The Bubble Bolus
Friday, January 7, 2011 at 11:59AM Yesterday I was high all day long. I bolused and bolused over and over and nothing seemed to work.
Is it my site? That’s the first thing I think.
So I pulled it out. I figured I would see some blood or a bent cannula but no dice. All looked good.
I assumed it must be scar tissue so I moved it to a spot on my leg that was not used much because it hurts but I figure I should just deal with the pain to get a good site in.
OUCH! I put it in and bolused. A lot.
Still I floated right around 300.
“Screw it, I am just going to go to bed and see where I am in the middle of the night. I am sick of this.” I stormed out of the living room and went to bed.
I woke up around 2AM and grabbed my Dex on the nightstand. I saw the HIGH ABOVE 200 screen. “ugh, lame.” I verified the bg with a finger stick and then rolled over and went back to sleep. The last thing I wanted to care about was diabetes.
But then I thought about the insulin. What if the insulin went bad? I never ever think about the insulin being the problem! Of COURSE! That has to be it!
So I decide NOT to change it right then but to just do it in the morning. I was tired and annoyed.
At about 5AM my bg tanks. According to my Dex it dropped fast and then leveled off. I tested when I woke up at 114.
And so far, my BG has been doing it’s thing all morning.
And that my friends is a great example of how diabetes does not play nice at all and ANYONE who says “you can ‘control’ it” is wrong.
I have this image of an insulin bubble under my skin waiting to erupt and THEN my body absorbs it. Why else would this happen right?
Reader Comments (19)
That's annoying! Maybe you had air in your tubing? That's the only other thing I can think of. Glad your BS came back down finally!
Kim
I feel you. I woke at 3am with bg over 400 (had been less than 150 al day the day prior). Random IP/tubing/site failure. You know its bad when you wake up nauseated (ketoacidosis). Bad tubing, maybe bad infusion. The first thing i do in these situations is grab a backup syringe and give some I the old fashioned way.
Re-did everything pump-wise (my tubing was not expelling insulin for some reason) and then waited to check bg. My first re-do of the infusion didn't work, the catheter ended up bending at a right angle.
Took about 1.5 hrs b4 everything was headed in the right direction and I was satisfied my pump was working correctly. Yeah, "its controllable" drives me crazy since something out of my realm of control invariably goes wrong at least once every 2 weeks.
It's always interesting to me the words we choose to describe our lives with diabetes. We deal with it, manage it, try to control it, take care of it, fight it, survive it, and yet ultimately we just have to live with it. Glad things are going more smoothly today friend.
I agree!! My ds Phoenix does this after every site change now, high for hours, then after a few boluses to try and bring him down, just when I think all the IOB is gone, he drops! I wish he evened out, but usually ends up low. the last couple sites I have skipped a correction and waited it out, and what you do know he comes down on his own, so I guess now I should say the bubble pops!!
George! Sorry to hear this happens - even with a pump... I am still administering the old fashioned DMI way, as I am afraid of the pump...
You are so correct - I hate when ppl and advertisements and Dr's say that Diabetes is manageable. Sure it is if you factor in every single variation that could possibly have an impact - including the weird ass freaky things like what you describe. I too have made correction after correction - worried that I am going to eventually over correct but nothing.... Where does it go?? Did I inject wrong? I too have wondered if my insulin had gone bad. Or if I was injecting to an area riddled with scar tissue...
Glad to hear it did eventually come down and not in a crashing low sort of way...
Krista
This kind of thing drives me CRAZY! I am the type of person who wants to know, actually needs to know, why my daughter's numbers go screwy. I truly admire those of you who are diabetic and work so hard to manage your diabetes.
The same thing happened to me the other day. My last thought was the insulin and what do ya know, I replaced the vial and have been back to "normal" ever since. Sheesh, it's so tiring! I have a check list I used to use when my sugar was high which I have neglected to use. I should go back to it...at least to save a little grief lol I spent two days confused about my 250 average, ugh!
Glad you figured out your insulin issue, too!
PS: I too said "screw it" and went to sleep one night (and I'm not ashamed to say it to someone who undertands)
I'm still a firm believer in punching people in the nose that say that. But I suppose a ninja would use nun chucks.
Did you see the article this week about how pump placement (significantly above or below the site) can throw insulin flow off + or - about 25%? You must have been sleeping on the upper bunk while your pump was sleeping on the one below, ha, ha!!! Sheesh, how many variables are our little pea brains supposed to calculate to "manage" this thing anyway!? Especially in the middle of the night!
Blech.
I hate troubleshooting highs. Period. HATE. IT.
Your idea of a little bubble that just pops is really interesting. And, honestly, it doesn't sound far fetched at all to me.
Ah, well. Back in the game, I guess...
Ugh. I hate it when that happens. Some days it seems like my numbers could be more accurately predicted with a random number generator than with actual counting and measuring.
I hope this site behaves for the rest of the time it's in.
The insulin bubble makes complete sense. My kids just went through 2 days of the same thing. I thought maybe the insulin was bad since we have been at the beach, no go. And every time the bolused for the hi...it's always with a...shit is this one going to be the one that makes them drop like a rock? Sooo not cool....
Well, the silver lining...you came down!
Lol at Carla!!!
I never think about the insulin being bad either but I never think about insulin bubbles-I learn something new all the time.
I use to say I control diabetes when I was first diagnosed but not any more-I manage it.
Just my 2 cents. I think I've managed a routine that works for me based on these principals that I have discovered about my body.
My sites will only accept 100 units. Once I hit that wall the site will fail.
I rotate my sites based upon the age of the insulin bottle. A new bottle is more potent so I place those first two "pulls" from that bottle into my slowest site, ie Arms. Then I place the next one in my leg or backside. The final pulls from the bottle go in my abdomen which is my fastest site and at that time the insulin in the bottle is the oldest and less potent.
I also gently rotate the bottle in my hand before I pull insuiln out of it. This helps the particles of insulin to mix more evenly. Sometimes at the end of a bottle I will get a really aggressive site and that is because the last of the insulin has more "particles" in it.
hth
Ressy
This sometimes happens to me too, and it is so frustrating. I think the imagery of the bubble is perfect.
Very interesting stuff by Ressy! Might have to think about experimenting a bit with that...
I have had that happen, too. It's frustrating because it's so unpredictable. I'm glad you didn't crash at the end!
I always carry a Humalog pen with me as a back up. Some times the pen works better than my pump on stubborn highs. I tend to use the pen on sites my quick-set never uses, like my upper arm. It gives me better results.
And above 200, my ratio changes from 50/1 to 25/1. I'm always looking for the rebound low.
Ugh
I like the bubble theory. This story sounds all too familiar...I just accept that pump change night is going to be a roller coaster ride. Then I'm happy if it happens to go smoothly!
Hi. I changed my site this morning, and have been running mostly high all day. Not high enough to suspect a bad site, but above the lines all day. Low 200's, etc.
Been taking lots of insulin all day. Didn't budge. Doubled meal boluses. Nothing (but no huge spike either).
Now that I'm trying to sleep, the bubble has popped and all that insulin is catching up. Been thinking of this damn bubble theory all night. :-)