The saga of my broken elbow continues and I had to return for surgery again yesterday.
Unlike the first time, the surgery was scheduled after lunch and the “diabetes card” for the first appointment no longer works since they have seen how well I cope.
I was advised to be Nil By Mouth (NBM) after 6:30am although my surgery was not until after 3pm.
My usual breakfast is fruit but I chose to have yoghurt as the carb content is written on the tub so my insulin dose was likely to be more accurate. I was conservative with my dose to avoid a hypo which would break my NBM. At breakfast time, my BG was looking good at around 5.5, especially as I was expecting my slight surgery anxiety to kick in … or kick my liver into a dump.
My pump has an auto suspend function - when my CGM detects my BG is heading towards a hypo, it suspends the basal. But it is not full HCL - it does nothing when my BG goes high. I also double checked my CGM before breakfast to ensure the auto suspend was working from a reliable number.
Despite my careful, conservative carb counting, by 10:00, my BG was getting low enough for the auto suspend to kick in. It stayed below 5.5 for the next 4 hours. I partook in no exercise since the weekend, have drunk no alcohol for the last week and, as I mentioned, a had slight surgery anxiety. It was as if my liver had just stopped dripping glucose … or my pancreas had started working after 20 years.
As the surgeon came round for his pre op rounds everything woke up and my BG started rising. From previous experience, I know that after more than an hour of auto suspend, my basal is lacking so I gave myself an additional bolus boost for the 2 hour surgery. This seemed to work as I woke at around 5 with no sign of a hypo.
Then my BG started climbing. By the time food arrived, I was at 8. By the time I got home, I was at 17 (as checked with a finger prick) even though I had correctly bolused for the sandwich and small flapjack (yes, I know a flapjack is probably not the best choice but it was a cherry flapjack and I deserved it). With a few hours of rage bolusing and increasing my basal to 160%, I was back down to 10 when I went to bed at midnight. I would liked to have been lower but it was going in the right direction and I needed my sleep.
This morning I woke with a BG in the 7s. A little higher than usual but acceptable.
Sorry, this has been a long post but it highlights
- how weird our bodies behave sometimes
- how amazing they are when they work (if I did not have diabetes, I would have been oblivious of the “sleeping liver”)
- how grateful I am to have a pump in times like these.
Unlike the first time, the surgery was scheduled after lunch and the “diabetes card” for the first appointment no longer works since they have seen how well I cope.
I was advised to be Nil By Mouth (NBM) after 6:30am although my surgery was not until after 3pm.
My usual breakfast is fruit but I chose to have yoghurt as the carb content is written on the tub so my insulin dose was likely to be more accurate. I was conservative with my dose to avoid a hypo which would break my NBM. At breakfast time, my BG was looking good at around 5.5, especially as I was expecting my slight surgery anxiety to kick in … or kick my liver into a dump.
My pump has an auto suspend function - when my CGM detects my BG is heading towards a hypo, it suspends the basal. But it is not full HCL - it does nothing when my BG goes high. I also double checked my CGM before breakfast to ensure the auto suspend was working from a reliable number.
Despite my careful, conservative carb counting, by 10:00, my BG was getting low enough for the auto suspend to kick in. It stayed below 5.5 for the next 4 hours. I partook in no exercise since the weekend, have drunk no alcohol for the last week and, as I mentioned, a had slight surgery anxiety. It was as if my liver had just stopped dripping glucose … or my pancreas had started working after 20 years.
As the surgeon came round for his pre op rounds everything woke up and my BG started rising. From previous experience, I know that after more than an hour of auto suspend, my basal is lacking so I gave myself an additional bolus boost for the 2 hour surgery. This seemed to work as I woke at around 5 with no sign of a hypo.
Then my BG started climbing. By the time food arrived, I was at 8. By the time I got home, I was at 17 (as checked with a finger prick) even though I had correctly bolused for the sandwich and small flapjack (yes, I know a flapjack is probably not the best choice but it was a cherry flapjack and I deserved it). With a few hours of rage bolusing and increasing my basal to 160%, I was back down to 10 when I went to bed at midnight. I would liked to have been lower but it was going in the right direction and I needed my sleep.
This morning I woke with a BG in the 7s. A little higher than usual but acceptable.
Sorry, this has been a long post but it highlights
- how weird our bodies behave sometimes
- how amazing they are when they work (if I did not have diabetes, I would have been oblivious of the “sleeping liver”)
- how grateful I am to have a pump in times like these.
