urgent, just had a hypo

[Morris "Type 1"]

Hi guys,

Im a bit scared, I just had a hypo and my sugar fell from 4.3 to 2.4 in a matter of moments.. maybe a couple of minutes, I dont know.. But I think it was caused by my lantus, when I withdrew the needle there was blood at the site and it occured to me that it may leak into the blood stream so I tested.. sure enough my sugar dropped a lot.

[Morris "Type 1"]

So, I called my friend, as a safety measure, he stayed on the phone and I ate a bunch of glucose tablets.

I have now got too much sugar in my body lol

I just check and it was at 9.0 mmol/l and still climbing..

I ate 6 or 8 dextros tablets coz I was panicking, a sugary drink, and a white bread sandwich...

I'm worry now I might be heading for ketoacidosis or whatever?

Anyway, **** this ride was scary :/ :(

[Morris "Type 1"]

9.8mmol/L hehe, I assumed higher is safer than lower, but uncomfortable atm

[Delphinus]

So, I called my friend, as a safety measure, he stayed on the phone and I ate a bunch of glucose tablets.

I have now got too much sugar in my body lol

I just check and it was at 9.0 mmol/l and still climbing..

I ate 6 or 8 dextros tablets coz I was panicking, a sugary drink, and a white bread sandwich...

I'm worry now I might be heading for ketoacidosis or whatever?

Anyway, **** this ride was scary :/ :(

First.

Never panic.

There is a 15/15 rule.

Consume approx 15 grams of carbs, wait 15 mins. Test. If needed. Repeat.

You may have just gotten yourself on a glucose rollercoaster. :D

I have a juicebox on my night table... The straw is already inserted and it's ready to drink. I do this to remove as many steps as I can so i don't have to think or do as much in case of a severe hypo.

The good news, yer gonna live. The bad news. You may feel like $hit for the next 12hrs or more. Depending on how your body is able to recover. :eek:

Also, keep in the back of your mind, those tabs, are 4 grams, per single tab. You would probably only ever need 2 or more, and it's not a good idea to use those unless you have nothing else.

A juicebox is perfect. If it's all you have available, and drink the whole thing, you won't overdo it. It has an end, and once it's gone, it's gone.

[Delphinus]

9.8mmol/L hehe, I assumed higher is safer than lower, but uncomfortable atm

Don't start correcting just yet.

Approx how long ago did you take the tabs?

[Delphinus]

You have to also remember.

Glucose only gets absorbed into your body at a given rate anyway. So popping a bunch of tabs, or eating too much, doesn't speed the process up.

In fact, you will soon find out, you temporarily became your worst enemy. :D

But hey, welcome to the club! :T

[Morris "Type 1"]

I think about 30 minutes ago now roughly, maybe longer, I lost track of time :$

[Morris "Type 1"]

lol :d

i love your humor always makes me laugh :d

I tested a little while ago and I was at 11 lol i think

[Morris "Type 1"]

scary scary stuff

has this happened to you before?

[jenb]

Hey there Morris. That first hypo can be pretty disconcerting! Take deep breaths and know that even if you feel like you've been kicked by a mule, you will feel better.

In my experience, the most important thing to remember (hard in the middle of a hypo) is to stay calm. You will not die! Find out how much one gram of carb raises your blood sugar, then determine how many carbs you need to ingest to get into your target range. Then consume that amount - not more, not less. I do not follow the "15 gram rule" since it would cause me to rise 90 to 120 points. I usually eat one 4 gram glucose tab and drink some water, then test again in 15 or 20 minutes. If I'm on the rise then, yay. If not, I grab a strawberry or a couple of cherries and down them and retest in 15 minutes. Do not over-consume carbs or you will find yourself rising too high, having to correct for the high, and yoyoing around.

Hope you feel better soon. Those lows are really exhausting!

