“Have no fear of perfection – you will never achieve it.” – Salvador Dali
I can’t get my head around it. Does anyone with diabetes who is motivated in their management think they can’t achieve perfection? Yes I said CAN’T.
As a Person With Diabetes I think that not only can I achieve challenging feats beyond my day to day life, such as ascending the Peruvian Tundra to over 15,000 ft BUT I can also achieve perfection with my diabetes.
As a PWD I know that this mindset is superfluous. BUT, I still want to pursue it, just in case I can achieve it. You never know, right?? Isn’t that a great goal to set and pursue. Almost like a cure, really.
BUT….yes, I said BUT…I am reminded of how the attempts of trying to be all that to my endocrine system and diabetes management isn’t that simple. Even after coming into 40 years of living with diabetes and being a Mom of a PWD for 14 years.
I am reminded on our flight to Peru, no matter how hard I attempt to make my diabetes perfect, I cannot.
Upon take off I am aware of the potential impact the air pressure can have on my insulin pump delivery. The rule of thumb despite there is not total clinical evidence with regards to this is to disconnect on ascension and descending. Why? The talk of the town is that upon take off the pressure can change the delivery of insulin to cause a low blood sugar. During the flight the pressure change can create air bubbles resulting in missed insulin after landing.
I have experienced this throughout the past 14 years of travel on an insulin pump but was not aware of the ‘talk’ that circulated about this until the past few years.
So, whether clinically relevant or not, I decide to take heed to try and avoid this.
We are prepared for take off at Pearson. Status quo. Prior to boarding I check my Continuous Glucose Sensor. All is good in my diabetes world.
As the plane positions itself for take off on the runway I disconnect from my site with the intention of reconnecting within a few minutes after the rapid ascension is complete.
I am excited. I am thinking about our trip, the flight which is 21 hours with stop overs. In my mind I am running through what we packed versus the list I print and check off. I am nervous. I am landing in a city that has an elevation of over 8,000 feet. I am worried after the stories I am told of elevation sickness.
The airline steward serves our snacks. I give it to Steve. Packed full of gluten. I don’t need a snack anyway. I’m not hungry. I look at some magazines. I do a Word Search.
Several hours pass by. I start to feel like the Sahara desert lives in my mouth. My stomach feels like a brick made a home in it. My chest feels heavy.
I question these feelings. Why? It feels like I am high. How come? I don’t clue in to check my sugar though. I attribute it to the elevation, the dry air, the excitement.
The steward comes around again. Offers snacks. I pass mine onto Steve’s again. Maybe if I eat and drink a ton of water I’ll feel better. I take one of my gluten free bars out of my bag. I bolus, I eat. I feel like crap.
Is it the flight? The cabin pressure? I just can’t make sense of it. Obviously my brain cells are not firing on all cylinders. Doesn’t being on guard all the time with managing diabetes do that to a person?
Then…I get an itch at my site. And so I scratch. It is so itchy I must lift my shirt enough to place my hand under so I can make skin to skin contact to find satisfaction. While scratching I realize my tubing at my site is flopping back and forth….I am NOT attached to my site.
I forgot to re-connect after take off. That was 3 hours ago.
In my effort to achieve diabetes management perfection, I fail.
Now, forgiveness is mine. I am so insulin sensitive that I only end up with a BG of 11 mmol/L. I check for ketones as well. They measure at only 0.3. So…I correct for the gluten free bar and basal rates missed as well as a small amount for the trace amount of ketones. It takes several hours to come down and even though my sugar is only 11, I feel like I’m on the edge of DKA. I know what it’s like, I’ve been there.
We land in Peru and I am almost in target.
After that incident I make a promise with myself. Disconnecting on a flight to achieve perfect blood sugars is not a goal I wish to achieve. For what I wish to achieve I fail. I avoid a potential low but instead end up high and feeling terrible.
What’s the lesser of two evils. I can’t answer that but I will tell you I will no longer disconnect my site.