As well as being a regular commentator at your soaraway Shoot Up, Dave is a blogger extraordinaire and regularly posts over at http://www.thetangerinediabetic.blogspot.com/
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The day was planned perfectly. Twice a week I work in Leeds, which is a leisurely two-hour train ride away from home. Strips for my (current) favourite testing machine ran out on Thursday but I had a plentiful supply of backups for another meter I get along with, so I wasn’t overly stressed about getting to the pharmacy to pick up my repeat prescription that I’d ordered online a few days earlier. Knowing the pharmacy opens at 7am and my train leaves at 07:20 gave me the perfect opportunity to collect them on the walk to the station in the morning. I tested on waking and was higher than I’d have liked (11.7) but breakfast and a correction on a dual-wave would sort that nice and simply. I left the back-up meter at home whilst I set off for my leisurely walk to the station.
Now if you’ve read the title of this piece you may have guessed that my flawless plan had a flaw – and you’d be correct in that assumption. On arrival the bloke behind the counter apologetically explained the pharmacist was running late and wouldn’t be in for another fifteen minutes. No pharmacist, meant no dispensing and thus no strips. For the day. At all. First thoughts were anger and a quickly worded but slightly too rude email to the boss ignored the fact it was my own stupid fault for just assuming my tight timelines wouldn’t cause any problems. Within an hour I got a very apologetic reply and I gracefully accepted that and replied apologising for my bluntness earlier.
So I was now sat with a pump in my pocket and no way of knowing if the day ahead was going to be good, bad or indifferent control-wise with my only real judge of BG levels being my normally half-decent hypo–awareness signs. A quick tweet to anyone reading was met with a mixture of “Oh no, total nightmare!” to “Hey ho, that’s how we used to live wasn’t it?” That last one was very true and quickly reminded me how far I’ve come in the last two years. I’ll admit Dave and ‘good diabetic’ weren’t terms that went together too often in the previous twenty years – before that I had parental guidance so can accept no credit for doing any better.
Back in the day, well two years ago anyway, I’d quite happily go days without testing and without it worrying me at all before a random test at some point in the day on some days just to make sure my BG didn’t start with a 2. There’s a whole other story on how I totally mismanaged my diabetes but that’s for another day. So why am I less able to prevent myself going low today than a few years ago without assistance? Indeed the bolus wizard on Adam the pump should mean I am more able to handle circumstances like this and avoid ketoacidosis and collapsing from being low.
On the train home I was reading the latest Shortlist magazine and there was an article on how we get too attached to technology and whilst this isn’t really similar it does strike up thoughts about how dependent I have become on my tech recently. The link is very tenuous as not tweeting for a few hours is not at all like judging if I’m in danger of a serious medical emergency but I’ll go with it anyway. For those who had ‘the diabetes’ as my Type 1 uncle calls it, for a couple of decades or more you may remember the days when testing involved peeing into a test tube – easier doing it as a boy than a girl I guess – before dropping in a tablet and waiting a few minutes before holding it up to a colour chart to decide whether you were high a couple of hours ago – low was irrelevant and couldn’t be checked without looking for shaking hands. It was an entirely different, much more vague world back then. I’m not saying it was better, as it obviously wasn’t but it does open the debate as to whether having constantly available information always assists.
Well I made it through the day with my usual fast walks from the station and my standard 70ish grams of carbs for lunch and a bag of crisps on the train back. I got home after sheepishly returning to the pharmacy to collect my strips and the closing result for my time without a meter was…………can you feel the tension?…………5.8mmol! That’s the best home arrival test result than I’ve ever achieved! I’d survived but I know I didn’t like the separation of knowledge about what my body was doing. It was certainly an interesting exercise – though one not to be deliberately repeated.
I’ll finish by acknowledging that I’m very lucky not to have complications or any lack of hypo-awareness and I understand how for others (I’m looking at you @Lizz) being without a means to test would cause very real life-critical problems; it’s just for me that a day without testing was inconvenient but not that frightening or stressful. It was also a suggestion by @Tim that maybe I could go to Boots and just buy some. I feel I’ve come to know my online community better than they know me. Buy? Spend money on something I’ve always got free? Are you mad??? Saying that, it would be a good option for those less reckless than myself.
I’d love to hear how others would feel in a similar situation – or maybe I’m the only one stupid enough to live that scenario for real?
I did the same on a recent trip to Spain – except I left my insulin on the plane, and the spare was not where the spare should be – ie still at home! Considered going for 2 days with only long insulin, not eating much and excercising, but the excellent spanish local hospital sorted me out – BUT I had to pay £30 for rapid insulin and a box of needles! What a dork!
I think that comes down to ‘live and learn’ @smiles!
Paying! Nooooo!!!! Do you think we are becoming a little bit forgetful about how good the NHS is sometimes?
Well I ‘m just recovering from locking myself out of the house this morning without meter and yes I to thought “How am I going to manage?” but like you Dave I am still hypo aware and I have my pump. Thankfully my husband wasn’t to far away from home as the children didn’t take their keys. My only worry was what to do with the dog whilst I went to work as schools don’t like animals. I think unless your sensitivity to hypo’s isn’t good or your ill and need to monitor more the odd day without is fine. Perhaps we should all have a day without bit like lent and see how we go? I know my doctors would be pleased buying me fewer test strips!
