This is Diabetes Blog Week, and I’ll be writing all week on a variety of D-related issues. Today: A day in the life.
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Diabetes is a strange thing. It’s part of me, but it’s outside my control. As Jessica Bernstein said on Diabetes Mine last month, the best I can do is influence my blood glucose numbers. I can’t hate diabetes without hating myself; but if the ‘Betes were another person, I would probably say that I hated it the way treated me on a regular basis. And yet, it’s also inspired me to make changes and take risks and to go beyond my comfort zone on an almost daily basis. Today was such a day.
Most of the time — for me at least — these excursions beyond my comfort zone aren’t very exciting. It’s not like I’m pushing the limits in adventure activities or in the Olympic games or in world-class professional bicycle racing. It’s true that I do like to ride my bike, which means almost daily changes to my insulin pump therapy. And I also like to travel and do (tame) “adventure” things, like going to crazy places and driving an RV. But the things that make me the most nervous are the ones where my diabetes might get in the way of working with other people.
For example, let’s consider this morning. I went to the dentist. The stuff of adrenaline-fueled adventure magazines or inspirational speaking, eh?
I woke up with a high blood glucose: 300ish mg/dL, and I gave myself some insulin to correct for it.* I’m more sensitive to insulin in the morning than later in the day. At least I think I am; I’m getting closer to having better pump settings after losing about 35-40 pounds over the last year and after years of never really knowing the right settings. Anyway, I took a slightly lower than recommended amount of insulin for the correction, and then I had breakfast (and more insulin) at work about two hours after my first bolus. Before eating my Monday morning chocolate croissant indulgence, my blood glucose had come down nicely to 220.
An hour and a half later I brushed my teeth.** And then I thought, “I should test again, since I’m going to be driving and away from food, and I have that extra insulin platooning around.” I was expecting something sorta high but not too bad. So I was surprised by an otherwise very good 139.
And this is when I kinda freaked out . . . in my own stoic way. “139! I have to go to the dentist, which means I won’t be able to eat for an hour or so. And I’m on a downward trajectory. And I had expected to be higher. I mean 139 is very good. I should be happy. But I don’t wanna say have to say, ‘Doctor, can we stop with the filling? I feel funny and I need to check my blood and maybe eat something.’*** Ohmigod that would be so embarrassing and betray the fact that I really don’t have my shit together. Gosh, I really don’t want anyone to know about that. I should never write that down. Let’s just eat a banana, why don’t we? Ack! A banana after brushing my teeth. Ack! Well that’s done. You know what, Imma fill up my water bottle and hope that I can ‘clean’ my recently brushed teeth on the drive to the dentist’s office. I hope that doesn’t make me need to pee while I’m getting the filling. You know what, I’d better bring my toothbrush and toothpaste along, too. Awesome. I can hold onto my toothbrush along with my meter while I sit in the dentist’s chair. Gosh, I hope my blood sugar doesn’t go any lower. I’m a total freak show. Get it together.”
Okay. Banana: eaten. Water bottle: partially filled. Toothbrush and toothpaste and BG meter: check, check, and check. Dignity: mostly recovered. Confidence: bruised, but holding. Out-of-the-office e-mail: late, but sent. Car keys: let’s roll.
A mere twenty minutes later I’m sitting in my car in the commuter lot in Newton Centre checking my blood before walking the half-block to the dentist. 132 mg/dL. “W.T.F. Breakfast and a banana! I should be golden — or at least going up. Let’s eat some glucose tablets. I needed to brush my teeth again anyway.” It was probably unnecessary but at this point it’s the diabetes equivalent of holding on to a security blanket or whistling past the graveyard.
And everything goes fine. No low blood sugar while in the dentist’s chair. In fact, I finally start to go up and have to correct a tiny bit the other way afterward. And the rest of the day is golden.
And that’s today’s path through the Choose Your Own Adventure™ that is diabetes.
* — I say “300ish” because although my meter said 317, I suspect in retrospect it wasn’t quite that high. It seems that if I don’t get quite the right amount of blood into a test strip, my new-to-me meter will give a value that’s higher than it actually is. (I like my new meter, the One Touch UltraLink. It talks to my Minimed Paradigm pump, after all. But starting testing as soon as it sips the first drop of blood and then potentially being off by by 20% for an incomplete sample… Damn! But I only learned that this afternoon when I did a little impromptu experiment.)
** — I hate brushing my teeth at work. It seems a bit obsessive. At least that’s what I think about the people I see brushing their teeth at the office. But I believe it’s a felony — not to mention plain-ole nasty for everybody — to go to the dentist with anything other than freshly brushed teeth. So I brushed them for the second time in a few hours.
*** — Except that I would have gauze and a little mirror and a drill in my mouth so it would probably sound something like, “mmrphr mmm mee mrphp miff ma fiwwing?” etc.
Ah yes, eating at the dentists office. That reminds me of the kid at the clinic when I was young who was eating a Snickers bar in the waiting room. Someone casually said something along the lines of “Eating candy at the dentist’s, eh?” To which he responded, “I’m just here because my sister needs a filling.”
For the record, I was getting three “fillings” today — except that they aren’t really fillings. (Although if you’re my insurance company, they totally are.) It seems that over the last 25 years or so, I’ve been a bit too vigorous in brushing, and have “abrasions” on three molars, where I’ve worn away the enamel to expose the dentin underneath. My fantastic dentist is just putting some “enamel” back over it, so that I can “go to work on that over the next 10-20 years.”
