Category Archives: Diabetes

type 1, insulin pump, blood glucose

Sometimes…

Sometimes I don’t want to stop.

Sometimes I’m in the thick of a really great book, and I don’t want to stop.

Sometimes I’m in the middle of writing a killer sentence, and I don’t want to stop.

Sometimes I’m climbing down the Eiffel Tower in the twilight hours, and I don’t want to stop

Sometimes I’m in the depths of a needed sleep, and I don’t want to stop.

Sometimes I’m at 8.5 km of a strong 10 km run, and I don’t want to stop.

Sometimes I’m hurting with joy, giggling so hard with my boy, and I don’t want to stop.

I can see the words on the screen go blurry.

I can feel the letters in my book as they punch me in the face with every bounce across the page they make.

I can sense the happy flutters in my belly being strangled into sickening worry.

I try to control the shakes.

I try to ignore my heated cheeks.

I squint at the screen.

I cover one eye, hoping it will empower the other.

All for just a few more minutes.

A few minutes without Dear Diabetes.

But then, the full-body sweats come. Reality sets in. I cannot ignore Dear Diabetes. I cannot shove him off to the corner, not even for a few seconds. He is there. He will always be there. He won’t ever let me forget it.

The other day my blood sugars dropped to 3.0; I felt as though they were 2.0.

I didn’t want to stop.

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Hospital: the first

Dear Moms,

I am sorry I was such a sick kid. I am sorry I got whooping cough at three weeks old. I am sorry my appendix nearly burst at three years old. I am sorry about the whole diabetes diagnosis at nine years old that caused a tumult of ER runs and hospital stays. I am sorry I threw my lunches into the bushes and gave your plants my insulin doses and gorged out on chocolate under the covers of my bed, which no doubt added to those aforementioned sick-induced adventures. I am sorry I got jaundice at 11, and a near concussion at 17. I am sorry your mother’s intuition was forced to work over time for so many years just to ensure I made it through the night.

Never in my 38 years did I imagine the anguish I put you through until now.

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NYE: The Sickness part 1

It is an anguish all parents go through, I am sure, but one I had yet to truly experience until recently.

On Christmas Eve Little Ring woke up with a cold. He’s had colds before, but this one was a doozy. He was lethargic; his head seemed to be in a thick fog for most of the day. Still, not a huge deal. Just a cold. On New Years Eve, he started puking. He is not a puker; I think he has puked once, maybe twice, prior. He was scared. He started screaming to scare the “fire in his belly” away. That was hard. It was the flu. Every parent has handled the flu. We could handle the flu. Two days later, his spirits were back up, his appetite was regaining steam. We thought we were in the clear. We took him sledding.

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If only the squeals had stayed joyful

I will forever feel guilt for that decision.

Oh he laughed and squealed with glee. Every ride down was better than the previous. We were out for about an hour. I was getting cold. I suggested we head for hot chocolate. His steps up the hill slowed; his body slouched. It was as though he were lugging an elephant up the hill with him. I had seen this before. It was classic Little Ring style. He was tired. He was dramatic. He wanted mama to carry him the rest of the way.

We got to our hot chocolate haunt. He and Big Ring sat down with their mugs, while I talked to my favourite tea lady at the tea counter. He came over to me and declared he wanted to go home. I thought it was exhaustion. He grabbed his head and started crying.

We got home. He laid on the couch, tossing and turning, writhing in pain. He had a fever. His ear was hurting. We gave him baby Advil. I was on hold with the nurses line for over an hour. By the end of the call, his fever had dissipated and he was chewing dried apricots, which seemed to help.

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With “fire in the belly” lying down was the go-to position

It was just an ear ache; parents deal with ear aches all the time. We were sure it would go away.

Mild fevers came and went for another week, but nothing too extraneous. On Jan. 7, he was nauseous, and feared the red bucket, again screaming to scare the pukes away. The next day he seemed fine. The fevers were on and off, but he generally runs hot. During the day he was eating, energetic, playing, building Lego, fighting superhero crime, cracking perfect Little Ring jokes. But at night, the ear pain continued to present itself.

We gave him baby Advil to make him comfortable. By Monday, we took him to see our bow-tie loving family doc. Dr. Nick looked in his ear, said there was some redness, but nothing overly concerning. He was loathe to prescribe antibiotics, which we were in agreement with, advising that it would likely clear up on its own and to continue prescribing baby Tylenol and Advil for comfort.

