Monday, January 12, 2015

The night I messed up my insulin

I briefly mentioned about my insulin fuck-up a few weeks ago. Here's the story if you feel so inclined. It's not an awesome holy-shit-I-can't-believe-that-happened-story. It's more like a holy-shit-you-stupid-twat-story.

As a needle wielding diabetic, I use two kinds of insulin every day. For those not-in-the-know: I inject my long acting (background basal) insulin twice daily. My rapid acting insulin is the shit I use to bring down highs or inject for food. To get an idea, on a normal day I take anywhere between 12-20 total units of Lantus (long-acting basal) and about 10 total units of rapid over the course of the WHOLE day.


I choose to use syringes and pen cartridges for the size and duration factor. It all fits in my sack of goodies and at the low rate of insulin I use, the smaller cartridges mean it never spoils and goes to waste. Vials would go bad before I ever got a chance to use them up.

On this particular night I accidentally injected 10 units of Novo Rapid when I had intended to take Lantus. It was dark. I was in my car stopped at a light (shut up). I had just stopped at the mall to buy ONE LAST xmas gift on my way home from work on December 23rd. It was the start of 5 (measly) days off work. What gets me is that when I was on the pump and got a bullshit BG of 20 or higher I would routinely inject 10units. NOW, post apocalyptic (pump era), 10 units nearly kills me. I was taking more than three times as much insulin on the pump.

Now normally, I am neurotic about injecting the right insulin because this exact situation has always been a massive fear of mine. I often inspect the cartridge. I draw up the juice and inspect the cartridge again. I inject and then one last time I inspect the cartridge before putting it away.

I'm sure my absent-mindedness, distraction and stress played a role in why I wasn't so neurotic this time.
I looked down as I was about to put the cartridge away and saw the familiar orange top. I'm fucking glad I looked because if I hadn't.... I don't even want to think about it. I screamed, "HOLY FUCK!" in my car while immediately consuming an entire container of glucose tablets (10) before even thinking about how to proceed. It didn't take a mathematician to calculate at an evening carb ratio of 1:15-20g would need to eat 150-200g of carbs in the next 2 hours. 

My game plan, should this ever happen (because it was bound to happen!), is to go to the hospital.I need to make this clear, most people can handle this kind of thing at home on their own. Me? I get nauseous after eating only 4 glucose tabs. 1 juice box upsets my stomach. I get nauseous after I treat ever single low. It's a shitty side effect. Also? I have one glucagon pen and it expired 2 years ago. (shut up again). So seeking medical attention was what I always thought I would have to do.

Lucky for me I live a stones throw from a hospital! OH BOY!!

I drove home and called my girlfriend because Ryan was working late. I thought she could just come over and keep an eye on me and drive me to the hospital if need be. She insisted I go to the hospital regardless (she knows me well). I was also crying and panicking on the phone. I ran inside the apartment and grabbed a bottle of honey before going to the dreaded ER.

150-200g of carbs. I ate 10 Dex and some swigs of honey. I was probably only at 60g and I was already very nauseous. They got me in fairly quick. I was testing my BG every 5 or 10 minutes to keep an eye on how I was trending. This would be the time I wish I had a CGM. My poor fingers that night got destroyed. I was keeping it steady between 6-8mmol/l (108-144) but my stomach was increasingly nauseous and I couldn't take another sip of honey. Time was ticking by. The insulin still had another hour of action. They blew 1 dose of liquid dextrose into me intravenously.

IT WAS THE WORST THING!! Holy motherfucking shit balls. It was painful going in and made me instantly high. LIKE INSTANTLY. I went from 7.1 to 15 (128-270) in less than 10 seconds. Not to toot my own horn (okay I'm going to toot my own horn) but I have had decent control for months now. A BG of 15.0 feels like what a 20 used to feel like. TERRIBLE. I was more sick. My head pounded and I resisted the urge to sneak insulin. The speed in which it shot up compounded that horror.

I sat with my head in my hands and my two friends at my side. I glared at the other box of dextrose the nurse threatened to shoot me up with. I watched my BG come down and within an hour it was back to 6. I sipped more honey and begged not to get the other box. At this point I felt like I could handle it. The insulin was now out of my system and I would deal with the trickle effects of lows.

The doc came in to see me before releasing me. She interrogated me (not meant in a bad way). She asked me a myriad of questions which sounded like she was trying to determine if I did this on purpose and what my handle on diabetes was like. I guess I answered all the questions to her liking because she let me go. She told me not to take my Lantus that night. I'm like, excuse me? You tell me that NOW?! What do you think I did when I noticed my error? I immediately took the 10units of Lantus. She shook her head. I was dumbfounded. That Lantus is for the following 24 hours. If I didn't take it I'd be back in the hospital in diabetic ketoacidosis the next morning. Okay probably not really but you get the idea.

The following day was rough. I didn't eat until late in the evening. I had no appetite and I felt like I was hit by a truck. I guess forcing 150ish grams of carbs into ones body somehow satiates it for days to come. It was a good 4 days before I felt somewhat normal again.

So this was not a horror story but it WAS a lesson. It was something that I knew would happen one day because despite my best efforts, fucking up is human. For the other 703 Lantus injections per year I have it mastered.


"I'm a little teapot" photo courtesy of Steph. Friends are good even in rough situations.

5 comments:

  1. Sorry to hear about this Scully. And happy that you came out of it ok in the end. Thanks for sharing. For some reason hearing a good outcome from a worse nightmare situation like that gives other Type 1 gamers hope...

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  2. Another of your posts that make me HOLD MY BREATH!
    Glad you're okay.

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  3. It's amazing this doesn't happen more often. I'm so glad you're OK!

    Your parenthetical admonishments of judgmental asshole readers are perfectly timed. (I mean, my imaginary judgmental assholes would have been chiming in at the exact same times!)

    The no-Lantus nurse...do you think she meant like: "and don't use insulin for a while, so you can recover from this overdose"--- not realizing how quickly we can over-steer into the other part of the equation?

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  4. I had been meaning...in a non-nosey way...to ask you about this 'episode'...

    1. I am so glad you are OK.
    2. I am glad I read this from the 'TOP' down because, the pic looks like you were simply getting your nails done!
    3. I love your friend(s)

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  5. And yet, it looks like you were smiling through it all (I'm sure you weren't).

    ER Doctors can be so stupid sometimes. They know how to triage the immediate situation, but have no idea what their directions may lead to if you follow them as you walk out the door. I disregard ER doctors (when it comes to insulin) all the time.

    So glad you're smart enough to know when to ignore them. It scares me to think of the people who have absolute blind faith in their trained professionals.

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