Tuesday, July 29, 2014

Stymied Sensor

Yesterday's blog whipped through the weekend rather quickly because that was all I had time to write. Now that I have a few more minutes, there are some things I would like to revisit. Specifically in the diabetes department.

I've been working at figuring out how to keep my blood sugars fairly stable while I play golf. Golf is different than swimming or running and, as a result, I'm learning all over again. There are a few diabetes challenges when I play 18 holes.
a) I'm doing 4 hours of walking and carrying golf clubs so it's a lot of low intensity exercise which I'm not used to doing.
b) It's usually really hot out so dehydration is always a risk
b) I get hungry and need to have a snack partway through. If I don't I'm a shaky mess by the end that has nothing at all to do with diabetes. I'm just beyond hungry.
c) I don't want to take insulin if possible on the course because, in combination with the activity, it usually leads to a yoyo of lows and highs that involve me eating way more than I want and feeling sick or not being able to eat even when I'm starting.

After a bit of trial and error I've worked out a system that seems to be effective. I don't do it when I play 9 holes but I do when I play 18.

(This is where I add the reminder that your diabetes may vary and my experiences are my own.Add to that the fact that I'm not a doctor and you'll realize that doing exactly what I do is probably not the best way to handle your diabetes. If you even have diabetes.I guess I should add that your golf may vary too so don't be copying my golf technique either)

I lower my basal rate by 40% 90 minutes before we start. I set this temp basal for 4 hours which means that my regular basal rate kicks in before the golf game ends. I do my best to make sure my blood sugar is mid-range (6-8) before I start and that I have no insulin on board from a previous meal. I have a small snack before we head out (ex. a banana or an oatmeal cookie). No insulin for the snack.

I check Rose after every hole to catch highs or lows before they happen. Once we finish 9 and confirm that we are indeed doing all 18, I will have a Clif bar. If my blood sugar is hovering a little high (10+) I will have half the bar and if it's a little lower (under 8) I'll have the entire bar. No insulin.

The carbs in the bar do battle with the exercise in my legs and it usually results in my staying between 6-9 for the back nine.

On Sunday, I got to test this system on faith. I lowered my basal insulin as usual. I was 6.9 at the start of the 10th hole so I pulled out my Clif bar and ate the entire thing. I teed up and hit my ball. My shirt which was rather sweaty from the heat twisted against my side and I felt my sensor pull out as I hit the ball. I mean entirely out. I lifted my shirt and it was hanging there limp and unusable. I did not have my glucometer with me because Rose is so consistent that I never need it on the course.

Option 1. End the game.
Option 2. Trust my system and my ability to sense when I'm high or low and carry on.

I carried on of course. I felt fine the entire way. I made sure to drink a lot of water to help avoid dehydration-induced highs and I kept checking in with myself to see how I felt. We finished and I guessed I was 8.5. I was 9.0. Perfect.

By the time we got home and I showered, it was 8pm. If I put in a new sensor I would have to wait two hours to calibrate it and I knew I was too tired to stay up that long so I went to bed without a sensor. Probably the second time I've done that since last November. I used to sleep without a backup system all the time but, now that I've gotten used to it, it's a little disconcerting to think that the only thing that will wake me up if I'm low is me.

I checked at 1am and I was 9.6. I took a modest correction bolus and woke up at 6:30am with a lovely 5.0. By 9am my new sensor was up and running and the comfort of being able to look down and see how I'm doing was back.

It's nice when the diabetes gods play nice.

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