I had a long day at school Tuesdaay; I was out of the loft by 6:18 a.m. and didn’t get home until 8:15 p.m. meaning I didn’t see the boy at all. Big Ring texted that Little Ring had swelling around his ear, but wasn’t complaining of pain. He woke up at 10 p.m., crying out, his blanket over his head. His ear hurt. The swelling was significant. Behind his ear, his head was so swollen, his ear was pushing forward as thought it were Spock’s ear. It was red and tender. His lymph nodes were also swollen.

That was it.

Off to the ER we went. The first for the boy.

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Dear kid, PLEASE don’t become a regular like your mama.

Nearly three hours later, we had a diagnosis. The infection was in the early stages of attacking the bone. It was mastoiditis. If left untreated, it could be serious. I didn’t know the implications. All I knew is that the doctor, who I think might very well be Royal Columbian’s version of McSteamy (and he knows it!) caused my child to cry out in pain. I know he had to do it. I know they needed to see his pain level. With my fists clenched in my pockets, the nails of my fingers digging into my hands, the feeling of wanting to jump out of my skin, it took every piece of strength I had not to attack.

My eyes shot daggers.

We were prescribed a heavy dose of antibiotics; so heavy even the pharmacist winced. I didn’t ask McSteamy about the side effects, I didn’t ask if there were any other alternatives, I heard “serious implications” and everything stopped. I just wanted my boy better. It wasn’t until I got home that I started questioning the prescription.

It’s taken my control away. It’s taken Little Ring’s control away. Neither of us like losing control.

For the first 20 years of my life, without realizing, I watched as my moms protected me. I watched her advocate for me, press the doctors  and other such medical professionals for the utmost best care, and challenge them if they didn’t give it to her standards. I watched as her face never cracked. She was calm. She was patient. She rubbed my back, never showing weakness – not in my presence, nor the doctors’. She was strong. She was fierce. She had an Elizabethan fire in her not to be stoked.

Last night, I wanted to cry.

My moms never cried.

Neither did I.

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She will forever be my hero ❤

Pizza, worse than a tequila hangover

Pizza, it is the bane of existence for diabetics the world over.

The taste, a garlic-infused crispy crust, savoury tomatoes and fungi, oozing mozzarella, and the spice of the carefully placed basil tantalizing your taste buds. So savoury. So delectable. A treat that calls out in your dreams, lures you in your wake. But a treat, nonetheless, that makes you look at diabetes in the same manner as organic chemistry.

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More fear calculating this than prepping for a statistics final!

I have had this disease for 29 years, and I have yet to master the skill of calculating the bolus’ and basals for pizza. I can eat baked cheesecake, no problem; cheese oozing quesadillas, no problem; but pizza, it has foiled me nearly every time I partake.

Shame.

Big Ring is a master of the pizza-making skill. Ever since we visited Italy seven years ago, he’s been perfecting the art of Neapolitan-style pizzas.

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Food art at its finest!

But for years, I’ve been shaking my head more times than not when pizza is suggested for the menu. Irregardless of my love, those middle of the night highs, that inevitably occur following said pizza, overrule the love.

A pizza hangover is worse than a tequila hangover.

It’s not the flour, the farina flour we use is a specialty pizza flour molded into a paper thin crust that I can pretty effectively calculate the bolus for. It’s not the tomatoes or the tomato sauce, even though they are sugar behemoths, they too can be accurately calculated for. Nope, it’s the cheese.

That cheese, the star of the show in some respects, kills us.

You can’t give a huge amount of insulin right off the hop, just before that first bite, because you’ll no doubt suffer lows shortly after. And when you feel that low, you’ll think, oh freaking crud, I gave myself way too much insulin. Nope, no you didn’t.

You see, that cheese, she’s an underhanded deviant. She’s laughing, watching the clock, counting down the hours until she can strike.

Cheese is full of fat. Fat slows digestion. So, an hour or two after you eat your pizza, your body still hasn’t properly digested it, but the insulin you took is shooting so fast through your bloodstream, you’re grabbing every last bit of sugar in your house to bring your blood glucose back up again. And then, midnight, 2 a.m., 3 a.m. hit and BAM! Cheese strikes. Your BG shoots up and you spend all night and well into the next day trying to bring her down again.

