Lemonade Life

Thursday, April 12, 2007

My First Oops

Well, technically this is probably my 55,670th oops when it comes to diabetes, but on this new "Unthethered Regime" (see post below), this is the first.

For the most part, things have been going smoothly (in the three days total I've been doing this...). Monday was rough with that 372 mg/dl, but on Tuesday and Wednesday, my numbers were actually normal, except for two bounces into the low 200s right at lunchtime.

On Wednesday, my flight was supposed to leave at 3:23 and didn't leave until an hour later, leaving me to kill a whole hour at the airport. Luckily, I am from Portland. Which means we have a Powell's bookstore *inside* the airport. After picking up a copy of Devil Wears Prada (I'd always wanted to read it and now seemed as good a time as any), I tested to see if I should have a diet soda or a smoothie - 83 mg/dl. Nice. I opted for the soda and chicken nuggets from Wendy's because the smoothie was a little too expensive (frickin' airport) for my wallowing wallet. Didn't bother reconnecting to bolus because I didn't think the nugget would do more than maybe a 20-30 point damage.

When I got on the airplane, I tested again to see if a temp basal was in order - 81 mg/dl. Huh. Okay, probably should leave the pump off. Two hours later when we landed in dirty smoggy disgusting sunny and beautiful Los Angeles, I tested to see how much damage a 2-hour flight and a mini-package of pretzels (seriously, why must they mock us with such small portions? They might as well just hand us a frickin' picture!) had done to my system - 230 mg/dl. Not bad. I've seen worse numbers coming off of a flight.

I met up with my friend, Christina, a fellow diabetic and journalist living right near the beach in LA county. We've known each other since my CureNow days, but this is actually the first time we've met. I'm all about meeting the imaginary internet weirdos. ;-) We drove to Barney's Beanery on the Santa Monica Third Steet Promenade for dinner and I tested at 144 mg/dl. Huge turkey burger with guac and bacon (mmmm) and onion rings (mmmmm) and bolused for 80 carbs. Possibly too conservative, but I didn't think I was that far out of the ballpark.

That's when things went downhill.

After dinner, we headed over to meet a friend of mine from high school at the Starbucks near the University of Southern California campus.

I hadn't seen her since last fall when she was up in Portland, so we chatted in line.

I ordered a Mocha Light Frappaccino (half the carbs! Only like 45 instead of 78 - yes, 78. I looked it up once).

We talked about agency work, interviews, finishing up school, Santa Monica, and the breakthrough stem cell research in Brazil.

And I forgot to take my Lantus.

When I tested at 10:30, my blood sugar was 353 mg/dl but when I tried to bolus, my pump said I had to much active insulin in me from bolusing for the frappaccino. It never even occurred to me that it had been an hour and a half since I was supposed to take my shot of Lantus.

On our way home, Christina and I stopped at McDonalds to get a couple of diet sodas -me thinking I was thirsty because I had been talking so much. When we got to her house, I finally realized the missing item to my evening.

I rang in at 453 mg/dl. Lovely.

Of course, not knowing quite what to do, I just took a shot of Lantus and went to bed. Hopefully the three-hour difference tonight won't be that big of a deal, though if anyone has any idea how to mitigate a possible low, that would be appreciated.

Woke up at 8:00 to a 198. Correction bolus.

Woke up at 11:00 to an 86. Off to make a quick (ha!) post, and now... breakfast!


At April 12, 2007 2:29 PM , Blogger Megan said...

I think mistakes are bound to happen whenever you switch to a new treatment plan. But you caught it well, and corrected nicely, so congrats for that. Have fun in Cali!

At April 12, 2007 2:56 PM , Blogger Jonah said...

I used to worry a lot about injecting the Lantus at intervals that aren't perfect 24 hours, but after screwing it up dozens of times and not seeing any problems from it even once, I don't worry about it.

At April 12, 2007 4:17 PM , Blogger julia said...

I was told if it was more than an hour after you were supposed to take it, then you should just wait until the next night and give mini doses of insulin all night. Um, no. Three hours, I would have done the same thing you did. Had it been six or more, that would have been different.

You might want to keep a closer eye on things tonight. Having that overlapping Lantus might make you bottom out a bit overnight. That was what I noticed when O was doing the untethered thing.

At April 12, 2007 9:17 PM , Blogger Lori Rode said...

I so hope you're having fun!! I must see photos of you meeting all these great folks IN PERSON, you lucky gal.

Keep on, keeping on. You fixed the mistake when you caught it, and you're making good choices. Are you wearing sunscreen?

At April 12, 2007 11:41 PM , Blogger Chrissie in Belgium said...

Yay - bloglines is finally delivering your blog posts to me! You don't know how long I have been struggling with this! Anyhow I wanted to mention that it is really interesting to hear about how you manage being untethered. Another thing is that I have so many times noticed that airplane trips make bg value go up! Is it b/c we sit in a chair and cannot move, or could it be something else??? I just wonder. I have posted about Croatia....

At April 13, 2007 10:12 AM , Blogger Allison said...

I've actually switched back to the pump just for today. Between missing the Lantus shot, going to a party and my 2-hour drive to San Diego today, this is ending up being a day where having the pump only has advantages. But tonight I'll be shooting up again and hopefully will be pump free for at least another few days. Of course, this is entirely the advantage of being both on Lantus and the pump - you can go back and forth with minimal hassle as long as you plan things fairly well.

Chrissie, my blood sugars always go up on the plane, especially long ones. My temp basal was at 125% when I went to New York, and even when I went to California, even though I was only sitting for 2 hours, I left the airport at 81 and landed at 230. Huge difference!

At April 16, 2007 10:24 AM , Blogger Sasha said...

It's great that you can take a break from the pump like this and still not have to go back to shots. Just be careful with Lantus, I find it a very tricky thing. It's supposed to work evenly 24 hours, but I found out it's never the case.

To answer Chrissie's question, the blood sugars go up on the plane beacuse of the change of the preasure in the air, also you're more dehydrated during the flight, which also effects the sugars. I always take extra insulin when I'm on the plane.

At April 27, 2007 11:17 PM , Blogger Chrissie in Belgium said...

About airplane travel - Allison has your endo instructed you to increase your basal during air travel, or did you figure it out? Mine has said zip about this! And Sasha, why does changed air pressure affect bg values? Has your endo really EXPLAINED this to you? I understand dehydration and lack of exercise, but air pressure?! What doesn't affect our bg values! Pls drop me a line to explain this! And Allison congrats on your new job (((HUG)))))!


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