I'm So High Right Now, Part 2 of ??? AKA: The Part Where I Explain the High

So...yes...now 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 is...no. 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. 

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....

Mic Drop

When you drink several beers, eat some candy, and have several extravagant yet low(ish) carb meals....and through some miracle of long walks between bars, Afrezza, and basal insulin, you make it home without a single high blood sugar and you're all like...

Sweet Dreams

You guys know the drill. You hear the three short buzzes calling in the middle of the night, or awake to the cold sweats and deep feelings of paranoia. Knock knock, who's there, it's a late night low blood sugar. So you reach for the snacks beside the bed (if you're lucky), knock back the juice box, and like hell you're about to go brush your teeth down the hall.

My dentist friends (no seriously. They are my friends and they are professional teeth carers) pressured me into a new practice, swishing with baking soda and water. I changed over one of my water bottles to a diluted solution and it tastes flipping nasty and I keep accidentally drinking it during the day, but if it will keep me from having George Washington-style dentures when I'm 45 then I guess I'm into it. 

To All the Things I've Had to Eat

To the thoughtfully chosen and consumed apples, oranges, and bananas.

To the candy and candy-flavored protein bars before bed, a childhood dream that doesn't quite live up to the hype.

To the midnight Lara bars, to the mid-hike glucose gels.

To the snacks of slightly concerned friends, to the bear bags and canisters of more concerned friends.

To the juice, apple cider, fruit punch, pouches, boxes, cups.

To the good choices, carefully measured out tablets and singular pieces of dried fruit.

To the choices that lead to roller coasters of emotions and exhaustion, like cups and bowls of granola or ice cream.

To the second dinners, breakfasts, and unscheduled snacks.

I think it might be fair to say that I've hated you all. 

Silent But Deadly

I generally choose to coexist peacefully with my diabetes. There are many reasons for this, including counting my blessings that this is the worst I'm hit with. Including lack of other options--to rage against diabetes would be pointless and even more exhausting. Including even gratitude, for its grounding presence and the healthy habits it encourages in me.

But lately, rage has been seeping in. It started a week or so ago, when I was walking to work and reminiscing that I'd actually had a really nice night's sleep. And then, all of a sudden, I remembered that I had been woken up no less than three times the night before. From a buzzing alarm on my OmniPod reminding me to check my BG 2 hours after putting on a new pod (never mind the fact that I wear a CGM and therefore don't need that reminder--I'm unable to turn it off). From a low BG that danced around 85 and sent buzzes off twice on my Dexcom before it finally calmed down. And that was a good night. I suddenly got so angry. Angry that this was acceptable to me, that I didn't even notice or really remember what it feels like to sleep the entire, whole night through. 

Since then, I'll say it. The buzzes have been pissing me off. They ruin my sleep, disturb my yoga classes. The incessant beeping of my Pod every 3 days--I know it's going to expire! I know it did expire! I'll keep it on as long as I please, since I paid so much freaking money for it!! I'm angry. I'm frustrated. I feel like my devices are running the show, and while I don't want to give them up since they allow for such well-calibrated maintenance of my health, they are causing other problems for my health. Mostly my mental health I guess. 

I am angry. I'm angry that other people's pancreases are free, and my insulin costs me 2 pairs of Lululemon leggings every month and a weekend vacation getaway every 3 months for my Pods and sensors. 

I'm angry that there are lumps on me when I wear my clothes and that my students can feel my pump when they hug me and that there are rashes and scars all over my body.

I'm angry that I have to poke holes in myself constantly and that at least one of my devices seems to constantly need something from me. 

I'm angry at the moments that are, if not stolen from me, at least force me to fight for them, through the soup and fog of a high blood sugar or the exhaustion and fuzziness of a low blood sugar. 

I'm angry at having to explain myself, at feeling like people worry about me, at constantly worrying about myself.

I'm angry at how much of my brain power I waste on thinking about food. 

I don't feel like issuing a disclaimer here. I know there are people worse off than me. I know that everyone has their stuff. I know that my life was not perfect, nor even necessarily better, before diabetes. I know that I'm lucky that I even got to experience so much of my life before diabetes. I know all that and I'm still angry. It's not that it feels unfair. It's perfectly fair. It just also sucks. And I'm angry about it. 

I'm hoping that writing will help me relax, because stewing in it hasn't been working so far. It's been eating at me, creeping in whenever I hear a buzz or see a flashing screen or buy more crap to keep myself alive. Maybe saying some of these things out loud will allow me to shake them off and move on. Because while I do see a future for myself with better management, and hopefully less effort, if I'm being honest, I don't see a future without devices. I certainly don't see one without diabetes. 

Surfing the Crimson Wave

Yeah, it's not what you think it is.

But occasionally, very occasionally, I hit what I like to call a "sweet spot" or a "gusher" with my cannula. So when I pull the Pod off my body, aside from the usual sting of the tape ripping off, I also get a stream of blood running down my body, extremely disproportionate in size and velocity to the tiny, tiny hole the cannula created.

(Cannula=small, thin, plastic tube that does the dirty work of piping insulin into me)

It doesn't hurt, but it is a lot of blood, and I have to fumble around to contain it and recently it cost me a PJ shirt. The funny thing is, is that I'm pretty sure this is what people picture when they (I'm sure extremely rarely) imagine what it's like to change an insulin pump. So this is just a PSA, folks. It's not like pulling a tooth. You don't get a sweet view of my inner organs working like that fistulated cow I mentioned a few months ago. It's just a small mark, hardly noticeable, except when it's not.