Feeling pukey, lethargic, all around gross the entire time.

Not fun.

I’ve tried a big dose up front; I’ve tried doing an assortment of combo boluses; I’ve consulted with the diabetic community, but to little success. And on the rare occasions I do get that A+ in the pizza-diabetes equation, I think, fantastic, I’ve got this – only to do the same thing the next pizza adventure and miserably fail.

Our bodies are not static, our diabetes is ever changing, what worked one day may not work the next.

But I am no quitter my friends…

The winter farmers’ market (which, by the way I’ve been writing regularly for since last January and can be found here: http://www.tenthtothefraser.ca/category/eats-and-drinks/) started back up again last weekend. Among other things, we came home with a bag full of market-fresh arugula, and market-fresh pine mushrooms (hand picked by a local forager!!!), we had mozzarella and prosciutto in the fridge, garlic and tomato sauce in the cupboard, and it was a crazy crummy day outside – the perfect recipe for barbecued pizza!

It was time I stomped that Cheesy Deviant to the ground!

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You will not win this time cheese!

But alas, she had other plans.

My blood sugar before first bite was 7.9 mmol. I tried the advice of a friend and liberally bolused 75% right off the hop, with the remaining 25% slowly seeping into my blood stream over the next half hour. I thought for sure my blood sugars would go low, and I’d be seeing a later high. Nope. They went high.

PIZZA EXPERIMENT:
• BG pre-pizza: 7.9 mmol
• BG one hour post pizza: 10.4 mmol
• BG two hours post pizza: 13.1 mmol (Correction given and 100% temp. basal for 1.5 hours)
• BG four hours post pizza: 9.1 mmol
• BG 10 hours post pizza: 4.1 mmol (It was 4:30 a.m., I gave myself two DEX tabs to get me to breakfast)
• BG 12 hours post pizza: 10.1 mmol
• BG 15 hours post pizza: 11.2
• BG 18 hours post pizza: 6.3… FINALLY!

Needless to say it was a major pizza fail. Next time, I will try for a larger dose up front and a longer combo basal over several hours instead of a half hour and see if that works.

I’m interested to hear, how do all my diabetic readers deal with pizza?

Until next time…

29 years: “Perfect storm for an eating disorder”

Apparently furniture is to be given for the 29th anniversary, but for me, all I got was guilt.

There’s a part of me I am not fond of; a part of me that scares me; a part of me I’ve feared, hated, fought and succumbed to; a part of me I don’t like discussing much, but a part that is very much there – always. It is something I have lived with for 29 years.

My relationship with food.

The other day I was chatting with a pediatric dietitian who works with young diabetics at a local hospital, and so much of what she said to me resonated. We were talking about the different methods of treatment specifically with diet, post diagnosis. There’s the Nazi-like conventional method: no sweets, no treats, you best be perfect or you’ll die. And then there’s the flexible method: make it personal, make it healthy, do what works for your child and the family as a whole, no labels.

When I was diagnosed it was Nazi style only.

As this dietitian said so perfectly: It’s a perfect storm for an eating disorder. Unrealistic expectations are being put on a child who just yesterday could eat what they wanted, when they wanted, how they wanted, and now you’re telling them nope, you can’t eat that, you can’t do that, eat more, eat less, if you don’t listen, you’re doomed.

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My first trip to the hospital courtesy of Dear Diabetes.

So, my story.

For over two decades my moms has been telling people I was malnourished Ethiopian child thin for the first four or five years of the disease, so thin the doctors kept adding to my diet, telling my parents I needed to eat more, they had me on a 2,700 calorie diet, and when I did start gaining weight, they didn’t take me off, so by the time I was 15, I was hiding my suddenly soft frame behind baggy clothes.

bday cake
My 15th birthday. Look closely and you’ll see the low self-esteem.

And sure, yeah, that happened. But what also happened is I became the child who would throw her “healthy” lunches in the bushes; I became the child who hid under her bed eating Halloween candy after Halloween candy; I became the child who would sneak spoonfuls of ice cream every chance I got, and one time hid under the table with the whole bucket thinking no one would see me there; I became the child who found bakers chocolate in the cupboard and ran to my room, crawled under my covers and took a nasty chomp. I didn’t learn from that. I hid in my room with a mixing bowl full of raw cookie dough; I ate Christmas chocolates in the bathroom; and something I am so not proud of and have never told anyone, but am now telling all of you, I used to snake my way into my parent’s room, on my stomach, in the early hours of the morning, when my moms was having a bath, getting ready for work, and would steal money from her purse – to buy chips and chocolate at the high school canteen.