Jen

[Morris "Type 1"]

aw thank you, my friend was on the phone at the time, he isn't diabetic but he urged me against consuming so much sugar but I kind of insisted and went ahead and did it anyway :$.

woah, you aren't kidding it is scary, watching my sugar drop so rapidly terrified me. im still shocked i think, I rang the medical hotline thing here, they are going to get a doctor to call me back.. but I knew if I write here I will have real experts write back, it was comforting to be able to read this thread and put my mind at rest. focussing on being ok and calming down, because even now it is hard, I feel anxious, I keep wondering if suddenly more lantus is going to go into my blood stream randomly and take me by surprise.

mayhem, my alarm went off just now, that means unless I was being scatter brained when I set it that over an hour has passed since it happened. I don't know why I had 30 minutes in my head.

you guys are awesome, I hope you can imagine how much i needed your msgs, thank you so much

[howdysf]

I had a pretty wild one the other night... I ate spaghetti for dinner, bolused.. like three hours later I ate a sugar free pudding cup, did NOT bolus... checked blood at 9:00, it was 112, at 9:27 I was 37!!!!! WTF!!!???
weird night... I don't think I've ever dropped 70 points in 30 minutes before.. I still think it was a glitch with my meter, but who knows? always an interesting ride, this thing...

[Morris "Type 1"]

13.2mmol/L

I thing the advice to not adjust that is a good idea, I'm too scared to anyway, I rather stay high for a while I guess..

is there long term damage risk if it climbs any more?

[Morris "Type 1"]

DKA or whatever it is

[Morris "Type 1"]

Do you know what is really bizare?

I was eatting a sugar-free jelly I had made at the time as a snack lol. weird how you was eatting a desert type thing too lol

Although it was late here, I hadn't bolused for dinner since I was extremely low carbing :/

[xMenace]

Down into the 2's likely means a liver dump. You might have a lot of fun over the next 6+ hours. If your lantus hit a vein, then your next 24 hours is gonna be a party. I'd set alarms every 2 hours until some form of stability sets in. Seriously.

Whatever you do, don't over-react with corrections. Ketoacidosos won't set in just because you're high. No worries there.

scary scary stuff

has this happened to you before?

If I had a nickel for every time ...:elefant:

[Morris "Type 1"]

by the way, sorry for slow disorganised replies, sort of finding it hard keeping up atm. The high sugar has got me a bit messed up lol

Is it possible to prevent this kind of thing happening again do you think ?

Areas that are less likely to have blood vessels or whatever

[Morris "Type 1"]

okay thank you, alarm is set, *feeling tired as *****.

good to hear the DKA won't kick in or something.

When you mentioned the liver dump, is that like the bodies way of trying to protect you from a hypo?

[Morris "Type 1"]

Delphinus

I just wanted to thank you for your prompt replies earlier, I did read them although wasn't really able to reply as I was on the phone and still quite anxious so I couldn't really write anything sensible in reply. Thanks for your advice, I think I will copy the sugary drink idea, I must admit I do have 2 unwrapped glucose tablets by my bed.. but they look gross now as they have been there a few days haha. I would have to be very desperate to want those lol.

jenb

I am quite new to carb-counting, in a way partly due to my obsession with trying to eat as close to zero carbs as possible and simply because I don't even know my I:C ratio yet, I know that when I have tried 1:10 that was not good enough at all. Still unsure how far I can push that safely, tempted to go higher with the insulin but I was quite worried. I guess now that I have had my first hypo, I will have less to fear.

Suddenly I find myself talking loads. :$


howdysf

That sucks, completely confusing, I don't get it why sometimes things come down nicely then others they won't. I had heard through this forum that peopl can have odd reactions to food, I mean, something that is fine normally is suddenly not fine.. I recently experienced this and it confused me loads!

xMenace

I think it's been about 1.5 hours now, I initially was unsure but I think that is about right. my sugar 30 minutes ago was 13.2, it is now 11.5. I needed the toilet twice in quick succession, so I guess that is the body removing some of the sugar out of my blood stream.

wow this is exciting stuff lol

[GeishaGirl]

Also, keep in the back of your mind, those tabs, are 4 grams, per single tab. You would probably only ever need 2 or more, and it's not a good idea to use those unless you have nothing else.

A juicebox is perfect. If it's all you have available, and drink the whole thing, you won't overdo it. It has an end, and once it's gone, it's gone.

Note: Not always true. I've been having some really stubborn lows recently where I will consume upwards of 15 glucose tabs and have my sugar be exactly the same for more than an hour (50s or 60s). By the time it hits 90+ and I go back to bed, I'm convinced I'll wake up at 300.... but I always wake up still under 100. I'm working on this -- but the point is that sometimes, overdoing it is the right thing to do.

Also, as my endo constantly points out to me, while being high is very dangerous in the long term, it really only applies to being constantly over-target for years. It only takes one severe hypo to destroy your life. My mom has had seizures and a small stroke because of her hypos, and it's only after a few years of having Dad and I on her case that she got over the aphasia associated with the stroke. It only takes one hypo to crash your car and kill your child (read about that one in the newspaper).

