Ketones

This past Memorial weekend my husband and I stayed home. The weekend was fantastic and we had a great time celebrating the holiday and my mother-in-law and brother-in-law’s birthdays. Monday night I got to bed on time to prepare for work the next day. My BG readings just before bed were at 147. Around 5:00 in the morning I was awakened by nauseous. I tried to put it out of my mind and go back to sleep, but I couldn’t. The taste in my mouth reminded me of pencillin or some kind of medicinal residue that gets left behind on your tongue. On top of the disgusting taste that filled my tastebuds, my mouth was incredibly dry. I drank some water and fell back asleep.

Within an hour of falling asleep I was immediately awakened by the sudden urge to vomit and that is just what I did. However, all that came up was water and bile. I knew it couldn’t be food poisoning because there was no food in my vomit. Once I was done I felt better, but I checked my BG as a precaution. Sure enough my readings were at 318. I turned on a temporary basal of 130% and I bolused to correct myself thinking this might help fix the problem.  Unfortunately it did not and I was awakened yet again with the sudden urge to vomit more bile and water.  Since I had just bolused and turned on my temporary basal I figured it would be a little bit till I felt better. I called out of work and stayed in bed.

Around 9 am I woke up not feeling nauseous, but fatigued and sore. My lower back had been sore all day which I read is a result of the dehydration caused by my kidneys being overworked from the vomit and high blood sugars. I checked my BG’s hoping to see some improvement, but I was still only at 276. I checked my pumps settings to make sure it was not malfunctioning, and everything was okay. I checked the expiration date on my insulin and it was fine too. I then replaced my infusion set and cranked up my Temporary Basale to 150% . I had a small breakfast which I bolused for accordingly. I decided to check my ketone levels, but I was not sure on how accurate the reading was since they were expired. According to my ketostix I had a high level of ketones in my system, which could explain this sudden onset of symptoms.

I decided to go into work since the nauseous had subsided, but to be safe I  stopped off at the pharmacy and got some new ketostix  and some glucose tablets to prepare for what I thought would be a rapid decline in my BG’s throughout the day. I have not eaten much today and I have had a ton of water. I have checked my ketones throughout the day and they have gone from moderate to trace/small amounts. It is now 6 p.m. and unfortunately my BG’s are still over 200. My latest reading was at 238.  My temporary basal is now at 170% and I have no desire to do anything but lay on the couch and drink water. My lower back hurts like hell and I feel like I was mugged. My mouth no longer tastes medicinal, but I have to pee every hour and I have an unquenchable thirst. I am going to have protein with very low amounts of carbs for dinner and see what happens. If I am not better by tomorrow I am going to call my endo and see if she can help me out.

I have had ketones in my system before but the onset only lasted a few hours and I was able to get it under control quickly. This is the first time I have experienced something like this. I am fearful of getting DKA. For anyone that does not know what DKA is it’s:

“Ketoacidosis (key-toe-ass-i-DOE-sis) is a serious condition that can lead to diabetic coma (passing out for a long time) or even death. When your cells don’t get the glucose they need for energy, your body begins to burn fat for energy, which produces ketones. Ketones are acids that build up in the blood and appear in the urine when your body doesn’t have enough insulin. They are a warning sign that your diabetes is out of control or that you are getting sick. High levels of ketones can poison the body. When levels get too high, you can develop diabetic ketoacidosis, or DKA.”

http://www.diabetes.org/living-with-diabetes/complications/ketoacidosis-dka.html

Wish me luck because I am sure tonight will be a long night filled with drinking tons of water and checking my BG every few hours.

Alcohol and Phish food

It’s hard not to succumb to the pressures of social drinking when your in your 20′s, but if you want to maintain a social life and decent blood sugars it is a constant balancing act. This has been one of the hardest things I am learning to balance because alcohol and diabetes do not mix. A few weeks back I went out on the town with my best girlfriends. We started the night off with dinner at Bj’s restaurant. I split a Mediterranean mini pizza with one of my friends and one glass of Jameson and Diet with a side of water. Blood sugars at that time were right where I wanted them. After dinner I prepared for some higher BG’s by adding a temporary basal, because lately when I go out on the town my excitement/adrenaline causes my BG to run higher than normal.

