Remember how yesterday I commented that, after fasting from 8:30 am till 6pm, I was feeling better about the past week’s diabetes experiment? Not only had my new 1:8 insulin-to-carb ratio worked out well for breakfast, but I’d hovered more or less steady from 10 am till 6pm. I was feeling pretty good. Less so when I had dinner and shot up to 290 (I hardly ever do that). But at least I thought I’d correctly identified that I was having a bolus, not a basal issue — and that I’d figured out how to have breakfast.
Fast forward to this morning. I ran out of bananas (which I’ve been eating consistently for the past week, weighing them on the scale to make sure I’m eating exactly six ounces at a time) and had to get to the diabetes center at 9am. I looked in the fridge and decided to go for the oatmeal breakfast I’d been experimenting with before I started this diabetes workshop. I measured everything out. 1/4 cup dry oatmeal (normal, not quick-cooking), 2 tablespoons of peanut butter, 4 ounces of strawberries, one spoonful of plain yogurt, and a tiny bit of Splenda. It came out to exactly 32 grams of carb. Yesterday’s 1:8 ratio for breakfast worked almost perfectly, so I tried it again.
Guess what? By 11, my blood sugar was in the 200s and showed no sign of coming down, despite the fact that I biked to and from the train station this morning and climbed about seven flights of stairs. By the time I got home to my fridge (I was trying to eat something with an identifiable carb count, and so didn’t want to just grab a snack someplace) and made lunch, it was 3:30 and I was still in the 190s. I ate the lunch (43 grams), met a friend for a (non-carbohydrate) drink, tested, and was at 260. By this point, I physically felt it — no ketones, but I was groggy and irritable, with a headache spreading over the back of my skull.
Since I’m still running my experiments from last week’s class, I’m not supposed to take correction boluses right now outside of mealtimes, so I went home and made dinner — scallops, 3/4 cup blended cauliflower, and 1 cup of strawberries and took a combination food and correction bolus. I’m now finally on my way down — and am actually worried I’m going to go low. (I went from 222 to 178 in a half hour.) I’ve got an alarm set for 2am.
I’ll admit it: I am very frustrated right now. I was trying to encourage myself to be stoic — come on! It’s not that bad! Suck it up! — and then I realized, you know what? I don’t want to be stoic right now. I am really fucking exhausted. And I realized something else: when my numbers go out of range during my normal, non-experimental life, I find some comfort in the idea that I could have done better. Oh, I say to myself, if I’d only used a measuring cup for that broccoli, or if I hadn’t had that extra piece of chocolate, my blood sugar would be great. It was my lack of self control that made my blood sugars go up — an assumption that, screwy and self-defeating though this may sound, actually helps me feel more in control.
But the past week has gone against all that. For the first time in probably my life, I have been near religious in my carb counting. Save for a few pieces of cheese, I have not been snacking between meals. I have been using measuring cups and my food scale. I have been eating at home, counting every carb, subtracting the fiber, using the bolus wizard on my pump, running experiments where I fast for half the day just to see what happens. I am being as perfectly self-controlled as I can imagine. And . . . guess what? It’s been the worst week I’ve had in months. I feel physically paralyzed every time I get hungry for lunch. And far from feeling like this experiment is giving me more freedom, I’m feeling increasingly restricted. Since my basals are so reduced, my former guesstimations are off — they would now be way too low. But I don’t know by how much to bump them up. It makes me terrified to eat.
I don’t want to be like this. I don’t want to carry around a log book all the time. I don’t want to say no to dinner with friends because I’m too worried about how to calculate the carbohydrates in a restaurant. I don’t want to let diabetes get between me and my husband. I don’t want to let it stop me from having a life.
I have a follow-up appointment with my doctor tomorrow and I am very much hoping she can shed some light on how to interpret what’s been going on for the past week and a half. At this point, I really have no idea.
As a post-script, lest this sound like too much of a personal sob story (though I suppose it is a bit of that), I should also say that I’ve been reading a bunch recently about the history of diabetes, and of what treatments were available before the discovery of insulin. The best one? Starvation. (The upside: you didn’t die from diabetes. The downside? You starved to death.) Tomorrow, when I’m not so physically exhausted, I’ll post one of the articles I found about it. I may be feeling down right now, but seeing how things used to be certainly helps put things in perspective.
Confession. I have been avoiding reading the rest of your series because, after reading about your commitment to figure out your ratios “for real”, I felt guilty for not taking the repeated advice of my endo+cde for doing the same for myself. Now that I have come to my senses, I can say that I am with you 100 percent on the “what ifs” and frustrations and labors of trying to do the best thing for my body in the hopes of sanity and feeling physically+mentally well >50% of the time. Totally with you on all of these battles, which… Read more »
It has been a great series, Catherine. I’m sorry you had to go through so much frustration in order for us to have good reading material!
In my own experiment (inspired by you), I ate the exact same meal two dinners in a row – all factors within my control were the same. I was 122 after the first, and 186 after the second.
I love this whole series of postings so much. Thank you for all this blow-by-blow documentation! It’s helping me understand my own management theories, practices and superstitions much better. But I’m sorry to hear the whole business is taking its toll on you. I really hope that after the experimentation period is over, you end up with a retooled, workable set of guesstimating habits and can go back to feeling pretty free and socially/emotionally healthy. What I think is really valuable here for your readers: You’re putting the CDE’s formulaic model of diabetes management on trial and comparing it to… Read more »