A new adventure

[John]

Hi Jenny

Sorry I should have said a fridge full of super glue as that is where I keep the unused bottles as it keeps them fresh, I also have some disposable thin tips which fit on the bottles. I have used it in the past to fix minor cuts which wouldn't stop bleeding and I always use a bottle from the fridge and a new disposable tip which I throw away afterwards. The only problem with this is that my wife complains about having a fridge full of glue.

With regards to Clopidogrel and warfarin according to my consultant they work in two different ways the Clopidogrel acts as a lubricant type of thing and stops clots forming and makes the blood flow easier. Whereas warfarin is an anticoagulant  and turns your blood to water and makes it easier to pump hence all the dire warnings and monthly INR tests to make sure it is within the desired thinness range.


john

[Pattidevans]

So now I am on basal injections so that will go to running my body and than any left over from that together with any insulin my pancreas is producing is used to correct my BG. If there isn’t enough left over to combat spikes etc then I might have to go on bolus as well.

Well, not quite John.  There should not be any "left over". If you are on a correct basal dose you should be able to go without eating all day long and remain level.  If you start to go down and need to prop it up with food then that indicates that your basal dose is too high.  May I suggest you have another look at that link and check out the paragraphs on "Basal testing"

[sedge]

Hey - she means a fridge full of glue and insulin now!  LOL  (and the insulin goes in the top shelf of the door so if that's where the glue goes - tough, ditto if Mrs John likes to keep eg the butter there.)

[John]

Thank you Patti I had a feeling I hadnt got it quite right.

I am doing some night time testing as I wake up several times a night due to other problems so I have been testing to see what is happening. I go low then high then come down a bit again, I seem to go up sometime between 3.30 and 5am I am just hoping I wake up during that time so I can test.

Unfortunately my appointment with my DSN didnt happen on Monday as she is of sick, hopefully she will be back by Friday. I did talk to a junior DSN about splitting the dose etc but she said I need to wait until Mary comes back.



It is taking me a long time to get back to pre eating levels even on very low carb meals so I think Bolus is coming soon.

[John]

You are not wrong Jenny I have had that comment followed by there wont be room for food in there soon. I think she wants a new fridge freezer as she keeps dropping hints about one of those american stile fridge freezers with ice making as one of my sons brought one a couple of months ago. The problem is to fit it in she will lose a cupboard so she is thinking which she wants most, my comment was it was a good idea to get a new one as it gives me more room for insulin once I go onto Bolus as well.

[Pattidevans]

my comment was it was a good idea to get a new one as it gives me more room for insulin once I go onto Bolus as well.

LOL LOL!  I keep mine in the butter compartment of the door, along with the butter and the opened tube of tomato puree!

[sedge]

Our fridge has two shelves apart from the bottom one where we keep the open milk and the currently open bottle of Tescos famous water.   Top one is all me - still got a vial in there (prolly out of date now so needs chucking) two prefilled pens (for emergencies) my Hypokit in its plastic box  and up to three boxes of pump cartridges - the one that only has the last cartridge in it, plus the replacement two boxes on the new prescription I just had filled.  Butter and eggs on the middle one.

If I start making/buying stuff that needs fridging eg a chilled raw chicken and a relatively small premade gateau it's a jigsaw.  If we had an actual party - we'd have to turn the fridge in the Moho on!  In winter of course - wine, beer and mixers go in the big fridge that God made for us all to share, right outside the back door on the slabs!

[John]

HI all, I am still around just had a few very hectic days followed by a few days of some bug so not been in the mood to do anything really.

At the moment I keep my one box of pens on the top shelf of the fridge next to the super glue.

I had a good chat with my DSN, she is a fully qualified DSN, and I am now gently increasing my insulin as required by 2 units every 4 days. In addition I have split the dose to twice a day I was getting bad liver dumps or something during the night, I only started on the split dose yesterday but for the first time since I started on the insulin I went through the night without a liver dump, or at least one that woke me up.

[Pattidevans]

John

Sorry you've not been well and hope you are feeling better.