After dinner we made our way to downtown Pasadena where we spent the night bar hopping. Typically I have  pretty decent blood sugars  provided I stick  to my trusty Jameson and Diet with a glass of water between drinks. I check consistently throught out the night to make sure I am balanced. If I stick to that routine I tend to be okay. However, once I introduce other cocktails, beers, or shots I start to throw my body into complete disarray. Most of the time I am responsible and careful. Every once in awhile I knowingly disregard what I should or shouldn’t be doing. I do so in an attempt to feel “normal” or like everyone else my age who is living a carefree 20 something year old life. This particular evening I decided to have a few shots, cocktails and beers. (Mixing is not good for anyone, but especially not good for diabetics.)  Initially my blood sugars ran higher as I expected, but once the sugars had burned off and all that was left in my system was the alcohol my BG’s crashed. I turned off my temporary basal once I noticed the trend heading downward.

I am not sure if anyone else has ever gone through this, but people that don’t know that I am diabetic try to peer pressure me into taking a shot of some sweet looking concoction that I am sure is liquid sugar. More often that not if I decline I am bombarded with comments like “Wuss, Chicken, so on and so forth.”  Most of the time I will just say “No Thanks!” However, every once in awhile I decide to be dumb and take one of those shots.  I find myself sometimes embarrassed to tell these people “sorry I can’t because I am diabetic!” In the past when I have they either ridicule me for drinking at all, or they want to go into deep conversation about my condition.

This particular evening ended with cold sweats, shaking, ringing in my ears and a very scary low BG.  The only thing I had to bring my blood sugars back to normal was my sister in law’s Ben & Jerry’s Phish food Ice cream that she left in my freezer. The sugar in the ice cream absorbed slower than I would have liked and as a result I was up for an hour trying to correct my blood sugars. I am learning more and more that in order to lead a healthy diabetic life I need to reconsider certain social habits and stick with my comfort zone. The only person that is going to take care of me and keep me safe from my diabetes is myself. Slacking off for just a night could have potentially dangerous consequences.

Cruisin with diabetes

I just recently got back from a week long cruise out of San Diego,CA to Cabo San Lucas and La Paz Mexico. We had the greatest time, but I am left in a food coma! For those of you who have never been on a cruise let’s just say that there is a lot of eating and drinking involved. (Well at least with my family) With around the clock buffets and endless cocktail waitresses and bars throughout the ship I found myself in pure gluttony for 7 days straight. I went from 30 carbs per meal at home to about 100 carbs per meal on the cruise!

One of the oddest things I get excited about before a cruise is the fact that Carnival Cruise lines serves Diet Sprite in addition to Diet Coke. To date I have never been to a bar that serves anything diet besides diet coke, so it was nice to be able to experiment with my different drink options. My drink of choice I discovered on the trip was Bacardi Razz and Diet Sprite. It was sweet but without an overload of carbs and sugar. However, I have to admit that I stole a few sips from my families Pina Coladas and entertained myself to one Berry Mojito. When it comes to drinking (vacation or not) I am always cautious. I am constantly checking my blood sugars, drinking water, and I never go way overboard. I went through a lot more insulin than I normally do, but other than that I was A-okay.

You would think with the excessive eating I would have had some serious issues, but I did not have any serious issues whatsoever. The only unusual thing that happened was on the first day in Cabo. I took  my pump off for about 3 hours ( I lost track of time). During that time frame I had no basal coming into my body. Once I realized how much time had elapsed I immediately put my pump back on and checked my bg. I was in the mid 200′s, which didn’t surprise me, and in fact I was happy with that number considering the circumstances. The thing that caught me off guard was that for the next eight hours once I put my pump back on my bg’s remained in the 400′s. I was left wondering all night long if this was a result of zero insulin for an extended period of time, or if there were other factors at play. For example, does warmer weather impact the potency of  insulin? If any one has theories on this I sure would love to hear about them.

I have to admit despite the higher than normal blood sugars it was well worth it. It was nice to escape not only from my everyday reality but from my every day diet as well. I had the greatest time and I can’t wait to go back. The weather was beautiful, the people were friendly and we made some great memories!

