Spring Travel; Diabetes, High Ketones, Normal Blood Sugars, And The Stomach Bug From Hell

OK-first and foremost  — spring has finally sprung. YAY!

Secondly, sorry for the being MIA the last couple weeks. 

I came home from a work trip on the night of Tuesday, April 24th, with a 101.2 fever, Moderate to Large keynotes, and the stomach virus that has been the plague of spring 2018 for many — and it was horrible. 

It was the longest car ride home of my life and an hour after I walked in the door and 55 minutes I found out I did indeed have Moderate/Large ketones, (literally the color was somewhere between the two on the chart,) I Linda Blaired it, a'la "The Exorcist." 

I immediately felt slightly better and made a deal with myself. 

If my ketones went down to moderate in 80 minutes and I didn’t vomit again, 

I wouldn't call 911.

If either of those things happened, I would. 

I filled up my 24 once water bottle and immediately drank 1/2. 

15 minutes later I finished the other 1/2 and filled up the bottle again. 

I was scared but I was calm  — weirdly and mythodically so. 

I knew what goasl I needed to meet and had made peace with my plan B option. 

Yes, I was scared, but knowing that I had a plan helped me stay calm.

Luckily, 80 minutes later I checked my ketones and they were indeed  moderate, I didn’t vomit again and I downing drinking water. My blood sugars were normal with insulin on board. I drank a little juice and went to bed. 

I woke up in the middle of the night, checked my blood sugar and  keytones ( 109 bg and small to moderate Keytones on the color chart), downed 10 ounces of water and went back to sleep. 

I woke up Wednesday with small ketones, that quickly and thankfully moved Trace, and finally edged to Normal by Wednesday afternoon. My fever kept shrinking until it left me for good on Friday.

Which would be the exact day the whole, not being able to be too far away from the bathroom, thing kicked in with a vengeance. 

I continued surviving on Mixed Fruit flavored gatorade, saltines, and weak black tea because those were literally all I could stomach. 

After 5.5 days,I was finally was able to drink coffee (and leave my house,) Sunday, April 29th. 

The last day of April and the first day of May meant working on deadlines and I flew to Boston on May 2nd. 

Dealing with all of the above reminded me of some important things that I'm going to share with you. 

1. We ALWAYS need to bring Keytone Strips/Keytone Meter and thermometer when we  travel — and even if we're only going away overnight 
2. Why? because you can have normal-ish blood sugars and still have nasty keytones — even if you drink lots of water. And if those sneaky keytones get the upper hand, no good will come of it.

3. You can feel “off,” but because diabetes can be a tricky bitch, your blood sugars might not reflect that. I felt tired and in need of a nap early Monday afternoon - but my blood sugars were stellar and I wrote it off as  travel day fatigue. 

But it was an easy travel day by car. Looking back, feeling that tired was a sign of things to come.

Also: You can feel hot and blame the traveling and hotel air conditioning, but it might actually be a fever. I was walking around with a fever that alternated to the chills for a good part of Tuesday - and I blamed the forced air heating and air conditioning system. 

Here are my stats from Tuesday, April 24th. 

For the most part, everything looked "OK," numbers wise. 

Insulin total breakdown for 24 hours on 4/24 

Bolus history 4/25

4/24 bg from early in the morning.
Elevated morning bgs thanks to a low bg
in the middle of the night. 

4. ALWAYS make sure that you not only have regular ginger-ale in your pantry, but 3 or 4 bottles of your favorite flavored Gatorade and saltines, because if you end up with the stomach virus from hell, regular Gatorade is your best friend. It helps keep your hydration levels and electrolytes where they need to be, gives you drinkable carbs, and is the only thing (besides maybe a few saltines), that won’t add to the destruction of your gastrointestinal system.

5. Also, stomach viruses can be f^cking tricky, not to mention confusing. 

I had damn near normal blood sugars ( Bgs were constantly running on the low side of normal), for 5 days — it was like I was like my pancreas was messing with my head and I was this close to thinking that I was making insulin. But I was still “real people sick," and barely eating anything. 

6. Sleep is your friend and hydrate like your life depends on it — because it does.

7. Stomach viruses NEVER come at the right time and playing catch up is not easy — but you do it because you must. 

I’ve had trips scheduled the last two weeks and I travel again on Thursday. 

Sharing all of the above because it’s diabetes and life related and I think we need to be reminded that everything can look good on the surface, but there can be a literal shit storm (sorry I couldn't resist,) brewing - So check your blood sugars and your keytones!   

New blog posts re: what I learned on my travels soon!

***FTR, when I was down for the count being real people sick, I made sure to let a couple close friends and family know what was going. I live by myself and like to think I can handle it all - but when I'm under the weather, I let a few of my "go-to," friends know.... just in case I need help. It makes me feel better - and it makes them feel better. 

