Monday, August 12, 2013

The Battle of High Blood Sugars & Ketones...

I've used the word "ketones" entirely too much in this post - And I hope I NEVER have to do that again - Or deal with them again. 

I woke up incredibly tired Sunday morning and realized midway through that I was running in the 150's  #bgnow range for most of the day. 
I'd been out to dinner the night before and it was a carb filled feast and I figured the elevated blood sugars were the remnants of said feast. 
 I drank coffee, did some work (OK, attempted to do some work), did some laundry, took a walk and finally headed to the beach in the late afternoon where I spent over an hour (OK, an hour and 20 minutes,) swimming and body surfing in the Atlantic ocean  - where I left my worries in the sea. 
I'd begun my untethered swim/body surfing break  with a bg now of 170 and emerged from the ocean with a a bgnow of 140. 
I came home, decided tested again and  was 160. Still running high & still not sure why. 
I changed my site did a correction/meal bolus and an hour later started to make dinner - Not my norm, but my #bgnow was 140 so I wasn't worried. 
I  was tired from swimming and hungry, so I made a tuna salad with a handful of low carb crushed gluten free tortilla chips sprinkled on top and loaded with veggies, followed by a Popsicle and didn't think twice about it.
I'd made that very same meal a hundred times before - it was low carb and easy to bolus for. 
 After dinner I started to drag and around 10 pm, and just as I was ready to hit the sack, I discovered that not only was my blood sugar high - like 407 high, but so were my ketones. And I realized my over tired feeling had nothing to do with body surfing.  
my head was pounding, I was incredibly thirsty, and I literally felt like I was walking through J-E-L-L-O,
and every action felt like a monumental task and all I wanted was to go to sleep. 
But when I saw the 407 flash up on my meter, I knew that sleep wasn't a possibility. I went to the bathroom and emptied my filled to the brim bladder and found out that my ketones were hovering precariously between the Medium/ High ketone hues of deep mauve and purple. 
I can't tell you the last time I had moderate to large ketones and I was more than slightly freaked. I was down right worried. 
And at that moment I would have given anything to have someone next to me - telling me it would be all be OK - But I was on my own & I needed to keep it together if I wanted to do battle in the war that was going on inside me.
 I kept surprisingly calm and did a massive correction bolus of 6.2 units & downed 3/4's of a 16 ounce bottle of water and said a prayer to the Diabetes Gods re: my blood sugar, test strip accuracy & stripping safely, & keeping ketoacidosis at bay. 
I was downright methodical in my obsessive checking and tried my best to detach from the emotions and the diabetes "what-ifs" and do what needed to be done. 
20 minutes later my bgnow was 383 and my ketones were decidedly on the moderate mauve side of the ketone spectrum. I drank more water and practiced my yoga breathing. 
20 minutes after that my blood sugar was 355 and ketones were still in the moderate range. 
An hour later my blood sugar was 328,  ketones still moderate, and I made the executive decision to change my infusion site, directly followed by a 2.9 correction bolus. I finished my bottle of water and started a new one & set my alarm to wake me up at 1:45. for 1:30 a.m.
But I couldn't sleep, not one bit. I tried to stay calm and thought about the waves I'd caught earlier in the afternoon. I thought how the ocean temp had been perfect and how great it felt to ride a wave from chest deep water to calf deep water without breaking the wave's crest and how I was kind of doing the same again - except the waves were blood sugars and ketones instead of the salt water waves of the Atlantic - And how I had to ride out the high ketones and blood sugars in order to make it so shore in one piece. 
I finally got up at 1:45 a.m. and tested again. I was 279 & much like Elivis, "my ketones had decided to leave the building." They were suddenly non existent, disappearing as quickly as they'd appeared, like footprints in the sand as the tide rolled in. 
I drank more water and waited another 20 minutes - I tested for ketones again and there were none, so I went to bed. 
My alarm went off at what seemed like an ungodly hour this morning and I woke up to overly filled bladder, a 153 blood sugar and zero ketones. 
I hit the snooze button, emptied my bladder, turned on the coffee maker bolused for said coffee and went back to bed for a half hour. 
30 minutes later and with a #bgnow of 81, I dragged myself out of a bed and poured myself a steaming cup of coffee.
It's Monday and my work plate is more than full. I am battle weary and tired, and for the first time in years I'm glad that I wear glasses, because they cover the huge bags under my eyes. But no sleep and baggy eyes aside, I won the war against the raging blood sugars and ketones - And to the victor goes the spoils and yada, yada, yada. 

Still, winner or not, I feel like diabetes kicked my ass to the curb and then jumped the curb and ran over me with a bus & did a victory lap up and down my body. 
But it my head I know diabetes didn't crush me. And no matter what today brings, I know that diabetes didn't win - It happened, it's over and I now require major amounts of caffeine.


Callie Roberts said...

wonderful I shared on FB

Laddie said...

Sounds like you handled everything well and glad you won the battle over that bad boy diabetes. What I always find frustrating over instances like this is that usually you never know why it happened.

I had a day like this recently. I didn't feel at all nauseous until I saw the purple pee strip. Then major yuk! Before it was over I had used two new infusion sets, a new reservoir, a new vial of insulin, and a hefty injection. Still don't know what the culprit was.

DuG said...

Is it just me, or do you also worry that there is not enough caffeine in the world to help you after a night like that?
Sorry you had the fight, but happy you came through with only scratches. Nice job ;)

b2212 said...

I actually just blogged about this myself. I had a diabetes all-nighter last night, blood sugars so high the meter couldn't read them.
Lucky for me, no ketones. No idea why but I'm thankful they didn't make an appearance!

Karen said...

Oh Kelly. It makes me so angry that diabetes did that to you. And that while I was getting glucagon Sunday night, you were battling ketones. But I'm so proud of how you handled it, and I hope it's a good long time before the ketones ever make another visit.

Kate Cornell said...

I just finished reading Karen's post about her low and taking glucagon and now I read about your high and ketones. Crikey! I'm sorry and I'm impressed at how well you handled this. Oh, and your analogies in this post are awesome!

Scott S said...

I had a similar experience about 2 weeks ago; it must be something going around the D-o-sphere! Its one of the ridiculous things about living with a chronic illness like diabetes, which sometimes simply does not follow the supposed rules its supposed to. If there is a bright spot to any of this is that you're experienced and knew how to handle it pretty well. When I was pumping, I went right to an injection to make sure I wasn't dealing with any kind weird kind of infusion problem. The point is you handled it like a pro (actually, better than a pro since I think may CDEs would probably flip out if something like this happened).