[Insert Expletive Here] High

I don't know why it is that whenever I have a pump problem, or just a general blood sugar problem, it seems to crop up when a) I'm not using a sensor, b) I've thrown complex food in to the mix, and c) overnight.

I had a high this weekend that met all these conditions.

On Friday evening I met up with Allison Blass, of Lemonade Life and another friend who I met through the Insulin Pumpers UK mailing list around six years ago. It was lovely to finally meet Allison in person, and we had a very enjoyable evening at Fire and Stone in Covent Garden. The discussion ranged from socialised healthcare to the New York Subway, and covered everything in between! And of course diabetes couldn't be ignored. Fire and Stone serve delicious pizzas - the kind where the base is like a plate, and the toppings form a proper meal. They also serve delicious desserts that are very definitely bolus-worthy. We took pooled carb estimates, dialed in sizable boluses and enjoyed!

Over coffee, some hour and a half after bolusing for dessert, we had a simultanous BG check. Allison definitely gets the award for handling the challenging carbs like a pro!

I landed at 12.3. Or 220.

No problem. That's what correction boluses are for. Except... correction boluses are intended to actually correct your blood sugar level. But two hours later, right before I went to bed, I was 14.3 (257).

Huh?

I did give the tubing a cursory glance for air bubbles, and didn't find any. I did have a quick check of my infusion site, but nothing seemed amiss. I just assumed that the pizza and desert had really done a number on me. It was easiest to blame the food and my bolusing skills (or lack thereof). I took another correction bolus and fell asleep.

Fast forward to 5.30am.

I awoke from sleep to a tongue so dry it had adhered itself to the roof of my mouth, and a very pressing need to visit the bathroom. My meter gave me the reason why.

This wasn't a friendly greeting.

I can't even remember what the upper limit of my Freestyle meter is, but I knew this had to be well above 30mmol/l. Probably over 600mg/dL. I didn't really disbelieve it, given how I was feeling, but years of ingrained, habitual response to very high numbers made me check again.

"HI"

Fuck. Fuck. Fuck.

When I'm half asleep in the middle of the night, I'll often disregard the proper procedure. I might often just whack in another bolus via the pump. Or if I'm being cautious I might inject a dose and assume that will carry me through until morning. I'm not really one for interrupted sleep, and the thought of figuring out a pump problem and changing an infusion set in the wee small hours doesn't excite me much. (Does it anyone?)

But this was a "HI". I can't even remember the last time that I saw that on my meter.

I checked my infusion set again (fine) and looked for bubbles again (none) and then figured I'd disconnect, prime the pump and see what happened. It didn't take long to see that I wasn't getting any insulin at the end of the tubing. A closer examination and a confirmatory sniff later: the insulin was coming out where the tubing meets the reservoir connector. look closely and you can see the break.

(Those aren't my fingers, but that's a story for another post)

"How the hell did that happen? When did that happen? Thank God I bothered to check... "

It was pretty easily sorted, with a new infusion set, but the biggest problem was figuring out exactly how much insulin to take for. Not only did I not know how many hours I'd missed, I also has no clue what my blood sugar actually was!