Fun times (not)

Well I had a fun evening last night...

I was making dinner, when I went to drain the potatoes and somehow managed to pour boiling water over my hand. Luckily, I was next to the sink, so I quickly stuck my hand under the cold tap, but it hurt like hell. I dealt with it as best i could, wrapped my hand in a wet towel, and kept going with dinner.

When dinner was ready, I tested my BG and discovered it was 15.4. I was a bit surprised, since I'd been fine a few hours earlier, and my basals are ok over that period. I tested for ketones (don't ask me why, the rules are supposed to be that you check if you have two consecutive readings over 14, but it was such a random high I wanted to check) and got a reading of 0.6... Now I know that's not particularly high, but it's the highest ketone reading I've had in years, so I was a bit concerned.

I checked the pump and my site, and everything seemed fine, so I figured it was maybe a reaction to the burn, and bolused for a correction and my food (yes, I know, I'm a bad diabetic eating when I was so high, but I was hungry dammit), and then felt something....odd at my infusion site. I put my hand down to the site, and it felt damp, and I realised I could smell insulin on my fingers.

Oh joy.

I changed out the site, put on a 200% temp basal, and then tried to decide how much, if any of the bolus I'd received. I decided to assume that I'd got most of it (the site was damp, but not *wet*), and just keep an eye on my BGs. I checked a couple of hours later and I'd come down to 12, so I went to bed and set an alarm and was 5.4 at 3 am, and then 6.4 when I woke up.

I'm not entirely sure how that worked out so well, but I'm not going to complain!

You'd think after 22 years of being diabetic I'd avoid the rookie mistakes, but no...

I decided to treat myself to some chocolate after lunch and completely forgot to bolus for it, which lead to a lovely 15.1 at break time, and me making confused faces until I realised what I'd done (thank goodness for the bolus history on the pump!).

I managed to end up back down to a more reasonable 6.9 within three hours though, which I was rather pleased with! :D

I would like my immune system to start behaving properly now please...

I haven't posted on here in ages, mainly because life has been a bit hectic - buying a flat with Stuart at the moment, holidays, and to top it all off apparently my immune system is not content with trying to destroy my pancreas and my joints, and so it has now decided that my liver must die. As a result of which, I'm currently in the process of being diagnosed with autoimmune hepatitis. So I've been feeling quite pants.

It's been...interesting. It all started when I had my hypo seizure at the end on June, when they noticed that my liver enzymes were a bit elevated (apparently the proper medical term in "deranged" *grins*), so they asked me to follow it up with my GP, who ran some tests and couldn't find anything, and so referred me to the liver clinic at Addenbrooke's. At this point, I was feeling fine, so I wasn't too fussed, but then I started feeling ill, and turned a bit...well...yellow. And then I saw the doctor at the liver clinic who said that my liver enzymes were now really quite high, and suggested it might be autoimmune hepatitis. Basically, my immune system wants to kill my liver, for reasons best know to itself, which is resulting in liver inflammation and general dysfunction. It's taken a lot more tests, including a biopsy, to confirm, and even now I still haven't actually seen the AIH specialist to question him about everything, and that's not happening for another couple of weeks. The liver doctor I saw initially called me back in to get me started on medication, as he didn't see any point in hanging around while I was jaundiced and feeling like crap. Apprently the results suggest I have an unusual form of AIH, in that it's a kind normally seen in children but not usually in people my age, so they're a bit surprised.

My blood glucose levels went through the roof when I started feeling ill, as a result of which I ended up on about double the insulin I was on before. The diabetic clinic aren't hugely surprised (apparently liver inflammation will do that to you), and have generally recommended testing lots, using corrections and temp basals where necessary, and getting in touch if/when I feel like I need help. This is what I've been doing for the last couple of months, and my BGs in general haven't been too bad. However, I've just started on the treatment, which is corticosteroids, and I've been told that this is likely to be a long term thing, although hopefully on a decreasing dose.