My Experience: Diabetes + A New Virus That Mimics Severe Allergies = Steroids & Antibiotics~

This will most likely be the last post re: my sinus/upper respiratory infection drama for a while - I’m sick and tired of writing and bitching about it and I'm sure your starting to get tired of hearing about it. 
BUT with that being said, I'm writing about my experience today because I believe it’s important that:

1. You know about a new virus that mimics sinus/allergy issues and will knock you flat on your ass and make you VERY sick - And yes, I'm speaking from experience & I don't want you to go through what I did
2. Get the proper diagnoses and treatment
3. Take control (and the power,) from the steroids that may be prescribed to you to fight off the infection, but will reek havoc with your blood sugar numbers and insulin requirements... if you let them~

#####

Turns out my visit to Sinus City last week that I wrote about HERE, not only took a wrong turn, but was actually misdiagnosed and developed into a severe upper respiratory virus/infection, with bronchitis, laryngitis, pharangitis and a touch of trechiatis all rolled into one. Cripes, no wonder I felt like crap! 
Like most of the country, I’d been misdiagnosed with allergies and sinuses, when in actually, I'd developed a severe upper respiratory infection and on May 12th and was given an antibiotic - but it didn’t work. 
What I actually had was a new strain of an upper respiratory virus that’s been making the rounds and fooling doctors offices and ERs around the country, and I was sick as a dog by my Birthday, which was May 14th.
I couldn’t stop coughing and ended up pulling several muscles in my abdomen from 24X7 hacking. I had no energy; no appetite, no voice, breathing issues, especially at night. 
It was incredibly difficult to catch my breath during/after coughing, and I ran a low grade fever up until I was finally able to see my ENT on 5/21.
My ENT not only gave me the proper dx, but prescribed a new, stronger 14 day-antibiotic and a 6 day prednisone pack. 
And as much as I hated going on Prednisone for 6 days - I knew I was sick and I needed to get better.
And 6 days later - after taking my last prednisone pill this morning - I feel SO MUCH BETTER. 
I’ve written about steroids and diabetes extensively on this blog and I will continue to whenever I feel the need to.
Most PWDs know that steroids are a bitch re: high blood sugars and require copious/continuous amounts of insulin - but steroids are helping to cure my upper respiratory infection and I’m grateful for them.
Many PWDs allow themselves to run high their entire time on the steroids for fear of high temp basal rates and risking lows. 
I get it, but that doesn’t work for me. As someone who is blessed to wear an insulin pump, I’m not afraid to embrace high temp basal rates and check my blood sugars copiously while on steroids.
Is it a bit scary to have crazy temp basal rates? Yep, for sure. 
But as long as you check your numbers like a crazy person and accept the fact that temporary basal rates are indeed temporary - you’re going to feel better sooner because you’re not going to feel the constant affects of high blood sugars while you’re on the road to better.  
What goes up does indeed go down & reminding myself of that makes it easier to shake off the WTF feeling of my temporary ,but large amounts of daily insulin requirements.
my basal rates started at a 50% increase and the highest was a 200% increase and everything in-between. 
Here are my 24 hour insulin requirements since I started prednisone:  

5/21 60 units 

5/22  137.45 units  - 5 units of insulin an hour 
5/23: 163.70- 6.20 units of insulin an hour -
5/24: 142.25 units - between 4 and 5 units of insulin per hour
5/25: 121.35 - 4.8 units per hour
5/26: 107.25 (updated,) 4.2 units per hour
Please keep in mind that these numbers represent how my body reacts to the steroid called prednisone - Your diabetes may vary~

The number of high blood sugars i've experienced have been surprisingly minimal - maybe once a day. 

Yesterday my blood sugars didn’t go above 160 and the day before they didn’t go above 140. 

This morning I forgot to turn my pump back on after I showered and ended up with a 300 bg by 10 AM, BUT that was my bad, prednisone had nothing to do with it. 
*** Updated 5/28: 
Yesterday's (5/27) insulin total was 65.5 units in a 24 hour period with a temp basal rate between 1.9 and 2.8 units per hour. Not normal but well on the return to normal. 
Now that I'm off the steroids, I'm not feeling as energetic as a did when I was on them, coughing every now and then and scratchy voice.
Yesterday was day 7 on the antibiotics and yours truly I experienced stomach issues and nausea for the first time - which according to my Pharmacist, is normal. 
But I'm getting better!

If you or your loved one have been dealing with any sort of sinus or allergy issues, and if your cough doesn't get better, go to the Dr. asap so you can rule out this new virus strain. 
People are ending up in the hospital because of this strain - especially the elderly and those with compromised immune systems - and nobody wants or needs that. 
Xoxo, 
k2

Lost In Sinus City

Sinus City, as in real people sick since last Thursday, which was also my birthday. 
I'm talking sick in the head - As in head so clogged I can barely hear and coughing so much from the dreaded post nasal drip that the back of my head aches from my brain continually rattling in my skull. 
I think I pulled a muscle in my lower abdomen from coughing and every time I try and rest, my head needs to be propped up on a 90 degree angle. 
If it’s not chicken matzo ball soup with sriratcha or popsicles, I don’t want to eat it, and the antibiotic I was put on last Tuesday doesn’t seem to be doing much of anything 
All I want to do is sleep and I’m tired of feeling this way. 
Up until 2008, I never suffered from allergies or sinus infections and this Spring has been the absolute worst by far. I’ve become a person who constantly carries tissues in her handbag, keeps a box of tissues in her car and is generally miserable unless she has antihistamines at her disposal at all times - and even then I still feel and sound like crap. 
Luckily, the laryngitis that arrived on Thursday, departed this morning, but my normal voice has not returned. Basically I sound like a man, baby.  
Or as various family members have told me: I sound like Brenda Vaccaro in those tampon commercials from the 1980s. LOVELY. 
Sidebar: My siblings, cousins and I watched way too much television when we were kids. 