An overcorrection of a hypo, while certainly not the best route, is still better than the hypo itself. Lesser of two evils and all that.

Speaking of, my husband and I got into a fight today while I was hypo. We both knew I was hypo, and hubby walked away from me without making sure I got my sugar up. I figured (in my hypo state) that it would just serve him right if I passed out! Dangerous stuff, hypos.

Just for clarification: yes, I have a phobia of hypos. Blame my mother.

[Delphinus]

Note: Not always true. I've been having some really stubborn lows recently where I will consume upwards of 15 glucose tabs and have my sugar be exactly the same for more than an hour (50s or 60s). By the time it hits 90+ and I go back to bed, I'm convinced I'll wake up at 300.... but I always wake up still under 100. I'm working on this -- but the point is that sometimes, overdoing it is the right thing to do.

Also, as my endo constantly points out to me, while being high is very dangerous in the long term, it really only applies to being constantly over-target for years. It only takes one severe hypo to destroy your life. My mom has had seizures and a small stroke because of her hypos, and it's only after a few years of having Dad and I on her case that she got over the aphasia associated with the stroke. It only takes one hypo to crash your car and kill your child (read about that one in the newspaper).

An overcorrection of a hypo, while certainly not the best route, is still better than the hypo itself. Lesser of two evils and all that.

Speaking of, my husband and I got into a fight today while I was hypo. We both knew I was hypo, and hubby walked away from me without making sure I got my sugar up. I figured (in my hypo state) that it would just serve him right if I passed out! Dangerous stuff, hypos.

Just for clarification: yes, I have a phobia of hypos. Blame my mother.

You are right, it can vary from person to person.

But as a general rule, and since it is very easy to follow and remember, the 15/15 rule is still a good and relatively safe place to start.

After going this route, it at least allows you to know what works well for yourself, or not, and you can adjust up or down, depending on how it works for you.

It just makes sense to start there, since it is a modest treatment, and not overkill, and then you can adjust accordingly depending on how your body reacts.

[Subby]

13.2mmol/L

I thing the advice to not adjust that is a good idea, I'm too scared to anyway, I rather stay high for a while I guess..

is there long term damage risk if it climbs any more?

Hey Morris, glad to hear you got through this ok (right? be sure to update us). Sadly, like John, I'd be a rich man if I had a penny for all the times a hypo or liver dump gave me a BG grief...

13.2 is around the region where ketones are probably starting to be produced by your body. You may be noticing you have more body odour, sweet breath, and feel other effects. You might feel a bit groggy, dehydrated. Probably a little like when you were diagnosed (you were diagnosed with high BGs?)

This in itself, while not the healthiest thing in the world, is not nearly the same as ketoacidosis. That comes from a pretty comprehensive absence of insulin in the bloodstream. Personally, I start being concerned if I see 18 up, now that I am on the pump. Since I am on the pump, I can be without really any insulin within a few hours - that's a bit scary.

But for you, your long acting should always provide something in the background to buffer you somewhat. And if you get a correction in, you'll again be in safer territory within the hour, even if your BGs still hover high and it's a struggle to come down over hours (and it can be quite the struggle, sometimes).

So the upshot of that is - that when you are 13, if you are aware, monitoring, and prepared to correct even just a little, you should be in pretty much no danger. If it flies on up towards 20 in an hour or so whatever you do, well, that's another story. Do be sure to drink water when you reach this kind of area. Ketosis (not ketoacidosis) really dehydrates - it's one of the big dangers.

About the Lantus shot - where did you inject? I can only recommend the butt as a fine place for long acting, as somewhere I never had a problem with and it seems to have less blood vessels to hit than some other areas (and absorption is consistent for me in the butt). That's just my observation, nothing definitive.

Hope you're feeling better.

[Morris "Type 1"]

Thanks for writing subby, yeah hmm, lets see..

Prior to diagnosis I tested on my mothers meeter and was at 18mmol/L, I went out that day because I guess I wasn't ready to 'deal with it', I got home and was at 17mmol/L roughly.

Next day, I was in bed, finding it almost impossible to find any energy to stay awake, I was fighting it as hard as I could, in the end I decided to get up and try to buy a blood glucose machine for myself. Shop was shut, it was about 5:30pm at this point I think, my friend nagged me to go to the doctors and while he couldn't find a BG meter handy he checked me for ketones and I was about +4 I think.

