An action plan regarding my recent rough patch

I mentioned in a recent post the very arduous rough patch I went through. Constant crashing and spiking and finding it impossible to stabilize. I was in crisis mode all day. One day during this rough patch: I had breakfast around 10:30, go to the recycling center here in town around 11:15 and look at the CGM app in the car because no alarms are going off and it’s 150 with the arrow going slightly up, meaning it will go up a little more most likely. Ok, not bad. Then I’m thinking I’ll go to Walgreens and get a seltzer because I forgot a drink and head straight to the library. So I’m walking around Walgreens, which is maybe a mile from the recycling center, and suddenly it’s 74 and dropping (I had the alarm set to go off if it went under 75), arrow straight down. I rush and grab a coconut water with added sugar out of the fridge and chug it. I don’t know if anyone saw me, they probably thought I was insane if they did. I paid for it in a flash- scanned my card, “Yes, I think I get the e-receipts, thanks” and ran to my car. 61 and dropping. By the time I’m in my car and shoving glucose tablets down my mouth it’s 53 and crashing. How can it go down 100 points in a matter of five minutes? I actually really thought I was being a little too conservative with the amount of insulin I took at breakfast! I scramble to find my diabetes case and open the test strips as fast as I can to test manually. I brace for the number. It’s 76. Definitely better than 53 with the arrow going straight down. But unfortunately, I just had about 50 grams of carbs for a 76. Just another colossal drop off Matterhorn followed by a chopper lift back up to the top. Strangely, at the gym last week I had an epic crash after I took a small amount of insulin, the smallest dose of insulin available in my inhaled cartridge, because the app said I was at 178 despite having a long workout. Usually that amount of insulin would just stabilize me at that number. Not twenty maybe twenty-five minutes later I’m testing at 40, manually. The app just says LO. I almost called an ambulance. Let me think back to how I got out of this one. Well, I was in the parking lot of the deli I was meeting my dad at after I was done at the gym when I noticed it was going very low, very, very quickly, and did the manual test in the bathroom. Panicking, (I forgot to put my emergency glucagon in my gym bag, the one day I actually need it) I took a San Pellegrino orange soda thing off the shelf, 32 grams of sugar, sat down, and drank it as fast as I could. “Dad, I’m in trouble,” I whispered to him (he was already there when I arrived). “Can I please have one of those egg wraps? Vegetable?” It came out quick. Someone from my high school was sitting at the corner table with their family. God, what a disaster I am, I thought. 

Update: doing a lot better now. The brushes with death became a bit much physically and psychologically to say the least and I came up with this action plan. I believe in my ability to navigate this disease now more than ever thanks to this difficult period.  

For starters, I will use only glucose tablets to prevent myself from going low. No more coconut waters, etc. I find the carb count to be wildly inaccurate on coconut waters and various drinks I’ve purchased as a attempt to raise my blood sugar in a healthy manner and they spike me way too much. And I will take insulin or correct a low number based on both a manual meter and a CGM reading. I’m buying a smaller table to go in my office/exercise room where I am setting up test strips, at least two meters, plenty of lancets and alcohol pads. Usually I only have two meals a day- a mid-morning breakfast and an earlier dinner. A shake usually in between. Eating dinner before 6:30 is imperative for me so I’m not worried so much about blood sugar when I’m going to bed. If it’s under about 110 before bed, I’ll have something small, low-carb with protein so I don’t go low overnight. Usually a good handful of cashews is enough to do the trick. 

For when I’m on the go, I bought a bigger diabetes bag, I believe it says “Dead Pancreas Party Kit” on it, filled with two meters, alcohol pads, strips, glucose tablets, lancets, etc. During the day, I am setting the alarms on my CGM to go off within a narrow margin - anything under 90 and over 140 - so I have time to manually test and make a decision. Before bed, I’ll switch the low alarm to anything under 75, since there’s no fast acting insulin in my system and there’s more time. It’s definitely possible I’m getting more insulin sensitive, so I’m getting a fast acting insulin pen prescription again (with half units) to use so that I can do very minor adjustments more easily. Hoping this works!

According to the Diabetes Research Institute, 5.7% of all diabetics are type 1 and insulin dependent. That makes about 94% of diabetics type 2. And what I think about when I’m trying to relax at home (listening to Ray LaMontagne and watching the birds at the feeder) and find some repose from the heart-racing version of The Game of Life I’ve been playing over the last five years is that 94% of people with this disease are actually allowed to walk out of prison any time they want to. I would love to help anyone achieve that.