Saturday, February 27, 2016

On Multitasking

Sometimes, my brain capacity amazes me. Like when I remember the names of every single parent during parent-teacher conferences.

Sometimes, it definitely doesn't. Like, when I'm trying to text and calibrate my CGM at the same time and I realize not only do I a) have blood smeared all over the screen of my phone but I also b) entered a phone number as my blood sugar. So....sorry Dexcom. No wonder you're confused trying to reconcile you thinking I'm at 130 and me telling you I'm at 415. That one's on me. 

Saturday, February 20, 2016

I'm So High Right Now, Part 3 of ??? AKA: So When DO I Worry?

I spent a lot of the last post explaining about the day-to-day high blood sugar realities. And also reassuring people that they needn't worry about these. And it's true. There's a reason low BG gets all the hype, it's because when your sugar is dropping you can go from 80 mg/dL to dead in under an hour (probably. I would double check that science, for sure).

High blood sugars aren't immediately dangerous, but they are eventually deadly. High blood sugar leads to lots of fun long-term health complications, like diabetic neuropathy, eye damage, kidney damage, Alzheimer's...yeah, yeah, you know how to use Google so I'm sure you can figure this out on your own. The more high BGs, the more likely my chance of picking up these super-cool conditions. So, if you spend a lot of time with me or another diabetic and you notice that their BGs are consistently really high? Or they don't seem to really react when they have a high BG, or make comments or share that they haven't been taking care of themselves properly? Maybe they share with you that they sometimes let their BG run high on purpose in order to lose weight? Yeah, that's when you probably want to step in. Do what you gotta do, because that is dangerous. If you like having that person around you, and you think you might want it to be long-term, nothing says "I care about you" like, "let's discuss your personal private information AKA your blood sugar levels even though you probably don't want to AT ALL."

Lots of super-high BGs, like read: no insulin at all, can lead to a fun condition called diabetic ketoacidosis (DKA). This is how many T1Ds (read: yours truly) were diagnosed. It's the step before the diabetic coma, where your body is so starved for glucose as an energy source (because all your glucose is floating around in your bloodstream rather than being ushered into your cells in order to fuel them) that it starts breaking down all your stored fat and protein (aka muscle) and desperately scrabbling to get to any last bits of glucose. Like in the olden days when they would burn the furniture to stay warm during the winter. Except then imagine they ran out of furniture and also started burning the walls, which not only defeats the purpose but also results in them all being in comas.

Sad side effect of this is that, when breaking down muscle to get glucose, there is a leftover acidic tail called a ketone. Suddenly you're producing those like crazy. Your body is full of acid!! Symptoms of DKA include sudden dramatic weight loss (burning up all your fat and muscle dude! You're becoming a bag of bones!), exhaustion (no good energy sources, sad), heartburn (your body is filling up with acid), dehydration, frequent urination (gotta get rid of all that acid!!), craving sugar (because even though you're full of it floating around, none of it is actually getting to where it should go so you're actually starving for it), and eventually a coma. If you see any of these symptoms in people around you, especially the coma, I would say it's time to worry. Totally your call though.

Bottom line is that, discussing someone's BG with them can be tricky. It's private. It feels embarrassing to have a high blood sugar, even when no one around you understands what the numbers mean or is judging you at all. I judge myself. I don't want to talk about it. There's also really not too much to say about it, since all that can be done is to drink water, apply insulin and/or exercise, and wait. So weigh that when you bring it up. And also remember that, unless you are dealing with your own child who is diabetic and they are under 18 years of age,  you never, never, never need to worry about whether or not they "should" or "can" be eating whatever the heck it is they're eating. There's only one thing a diabetic can't eat, and that's poison (stole that from an internet meme. So tech savvy). So don't be getting on anyone's case when they're just trying to binge on ice cream okay?? Ummmm....I mean....responsibly enjoy a small cookie, okay??

Saturday, February 13, 2016

I'm So High Right Now, Part 2 of ??? AKA: The Part Where I Explain the High that we are clear on what I'm actually talking about when I bandy about the term "blood sugar," let's talk about high blood sugar aka "a high" as we in the know folks like to say. Some who are in the know might prefer to say hyperglycemia, but to them I say...take your fancy medical degree and shove it!! This is my blog and I'm the expert here.

Low blood sugar (hypoglycemia) gets a lot of hype and paramedic attention, but high blood sugar is also very deadly and also much more common and feels worse. Which is why I'm turning my attention to it here. For all you poor people who love/like me and are now feeling concerned like, I thought all I had to worry about was when to stab her with the glucagon needle???...well, enjoy.

A recap: Normal people's BG is typically between 70-120 mg/dL at any given time. Mine?? Well, I do my darndest to stay between 80-160 mg/dL during the day, but it's rare that I have a day where I don't hit at least 190 mg/dL. At least three times a week I can hit 250 mg/dL. I've hit as high as 487 mg/dL before, and I've also just gotten HIGH on my meter because it doesn't read above 500 mg/dL. So you might be thinking, why....what do u mean when you're telling me these numbers (s/o to JBiebs!)? What do these numbers mean to you?

Well I'll tell you. There are different types of high blood sugars. There are those that hit fast, like really fast, where I can literally feel the sugar flooding into my body. Those moments feel almost like getting on an elevator going up just a liiiitttle too fast when you're also pretty hungover. Once my sugar is stable, but still high, things feel different depending on just how high I am. It's also all relative--if I've had a lot of high blood sugars recently, then they stop feeling so shitty because my body is used to them. But if I've had things relatively under control, then I'll start feeling worse way earlier.

