Sitting here again

[cheryl]

Ok, today was a **** of a day!!!!!!!!!!! I had to drive back from the Atlanta area which is 2hrs away from home because me and the hubby got another car. I was scared about this the whole time, I panniced in our car on the way down there.....Well we left, got stuck in traffic and all, I kept testing myself too because I had this bubble big air bubble in my tubing i noticed when we got there, but my bgs were stable and I kept watching slowly go up the tubing. Ok we stopped at subway to eat dinner about 7:30 because i told my hubby when we had stopped before(mind you I am driving all by myself in the new vehicle) that I didn't want to keep having these awfully late dinner, I ate 33 carbs only so that my bolus would not be alot but dosed for about 37 carbs cause i was counting the tomatoes, and condiments what not.....Ok we leave about I'd say 30 minutes later I get that feeling of low it is dark on the interstate, it is too hard to see a pullover and I can't fandangle around for my meter in the dark with all that traffic......my whole body is shaking awfully so and the exit to get off well the next one is 1 mile away so I slurped some coke praying to god, I can make it, well I got off thank god hubby was behind me.....I didn't drink alot of coke promise only a few sips or so..........well anyway.....when I got off and pulled up into the gas station my body is shaking and I check the bg 183 wtf, and I swear we have been on the road for 3+ hours so far cause of construction and what not so I had not pannicked and I was just a listening to music not thinking of my bolus and dinner being positive and boom that sinking low feeling that i am about to drop and die hits me, I know everyone and my nurse trainer told me too check it before I do that but wtf wouldn't you react fast just in case cause your alone on the interstate, I think any diabetic would in my situation honestly......well when we leave that gas station after 15 minutes it is 172 and I was at the exit before TN......so anyway.........we got home around 9 so I checked the bg at 9:30 assuming it was 2 hrs after dinner 200 well ok, I look at my tubing the air bubble is getting close and all.....so about 10 i am still 200 solid so I give myself .5 units and disconnect for a bath........ok..........well 45minutes later it is 265 yikes well I get my pump i put in a bolus of freakin 3 units to push the air bubble out so now I know for certain cause i see insulin running up after the air bubble vanished that it is time to reconnect and I make sure that i am connected, so stupid me because i am scared to death of lows give me just one unit and all, it had dropped to 210 before i went to bed so I set alarm for one hour because that would of also been 2hrs since my unit bolus ok......I wake up at 1am it is 283 yikes so I bolus 2 units and check 30 minutes later 200 and I am waiting till 2 am to check again, I didn't want to do what I did two days ago and change my site because I think I am too thick headed at night to give myself the proper correction and if the pump was not giving me insulin I wouldn't of stabilized around 200's for three plus hours so I am assuming i am all hooked up........now I am a little nervous that I am going to drop like a fish I don't know yet all i do know is this **** is for the birds, I hadn't had a low drop feeling well since thursday at lunch so I was so happy about that one and then i did in the car and I wasn't pannicked at all when i got back in the car after dinner pisses me off, I hate it, that I did the wrong thing but..........I don't know what else to do when i am driving grrrrrrrrrrrrr.....my a1c is gonna be all kinds of screwed up.....

Please someone tell me when this gets a little easier.........freakin hey, it wouldn't be so bad if that low drop feeling like I am about to die wouldn't happen


Cheryl

[cheryl]

Has to edit it is now 2am and my bg is 191 so that is one hour after my 2 unit bolus so I guess I am glad I didn't change the site, I am gonna go thru them too fast with all this pannic **** I am having this is my fourth set I am on already, grrrrrrrrrrr......have to watch it they don't give you enough for screw ups anyway, so I am glad that I didn't freak out cause of the air bubble because I noticed it on our way down to Atlanta but like I said I tested like a mad woman forever and a day and that I noticed the air bubble about 1pm so i know I was still getting insulin because for my dinner tonight i was only 104 so yea, i was fine and I am glad I figured to push it out with being disconnected and bolusing yay, it is gone and the only two things I am kicking my *** about is the freakin drinkin the soda when i wasn't even low, but I am telling myself it was dark on the interstate going 60 something there are loads of cars on the road and I can barely see where to pull off and the exit was 1 mile away..........so I am trying not to beat myself about that one, but I will say i am being quite stupid about these corrections, I have to realize that i am not on lantus and all so when I bolus a unit in the upper 200's especially after being disconnected for 45minutes and never correcting my mishap of the soda...which i should of but **** i was still gonna be driving.....**** Cheryl wake up so you can sleep at night grrrrrrrrrr cause when i was on lantus one unit did a lot of damage except during pms, now with this pump i dunno two units does more damage or good I should say then one, oh god all the learning experiences....other than that guys my sugars without me screwing up here and there are very steady.....so wtf, I was supposed to have a good bg day lol I woke up at 94 and stayed stable in the upper 120's lower 130's which I think is the smart thing to do when you are not quite sure of your basals yet,