I’ve certainly become a lot more connected to my meter than I was. After years and years of feeling that D was too random and annoying to improve control very much it didn’t take long to realise that irregular testing just doesn’t give you enough data to work out which are patterns and which are occasional diabetes randomness. As soon as my D settles into a predictable pattern I’ll ease off testing – though I’ve been waiting for that to happen for nearly 3 years now.
ah, @mike, that’ll never happen. I thought that too. I got the pump, and started doing lots of tests. (At least, lots more tests.) And realised that what I was seeing indicated just how much I was going up and down in between tests, without realising. So did even more tests. And now am at the ‘predictable pattern’ stage. That pattern being ‘there is no pattern, and you can’t predict it, even on a good day.’ And now I know how much I change between ‘official time’ tests (ie, those the Dr wants, pre and post meal), I cannot give up doing those extra tests. Just in case. I try to restrict myself to every 2 hours, unless there’s something I’m chasing (like after a low/high/gym etc) rather than the hourly I sometimes end up with, but even that is 10 per day (rather than the 7 per day that my pharmacist wants to give me). My average is about 12 per day. On a normal day.
And if I ran out of strips (unlikely, because I keep a nearly empty (4-5 strips) canister in my emergency kit which is with me at all times), I’d go buy some.
My mental state overrides my miserliness. (And I’m originally from Yorkshire, home of the tightfisted!)
Blind panic – and considering I’m partially sighted I’m already half way there.
With no hypo awareness being a strip addict was bad enough but since using cgm I have become even more dependant on strips to calibrate my cgm. With a sensor operating I’m relatively composed but the minute the sensor ends I am filled with dread in the same way I used to be between bg tests thinking- am I hypo? I must be hypo, I’m about to pass out. I was completely reliant on test strips before cgm but the new technology has made me even more needy. A day like yours would be my idea of hell.
@megs I fully understand where you’re coming from and appreciate my fortune at still having my warning signs available.
Couldn’t agree more @Annette – for me the difference is more testing:better control (in that errors made in juggling all those wayward and conflicting factors *plus* the ones you can’t control are rectified more quickly).
6 a day is a trim and uneventful day for me. Not so many years ago, like @seasiderdave I would gone a whole day without testing without worrying at all – and I had the A1c to prove it.
@Dave Your uncle is nearly correct about urine testing – you didn’t have to pee into the test-tube even boys would find that too difficult – you collected the pee and then using an eye-dropper put 5 drops onto a tablet in a test tube; comparing the colour change to get a reading. This was in the early 80’s. For the kids at that time it was called Dora Drop in the pharmco literature.
The test was about as much use a chocolate teapot. Glucose only got in the urine when it spilled over from the kidneys, so you knew you had been high at some point in the interval between pees. The colour coding gave some idea of the amount of time spent with a high BG, in theory at least; but if the pee volume was small then that pushed up the sugar concentration being measured and skewed the result. Of course if you had a high renal threshold then you could be high as a kite and never know it.
30 years later we have CGMS which can tell if the BG is falling or rising as well as its real-time value. And some question the accuracy of CGMS readings – do me a favour !!!!
@brian – It wasn’t my uncle peeing in a test tube it was me! Although the vagueries of time has led to me forgetting the test tube step. I do remember feeling like a fully quailifed scientist though.
The onset of tech is without doubt a fantastic development but as shown in other comments it doesn’t always provide the reassurance that would be expected.
I guess we’ll never be happy 😉
Fantastic insights from everyone. Never more did the phrase Your Diabetes May Vary prove itself to be true.
@Steve I reread your reply and thought OMG there is someone who is super cool! I would have panicked madly. I remember when as a student the fridge packed up and my insulin became frozen. Thankfully the doctors/chemists were open so I could replenish my supplies but no I couldn’t cope without insulin in this country let alone another.
I remember sitting inthe spanish A&E with about 20 people around a sqaure of chairs all looking each other. Some spanish announcment on the tannoy I didnt understand, and they all pointed at me with amusement. All quite friendly and fun in a crisis. The doctors spoke english, gave me a proscription then it was a mad run around the town with a map finding the chemist before it shut at 10:30.
I relealise now that just doing a load of running for several days to lower glucose would not have worked as sometimes I rise after exercise. Anyone else find this?
The same happened to me fairly regularly but I’ve recently read in I think, the Pumping book by John Walsh, that if BG is 8.7 or above, that there isn’t enough insulin in the body to cope with the sugar released by the muscles. I’ve since given myself a unit before going out but with mixed results, mostly OK but sometimes a bit low. It seems better though than coming back with a sugar in the teens.
My dafne training was quite strict “Never do exercise if above 15”. bring it down first. I’d be surprised if the number was as low as 8.7 (or as accurate, I suspect that that has been converted from)
I’ve even heard 8.7 suggested as a target level for people with bad hypo awareness.
Peter.
I’ve had a similar experience to Dave a couple of times, most memorably on the day I went from Manchester to Sheffield on the train for a job interview and left my meter at home. Not the best day for being without testing! My strategy then (and now) since I have wildly varying BGs throughout the day at the best of times, was to keep taking small doses of extra insulin until I felt myself go low. Since I tend to feel symptoms around 4, getting myself deliberately to a mild hypo meant I knew exactly what my BG was, and a few glucose tabs would bring me back up to 5. It worked pretty well! Oh and I got the job, and am still in that job 12 years later!
Well, I missed this, and yes, have to admit the thought of having no strips sends me into a blind panic! Luckily my local surgery is very good when I forget and has always till now been able to supply at least one pot for me. Because I do forget, I’m hopeless, despite the problems no strips would cause.
I’ve done blood tests since the early 80s when I was given one of the first blood glucose meters. AND one of the first pumps.