Tuesday, October 19, 2010

440 and still going strong

440.  No, that wasn't my bib number during my last race, that was my blood sugar at 2:30AM.  Here's the kicker, I still woke up two and half hours later and ran. 

I woke up to my continuous glucose monitor (CGM) beeping out of control, I have the sensor set to beep if my blood sugar is over 200.  At the time, it read 223.  I knew right away it was higher than that.  My body was in ketoacidosis.  "Ketoacidosis is a medical condition usually caused by diabetes and accompanied by dehydration, hyperglycemia, ketonuria, and increased levels of glucagon."   Basically it's awful, my stomach hurts, I go to the bathroom when I finally wake up for about five minutes because the body is getting rid of everything and I have no energy.  After going to the bathroom, I went back to my room, took my blood sugar and it was 440.  

I knew right away it was the infusion set.  I had a swim workout the night before, ate right away, bolused and went to bed.  There was no way it was that high. 

Although I have given praise in the past to the insulin pump, it does have its fault's.  Mainly, that the infusion set can fail, the tubing can kink, over time the "sites" a diabetic uses can create scare tissue making the site work less, all of this among other small problems.  The worst is when it fails at night.  Sometimes the pump beeps "delivery error", sometimes though the pump is getting enough insulin through the tubing and doesn't realize anything is wrong.

After concluding in my half sleep state that the infusion site was bad, I ripped it out and started to set up a new one in.  The site bled the second I took it out, obviously something happened from the time I went swimming until 2:30AM, or should I say about 11:00PM.  To be that high the site must have been bad for awhile.  I didn't have any insulin for at least three hours, probably four or five. 

After putting in a new site and giving myself a hefty bolus, I went back to bed.  When my blood sugar is that high, nothing feels better than just laying back down. 

I woke up to my alarm going off two and a half hours later at 5:00AM.  I had to get up a little earlier than normal because of a work function early in downtown Los Angeles. 

My first thought "I still don't feel good, maybe I should just go back to sleep".

My second thought "ya right and let the 'betes win".

If I would have laid down and gone back to sleep, the 'betes would have won.  I'm sure my Dad will read this and think "no it didn't, sometimes you are just sick".  No, it would have.  I don't have something that should ever hold me back, failed infusion set or not.

When I started the run by about 5:20AM, I felt good for about the first mile.  I started to think "maybe this won't affect anything today".  Then the second mile happened.  Dehydration, my legs felt heavy, my stomach was upset, the whole kicker for ketoacidosis.   I started to think about stopping again.  I didn't. 

I ran this morning, despite still obviously being in ketoacidosis.  I ran 4.53 miles this morning, despite still feeling the effects of ketoacidosis.  I won, not the 'betes.

This happening is exactly why I would use long acting insulin in the days leading up to an Ironman and maybe even a marathon for my balas rate then use the pump only for bolusing.   With the pump there are many unknowns with the infusion set and the tubing.  Although this won't happen again for a long time, I know in my mind it will happen again. 

As Ashley Hall (a fellow diabetic) once told me, "and no one at work that morning has any idea you went through that last night".  No they don't. 

Race this weekend, first Olympic Distance race in Vegas

1 comment:

  1. You probably know, but you didn't mention it, so I will.
    When your blood sugar gets that high you should really start drinking as much water as you can. Your kidneys have been draining you, your blood has a high concentration of sugar and ketones. The more fluid you can take in, the better. It helps with all of those problems, dehydration, ketosis, and high blood sugar.
    I know you just feel like giving a big bolus and lying down. I feel the same way when it happens to me. But I try to drink some water, rest a bit, then get up again in half an hour to drink some more and test to make sure the insulin is kicking in.