The theme of my post baby diabetes management has been a sharp decline in planning, time, and attention devoted to controlling my blood sugars, particularly in contrast to my meticulous management during pregnancy (Read about Kelsey's diabetic pregnancy here). For the most part, I've been able to maintain adequate control despite this deficiency in organization.
In the last 24 hours diabetes has taught me a couple lessons, unfortunately learned the hard way.
Yesterday, around 10:00 a.m., I accidently ripped my infusion site almost completely out of its home on my left hip. Unfortunately, I had recently removed my spare infusion set from my bag. So, there I was, at work, about to attend a meeting, and I had none of the supplies I needed to sufficiently fix my pump set.
It appeared that the cannula was still barely holding on, so I pushed it into my skin and secured the site with packing tape! My blood sugar was 140 mg/dl, so I bolused a quarter of a unit and headed to my meeting. A little less than two hours later my blood sugar was 124 mg/dl. I figured the pump site was still working, so I bolused 2 units of insulin for my turkey sandwich on whole wheat. I didn't see or feel any insulin pooling up underneath the packing tape, so I figured I was good.
Nope, with .08 of a unit remaining in the bolus, my pump beeped and displayed a "Blockage Detected" message. I tried to convince the pump that there wasn't a blockage, but it didn't agree with me. The darn thing quit pumping.
I waited 45 minutes or so, and could tell that some of the bolus got into my system because my blood sugar was going down. I ate my sandwich and started preparing to leave work for the day. Since the pump wasn't working anyway, I pulled out the site and discovered that the little machine was correct; the cannula was all kinked and blocked. Little droplets of insulin had formed around the tubing.
Upon arriving at home, my blood sugar had crept up to 210 mg/dl, after going a few hours without any basal insulin. I changed out the reservoir (it was low on insulin anyway) and inserted a new infusion site. A correction bolus of 2 units and an hour long walk with my mom and Sienna put my blood sugar at 115 mg/dl by 5:00 p.m.
What's the obvious lesson from this experience? I should always have extra pump supplies with me. Being unprepared turns a little inconvenience like pulling out my site, into a big nuisance where I have to leave work early and interrupt my whole day to remedy the situation.
Ultimately, as a one time occurrence, this wasn't a big deal. Luckily my workload was light yesterday and I ended up spending the afternoon with my mom and daughter, which was a nice break from my daily routine. However, had my site ripped out on a busier, more hectic workday, I would have really been kicking myself for not having extra pump supplies on hand.
The other recent lesson I learned involved a low blood sugar. This morning my blood sugar was high because I overcorrected for a low at 2:30 a.m. I corrected with 1.25 units of insulin and went about getting ready for the day. I considered testing before we left the house, but didn't. Then, after dropping Sienna and Dennis off, I thought perhaps I should test before starting my 20 minute drive to work. Again, I put it off.
I was sleepy on my drive, but attributed that to needing my morning coffee. When I got to my desk, my blood sugar was 59 mg/dl. Yikes! Luckily I function well when my blood sugar is low. However, it's disconcerting that I didn't feel low, just kind of tired.
Again, the lesson is obvious: test after giving a correction bolus! And, for that matter, I should test before driving when it's been more than an hour since I last checked my blood sugar.
Both of these situations stem from a general lack of diligence toward my diabetes management lately. Now that I'm a parent, I ensure that Sienna always has the extra diapers, bottles, and other supplies she needs. My focus used to be on myself, making sure I had everything I needed to control my blood sugar effectively. I need to remember to pay attention to my own needs too.
These experiences are reminders that not planning ahead and being organized can have serious ramifications for my health and safety.
Read more from Kelsey on her diabetes management since her pregnancy!
Published On: August 29, 2008