[gnstriker]

Important thing I suppose is patience ... You can't account for every number on any given day.

Even when I take 6 units of Humalog for a bagel, 9/10 times my blood will go back to normal taget range, but there will be that 1 time that it'll just spike up to 320. So ... wtf indeed.

Also ... if you're as stressed during the time you're taking the readings as your post makes you out to be (sorry if i'm incorrect, always hard to tell on-line :) ) then that'll cause major fluctuations as well.

[parrotletzoo]

The way I see it is you have a choice. Accept that the occasional low happens, stay calm and deal with them or choose to keep your bs elevated and accept the resulting complications. Its up to you, no shame in making a conscious decision.

As far as driving and having lows. You're on a pump, which is way more flexible and forgiving then MDI's. before you drive set a temp basal so you dont drop. I'd probbably go with 50% but if you are really afraid of lows while driving you can even suspend your basal insulin that is exactly what those functions on an insulin pump are for....

[JediSkipdogg]

One thing to keep in mind....stress and panic generally raise the BG. You need to realize that all of that paniccing probably added up somewhere ot a higher BG.

Also, since it's hard to tell your reading I'm going to make looking at your numbers easier.

7:30 pm - Dinner w/bolus
8:00 pm - 183 w/correction
8:15 pm - 172
9:30 pm - 200
10:00 pm - 200 w/correction and disconnect
10:45 pm - 265 w/correction
1:00 am - 283 w/correction
1:30 am - 200
2:00 am - 191

A few things I must have missed....

1) You disconnected for the bath but there is no mention of giving any insulin while being disconnected. Running that high while disconnected is very bad. Also, another thing to remember is that insulin is cooked above 85 degrees. So if you take a bath and submerge your infusion set then you are letting it sit in warm water which breaks down the insulin you just gave and also breaks down the insulin in the canula of the infusion set.

2) Your correction doses seem to be way off and you stacked quite a bit. Do you have any idea what 1 unit of insulin does to you?

3) Have you done any basal testing yet to determine if your basals are correct? Are you on multiple basal patterns or just one flat line throughout the day?

[Gordonm]

I find when I am anxious about an event or nervous it spikes my BS. I think you might be self inflicting some of your high BS readings. I actually will increase my basal about 20% for a drive over 2 hours because of the sedintary activity. I find this works well. On the pump my lows are way less than on MDI and they come on much slower and are not nearly as severe. I know everyone is different but I think you are being a little to anxious about it. The best is to do what you are doing and keep testing to see how different situations react with you. If you are going to be panicked every time you go out your BS will be all over the place. Try to relax and enjoy the countryside going by while driving. I drive about 35,000 miles a year for the last 22 years and have never had a problem with it. I do get low at times but correct and I never leave without having food in the car.

[Cyborg]

I'm assuming you had a sub at subway. I have the carb count memorized for subs there, 47g of carbs for a 6 inch...

It sounds like you had a panick attach which may have contribed to your bg. It also seems that you may have under bolused for your dinner and that your ISF may not be set correctly. Keep in mind also, that with increased bg, your ISF will need to be adjusted (lowered) when doing a correction bolus.

It takes awhile to get the pump fine tuned and for the anxiety to subside. While driving, try to pull over and test yourself at least every 2 hours.

Good luck and stick with it. It does get better with time...

[Gordonm]

I'm assuming you had a sub at subway. I have the carb count memorized for subs there, 47g of carbs for a 6 inch...


Me too. I eat there quite often and 47g works perfect for a 6 inch Turkey sub.

