The Hellacious, Headstrong High

There’s lots of different “kinds” of high blood sugar. There is the type that is self-inflicted due to inaccurate carb counting or insulin dosing. There’s the sort that can be blamed on technological error – an insulin pump failure or a cannula kink, for instance. And another kind is linked to illness, when a cold or other sickness prevents insulin from working efficiently, thereby stopping blood sugars from coming down to normal levels.

And then there’s the type of high blood sugar that simply can’t be explained. It’s high for seemingly no goddamn reason, and it’s the most frustrating high of them all.

That kind of high is also the kind that takes what feels like forever to come down.

I experienced this after a Saturday of travel earlier this month. I’m fairly accustomed to traveling, especially if it’s a quick trip on a plane or just a few short hours in the car. I say this because I’m almost positive that my hours-long high blood sugar had nothing to do with my travel day…although when it comes to diabetes, nothing can truly be ruled out.

Anyways, I digress. That day involved me heading out of the house at 10 A.M. I drove to the shuttle that would take me to the airport. I got to the airport about an hour before my flight was due to take off. I went through TSA Pre-Check – my first time using the service, which I totally recommend – without any issues. I had enough time to pick up some food for a small lunch, but when I checked my CGM and noticed that my blood sugars were hovering in the 200s, I decided to deliberately pick lower-carb snacks to munch on in lieu of a real lunch. Turkey jerkey and cheddar popcorn weren’t the most filling snacks, but it was something.

I figured that by the time I got on the plane, my blood sugars would be stabilizing. No such luck. I was still in the low 200s. I took one or two more boluses during my quick hour-and-a-half long flight, thinking that I must be heading for a blood sugar crash by the time I deplaned. Nope. I was still running high, even by the time I met my partner by the baggage claim. I raised my temp basal and kept my fingers crossed that by the time we reached the restaurant we were bound for, I’d be coasting down. As we got settled at our table, I checked my blood sugar and felt slightly relieved to see that I was 183. At least I was finally below 200.

Teacher's Month 2020

I pushed blood sugar worries out of my mind for the next hour or so. I just wanted to enjoy my meal and my time with my significant other. But as we finished eating and made our back to the car, I couldn’t help but notice the repeated buzzing coming from my CGM. I was rising gradually, well on my way to 300. I tried to not panic and gave myself more insulin. We arrived home and the vicious cycle truly began. For the next three or four hours, I tested and corrected every hour, on the hour. Midway through that interval of time, I changed my pod – perhaps it stopped working properly – and prayed that the new pod would finally bring me back down.

And, spoiler alert: It eventually did. But in the agonizingly long hours I had to wait before my blood sugar was down…I experienced a bevy of emotions. I was mad. I was upset. At one point, I was very technical and rational, going through my next steps both in my head and out loud to my worried partner. He asked me what we should do in the event that my blood sugar was still elevated after a certain length of time, and that’s when I started crying tears of fear and frustration. It all felt so unfair. I was doing all the right things and it wasn’t make a difference. That was a hard reality to swallow. And I couldn’t help but cry harder when he asked me to show him how to use glucagon again (it’s been at least 3 years since he had formal training with my diabetes educator). Part of me felt better, knowing that he was prepared for adverse affects of taking so much insulin to combat a high, but I think I was more focused on and distraught by the fact that he might need to intervene, which was an especially upsetting scenario because I never want to put that responsibility on anyone.

Once I calmed down, I filled a water glass, sat down on the couch, and texted my mother, who is always my T1D sounding board. She reassured me that I was doing the right things, and that I should continue to wait and see what happened. She also advised me that I should be prepared for a crash, because sometimes, it seems like all the insulin kicks in at once when blood sugar drops too quickly/low from a high.

So I waited. I drank water. I showed my boyfriend the app on my phone that simulates glucagon injections – just in case. I played video games. I tried to keep my cool. Before long, it was nearing midnight, and I desperately wanted to curl up in bed. I went through my pre-bed routine, washing my face and brushing my teeth, knowing I’d check my blood sugar for the umpteenth time that night once I was done.

And…it was 153. Better yet, it didn’t go as low as it could have overnight: I dropped to about 75 by 8:30 A.M. All things considered, it was a decent outcome.

The hellacious, headstrong high had finally subsided. I was so, incredibly relieved. And I’m so, incredibly hopeful that I don’t experience a day like that again any time soon.

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Rolling with the Punches (and the High Blood Sugar)

I just wanted a nice dinner out on New Year’s Eve…but diabetes – or rather, my diabetes devices – had another plan in mind.

You see, that’s when my brand-new pod decided to stop working properly, leaving me no choice but to deliver insulin via syringe in the middle of a fancy restaurant.

Hence, my unamused expression in the following photo.

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Shooting up like the diabadass I am.

On the one hand, it was irritating to deal with, especially since my malfunctioning pod delivered high blood sugar to me in lieu of insulin. But on the other hand, what else could I do except roll with the punches? After all, it was New Year’s Eve – the final night of 2018. I was NOT about to allow diabetes to ruin it for me.