Seriously, I am so sorry moms.

My relationship with food was not a good one.

For me, when they closed the door on all things sweet, when they took my control away in what I could eat, when they forced me to drink milk, something I had loathed my entire life, and something I was allergic to up until I got diabetes, and something I still very much dislike, they took my personal power away.

They took a part of me away.

My only control was a full-throttle diabetes/me revolt.

Did I have an eating disorder?

Yes, I believe I did.

I didn’t starve myself, I didn’t regurgitate what I ate, but I binged. I struggled for years to get my eating under control, and ultimately to get my diabetes in control – on my terms. And even now, although I am now crazy healthy, and in complete control, I still struggle. I don’t gorge out on sweets and treats like I did years ago, but I question nearly everything I eat now as a result; I worry about the softening of my body; and sometimes I berate myself of indulgences. Not always, but it is there.

It doesn’t go away.

Dear Diabetes gets the thanks for that.

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My relationship with food hasn’t always been a confident one.

Today, Aug. 23, is my diaversary. I have had this disease for 29 years.

Smurfette Part 2: The Bone Scan

Ohhhh, the déjà vu.

2011: I was training for my second marathon, and struggling with a sore ankle every time I ran. I spent months in physiotherapy with no relief. Dear Physio was getting frustrated; I was beyond frustrated.

2016: I haven’t run in 9 months. I’ve suffered horrid pain that’s become more a dull ache in my left foot for 12 months. I’ve spent thousands (note the plural) on physio, chiro, acupuncture, essential oils, and more with no relief. Frustrated. Desperate. Moody. Sad and envious as bloody hell.

Both outcomes resulted in bone scans. In 2011, it turned out I had stress fractures in both ankles. In 2016, well, as I’m currently writing this post in the waiting area of nuclear medicine, I don’t yet know the results.

What I do know:

At 9 a.m. I was injected with a blue radioactive tracer containing phosphate and technetium. The phosphate is treated by the body as a building block; anything broken, stressed, out of alignment, not as it should be is a hot spot trigger for the phosphate and will glow brightly under the scanning camera. They took a few pictures right off the hop to see how the body reacted to the dye, if there were any blood irregularities, etc. These pics, which I could see forming on the screen, made my feet look like sparkly glass slippers.

Cinderella! Cinderella!

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From 2011: Injecting the blue dye

Then I waited… and waited… and waited. Waiting, pretty much an apt description of getting bone scans done. Because you’re injected with such a small amount of the radioactive tracer, and because it’s got to travel all the way down to the feet, you’ve got to give it sufficient time. The injection was at 9 a.m. and the scans didn’t start until 2:40 p.m.. In between, there was a whole lot of water drinking (to flush out the kidneys) and tea drinking (because, well, I love tea) and studying (same thing for 2011, except this time it’s for college chemistry and last time it was high school chemistry).

The scan itself was only about 20 minutes!

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From 2016: The masking tape chronicles

The fellow doing my scan was great. As soon as he saw my insulin pump, he started telling me about how all four of his sisters have type-2, and his brother-in-law in Finland has type-1 and takes daily pen injections. We talked about Canada’s medical system (which by no means is as free as many in our country and others believe it to be) vs. Finland’s. This came as a shocker to me given how great the country is with its educational system, but apparently in Finland, the cost of diabetes is based on a weigh scale; those overweight pay way more than those not. This man’s brother-in-law pays in the thousands (Canadian equivalent) every week!!!

“He likes his sweets,” the tech said.

Don’t we all!

He took three photos of both feet (to compare the two): one of the top of the foot, one of the bottom, and one of the side. The photos took five minutes each and you had to stay still for the full five minutes. I was good for the first two photos; I think because we were talking so much it took my mind off it (plus, for one of the photos, my feet were taped with masking tape). But the last photo, I don’t know. You know when you’re told to stay still, but try as you might, all your body wants to do is move. That’s how I was! The last two minutes of that last photo, I could feel my feet and knees starting to twitch, and I kept thinking no, no, no, be good, be perfect, follow the instructions, don’t you dare move, dammit, stop, stop, stop. I tried taking my mind off what was going on by looking at the skeleton feet forming on the screens and trying to figure out which ones belonged to which foot, and wondering if that glowing line was normal foot bones or Princess problems. When the musical ding finally rang, I nearly shouted Hallelujah!

