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Thursday, July 12, 2012

The Flight-Jumper Effect (Or History's Shortest Camp)

I think that once you've had diabetes for a certain amount of time, you tend to become a bit lazy about it.  'Oh yeah, my blood sugar's a little high - that happens after *insert activity/food here*.  It'll be fine.'  We like to think we're in control of it, that we are the all knowing monitor of diabetes.  Unfortunately, that isn't always the case.

Note: *Extremely long and slightly scary story to come, D-Mamas.  But hopefully for the best.*

Recently, I was in New York for a summer camp of sorts.  It was my first time there, and naturally I was excited and terrified for my life at the same time.  I kept getting those jittery legs - you know, the ones that you get when your blood sugar's high but also when you're really stressed?  I kept checking my blood sugar - nothing out of the ordinary.

Jump to two days into the program.  I unluckily enough have food allergies on top of my diabetes (hooray for a suckish immune system), so the cafeteria food was not doing me much good.  I cut back on my eating a lot in a short amount of time, relying on the small grocery store a few blocks from the dorm I was in.  There wasn't much, but it was the only one I could reach in the boundaries the camp had set up for us.  Also being a first-time camper, I was suffering from that wonderful feeling known as 'homesickness'.  Stuff was going on in my family, and I was upset I wasn't there for it.  So add that nervousness on.

Getting back to my room that night, I was not feeling up to par.  I figured the cafeteria had poisoned me again (Cross-contamination, I was starting to think, because they insisted it was gluten-free but I kept ending up sick), and went to check my blood sugar.  134, I clearly remember.

Now, I've learned to rely on my body a lot when it comes to my blood sugar - I can usually tell when my blood sugar's low, when it's high, and when I have ketones.  You can get them in the low 200s, I've unfortunately discovered.  So I didn't care if it was 134 - something was not right.

My parents had splurged on a ketone meter for me that I could take to New York - you know, one of those 'just in case' things.  I grabbed that, knowing that despite my picture-perfect numbers, something wasn't right.

My ketone level was 1.3  

For those of you who don't use it, a 1.3 on the ketone meter is pretty much off-the-scale on the strips.  It's larger than large, one of the deepest purple colors you can find.  The stress I was under, combined with a sudden lack of carbohydrates and protein, was sending me right into DKA with squeaky clean blood sugars to match.

Let me just say that seeing that number was one of the most terrifying experiences in my life.  I was on my own, no parents (already homesick), and had no clue what to do.  It was like being transported back to the hospital room when you first hear you need shots every day for the rest of your life.  And there's a sort of fight or flight response when it comes to numbers like that.  I chose the flight response - literally.  The next day I was on a plane home.

Now let my say it was not solely my diabetes that made me leave (I don't want you going to your parents using this as an excuse for why you shouldn't spend the weekend at Grandma's), but I'd be lying if I said it didn't play a role.  Now I can go into a million 'what if' scenarios on this, but that will get me nowhere.  So based on my personal experience, I'm going to share what helped me with this (besides airplanes), and what I feel could've been extremely beneficial in my situation.

*Get rid of stress*

This was not a step I followed very well.  Wanting to be home so badly for various reasons, I'd managed to convince myself that the only way to relieve stress was to go home.  That probably wasn't my best option, but it was late and I was tired and it seemed brilliant at the time.  Either way, the main point stays - calm down.  Do yoga, meditate, watch your favorite TV show; just try and find a way to take a load off for a little while.  Stress is like adrenaline for ketones - it just makes them keep going.  You calm down, and they loose energy.

*That water there?  Chug it*

I followed this step much better.  If your blood sugar's in the normal range, you can't exactly take insulin.  That leaves your other favorite alternative (the one my school nurses are always recommending); water.  I downed two bottles in a half hour.  Some websites recommend eating something and taking insulin to cover for it, that way it can also get to work on the ketones.  I have no idea if this method works, since I didn't try it.  What I can say, however, is that water will be your new best friend for a while.

*Call a professional*

Most camps are lucky enough to have an RN or some type of medical professional on staff for an emergency.  I, however, got an Asian guy who was not completely fluent in English, kept his office locked at night, and slept in an entirely different building then the one I - and his locked office - were in.  So obviously, I didn't have professional medical help.  In a situation like this you may feel like you can pull the 'I know my diabetes' card, but that's going to look pretty lame in comparison to a trip to the hospital.  Call your doctor.  No ifs, ands, or buts.  If you're like me, and it's the middle of the night (isn't it always when bad things happen?), you may quickly find out how Google can also become part of that buddy group with the water bottle.

*Do not expect a sudden miracle*

I later found out that from the time I started my camp to the day I left (three days), I'd lost 6 pounds.  My ketones had obviously going for a while, and they had no plans of stopping.  Five days of building them up in your system does not equal five hours to get rid of them.  It took me two days before I flushed them out.  It's going to take time.  You will still feel crappy, yes, and I'm sorry.  But it's going to be a little bit before they're gone.

The normal blood sugar/high ketone scenario is a scary one - I'm not going to lie (especially in an unfamiliar place in the middle of the night with Dr. Useless for company - but I digress).  I honestly don't know if I handled it well or not.  But what I have to remember is that what happened happened, I did not end up in the hospital, and I have a better understanding of how to prevent it.  Having diabetes for a certain number of years does not suddenly put you in the clear of the emergency room.  Keep that in mind.

On the other hand though, all those perfect blood sugar's caused my A1C to lower a full point.  Maybe New York has some positives after all.

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