[cheryl]

Ok, at subway, I ate a turkey wrap which was 33 carbs I asked for a nutrition guide, and gave 4 extra carbs for some of the condiments I like, ok so when I was driving it was about 45minutes later I just got this sinking shaking, god awful I was about to pass out and die kind of drop which maybe my bg was dipping quick but not a low, obviously because when I was able to pullover it was high, now as far as when I disconnected i gave myself .4 units bolus also to cover the time I was gonna get into the bath, even though it was 45 minutes....I honestly didn't correct the 200 because like some have metioned I am not quite sure what the heck my freakin basals are.....and when these stupid situations come up, it is like i am back to square one, which is awfully fustrating, infact when I woke up at 8:30 this morning I was 123 which was about 71/2hrs after my last correction bolus of 2 units so my basal is still obviously off. for the night time, and all, I know I have options but I am not beating myself up for me being in the car alone.....in the dark on a pump brand new to it, not quite sure what the **** to do sometimes so yea, i pannicked and yea i got high and yea i was a little nervous to bolus alot to suffer another low.....my in sensitivity factor is 1:70 but obviously didn't work well at first last night because of my not being accurate in first fixing the high and missed bolus and stress and anxiety from the whole day...which didn't help i am looking on how my body works and actually i would spike a bit while i was driving and would check and it would go back down it never stayed level so if I would of upped my basal since I am still unsure of what I really need god I would of dipped eventually because I know there are sometimes that I need more or less the point is figuring that out and since I am new I am not going to play screw around with basal since I am still not there yet.....I know my fault for a lot of things but I am not going to feel too bad about this particular attack.....today on the other hand am doing ok, except I was 68 when i wanted to eat lunch and i was mad grrrrrrrrrr......so I have to see where I need to fix basal because my bolus from breakfast was gone.....anyway...yesterday I dropped the same time of day so I went to 10am and went down to .4 and all....so anyway.....kind of still learning so it is hard to do so many things when you are still unsure what you really need and when you know your basal is obviously still off it is hard to trust everything.....oh well....I just know i won't be driving after eating on the interstate in the dark for a long time, so that situation won't happen again....until this is worked out, I actually yelled at my husband for putting this pressure on me when I was not ready to really do it and I was pissed we couldn't find anyone else to find to help him get the car....we argued for two days about it, I told him this is not the right time to depend on me for this not yet, I was angry and scared to drive honestly for that length a time alone.....well it's ok, I wasn't asking to stop my responsibilities at home, but to do something that i don't normally do, i didn't think this was the right time for me to do it, only being hooked up since Wed...yea, I was nervous....anyway thanks all I am ok, my fault with alot of things, but quite a new experience to me, I know what I did wrong some of you already stated that, but I was in a position that I really shouldn't of been put under to do yet......other than that I am doing ok, not completely stable stable but I don't really get high high or really low low for the most part...just a lot of tweaking to still do.....

cheryl

[cheryl]

The way I see it is you have a choice. Accept that the occasional low happens, stay calm and deal with them or choose to keep your bs elevated and accept the resulting complications. Its up to you, no shame in making a conscious decision.

As far as driving and having lows. You're on a pump, which is way more flexible and forgiving then MDI's. before you drive set a temp basal so you dont drop. I'd probbably go with 50% but if you are really afraid of lows while driving you can even suspend your basal insulin that is exactly what those functions on an insulin pump are for....

I had to comment on you, I never said I wanted to keep my bg's elevated forever just while I am tweaking, so I don't see where i am going to break a vessel or develop neurothopy from it honestly I have been worse for the first twelve years thus far and nothing really has gone wrong with me.....so this type of talk tends to give some people more stress in seeing a 130 thinking they are gonna die now....and also, I really do know what the pump is for....trust me.....just not sure how much i should fandangle with it, on the first 4 days since I don't really know what my basal rates are.....so suspending it makes it worse for me to work out too.....just a bad bad day for me all together, I accept my lows I really do......i was low city on mdi's technically going as low as 26 and dealing with it....which is not good either, I was always on the low side for a good two months all I wanted was a little elevated sugars and to work my way down not the other way around I thought that was smarter to do on the pump run between 120-140 for the first week or so and work the way down.....I don't think I am immediate danger for it.....oh well we all have our opinions on the matter I value yours but trust me it took a lot for me to talk myself into running like that and all, but the fear of sudden low death conquers the defeat sometimes since this is new.....
I was not trying to be a smart butt so don't take it that way:)

Cheryl

[cat_collector]

Sounds very familar to me . I worry alot about low s and have had this very thing happen many times . Panic attacks are no fun and most time come out of the blue . It takes time to get use to being on the pump all I can say is hang in there and take a deep breath .