By time I reached hospital, drank lots of water, I was down to about 12mmol/L according to their records. I wasn't 'seen' by a doctor till about 2am, where I was then started on a sliding scale and saline? drip.

During the time between getting to the hospital (by taxi) and being seen I had felt horrible, I do self-hypnosis so I was able to mitigate a lot of how I felt but I couldn't stop myself from feeling waves of sickness and feeling really horrible. I was sick, bringing up a lot of water, drinking a lot of water and generally feeling horrible.

I guess this stuff is all pretty normal though, was quite an experience though especially allowing a doctor to treat me with any kind of drug because I know of people who have died/been seriously ill because of mistakes they make.. If I wasn't quite so coherent, it would have happened to me too, they didn't want to give me insulin during my stay in one of the wards, I urged the nurse to check my paperwork again and sure enough I needed it.

Then that begs the question, how do you know if they have even injected you with the right quantity or even the right drug, before I left they tried to send me home with someone elses insulin.

Oops, I ranted a bit there!

Today, I am feeling quite good somewhat tired though, but I think that was from the hourly alarms I had set.

I checked a little while ago it was down to around 5.1 or there abouts. Wow, last night was horrible. Not liking the idea that I will experience more of them, but glad that in that case I was aware enough to be ok.

Is there a way to know if you have a hit a vein before injecting?

[Morris "Type 1"]

Just realised I forgot to say that I inject in the abdomen, I am scared to inject anywhere else because I don't know how to. lol

[Morris "Type 1"]

another question..
do I _need_ insulin, to stay alive, even if say, I eat hardly any carbs?

like I would use the basal one, but I often skip novorapid as I am back to eatting as little carb as humanly possible..

I can't figure out if this is going to me damage or if it is actually acceptable?

[Subby]

Your body is always releasing glucose to provide for basic functioning. It converts non-carbs into glucose. The liver releases generated energy all the time. So you always need insulin. That's what basal insulin is about, it's meant to match this need.

You might find discussions where type 2s talk about diet only control or getting off insulin altogether. That's because their pancreas still may produce a significant amount of insulin, and tactics like other drugs, lifestyle, low carbing, might be enough to alleviate the load on the already existing insulin supply. As a type 1, you are likely to now, or in the future, produce very little indeed, and do not have this luxury of treating insulin as potentially extraneous to control. You will always need basal. And hey, if somehow you don't (just not to be completely fatalistic about it), you'll know it quickly, you'll be going hypo all the time from insulin and need to cut your dose right down, as a matter of course.

You might be honeymooning, so your body might still be providing for the moment, and things may not be quite "clear" through your insulin use. Typically, on a high carb diet so lets say 250 - 350g carbs a day, of total insulin used, a type 1 might have 50% total basal and 50% bolus. The reason I mention high carb is not to recommend it, but as a point of reference, that basal reqs are often the equivalent of eating a lot of carbs a day.

Out of interest, how much basal are you on? And did you ever work out an insulin to carb ratio for your bolusing?

As for low carbing, you'll find people prepared to tell you unequivocally that you need not one bit of carbs to stay alive. Are they right? Perhaps. I tend not to put complete stock in what any one person says, no matter how assured or knowledgeable they sound. The question seems to rage on quite a bit, the further you get into it. There is an entrenched and perplexing persistent suggestion in mainstream medicine, that really high carb diets are necessary. I don't think that makes sense at all, on really any level, even if one does not embrace "ultra low" carb approaches.

Your carb consumption is something you'll need to decide on yourself. I eat my carb amount (around 100-120g) for quite a few reasons. I don't know if it's my perfect amount, but that's also only one factor amongst what I see as importance in eating the right kinds of foods as well. It's where I tend to feel the best. I find short term fasting makes me feel great, but really low carbing does not seem to sit well with me. I tend to emphasis good quality produce, especially leafy green unprocessed vegetables, in my diet. I find a varied and balanced diet increases my sense of health and well being. I go out of my way to reduce bolusing dosages, especially because I have some insulin resistance, but at the same time, I am not afraid of it. I think it's wise to bolus correctly, bolus well, even for small amounts of carbs, and even sometimes for proteins.