In addition I have split the dose to twice a day I was getting bad liver dumps or something during the night, I only started on the split dose yesterday but for the first time since I started on the insulin I went through the night without a liver dump, or at least one that woke me up.

Please can you explain what you mean by "bad liver dumps"?  In the context I understand them I have no idea why they should wake you.   

[John]

HI Patti

It is probably the wrong term or in the wrong context. What I mean is that I wake up very hot and sweating if I immediately measure my BG it might be around 6.0 at that time and then check it again 15 minutes later and it can be as high as 11.0. I was told many years ago that this was caused by my liver dumping some of its sugar store as I had gone very low while sleeping.

I dont know if this is correct but it seems like a reasonable description to me, it is the same feeling I get as when I am low and raise my BG quickly with glucose tablets etc or after a big meal.

[Pattidevans]

John

It is probably the wrong term or in the wrong context. What I mean is that I wake up very hot and sweating if I immediately measure my BG it might be around 6.0 at that time and then check it again 15 minutes later and it can be as high as 11.0. I was told many years ago that this was caused by my liver dumping some of its sugar store as I had gone very low while sleeping.

What that would say to me is that you are suffering hypos whilst you sleep and only waking to the subsequent liver dump, rather than having unexplained liver dumps.  Therefore I would be cautious about raising insulin at the rate of 2u if part of that 2u is overnight.  On the contrary you may need to reduce it over that time to avoid the initial hypo which is causing the subsequent liver dump, as opposed to raising it to counteract a completely spontaneous and unexplained liver dump.

OR a completely different explanation might be that your body, having got used to higher levels thinks it's hypo at a level of 6 and reacts accordingly.  In other words a false hypo.  In either case I would be extremely reluctant to raise overnight basal until you know what's what.

[John]

HI Patti

Yes it is probably caused by hypos at what level they start I dont know yet but I will find out.

I have spilt my dose so instead of 10u at night I am taking only 5u which at the moment seems to be working but it is early days. I am now taking a morning dose as well which with the raise of 2u is now 7u in total which also seems to be working.

I am currently going to bed on about 8bg and waking up in the morning at about the same level, same during the day my BG is reducing after meals a lot quicker than it did when I was on the single dose.

It is early days still so I am keeping an eye on what is going on, some of it is down to a change in diet but some is definitely down to the insulin.

[sedge]

On a split basal - Levemir - I landed up on (approx.) 15u in the morning and 5u at night - I always imagine I needed less at night - but since getting the pump have seen that it was not the case.  However - there was enough of the 15u left over and still working through the late evening (say 10pm - 1am) with the evening dose of 5u at 9.30pm ish added on - to do the job.  Fascinating !

As long as the nurse isn't saying increase both doses, that's what Patti meant - cos it wasn't apparent you were already not doing that.  You ain't - so  that's OK - Phew !  LOL

[Pattidevans]

It is early days still so I am keeping an eye on what is going on, some of it is down to a change in diet but some is definitely down to the insulin.

You do sound like you hope that once it is sorted that's it, it's sorted.  I hate to burst your bubble, but insulin doses are never sorted and fixed rigidly.  You will get it right and it may stay right for maybe a couple of months and then something will happen and you may not ever know what that something is, but you will have to tweak and change it again.  So it's not like "I am keeping an eye on it now because it is early days"  you will always and forever have to keep an eye on it.

I'm just going through a period now where I know it's not right, but I am unsure as to where to change it.  Or if it's even  worth it right now as my circumstances are about to change radically and I might as well bumble along and fix it then.

[John]

On a split basal - Levemir - I landed up on (approx.) 15u in the morning and 5u at night - I always imagine I needed less at night - but since getting the pump have seen that it was not the case.  However - there was enough of the 15u left over and still working through the late evening (say 10pm - 1am) with the evening dose of 5u at 9.30pm ish added on - to do the job.  Fascinating !

As long as the nurse isn't saying increase both doses, that's what Patti meant - cos it wasn't apparent you were already not doing that.  You ain't - so  that's OK - Phew !  LOL

The nurse has left it to me to sort out the dose but she is on the end of the phone if I need her.
Just upped my morning dose to 9 units things are going good.