Appointment with an ENT Thursday morning and hoping that I will be better by then. 
So far, diabetes has played nice - Actually, diabetes has been a walk in the park compared to whatever war that has erupted and continues to reek havoc with my sinuses.


Today I'm trying to catch up on everything I missed in my Sinus City haze and come hell or high water, I will be blogging in full swing tomorrow - But wanted to update you regarding my lack of posts, lack of energy and being lost in Sinus City. 

FYI: Insurance Co's - Life With Diabetes & Dealing With/Trying To Prevent "Real People Sick" = A Lot Of Insulin, Test Strips, Infusion Sets, ETC.

I’m thankful that I have technology and the extra insulin to fight off whatever’s going on inside me right now. But the cost of the all the extras is stressing me out and puts me on the defensive with my insurance company - And I don't feel like playing defense all the time - especially when I'm trying to prevent "real people" sick from occurring.
Why do I, and by “I” of course I mean “WE,” need to continually play defense, even when we feel like skipping the game entirely and sitting on the sidelines until we're ready to grab the ball. 
And yeah, I can't believe I'm using a sports euphemism - I'm so much more of an "Arts & Entertainment" Chick. 
#####
Because I’m fighting off some sort of something in the cold/infection variety since Sunday, I’ve been dealing with elevated blood sugars, a scratchy throat and slightly higher than normal body temp between 98.9 & 99.2. 
I've been popping extra Vitamin C, craving early bedtimes, chicken soup and spicy food.   

And because of diabetes technology, I’ve increased my temp basal rate to 129% and that seems to keep my blood sugars in the normal range and I can go about my day without skipping to many beats. 
It also means I’ve been going through insulin like water (between 54 and 56 units per day on average since Sunday) and the same goes for infusion sets. I’m literally changing out my site every 24 hours - And not because I want to, but because it’s been syphoning so much insulin subcutaneous , it literally craps out somewhere between the 24 & 32 hour mark. 

The good news: Like I said, nothing has to be put on the back burner during the day and fingers crossed that soon I can get back to a normal amount of insulin. 
The not so great news: How does one explain to their insurance company that they are going through insulin and infusion sets because their body is actually preventing "real people sick," from occurring, thus requiring  a shitload of insulin, test strips and  pump silhouettes in order to do so? 

Your diabetes may vary, (YDMV) doesn’t fall into the insurance RX math of diabetes. 
Not only do insurance companies not understand the “diabetes math” of it all, but that don’t understand that that “your diabetes may vary,” depending on the day, the week and the year. 
You might be staving off an infection in January that require copious amounts of everything - no matter what the insurance company thinks you require. 
Which means by the time you're better, you’ve already gone through 1 box of Silhouette infusion sets and have started into your second box, both of which were part of the four boxes included in your 3 month supply (FTR: I have pay extra for that fourth box,) that was delivered on December 29th. 

No matter if you’re using a insulin pump or multiple daily injections, when your body is fighting off an infection and trying its best to stay healthy, you’re going to require more insulin and supplies - And don’t even get me started on dead spots and scar tissue.  Insurance doesn’t understand or care. 
I’m lucky, my Endo gives me insulin samples  - And I still have a 3 unopened bottles before my mid February appointment - but by the looks of things - I’m going to  be cutting it close. 
As of today, I've gone through one whole bottle of insulin since January 10th.  
This afternoon I will start a new one - What if I go through that one in 13 days? 
What about PWDs who don’t have insurance? 
What about Children in developing countries who don’t have access to insulin? 
Sidebar: Spare A Rose is just around the corner, you can literally  “spare a rose, save a child,” and provide 1 month of insulin for a child in a developing country for just 5$
And you know what? It's the best 5 bucks you'll ever spend! CHECK IT OUT!

People with working pancreases require more insulin when they’re fighting off any sort infection, so do we. 
People with working pancreases require more insulin when they eat certain foods. 
So  do we.
We have to pay for our insulin, infusion sets, test strips, extra and otherwise - And we have to pay extra when our bodies require extra - And that SUCKS. 

I wish insurance companies would allow for a cushion, a backup of supplies for all the variables of life and life with diabetes. 
Real people sick/preventing RPS and what is required for both. Insulin requirements varying from day to day, sick or not. Deadspots, tile floors and their magnetic pull towards the last bottle of insulin. Error messages on meters and CGM transmitters that get funky before their time. 


Anyway, that's how I'm feeling and I just needed to share, because I know I'm not the only one who's dealing with all of the above - And we are in this together.