Now it’s back to life…back to reality.

Happy Hump Day!

Lows

Have you ever gotten a low blood sugar that you purposely tried to ignore? I seem to get these every once in awhile and when I do I just think to myself “Yeah I know you are here. I can feel the buzzing in my ears and the shakiness of my body, but I really just don’t want to deal with you right now…Maybe later!” It isn’t till I start feeling the more serious symptoms that I finally do something about it. More often that not I just suspend my pump for a little while, then reactivate it once I am feeling better. (Probably not a great idea, but hey I am being honest)

I hate having to stop what I am doing all just to fix a low blood sugar. This is especially true if I am very involved in something. Last week I had a few lows at night just before bed.  I was very warm and comfortable and I did not want to will myself to get up, check my blood sugar and correct it. Instead I just decided to ignore the symptoms and I fell fast asleep. Luckily I slept through the night just fine and I woke with decent blood sugar readings. However, that has not always been the case in the past. In not my finest moments as a diabetic I have been know to ignore my low and go to bed without giving myself any glucose boost. I then find myself immediately awakened in the middle of the night shaking and drenched in sweat. At that point panic has set in and I have no other choice, but to remedy the issue… and quick! I have never fainted, or experienced any seizures as a result of a low, but I have been close enough for a short period of time to know that I do not want to ever go through that.

I am trying to turn a new leaf in my life and I do not want to continue on with those bad habits, at least not to that extreme. While deep into a workout today I did not want to stop, because I did not want to loose my rhythm. Unfortunately, diabetes could give a shit about my wants and it decided to tank my BG while I was working out. Fortunately the low did not strike until the end and I was able to finish my work out and fix my blood sugar after wards. It stunk that the low killed the climax to my workout, because I did not get to finish as strong as I would have liked to.

Another confession I have to make is that I do not want to gain a lot of weight as a result of treating lows. When I am having lows I find that I do not stick to the 15 grams of carbs rule. I feel like I am starved and I just eat until I feel better, only to realize that I just binged on more food than was necessary. Over the last three months I have been determined to get into the best shape of my life, so binge eating as a result of low BG is not conducive to my fitness goals or overall health. When I start to do it now, I catch myself and wait and see how I feel after 15 minutes. If I am not doing too well then I continue to eat and repeat until I am doing better.

I hope that as time wears on the lows will diminish as I stabilize my blood sugars. My insulin requirements can fluctuate quite a bit from day to day. The best way to keep up with those changes is to stay in tune with what is going on with my disease in the present and how it is effecting my insulin needs. In turn this will help me stay on top of changes that I have to make to my pump settings. With all this being said, my next goal when I see my endo is to have my A1c down to 6%!

Wish me luck!!!

6.8

I finally got in to see my Endocrinologist today. She said, “The diabetes has not damaged anything yet!” All the labs came back clean and according to her I am a healthy gal. My A1c was 6.8. Not too bad, but not as low as I would have liked. I am scheduled to go back in early June. My goal from now till then is try and get my A1c as close to 6 as humanly possible. The lowest A1c I can recall having was 5.5, but I was going through my “honeymoon phase” at that time.

I know I haven’t been blogging too much lately, but SugarFree4me.com is never far from my mind or heart. Between working full time, trying to workout daily, and being a devoted wife, family member and friend my days are stretched thin. I find myself vegging out on the couch by the end of the day. My new goal for the upcoming week is to try and get in the habit of posting more frequently. Just in the short time that I have been blogging and getting more actively involved in the diabetic community I feel like I have transformed. My doctor even commented on the fact that I am very in touch with what is going on and she said if I keep it up I should be set to live a long, healthy life absent diabetic complications. (Let’s hope so!!!)

Going to go enjoy some quality time now with the hubby and watch some American Idol. Have a great night everyone.

Diabetes always finds a way to try and ruin my FUN!

I am not sure if anyone else has had this phenomenon, but whenever I go on vacation or, if I am out having a great time like at a concert, club, or whatever the activity may be my BG are almost always higher. I am sure it is probably a mixture of the endorphins, the excess carbohydrates and whatever else, but the timing could not be any more inconvenient! With that being said It is official that the “betes” is out to ruin my fun, but it does not realize how stubborn I can be.