Apparently my doc will have the results in a week’s time.

Hopefully there will be some answers, something that will get the recovery process on the right track. Because seriously, I just want to bloody fricken well run!

Home is the Mountains

I didn’t want to call him.

Big Ring was expecting it; I know he was. He didn’t say he was, but the implication was there. This is the way you need to go,” he said, his eyes boring into mine. These are the roads you want to be on,” he emphasized, sloooowly. “Do you know where you’re going? Do you know where you’re going to turn around? Do you know your landmarks,” he asked, the volume of his voice increasing with every new question. And finally, “I’ll be around for an hour or so if you need me,” he called out as I was shutting the door behind me.

Big Ring isn’t usually this over-protective. I have a history of getting lost; no matter how detailed the directions, 98 per cent of the time, I somehow get completely twisted around on the road, and in the mind. I’ve done it countless times both driving and running, so much so it’s a given I’ll be calling him to help unlose me. But this time I wasn’t driving or walking, I was cycling. It was to be my first solo ride to the city, and I don’t know why I wanted to go against my nature, but I was determined to not get lost, to not need outside assistance, to not call on Big Ring.

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Holly GoQuickly: It’s just you and me baby!

Years ago, when I first started riding again, I was riding solo all the time, but that was when I was still living in the valley, where I grew up; if I got lost there, it didn’t take much brainpower to figure out how to reroute myself back to an area I was familiar with.

City cycling is a whole other can of worms.

In the city, I’ve only ever ridden with Big Ring and a friend of ours, never alone. And I’ve only ridden to the city a handful of times; the other times, I’d drive and meet up with Big Ring on the bike before starting. It never once crossed my mind to go it alone. I ran alone in the city all the time, but cycling, that was a Big Ring and I thing to do.

But then we had Little Ring…

Riding together was becoming harder to achieve.

And then I couldn’t run….

I needed to learn to go it my own.

And so, I waved a worrying Big Ring goodbye and set out on my solo adventure. And at first, it was going well. I was following the B.C. Parkway, which essentially no one (except for maybe me) can get lost on as it follows the Skytrain the entire way into the city. As long as I could see the Skytrain tracks above me or to the right, I was good.

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Central Park: Wahoo! Made it to Burnaby without getting lost!!!

I veered off at Central Park, away from the Skytrain line, and was to follow the Ridgeway path into the city; as long as I saw the green signs that said Ridgeway, I was good. There was one, mini hiccup where the sign was posted just past the street I was to turn on, so I kept going straight thinking I was to turn on the next street, only to realize seconds later I should have already turned, and then when I turned around, I turned left, which I quickly realized I should have turned right. Oops. No biggie.

I was only planning on a two-hour ride as we were heading out of town the next day and I had some packing to do. I thought 20 km out would be a good place to turn around, but when I saw a turnaround road that Big Ring had mentioned, I was only at 18 km, so I kept going figuring I could hook up with the next turnaround road at Heather.

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At this point, I was feeling pretty proud of myself.

Minutes in to the turn, something didn’t feel right. Big Ring and I had ridden on Heather coming out of the city the other day, but we were going the opposite way that I was currently going. Hmm… I kept going, I kept following the little green signs, because surely the green signs would guide me in the right direction. Nope. A few more turns and a couple more kilometres and I knew something was most definitely not right.

Frick.

Don’t call him. Don’t call him. Don’t call him.

A commuter cyclist headed towards me. Pointing directly in front of me, I asked him if this was the way to the city. There was a look of laughter in his eyes, or was it pity? Nope, that’s the way to Richmond, he said, and then pointed behind me saying that was the way to the city. Neither of which were the direction I needed to go.

Soooo, which way to New Westminster? Which way to home?

Home is to the mountains, he said. North, he said. Go north. Go to the mountains.

Phew, no phone call to Big Ring!!!

