring and see.
Monday, February 1, 2010
Please go down
This is gonna be a long day...
10am 181
12pm 222
6pm 332
10pm 172
12am 119
So my numbers today would give my doctor a reason to say my basal is wrong (I'm not defending his suggestion I'm just explaining his initial reaction). I woke up high. I corrected and at lunch, I was STILL HIGH. I decided that I should take 2U extra to account for the 60mg/dL that I have been over. So what do you think happens? I crash real bad and fairly all of a sudden.
How does it feel when you crash? How do you know you're crashing?
Well, for me, crashing and 1-2hr after I eat feel very similar. A little anxious, fidgety and a little kind of tingle at my joints and stomach... kinda like I'm getting ready to run a race. But it goes away eventually. When I crash, it only gets worse. So I'm doing my work in the culture room and I start some really intense stuff when I feel 'normal'. Then I get involved in my work to a point where if I stop, a week's worth of material and time is trashed. I feel like I may crash, but can't really stop and then it hits hard. I barely finish before I really really start sweating and shaking.
And so I overkill and drink too much soda. I eat a couple granola bars to settle my stomach. And by 5pm I'm high as a kite on a windy day. Any doctor that says "Are you sure you were crashing that bad?" or "You shouldn't over do it" is a big fat A-hole. I'm at work. I'm trying to live. My actions before were rationale and the result was not expected. And obviously they don't know what it feels like. Seriously now... how many Type I diabetics out there have a Type I diabetic doctor? Huh? Anyone? How many doctors have woken up my sleep pouring with sweat and staggered to the fridge with blurred vision only to find the only sugar is your expired OJ? How many doctors know how the taste of Coca cola shanges when your BG is low and that sugary foods taste strange when your crashing, but you have to drink it anyway? How many of your doctors know what explosive diarrhea feels like an hour after a bad BG crash?
Truth is it scares the shit out of me and this time the crash was full-on before I treated it. I felt like crap for most of the day and it only got worse. Some freaking sympathy would go a long way. I corrected for the high BG and much later at home (we went to do taxes and grocery shopping) it was still a bit high. I ate, corrected and happily went to bed at 119mg/dL. So now we can see that clearly raising the basal is a very very dangerous idea for myself. Out of the past 5 days, count the number of reading that were near 120mg/dL. All of those times I would have been crashing. Simply put, I have a large day-to-day variation in my bolus needs and doctors have a hard time admitting that to my face. But I'm confident it my self-diagnosis.
I hope I stay lower these next days. I'm tired of feeling like crap.
10am 181
12pm 222
6pm 332
10pm 172
12am 119
So my numbers today would give my doctor a reason to say my basal is wrong (I'm not defending his suggestion I'm just explaining his initial reaction). I woke up high. I corrected and at lunch, I was STILL HIGH. I decided that I should take 2U extra to account for the 60mg/dL that I have been over. So what do you think happens? I crash real bad and fairly all of a sudden.
How does it feel when you crash? How do you know you're crashing?
Well, for me, crashing and 1-2hr after I eat feel very similar. A little anxious, fidgety and a little kind of tingle at my joints and stomach... kinda like I'm getting ready to run a race. But it goes away eventually. When I crash, it only gets worse. So I'm doing my work in the culture room and I start some really intense stuff when I feel 'normal'. Then I get involved in my work to a point where if I stop, a week's worth of material and time is trashed. I feel like I may crash, but can't really stop and then it hits hard. I barely finish before I really really start sweating and shaking.
And so I overkill and drink too much soda. I eat a couple granola bars to settle my stomach. And by 5pm I'm high as a kite on a windy day. Any doctor that says "Are you sure you were crashing that bad?" or "You shouldn't over do it" is a big fat A-hole. I'm at work. I'm trying to live. My actions before were rationale and the result was not expected. And obviously they don't know what it feels like. Seriously now... how many Type I diabetics out there have a Type I diabetic doctor? Huh? Anyone? How many doctors have woken up my sleep pouring with sweat and staggered to the fridge with blurred vision only to find the only sugar is your expired OJ? How many doctors know how the taste of Coca cola shanges when your BG is low and that sugary foods taste strange when your crashing, but you have to drink it anyway? How many of your doctors know what explosive diarrhea feels like an hour after a bad BG crash?
Truth is it scares the shit out of me and this time the crash was full-on before I treated it. I felt like crap for most of the day and it only got worse. Some freaking sympathy would go a long way. I corrected for the high BG and much later at home (we went to do taxes and grocery shopping) it was still a bit high. I ate, corrected and happily went to bed at 119mg/dL. So now we can see that clearly raising the basal is a very very dangerous idea for myself. Out of the past 5 days, count the number of reading that were near 120mg/dL. All of those times I would have been crashing. Simply put, I have a large day-to-day variation in my bolus needs and doctors have a hard time admitting that to my face. But I'm confident it my self-diagnosis.
I hope I stay lower these next days. I'm tired of feeling like crap.
Sunday, January 31, 2010
Bipbimbap overload
Trying to stay down today... not very successful.
11am 146
11am 146
5pm 207
8pm 213
11:30pm 274
I woke up fine and we had Tom yum soup for lunch which my wife made rice noodles for. There's something about high carb noodles when we cook them... They release a lot of gluten and carbs in the water during the boil so sometimes the count isn't completely accurate. I really only have this problem with Asian noodles and not American packaged noodles. I crashed a bit and ate chocolate and an apple and tried to patiently wait it out. I snacked on nuts while I waited to feel better.
By the late afternoon at the coffee shop, the BG only got up to ~200, which I was happy with (I felt like it was much higher). But it kept going up. I had corrected and still 3hrs later it was basically the same. Then we ate Bipbimbap and bean soup and it skyrocketed again.
I don't know what's going on, but sometimes this happens to me on a day to day basis. Like today was terrible and kinda unexpected. I feel a bit bloated, and my lips and tongue really feel like I have very very high BG (like I feel at 500mg/dL). I'm also feeling really tired. But tomorrow I could be fine and even go a bit on the low side. This is the kind of variation where sometimes I just don't even bother to try and figure it out. I'm hoping this bog will help to get at this kind of problem.
8pm 213
11:30pm 274
I woke up fine and we had Tom yum soup for lunch which my wife made rice noodles for. There's something about high carb noodles when we cook them... They release a lot of gluten and carbs in the water during the boil so sometimes the count isn't completely accurate. I really only have this problem with Asian noodles and not American packaged noodles. I crashed a bit and ate chocolate and an apple and tried to patiently wait it out. I snacked on nuts while I waited to feel better.
By the late afternoon at the coffee shop, the BG only got up to ~200, which I was happy with (I felt like it was much higher). But it kept going up. I had corrected and still 3hrs later it was basically the same. Then we ate Bipbimbap and bean soup and it skyrocketed again.
I don't know what's going on, but sometimes this happens to me on a day to day basis. Like today was terrible and kinda unexpected. I feel a bit bloated, and my lips and tongue really feel like I have very very high BG (like I feel at 500mg/dL). I'm also feeling really tired. But tomorrow I could be fine and even go a bit on the low side. This is the kind of variation where sometimes I just don't even bother to try and figure it out. I'm hoping this bog will help to get at this kind of problem.
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