Untethered For a Day

When I woke up yesterday with no more Novolog in my pump, I did what any sensible insulin addict would do and took some expired Lantus. How much? To be safe I took 50% of my total daily dose, 18 units. Immediately my levels returned to normal and I felt that twinge in my gut that signals glucose dropping quickly. It was such a distinct sensation that I wondered if Lantus loses it's time-release function and acts quickly when it's old? It leveled off in a comfortable range and I relaxed.

I disconnected my pump, but carried it around all day since it could receive data from my CGM and help me keep tabs on my levels. During the day I had to do corrections of expired Novolog from a pen. They sort of worked... I was able to keep my glucose at or below 200 all day. Due to a busy day and subbing for a colleague, I didn't have lunch, so I was able to skip the mealtime bolus drama. The corrections throughout the day were already keeping me pretty busy. (Meanwhile, in the pharmacy, it was taking them all day to get a hold of my doctor and get me some emergency insulin. Good thing I didn't throw that expired insulin away. )

I picked up some legit Novolog pens, but didn't want to start the pump back up until the Lantus was out of my system. I did have a low after dinner and had to do some snacking to keep things in check. I had been a bit aggressive with corrections since I suspected the Lantus would eventually start to taper off. Of course, overnight my levels started to rise and I was awakened by high blood sugar at 2:30am. I couldn't sleep so I got up, loaded the pump, took a Symlin aided correction and have been up since. I probably will regret not sleeping, but the week is winding down and after lying in bed for an hour, there's no point in staying horizontal.

It was an adventure. I kind of liked being free from tubing for the day, but correcting with Novolog every couple of hours was similar to being tethered to something. I didn't relax about it too much.

I have some blogging to do...

I've been storing up some thoughts, observations and data that I would like to document here. I'm going to make a list to remind myself of the writing I'd like to do.

• Blood Sugars Mysteries, the good kind... (why do we have a day or two of unbudgeable perfect glucose control?)
• Off label uses for Symlin
• My LDL Cholsterol went down (a lot) for the first time in 7 years. Why?
• My other data from the recent months, not as bad as I thought. 
• iBGstar Meter on sale, is it worth anything?

It might be an interesting day for glucose...

Every time I fill my pump reservoir I hold the wee cylinder of insulin up to the light and say to myself, "I can't believe this tiny little amount of clear liquid is going to keep me alive for the next few days". It's always kind of awesome to realize.

And then, today, I ran out... Like, really ran out! What's going to keep me alive?

I'm feeling a little irresponsible, but I'm also a victim of the random whimsy that is mail order prescription drug service. Usually they ship overnight, and usually they auto-ship. Neither of those happened, and when I got down to about a week of insulin left, I manually ordered my prescriptions. I got a confirmation that my shipment had been shipped and was relieved. Then yesterday, I came across this sad little package on the counter that had some pills in it that I didn't need. "Where's the insulin?" I checked the website and see that all the diabetes related stuff was hung up (no doctor refill response?), and not yet shipped.

Hmmm. In the fridge I have Lantus and Novolog pens, but they expired a year ago (it probably IS irresponsible to not know the status of those). I took some anyway (and Symlin). I know that when stuff expires it often still works, maybe just not as well. I could fill my pump from the Novolog pen, but I don't really want to commit quite yet. What works better 12 months expired Lantus, or 9 months expired Novolog?

I called Walgreens at 5:30 this morning and explained my situation. They are going to try getting in touch with my doctor, and then try to get the insurance to override the insurance limitations and get me some fresh Novolog. Sounds complicated, but I think they've done this before. I'm glad they are 24 hours.

I'm sure I'll learn a lesson from this, I usually do.