I got back on the route I came in on figuring I best not be too adventurous in trying new routes given my two hours had already passed and I needed to get my sorely padded butt home. Things somewhat fell off the rails when my blood sugars went drastically low. I try to test every hour on the bike, but getting lost distracted me; wanting to get home lickety split distracted me; and the diabetes was forgotten. Had I kept to that testing regime, I likely would have caught the low before it dipped below 3.0. Argh..

Waited out the low, found the B.C. Parkway, and off I went.

I came to a crossroad. The little green sign told me to go straight, but the path off to my left looked exactly like the path we’d ridden a few rides earlier, and given the so-called trusty green sign had already gotten me into an earlier pickle, I went with my memory.

Big mistake.

Oh bloody fricken hell, why do I not follow signs. Yes, it was the same path we’d ridden, and good on me for recognizing it, but I failed to recognize the turn I was to take to get back home, and suddenly here I was about to merge on to a crazy assed busy street. What the freaking hell? I had nothing left in me. My butt was sore. My head felt like a volcano had erupted. I was hungry. I was tired. I just wanted to be home.

And the phone came out. His number was punched in. Big Ring was called.

After all, it wouldn’t be a proper PoP adventure without getting lost at least once, right!

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Not even the chicken scratch directions on my arm helped.

RIDE-DIABETES-RIDE:
8:20 a.m. BG pre-fuel: 6.9 – PB&J sandwich (39g)
9 a.m. BG pre-ride: 7.8
Temp. basal: -70%
Time: 2:53:29
Distance: 44.86 km
Average speed: 15.5 km/h 😦
Ride BG: @60 min. 4.1 (applesauce + temp. basal -100%) @130 min. 3.1 (dried apricots) @200 min. 8.9
2:30 p.m. BG post-ride: 10.4
Temp. basal: +70% 2 hours

Cycling and Diabetes: Third Time Lucky

Third Time Lucky.

It took three rides on the bike before I managed near blood sugar perfection.

All the rides began around the same time, a few hours after breakfast, but varied in distance and length. The first ride back, I was chasing lows the entire time, even before we began, my blood sugars were dropping. Ugh.

About 30 minutes before the ride, I inhaled half a peanut butter and jam sandwich on whole grain bread, around 25g carbs, no insulin. My blood sugars were 7.6 before the sandwich, and 20 minutes later were down to 6.1. I dropped my continuous basal insulin down 70 per cent. An hour into the ride, my blood sugars were at 4.5. I ate a savoury salted sweet potato Clif gel, which was all sorts of disgusting, had 2 dried apricots, and turned my basal off completely. At lunch, an hour later, they were 4.2. I had a bowl of smoked salmon soup and a hunk of foccasia bread, no insulin. An hour and a half later, they were 5.1 – more dried apricots. The ride ended at 6.4 to which I increased my basal by 70 per cent over 2 hours, in the hopes of warding off post-ride highs, but instead resulted in a blood sugar crash an hour later.

Well that was a fail.

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Pterodactyl’s got to get his pre-flight PB&J fuel on too!

Next ride two days later, I upped the sandwich intake and had a full-sized peanut butter and jam sandwich, approximately 42g carbs, no insulin. My pre-sandwich blood sugars were 6.4, and post-sandwich were 10.1. I dropped my basal 70 per cent. One hour in things looked promising; my blood sugars were holding at 6.7. But this is an iffy area for me. If I kept riding without eating, they could continue to drop. Or if I ate without taking insulin, they could surge up. Or if I ate and took insulin, they could bottom out. What to do? What to do? What to do? I opted for a packet of apple sauce, no insulin. One hour later, they were up to 9.7, and by the time the ride was done they were at 12.1. Argh.

Well that was a fail.

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This was much tastier than that salted sweet potato blech!

The next ride, I didn’t do too much different for the pre-ride prep. I ate a full sandwich an hour before the ride, no insulin. The pre-sandwich blood sugars were 6.4 and the post sandwich were 10.7. I dropped my basal down 50 per cent. One hour in, my blood sugars were 6.3. I had half of a cashew-date-ohmygawdthisissodisgusting bar. An hour later, they were 6.1 to which I plugged my nose and swallowed the other half of that bar. By ride’s end, they were 5.9. I increased my basal by 50 per cent over the next two hours. No lows. No highs.

Oh happy girl!!!

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But was it fourth time lucky? Only time will tell…