PD and Blood Sugars

[Charlie B53]

I thought I finally got a grip of my morning blood sugar by increasing my nightly Lantus to 50 units, this morning I was at 118.  Only rose 24 since midnight.

Did my morning exchange, drained out the Ico and filled with 2 1/2 %. skipped breakfast and ran errands.

Came home to this exchange and tested 152  ? Seems I keep forgetting that all the daytime exchanges are   SUGAR.

I should be taking another shot of fast acting with every daytime exchange.

D'oh!

So now I just have to figure how much insulin for each daytime exchange.

I'm learning, been on the needle for almost 6 weeks.

Oh, and the last week I've been losing weight, up to a pound a day.  I didn't think I had any more excess water to lose.  I don't exercise, so I have to wonder of I am losing muscle mass. 

I'll just have to wait and see if I continue losing, it could be possible that I have been carrying some water, but I don't have any of my old swelling in my legs or ankles.

Maybe my fat head is shrinking.

[Joe]

A lot of balancing to do on PD Charlie. But you will get there, and then everything will just be second nature. Best of luck!

[Speedy1wrc]

118 is awesome, 152 isn't so bad really. If you're just beginning it can take months to fine tune everything. The hard part is learning how to deal with the curve balls. Foods you're not used to and being sick and on antibiotics. There are a lot of things you need get acquainted with.

If you don't mind me asking, how much do you weigh? 50 is a pretty decent sized dose of Lantus. I assume you are supplementing with something like Novolog?

[Charlie B53]

265 with 2 liters in on a heavy boned 6 ft frame.

I was a linebacker, and good at it, until a Buick and a Honda conspired to change my direction, into a tree.

No more football, or any other physical sport.  I retired on disability from a career mostly as a heavy mechanic.

I used to be strong, but these years on retirement have gotten very soft.

I can hardly even curl the back of  my Harley with one hand any longer.

[Charlie B53]

I've been losing weight for the last week, more than a pound a day.  I thought I was fluid balanced already and couldn't have any more excess water to shed.

Yesterday morning my BP was low  90/50 62 sitting, then 84/48  71  standing.  My BP cuff is plugged into my 'Health Buddy', a tattle-tale machine the VA gave me.  It phones home and rats me out.  Last time I had a low number my PCP's Nurse called me to figure out why.

She didn't call til this morning after I had another set of low numbers.

94/59  62  sitting, and 96/56  68  standing. 

She asked me if I had been outside working in the yard yesterday.  No.

Was I dehydrated?  I didn't think so, when I pinch the back of my hand it immediately falls flat again, no delay, no 'standing ridge'.

She told me to take it again at noon and she would call back.

I went out and mowed half of the middle acre of yard.  Just drove my mower around.  That isn't work, is it?  Just driving around.  I wore my straw hat to keep the sun off my face.

Noon, I was very tired. during my exchange my pressures were 97/54  80  sitting, and 72/47  44  standing.   Uh, that's strange.

Nurse lady called, WAS NOT HAPPY with me.  Told me to start drinking water.  I had had a couple small glasses, wasn't thirsty.  She wanted me to come to the ER.  I couldn't, wife gone shopping, took my truck.  AND i really need A NAP FIRST AS i AM VERY TIRED. 

She called back and had me call my PD Nurse.  Nurse Kim told me that I had to be somewhat dehydrated, get a can of chicken noodle soup into me, and another glass of water.  Next exchange use 1 1/2% instead of 2 1/2%

Drank the soup, took a nap and pressures are back to 124/65. 

So I guess I have finally found my fluid balance and will have to start paying a lot closer attention to my BP, weight, and then decide which solution to use.  No more straight 2 1/2%

Who knew that a bowl of soup could make so much difference?

[Speedy1wrc]

There's a hefty amount of sodium n the soup which will help you retain fluid better.

Fifty units for your body mass seems high. As things shake out I am curious if that will come down at all. I am around 170 and have been on 23 units of Lantus for years. It took some time to get it sorted out but has been stable for awhile.

I don't recall if you said you were on BP meds? Seems like you are getting a handle on your weight and solution vs BP.

[Charlie B53]

LOTS of BP meds.  I often complain that I am over-medicated, that I 'think' my chronic pain is a major contributor to high BP.

Taking 400mg tramadol daily for years, and justlast week added the smallest fentenyal patch.  I don't think I can tell any difference with the patch yet.  Dr won't increase it for at least a month, will want labs first to make sure it isn't accumulating in my system.

If it did, wouldn't I know it, feel less pain?

Since that episode and eating the can of soup my BP is hanging right in the 120's.  Far better than it has been for years.

But I am constantly so tired.  I can take a two or three hour nap two or three times a day, and sleep most all night.  Tired.

[Charlie B53]

Update, saw my Neph today for my monthly check.

He and the Nurse think that I've done great with my blood sugars since starting using the fast-acting insulin.  So well that PD has taken off that other 10+ pounds of water which caused the low BP's.

He dropped TWO of my BP meds, for now.  Will wait and see how my BP's run for the next couple of weeks.  If I stay stable, in the 120's and 130's I can leave those two out.

When my BP had dropped we switched from all 2 1/2 during the day to using a 1 1/2 then a 2 1/2, and a 1 1/2, still using an Ico for the long nighttime dwell.

I had noticed that a 4 hour dwell with 1 1/2 that I would often re-absorb some of the fluid so the drains were often less than 2000.

So they OK'd shortening the dwell on the 1 1/2 to three hours and increasing the nightly Ico 2 hours.

I thinkk this should improve my 'adequacy' by not re-absorbing.

We'll see what the difference is with labs this week vs next month.

Now if I could find some energy and make myself get up off my broad behind and move about a LOT more, maybe this body could burn a calorie or two more.

261.5 this morning.  Wondering if I will ever make it to 200.  It ain't gonna be easy.

Hoping when the Pain Dr re-writes my fentenyal patch today that he increases it, a lot.  I have only the one left to put on Wed, then it's "oh, Spit!' time.