My main concern is the effect it's going to have on my BGs. After 24 hours of being on them, I woke up with a BG of 17.8, which just refused to come down. I corrected, used temp basals, and kept an eye on my ketone levels, and managed to get things into a somewhat reasonable level by dinner time. It's been a lot of juggling trying to get things all to match up, and even now I still don't think things are quite sorted. I'm not sure whether there will be some kind of transition period while my body gets used to the steroids, and then my BGs will come back down, or whether they're going to stay up. Despite the fact that AIH is apparently more common in people with another autoimmune disease like type 1 diabetes, I can't find much information online about what to expect, which I'm finding slightly frustrating. I'm looking forward to my appointment with the AIH specialist so I can ask him everything. I might have to get in touch with my DSN before then though, as I'm currently using 90 units of insulin a day on basal alone, and I have no idea if that's going to go up... O.O

I have to say, though, I've been massively impressed with my GP and my diabetic clinic, who have been really on the ball and helpful, chasing things up, explaining what's going on and generally offering lots of support. I had a pump/annual review just after I saw the liver doctor the first time, and when I explained to my diabetic doctor what was going on, he spent ages going through everything with me, and was really quite lovely about the whole thing. I am very much YAY! NHS! at the moment! ;)

Ups and downs

My little diabetic world has been a bit topsy turvy recently, and it's left me feeling a bit out of sorts.

I think I was a bit more shaken by the seizure last week than I originally realised, because I have completely panicked and overtreated two lows since then. And then yesterday I ran high all bloody day, and had site issues (my first gusher, and another site I wasn't convinced was working). I worried all day about trying to get my BG down, wondering if the same thing was happening with absorption as I suspect happened before my seizure, and being very cautious about trying to bring it down, but being incredibly frustrated with the whole thing. I think I would have been less concerned if I hadn't had the seizure last week, and, while I know I have to take what I can from the experience, it's bothering me that it's having this much effect on how I'm managing things.

In addition, I'm still a little bit worried about my liver and I'm feeling like crap because I stopped taking tablets for my hayfever. The doctor had given me the names of some other things I could take for the hayfever, but they're nasal sprays and I really don't like them, so I figured I'd just deal with it. Except it's kicking in properly now, and I felt like pants all day yesterday so I caved and picked up some Beconase today. I also have a bit of sunburn from the weekend, so all in all there's about a million things that could be affecting my BG right now and I don't like it. *scowls*

However, it's not all bad. The reason I have sunburn is because I went to the DS meet up in Brighton on Saturday, and had a fantastic time. It's so nice to meet up with people old and new, and there's something about talking about diabetes (among many other things) with a bunch of diabetics that is just amazing. No-one else really *gets* it the same way, and I had a great time on Saturday chatting away, and also sitting on the beach, wandering along the pier, and eating ice cream in the sun. :)

I don't know where my towel is...

I seem to be having a day of over-reacting to things. I woke up to a lovely blood glucose reading of 16.7, which appeared out of nowhere. I was due a set change, and looking over my logs it occurred to me that I've woken up high on the third day of the last three sets. I'm normally ok changing every 3-4 days, so this is unusual for me, but maybe it's due to the heat or hayfever or something.

Anyway, I make a note of it, and change out the set. Now, the last couple of highs I've had like this have been stubborn, and it's taken extra corrections and an increased temp basal to bring them down, so I decide to be a bit aggressive and increase my correction by about 20%, and put on a temp basal of 140% for two hours, similar to what I'd ended up needing before.

Only, two hours later we're about to go for coffee, and I check my BG and discover I'm at 4. That's a drop of 12.7 in two hours, and I still have insulin kicking around... I grab a handful of skittles, bung some sugar in my tea and have a couple of slices of toast, since I missed breakfast, and underbolus for it all, ignoring the little voice in my head that's telling me that I'm usually quite sensitive to carbs for a while after a high like earlier.

Two hours after that and I'm sitting at 11.5. Damn that little voice, I should have listened to it. I correct, have lunch and bolus as usual, and three hours later I'm 12.9. Dammit.

If I hadn't overreacted to the morning high, I probably wouldn't have got the midmorning lowish number, and then I wouldn't have panicked and overfed it. I *know * that I tend to be insulin resistant for a while after waking up high, so the sensible part of me knew that I should have bolused for what I'd eaten at break. It's so hard to fight that panic when you think you're heading for a low, though.

Ah diabetes, it's never simple, is it?