Yesterday, as I was changing my pod due to an occlusion that resulted from slamming my pod arm against a door frame two hours prior, I realized why I don't log. I realized why I can't find a logging app that I like. I realized why I can't even create a form I like even with my mad spreadsheet skillz.
There is just too much to log.
Whenever I've tried to create a form with the fields I think I need, I feel fairly satisfied until the first time I find information I need to log that I can't fit into a tidy space.
Submitted for your disapproval: my yesterday
- CGMS reads low from 3am-7:30am. Husband woke me, worriedly, at 5:23am. Checked and registered 61 mg/dL. Groggy, I told myself I should get some glucose and....zzzz...snore...was gone again before I could treat.
- Woke again at 7:30am. Feeling really low now, but don't bother wasting a strip to confirm a value. CGM buzzing and freaking out on me saying I'm below 55. Ate 20g of glucose quick sticks. Drank some coffee without my usual makeshift coffee insulin dose.
- Breakfast bolus 6.05 units taken 10min before I eat (do I notate that I pre-bolused beforehand and how long?). Took additional insulin for coffee.
- Bumped arm while taking out the trash. "Ouch."
- Two hours later, high BG of 200 mg/dL indicates that the blow to the arm probably messed up my insulin infusion. Took lunch+correction bolus (10 units) as I ate lunch rather than pre-bolusing. Occlusion alarm happens about 5 minutes into the delivery and just as I'm finishing my 48g of sandwich and chips. Crap.
- Also, I lost count of the chips because I reached my hand into the bag rather than carefully weighing the serving on my gram scale like I normally do.
- I change out my pod, trying to notate some of this in my MySugr logging app.
- I forget to take the remaining 5.30 units of the 10 unit bolus that I didn't receive (because of the occlusion) and the whole reason I forgot it is that I logged it before I did it and therefore misremembered that I took it. That 5.30 units would have come on board late after the meal and peaked at the wrong time anyway, but I didn't even get it. I'm 258 mg/dL an hour later. I check and correct with 2.75 units of insulin.
- More coffee.
- Two hours later at 2:48pm, I am inexplicably 434 mg/dL. Prior to the occlusion, maybe I didn't receive any bolus or basal at all? Was it the post-insertion insulin absorption that inconsistently affects pumpers after I changed the pod? Was it a problem with the new pod? Was it the coffee? Is my insulin spoiled? I take 10 units via injection. My pump says I need 11. I know that I'm going to plummet if I take 11.
- My CGM alerts that I'm 258 mg/dL and dropping with double arrows down. I have 1/2 cup of sugar free pudding with a couple sliced strawberries. Should barely give me a bump, but it might stave off the bottoming out.
- Pre-dinner, at 7:11pm, I'm still 215 mg/dL. I bolus 7.80 units for the 3/4 cup of rice I'm eating with my broccoli and protein. My injected Apidra I took at 2:48pm should be well out of my system now because its action is about 3.5 hours for me.
- By 9:30pm, my CGM is going crazy that I'm low again. My husband slips me a cookie as I cuddle the kids to bed.
- At 10pm, I stumble into the kitchen. I'm only 64 mg/dL, but my legs are jello and my feet are on invisible roller skates. I eat some glucose. I drink some juice. I eat lots of other stuff. I don't remember the carnage. How do you log regret?
- At 11:23pm, I'm 201 mg/dL. I bolus 2.70 units and call it done. I'm afraid to dose that much because I drop through the night already and ANY insulin on board seems to do me in. But if I don't, I am going to be sick all night. I go to bed around 12:30am. CGM is flat most of the night in the 130s. I'll take it.
What would a logbook look like if it could tell the whole story? What app could possibly accommodate that many deviations, exceptions, explanations? What would my medical team say when they reviewed it? What do they see now?
So I feel overwhelmed by the information and I don't log it. I let my team upload my pump and CGM data and pore over the results. I watch The Evil Genius highlight numbers and ask me why I was high three weeks ago Monday after lunch. I don't know. Probably some combination of THIS DISEASE SUCKS ALL MY MENTAL ENERGY and IT'S A LONG STORY.
I do understand that logging all relevant data would help us make decisions about my dosing rates. Just as you know that you should probably exercise 30 minutes a day and put your phone down more and turn off the television.
But health care providers make it seem as easy as:
Time ____, Blood Sugar ____, Medication ____, Carbs eaten _____.
And that's a log of crap.