Friday, September 08, 2006

The Cover Up

I had considered now tackling the opposite side of the issues I discussed in the last two entries...but I decided against it. Although, the comments have been interesting, including Patti's, with whom I actually agree. But, as I said, I was trying to give a one-sided view on purpose.

Anyhow, today (actually last night) I was thinking about another topic that is aimed at diabetics, and my favorite topic: being self-aware of your symptoms.

But in theming with taking the "other side" of things this week, I wanted to talk about the things that make it more difficult to self-diagnose highs and lows.

What symptoms do you feel when you are high, and at just what point do you feel them? Likewise for when you are low? Symptoms can vary depending on just how high you've been, or how long you've been high, etc. Let me use my symptom of coughing. If my blood sugar is on the rise, generally passing the 200 mark or more, I tend to cough a lot. So, even if I don't have my meter handy, I'll generally take corrective action.

But there is a danger in this if there are other likely causes of the same symptom. And in my case, coughing can also mean a bit too much caffeine.

If I drink, say, two bottles of Diet Mountain Dew in a relatively short period of time, two things happen. First, I have to go to the bathroom, and second, I start coughing. This is because caffeine dehydrates. It runs straight through the body. But if I'm not paying attention, I might confuse my coughing and frequent bathroom trips as a high. I might correct when I don't need to, and end up low instead.

So it is important to not only be aware of your symptoms...but to be aware of anything else that might cause those symptoms, or mask those symptoms.

On the other side of things, I know that when I'm particularly tired, I'm far less aware of being low. That's because one symptom of being low is tiredness or lack of energy. So, when I've been particularly active, having worn myself out, or just tired from a lack of sleep, I'm more prone to end up low. Instead of noticing symptoms at 70 mg/dL, I might not notice them until I reach 50.

It is like a great "cover up"...where something else fools you into thinking you are high or low when you aren't, or fools you into think you aren't high or low when you are!

So what does this mean? It means that despite your best efforts in learning your has to go beyond that. You have to get to the point where you are also aware of when something else could be causing those symptoms. It also emphasizes the point that frequent testing, no matter how good you may be at determining the state of your BGLs, will always be needed.

But now I have a challenge for you. Or, perhaps, homework. I want you all to work on predicting your BGLs. How? Well, randomly, before you perform your usual BGLs, pay attention to how you feel. Note any symptoms you may or may not feel, as well as things you might not think of as symptoms, such as just feeling down, or tired, etc. Then "guess" what your BGL is. I generally say if I'm within 50 mg/dL, I'm pretty accurate. See how well you do. But don't just do it once. Do it for a week, or two weeks. And see if you start noticing any patterns. When you are way off, look at how you feel and figure out why it is. But always keep in mind the "cover ups".

For example, if you say, "Well, I'm really worn out. No energy today. I bet I'm low."
But keep in mind that you also only got four hours of sleep last night. So you test, and you find out you are 423!!! Ah, yes...don't forget that a symptom of extremely high BGLs is a lack of energy as well!

Okay. Let's synchronize our watches...and good luck!

Edit: By the way, I just realized that today marks the 1-year anniversary of the Ryan Bruner blog! Woohoo!


Scott K. Johnson said...

Congrats man! Great series of posts you've got going here!

And you are very correct with this. That is part of what makes diabetes care so intimidatingly all-encompassing at times. There's so much involved!

Sounds like a great game - and I'm all for it.

I work with a guy who is also type 1 diabetic. He guessed his bloodsugars at a particular time, two nights in a row, and he was not within 50 mg/dl, but 5 mg/dl.

I damn near fell over. One lucky guess is cool - but twice in a row!? Amazing.

Anonymous said...

Hey Ryan.

I managed to download the Logbook DM to my Palm. It's so cool, and already it's helping me alot.

Thanks for that :o)

Vicki x

Minnesota Nice said...

How can you separate the intellectualizing from the simple "body awareness"?
I tried it this weekend. On Sun. morning, for instance, I got up to test and tried to tune into how the body was feeling, but my mind-ramblings got in the way - what did I test at before bed? at 2 a.m.? did I sleep well? and a b'zillion other factors that might affect my fasting number. It's really hard to step away from that because we have to be thinking about all these little bits of information all the time.
Anyway, I guessed "60" and I was "135".
It is very intriguing. I've often felt that when I'm very high, say 300+, the energy in my meridians flows backwards - can't get much done on any level when thats happening.

RyanBruner said...


Thanks! I'm glad you're finding it useful!

M. Nice:

Well, it is your first go at it, right? I mean, the intellectualizing needs to work in SYNC with your "body awareness".

So, what was it that made you think you were 65? What symptom or symptoms did you feel? Then figure out if there was possibly another reason for feeling that symptom or symptoms.

Contrary to how it may SOUND from my posts, I'm not spot on my BGLs every time. Just frequently. There will always be times you guess and are completely off. I remember once thinking I was going low, and it turned out I was heading into the 400s. Wooops! It happens. But the idea is to become more aware, and gradually more accurate more of the time.

Sometimes "body awareness"...just a general feeling you have that you can't put a finger on...will be the best guide you have. Go with it!