So I left my frustration and dismay at my high blood sugars at home, where I first realized there might be something wrong with my pod, and did my best to maintain an upbeat attitude throughout dinner. Yes, I was checking my CGM often, but I also remained engaged in conversation with my dinner companions (thanks for that meal, Mom and Dad). I took comfort in the knowledge that I was prepared with a vial of insulin and syringes should my blood sugar stay high in spite of my aggressive boluses. And when it did indeed climb into the 300s, I calmly set down my fork and knife, fished a syringe and my insulin from my backpack, drew up eight units, and rolled up my sleeve to inject right then and there. It felt kind of weird to “shoot up” in the middle of the dining establishment, but I didn’t have much of a choice. I could’ve gone to the restroom, but I knew that the lighting would be bad – at least I could have assistance from my parents by injecting at the table (again, thanks Mom and Dad, the cell phone lights came in clutch in this situation).

As I pushed down on the syringe’s plunger, I vaguely wondered whether any restaurant patrons were watching and wondering what the actual eff I was doing. I was self-conscious about it for a hot second, but I got over it because I knew I was doing what needed to be done.

I was rolling with the punches, high blood sugar and all, because it was the best thing to do for my body and my mind. Plus, I really got to stick it to my diabetes by refusing to let it spoil my night, and to me, that was much sweeter than the cheesecake my mom and I split for dessert.

Testing My Patience: My Struggle Obtaining my A1c

People with diabetes understand the significance of a hemoglobin A1c test well. It provides information about an individual’s average levels of blood glucose over three months. While diabetes is about much more than numbers, an A1c reading is still important because it is one of the main points of discussion between an endocrinologist and a patient. It helps an endo determine how a patient is managing diabetes and can help direct course of treatment.

This test is a big deal, but the actual process of having it done is one of the simpler aspects of diabetes care and management. Historically, all I’ve had to do is show up to my endo’s lab the week of an appointment, write my name/date of birth/insurance provider/whether I’m fasting on a sheet of paper, and walk into the lab to have a small needle inserted into a vein located in my upper forearm. I have zero aversion to needles or blood, so it doesn’t hurt and takes less than five minutes. And it’s always mildly entertaining that every phlebotomist I’ve encountered feels the need to comment on how nice and visible my veins are – one even went so far as to call one of them beautiful! (My response: um, thanks?!)

Since my A1c blood work has been so quick, easy, and (relatively) painless in the past, I was anticipating it to go smoothly once again when I recently went into the lab one Sunday morning. But I didn’t have such luck. Moments after signing in, the receptionist informed me that they could not perform the blood draw. Nonplussed, I politely asked why not. She told me that the lab hadn’t received the orders from my endo. I explained that I would be seeing my doctor in just a few days and that this was a routine part of the process. She did her best to help me by making a couple phone calls to other suites in the medical facility, but it was to no avail. I was frustrated but walked out, accepting that I would need to call my endo’s office first thing the following Monday to figure out why my orders had not been sent to the lab.

Early that Monday morning, I received a message from a nurse who works in my endo’s office. She apologized for my inconvenience over the weekend, and let me know that she submitted orders for lab work for all future appointments for the rest of the year. That was great and all, but I still had to find time to get lab work completed for my upcoming appointment. I couldn’t go on Monday, but I carved out some time in my schedule at work to go back on Tuesday morning.

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The patient’s perspective: too much time spent waiting

I was flustered when I walked into the lab for the second time in three days, because it had taken me twice as long to get there due to local road work. I told myself to relax, it would be done in a couple minutes and then I could head back to work with this task checked off from my to-do list. But…of course it wasn’t, because upon entering the lab, the receptionist told me that the power was down and they would be unable to complete my blood work.

For a couple seconds, I just stood there while I let that sink in. I explained how I was rejected on Sunday and practically begged her, please, isn’t there anything you can do? Despite having access to both my medical history AND the orders on her computer, she said no, but I could try one of the two other “near” lab locations. Completely exasperated, I told her no, that I guess I’d have to try again tomorrow, and walked away with tears stinging my eyes. I was mad that I wasted another trip, confused as to why this was so difficult, and defeated by the lack of understanding from the receptionists.

The bottom line is that I have a few questions after experiencing all this:

  1. How come my lab orders weren’t submitted?
  2. Why did I let this affect me emotionally?
  3. Why does everything about diabetes management have to be so complicated?

While I don’t have an answer right now to the first question, I intend on finding out how the slip-up occurred. And my answer to the second question, I think, is tied to my response to the third one: Diabetes management is hard. I try my best every single day and deal with the curveballs that are thrown my way. But lately, diabetes is like a pesky gnat, flying around my head so it’s always in my line of sight and incessantly buzzing to keep my attention. It’s annoying as hell and gets in the way of living my life. So to have something that’s normally easy, something that barely even requires me to think about my diabetes, become so complicated is just ANNOYING.

The one positive result from this whole ordeal? My A1c was better than I expected. Thank goodness.