I find a lot of pop beliefs and arguments about either high carbs or "real" low carbing are not born out in my experience, and I suggest caution around overly dogmatic or "authoritative" input on this, as it is misleading, destructive and not necessary. There can be strangely cult-like elements to diet issues at times I recommend you be wary of. I suggest you instead try and learn as much as possible and put everything to the test, and let your body talk to you.

As for long term damage as far as BGs go, however you can maintain a decent A1c, and generally avoiding bad fluctuations, the kind of discussions you've been having here, you're doing a good job.

[Morris "Type 1"]

My basal is 16 units of the lantus pen, the doctor told me to do 4/4/6 for novorapid while in the hospital but obviously I don't do that. when I had tried to stick to that, and eat say a sandwhich or anything carb it never covered it sufficiently.

I tried the 1:10 ratio the other day and I found that to be unsuitable, not sure what is suitable yet though.

[Subby]

Yeah, as you've worked out, throw the set dosage thing right out. In this day and age, my thoughts about that approach is it's an absolute bottom line for people who need to be told basic rules and have no interest in managing the condition, in the hope they take some insulin and at least stay out of hospital with DKA. OK that's a little harsh... but I think elements of truth, sadly.

As for I:C and carb counting, different people find its useful to varying degrees when it comes to applying to different types of carbs, but I guess I think it's well worth finding a ballpark I:C to see if it does help with dosaging in general. It should.

As for finding it, there are a few rules and techniques, but one rule of thumb is to observe the problem (too aggressive or not enough?) and move up and down the scale accordingly, until you hit on something that works. 1:10 too aggressive? (My guess is it would be for you) You could try the pretty much considered "default", 1:15, or even 1:20 and work down if you really want to take the safest approach (hypo wise). Always test a lot when trying a different I:C ratio! Take your time and be very careful, the reason I am mentioning these approaches to you is that I know you will!

And folks, this was a message to Morris, in general if you want to change your insulin dose but are not sure about things, always do it in conjunction with your doctor!

[Morris "Type 1"]

Thanks subby, yeah the ratio thing is confusing, I think its due to the release of the sugar and me not timing it right perhaps.

I find it difficult to know what I will eat ahead of time, so I tend to inject just before the food, I eat pretty quick too, normally within a few minutes. I think I am not hitting the right timing and whatever else, not sure.
I will dable with the other ratio suggestions you provide, I will see how I react to that, curious about bolusing for protein intake as I tend to ignore the protein.

hmm, I had a go at correcting a high reading the other day, I think I went from around 8 down to 6 with 2 units of novorapid, but I can't quite remember clearly so I may be mistaken.

I keep forgetting to write these things down!

I do test a lot, I have gotten through so many test strips, its kind of insane I guess. I think I have gotten through at least 100 strips in the past few days. Not entirely sure though, because I haven't been keeping a track but I can check my meters later. I need to transpose the data from my meters to the pc anyway actually.. Not got the link up cable yet either.. I keep forgetting to order it.

Do meters differ much in their readings? I sometimes take 3 samples in one go to try and figure out roughly where I am at if I am unhappy with the reading I initially see. I also notice that the quantity of blood that goes into the machine occasionally varies causing a false reading.

[Subby]

Hmm, I've actually got a little protocol idea and matrix to try and troubleshoot whether issues are from timing problems, excessive doses, inadequate doses, or a combo. I hope I remember to come back to that and finish it and I'll post it. It may well be something I've unconsciously caniballised from John Walsh, who writes those great manuals on insulin use - Pumping Insulin and Using Insulin: I'll have to check.

[lark 27]

[Speaking of, my husband and I got into a fight today while I was hypo. We both knew I was hypo, and hubby walked away from me without making sure I got my sugar up. I figured (in my hypo state) that it would just serve him right if I passed out! Dangerous stuff, hypos.

Just for clarification: yes, I have a phobia of hypos. Blame my mother.[/QUOTE]

It's not a phobia of hypos it's a healthy fear!:) It's also interesting you mentionthe fight with your husband because I find that the majority of the times I fight with my wife it's because I'm having a low (I don't get violent like some. I just get testy.) Really the only other reason why we fight is because she's wrong! ;)

Morris,

I try to abide by the 15/15 rule, but have my exceptions. If I am or have been physically active and if I know I've got a bolus that is really in the peak window of action (for me 40 minutes to 1 hour 20 minutes). In those situations I'll surpass the 15 grams rule. Of course sometimes this doesn't work, and I'll have to chase a hyper, but you gotta be careful.