When my blood sugar is just a little bit high (160-250 mg/dL) sometimes I won't even notice really, for the aforementioned reasons. I'll generally feel a bit tired and thirsty since my body is not absorbing glucose to use as energy and it's also not absorbing water to hydrate me. I might also feel annoyed because my Dexcom is buzzing at me and/or I might not know or like the reason why my BG is high. If you're someone who likes to hang out with me, here's what you need to know if you notice this is where my sugar's at: I'm fine. I'm fine. You may hear two long, slow buzzes from my Dexcom. I may huff some Afrezza and/or adjust my insulin doses. I may roll my eyes. But let's just say it one more time: I'm fine.

When my BG is pretty high (250-350 mg/dL) I feel quite crotchety. Seriously. It's not my fault, grumpiness is a well-documented side effect of high blood sugar. I'm also probably feeling really tired and unmotivated. I probably have a slight headache and if I'm over 300, I'm feeling kind of woozy. I might also be feeling kind of snacky, either for salty things (because I'm dehydrated) or sugary things (because I am always craving that). Here's what you should know: I'M STILL FINE. You don't need to ask me if I need to take some insulin because guess what, I've probably already considered that option and I'm doing what I need to do. Sorry if that sounded defensive. What would really help right now would be the following: offering to fill my water bottle and/or take a long walk with me if it's feasible. Both these things help speed up the effects of insulin and lower my blood sugar. Also, accept that I'm not at my most organized or highly functional. It's not a great time to snap at me for making silly mistakes.

When my BG is very high (350+) I feel bad. Imagine post-Thanksgiving level exhaustion, plus flu-like symptoms (aches, chills, sore throat), extreme thirst, fogginess/wooziness. I am generally always annoyed at this point, because this is going to take some undoing. If I don't have Afrezza available, then I'm going to be feeling the effects for 1-3 hours. Here's what you should know: I'm still not going to go into a diabetic coma and crumple at your feet. Here's what you can do: The water and walk offer are still helpful, but at this point, maybe just be sympathetic and offer to watch a TV show with me or accept that I'd like to go take a nap until I feel better.

Is it always this way, you might wonder. The answer Duh. Because variability is the nature of this disease. And the spice of life. So, if I'm really involved in what I'm doing, or busy, or stressed out, I might not notice the effects or feel the symptoms as fully. My Dexcom will let me know what's up though, and I'll be taking care of things. I'm not incapacitated. But I am also expending some extra energy in order to be focused/present/attentive/pleasant when I'm around you and having a high blood sugar. I do it because it's part of living my life. I do it because there's no such thing as calling in high blood sugar to work. I do it because sugar doesn't dictate my life. I do it because I love you (I've accepted that only my family reads this blog). I hope these posts help you to understand and love me back. 

Saturday, February 6, 2016

I'm So High Right Now, Part 1 of ??? AKA: Background Info

*Pause for snickers*

Okay yeah but yes actually....this has a different meaning for people with diabetes. And it is not as much fun as the title might suggest. But it's an unfortunately common reality, and so I'm going to go a bit in depth about it here. 

DISCLAIMER: Blah blah blah the usual...not a medical professional...probably riddled with errors....I am known to conflate stories and am also notoriously stubborn soooo take everything here with a grain of salt. 

Still with me? 

Okay. So. First, a beginner's guide to blood sugar levels. Simply put, blood sugar is exactly what it sounds like. Go figure. It's how much glucose is floating around in your blood stream at any given moment. It's measured in mg/dL (milligrams/deciliter). How does that glucose get there? Multiple ways. It's released into your blood stream in a slow and steady drip throughout the day from where it's stored in your liver. It's released in a fast and furious rush into your body about 15-20 minutes after you eat a meal (discussion of how a meal breaks down=future blog post?). Maybe it comes in other ways, but those are the only two I'm aware of. Although if there are more glucose sources that I'm unaware of, that would really explain some days, know what I mean??

Okay, so whoo!!! Sugar rush!! We know where the glucose comes from. What happens once it hits the system? Well, for starters you need some of it floating around in there. Turns out your brain straight up thrives on sugar. YOU HEAR THAT MOM??? SUGAR IS GOOD FOR YOU!! Okay well at least glucose. Okay yeah mom it's true that veggies and fruit and healthy whole grains also break down into glucose. OKAY MOM SHUSH NOW. So yes. You need some sugar floating around in there to feed your brain, act as a quick source of energy for your muscles (ATP what what!!), etc. The rest of it is quickly ushered into the VIP lounge aka fat cells for storage via INSULIN which acts as a sort of escort service/bouncer that "unlocks" these cells and lets the glucose in. Ahem, science, science, details....knowledge on the topic.....etc. 

A normal person (or pancreo-typical, as I prefer to call them) has a blood sugar between roughly 70-120 mg/dL at any given time, depending on when they ate, exercised, muscle mass, and other factors that they'll never consider but that I spend a LOT of time considering. 

Me? Weellll things are a little different for me. I'm going to do a cliffhanger now which is ridiculous because a) no one reads this blog anyway who can't just text me and be like, what's going to happen next? and also b) this is not exactly a riveting story but you know what world, this is my little corner of the internet so I do what I want and you're gonna like it. 

So stay tuned to find out the story of the highest I've ever been and generally just how high things can be....