Tracy

[Worldcrzr]

Cheryl, I see you have only been pumping a few days. Do you have a Diabetic Educator to talk to? My DE had me call her every night for two weeks (even on the weekends) before she would cut me loose and then I had to go in every week to see her for about six weeks after. Did they just cut you loose without any help? There must be someone associated with your doctor's office or your pump company who you can call. I know Smith-Medical has people on duty 24/7 to answer my calls should I have a problem that needs a clinician. I also have a Diabetic Educator I can email or call and a nutritionist that I can email or call. Did they just train you and say you are on your own?

[cheryl]

Well i got my nurse trainer phone number, my doctor sucks so i don't want to talk to him long story anyway.......but I don't want to call her late at night, but i got her cell number, yea, I am pretty much cut loose though....and she told me I can deal with my dr on Wed, unless i have anyother problems oh well such is life.......I am ok, though, i figured mdi's basically from the forums and books I can do it on the pump.....just starting all over....just like i did a few months ago......

Cheryl

[Clint]

1 unit on the pump drops my blood sugar about 50..

From what I have read, you have been on the pump for what 3 days? Don't beat yourself up about it, esp since you don't know what your basal rate is.

Talk to the pump educator, get your starting basal rate and go from there.

[Cyborg]

Cheryl, I think it stinks that the your pump company didn't provide a dedicated trainer. Sounds like you need to take one step at a time and make small adjustments.

The first thing you need to do is get your basals set. Set a higher target initially to give yourself less anxiety about hypos. Pumping Insulin is a great book by John Walsh and I highly recommend it. There is also a great resource (http://www.insulin-pumpers.org/howto/baslr.html) online that describes how to do your basal testing. It essentially involves skipping some meals and seeing what happens to your bg.

Try not to stress as there are plenty of pumpers here that can help you along the way.

[cheryl]

Cheryl, I think it stinks that the your pump company didn't provide a dedicated trainer. Sounds like you need to take one step at a time and make small adjustments.

The first thing you need to do is get your basals set. Set a higher target initially to give yourself less anxiety about hypos. Pumping Insulin is a great book by John Walsh and I highly recommend it. There is also a great resource (http://www.insulin-pumpers.org/howto/baslr.html) online that describes how to do your basal testing. It essentially involves skipping some meals and seeing what happens to your bg.

Try not to stress as there are plenty of pumpers here that can help you along the way.



Thanks cyborg that is what I was wanting to do is get the basals set first and aim for little higher target but my bg's seem to like going low then i get an attack and go high and all, I am ok, I knew what i did wrong, I just over did it and reacted to quickly I have the book and try to think of it when i am faced with certain things but you know it just sucks lol....I'll be ok, I did in on mdi's i can do this lol, I may not be pump savvy yet but I get the jist of it, just putting it to use without anxiety is all I need now

Cheryl

[Funnygrl]

Running higher really makes no sense to me at this point in time. Say you get your basals perfect. Ok, now they are perfect- if you want to run 150. So you need to start all over again when you decide you want to run 100.

[cheryl]

Running higher really makes no sense to me at this point in time. Say you get your basals perfect. Ok, now they are perfect- if you want to run 150. So you need to start all over again when you decide you want to run 100.

I see what your saying I wanted to run actually between 120-130 and when you'd set your basal close to perfect or perfect, admit it they never are because of activity and pms lol.....then you can give a correction at a meal say.....for instance an extra .3 units to bring it down to a 100 level.....and since the basal would be perfect it should level there.....I think that would make sense maybe I am wrong but to me that makes sense....plus my pump is set at 100 anyway.....

Cheryl

[Cyborg]

Running higher really makes no sense to me at this point in time. Say you get your basals perfect. Ok, now they are perfect- if you want to run 150. So you need to start all over again when you decide you want to run 100.

Sorry, but I don't agree. If the basal profile were tuned to keep her at essentially 150 all day and night, then it would simply be a matter of gradually decreasing each and every basal setting by the same amount over time until the new target was acheived.