This past weekend was my husbands birthday. I changed my infusion site on Saturday morning anticipating some fun in the sun. It was a nice 80 degrees in Southern California and I did not want to get any circular tan lines on my stomach, so I switched my site to a bathing suit friendly area.  We made our way down to the Belmont Shores area of Long Beach around 2 p.m. I was feeling great and all my readings from my meter were looking good. I thought what the hell I will help myself to a couple of beers  with our friends. As the day continued to wear on, my BG readings continued to get higher. I set a temporary basal and got back to the good times.

As the evening approached I continued to have high readings despite the Temporary Basal. I bolused correctly for the beer and my food, so I was not 100% sure what the deal was. I was not sure if it was my infusion site, or just the excitement of the day, so I made a game plan. I would monitor my BG’s through the day and attack the highs with the insulin. If after a certain point they had not come down I would change my infusion site.  I did not want to assume right away that it was my infusion site, because I have wasted too many Quick Sets lately. Typically the moment I have uncontrollable high BG’s I assume that the cannula is bent. However, once I pull it out more often than not it is just fine.

There were about 12 of us that stayed at The Westin, which can I just say is beautiful and has the most comfortable beds ever! We got ready in a hurry and made our way out for the night to meet up with other friends at Panama Joes. I was in the low 300′s before we left, but I was still not convinced that it was the cannula. To be on the safe side I packed a Novolog Flex pen in case I had to correct myself. Once we got to the bar everything was great. My husband was having a ball and all of our friends were there. The only thing that was not good were my blood sugars. It was like they were on a slow and steady climb during the day and on a sprint once the nighttime rolled around. I must have dosed almost 3 times within a 4 hour period not to mention I cranked my basal up to 180%! I was then convinced that it had to be the cannula.

I did not want to have to leave the fun yet again, because I was having a diabetic moment, so I finally just gave myself the novolog injection. It seemed to help a little. However, by that point I was in the low 500′s. What is worse than feeling like crap from high blood sugars is feeling like a burden on other people. My friends, family and husband are great and I try to conceal when I am having a bad betes moment, but they are too clever to be fooled by me. I am no good at concealing my emotions, so they are quick to figure out  that something is not right. On Saturday once a few people figured out that I was not doing so well they began to keep a watchful eye on me.

I swear anytime my blood sugars are out of check I get a sour stomach and I feel like I have to puke. It is the worst feeling! I think I almost hate it more than the feeling I get from having low blood sugars. I downed about 5 big cups of water and made my way back to the hotel by 11:30 p.m.  Once I got back to the room I pulled the stupid cannula out and guess what the p.o.s was bent in a complete zig zag shape. I attempted to get a picture, but the quality was not so good. I was so mad, but so relieved at the same time. I changed the infusion site and pumped up the insulin. I spent the next 12 hours high, followed by 12 hours of lows.  We had a barbecue the next day with our family. Despite the headache and the memories of the roller coaster ride my betes took me on the night before I was doing much better.

Sometimes this disease can make me feel like a jerk, because it is not fair to the people closest to me to have to also be burdened with my diabetes. I can deal with the betes, but I cannot deal with it affecting others. I had a great time and I probably would have had an even better time if I did not have my little episode. Regardless of what happened it turned out to be a really nice and fun weekend. My husband had a great time celebrating his birthday from what he tells me and that is all that matters.

On this Valentine’s Day I want to acknowledge that unfortunately with any disease, friends and family members are going to feel the effects, whether we like it or not, because they love us and want to make sure that we are doing well. With all that being said I want to say how much I love my friends, family and husband. You are all so patient and helpful. I know it has to be annoying at times, but you never ever let me know. You guys are always so supportive and I could not do this without you. I have the BEST SUPPORT TEAM in the world, which when it comes right down to it is one of the strongest advantages I have in this fight. I appreciate all that you do and please know that even the littlest things are not overlooked by me. Happy Valentines Day everyone and to my love Happy Happy Birthday!!!