[Morris "Type 1"]

subby, definitely post it when you have time, I am interested. especially as I haven't got those books.

lark, thanks for the info there :)

[fairyblood]

Hi Morris,

I think it would be a good idea if you try and figure out you ratios now so that if you end decide you want to eat a little carbs sometime you aren't completely in the dark, or if you end up a little high sometime you know how to deal with it in a safe and effective way.

I would also once again snuggest buying, borrowing, or stealing (not really) some good books. It can help so much to both have a better idea of what is happening and to give you some starting point for the ratios to get then where you you want to go. You can do it on your own with the help from the forum but sometimes there really is a limit to some of the info you can get from here and I feel like without a basic understand and a good starting point it will be a lot more confusing and frustrating.

Shooting in the dark is a dangerous thing to do and that is all you can do until having some idea of your ratios. I also wouldn't worry about bolusing for protein just yet. Get the basics down before you worry about the more complicated stuff. You might not even need to bolus for protein and if you bolus for protein at this point without understanding how carbs behave for you it is going to be hugely frustrating to figure out what is going wrong.

I have had hundreds if not thousands of hypos in my life. They can be scary at times but it gets easier.

Think Like a Pancreas by Gary Scheiner and Using Insulin by John Walsh are both amazing resources and you need to get your hands on them. :)

[Morris "Type 1"]

thanks fairblood, are the hypos still frequently occuring for you ?

I just injected my lantus for the evening, I tried 3 sites prior to actually committing to inject because I was so scared. None of the sites I penetrated really bled so it gave me a bit of confidence to proceed.

After what I experienced last night, I am actually keen to get those books now, my enthusiasm for them had dicipated as I felt more confident. Wow, nasty stuff.

I wonder if its worth me splitting my lantus over 2 injections to reduce the chances of getting loads into my blood stream. decisions decisions.

Anyway, seems this evenings injection went fine lol

[It Ain't Over]

With the lows, it is always a good idea not to react and start changing everything right away. Might be just one of those days.
But it does bring to mind, at least for me, the possibility that you are taking in too much insulin. As a new patient you may be at the start of the famous diabetic honeymoon. This is nothing more than better control allowing the few remaining beta cells you may have to produce insulin again. That can make for a roller coaster ride if you don't get the correct basal rate and correct bolus. Like was said, it is a moving target.

[fairyblood]

thanks fairblood, are the hypos still frequently occuring for you ?

I would not say my hypos are frequent per say but that I am a type one diabetic who try's to have good control and hypos are part of that deal. Because the line between 80 (4.4) or 70 (4.0) and low is really fine. I am okay with that it just means I have to pay attention and always have some form of sugar on me.

It is a hard balance to play having great numbers but also keeping the hypos to a minimum. I much prefer to go low sometimes and have a great A1c then be higher most of the time with fewer lows but a higher A1c. It is worth it to me. However it always takes allot of work to keep things balanced.

I have also had diabetes since I was 10 years old, and they add up after awhile. ;)

[jenb]

Hi again Morris...just wanted to chime in on what great resources Think Like a Pancreas (Scheiner) and Using Insulin (Walsh) are. Mine are both completely dogeared! I have also found Walsh's Pumpin Insulin invaluable even though I'm on MDI. Get one (or all) ASAP. They will walk you methodically through basal and bolus rate testing, help you determine correction factors and give you lots of pattern recognition advice.

Insulin use seems to be as much art as science, and sort of dependent on how adventurous and inquisitive the user is. But understanding how it works for you will really improve your control.

Hope you've gotten over the hypo scare. You will get more adept at resolving them. At least you're in good company here!

Jen

[Subby]

After what I experienced last night, I am actually keen to get those books now, my enthusiasm for them had dicipated as I felt more confident. Wow, nasty stuff.

Don't let the confidence win again... ( :D ) buy or order one of those book now while you feel shaky. Because you'll really, really benefit from sitting down and learning about things in an orderly way - and having a whole range of well thought out, well presented subjects and tools at your fingertips - even if you go back to ultra low carb again, it's info that will definitely benefit you. Not just in the practise but in feeling confident again, that you do know what's going on and are aware of tools and ideas you can use in tackling any issues.

[Morris "Type 1"]

Thanks :D

I just got back from camping last night, I will try to order at least one book today lol!