Nothing Goes as Planned

Everyone knows that there are exceptions to rules. The rule for treating low blood sugar is to take about 15 grams of sugar (be it orange juice, glucose tablets, soda, or something else sweet without much fat to slow down absorption), then wait 10 to 15 minutes. If the blood sugar level hasn't started to go up, eat another 15 grams, and so on. In reality, trying to follow the rules when your blood sugar is low rarely works, because you're starving, tired, and your brain has (duh!) very little fuel to use in trying to follow the rules.

Last night, I was feeling extra groggy and tested by blood sugar: 69 mg/dL (very marginally low). I knew it was dropping, though, so I ate some glucose tablets, and a granola bar (what I had on hand, and I was ravenous). I suppose the 6 grams of fat in the granola bar slowed things down a little, but it shouldn't have mattered very much. Yet 15 minutes later, my blood sugar was 48. I was feeling like I might pass out - not a good thing, as I was home alone, with my daughter asleep -- so I disconnected my insulin pump (a nice thing to be able to do), ate 6 more glucose tablets and a banana, and about a half hour later started to feel marginally better. By the time I went to bed, my blood sugar was normal. But I knew I wasn't out of the woods: I'd eaten more than 100 grams of sugar, so I was bound to go high eventually. I took a little insulin, but I knew if I took too much I'd drop again. The only way to keep from going high would have been to stay up half the night, taking a little insulin at a time. Or maybe I could have programmed my pump to give me a little insulin over a couple of hours. But was my brain up to calculating how much I should take, for how long? And as far as I know, there isn't a rule for doing that - you're supposed to follow the first rule, silly! (If you want to know what happened: Yes, my blood sugar was quite high in the morning, but I had a pretty good night's sleep. I just couldn't eat breakfast for a while, but good thing it was Sunday.)

How often do you end up off a cliff because you missed seeing a stop sign? (If you live in coastal California, please don't answer that question.) It happens all the time with diabetes; one wrong calculation, made when you're least able to make calculations, and you're suddenly completely off track, and you have to scramble up a cliff to get back. We have a lot of rules and calculations to follow these days, especially those of us who do carb counting and use insulin pumps. But for every rule, there are seemingly infinite exceptions, and no signposts to lead the way back.

Still, it's better than the old days: 20 years ago, all we had was lovely urine strips (stick it under the urine stream and watch the pretty colors) to tell us what our blood sugar was several hours ago, or blood test strips that required a series of precisely timed wipes with a messy cotton ball, with dubious results. It would take me days to get back on track, or what I thought might be on track, rather than half a day. I feel fortunate to live in a time when I can expect not to go blind from my illness, if I take the right steps. But those steps end up taking an awful lot of my brain power and anxiety.

Which leads me to try to explain why I've called this blog "One Sweet Day." It refers to a few things: The fact that I have to take things one sweet (diabetic) day at a time; and also the idea that in some unknown, probably impossible future, this disease will be just a memory. I doubt it will be in my lifetime (despite what everyone told me in the hospital when I was first diagnosed, at age 13, in the up-beat 80s). But maybe it will be in my daughter's - though I don't even dare think what I would do if she develops the disease. There's a lot of good research out there - not only beta-cell transplantation (the Edmonton protocol), but work on using the thymus to retrain the immune system to stop attacking the pancreas. So my hope is that that research will be supported and lead to something. No one should ever think that insulin pumps are a cure. They're keeping us alive and without complications for far longer than injections (although I know plenty of people do really well on injections; I myself couldn't). And they allow us more flexibility in what and when we eat. But they also create new hassles, and they're far from perfect (more on that in future postings!).

One Sweet Day also refers to my daughter's birthday (the actual day of her birth). For all that I went through (yes, that's another post as well), it was the most miraculous day of my life. I'm thankful, every day, that she was born. I try not to let that make me an overprotective mother; I'm sure it does somewhat, but I might be one anyway.

Sleep is calling, and a work day lurks behind it, so so long for now.