FUDiabetes

FRUSTRATING SICK DAYS; how do you handle them?


#1

so i’ve been sick for the past 2 days. it happened suddenly. one minute i felt fine, and then the next i felt like i was on my deathbed.

at first, my BGs were remaining very stable and on target; so i didnt think i was as sick as i actually was. but as the evening crept upon me, i needed more and more basal. i was doing IM bolus corrections every 2 hours, just trying desperately to keep my BGs under 200. this has been working, but i have been having to increase my TB% as the day progressed. and today alone, i have done 5 IM corrections! (so far) and thats with the higher TB%. (currently at 150% TB)

how do you handle your sick days? do you have a plan? do you have any tricks up your sleeves? what is your frustration level like?

please tell all. i am feeling miserable and alone here. and my non-D husband hasnt a worry in the world. (of course he doesnt know how it feels when BGs get so high; its as if i have the flu, on top of having the flu) in his opinion, he just says "no big deal; take more insulin, have some oatmeal, have some tea, take some aspirin, get some rest…all logical of course, but who wants to hear normal logic when battling against one of the crimes of this disease!! :wink:

looking forward to hearing from all of you !


#2

@daisymae
Sorry you are not feeling well.
:frowning:
Hopefully you are better soon.

Unfortunately, IMHO your husband is correct. There is no shortcut that I am aware of. Push the insulin and push the liquids. Dehydration can land you in the ER faster than it seems possible.

Each person has their own insulin needs. As well for each person, what BG they are realistically trying to hit when sick is different. For us, my goal is to try and get the BG under 250. On sick days, I consider it “fine tuning” once it is under 250. I understand for some that sounds crazy but for us just that is often times very difficult.

I would typically start running the basal at 150% for a long time (we can just set the pump at 72 hrs). I would also do an extended bolus of 12 units, zero up front over 6 hours. (ie - 2 units per hour for six hours). I set the cgm low alarm at 100 (which is the highest it goes), crank the sound up to hypersonic (or whatever they call it) and wait it out. If it goes into the nighttime, I would also set regular alarms on my phone to wake up every 2 hours at a minimum for either a cgm check and/or a meter check if I was unsure. At night, when sick, and when running this much “extra” insulin, I usually feel more comfortable at night with a meter check to confirm the cgm is in the ballpark.

Once the BG starts dropping and hits 250 (and showing dropping) then I start backing off and monitor from there.

Often times a very high and persistent BG is the first sign of illness even before other symptoms kick in.


#3

I wish I had some diabetes stuff to tell you, but I don’t. Not if you want to survive anyway. :grin: But, daisymae, I HOPE you feel better soon. I don’t know how much your non-D husband is like mine, but sometimes mine can miss the boat. Maybe you can let him just bring you what you need rather than attempting to find the right words? And are you able to take Tylenol? Tylenol has done wonders for me when I’ve been feeling terrible…

I hope you feel better!


#4

Nicky, i cant take TYlenol b/c i am on the Dexcom, so i have been sticking to Excedrin and Benadryl. it does relief some of the sinus congestion, so i am happy about that.


#5

thanks for your detailed response. i really needed it.

i do exactly the same thing throughout the night. i have an alarm on my iPhone which wakes me up throughout the night to do finger sticks and to peak at my CGM to see if they are in sync. last night they were spot on (plus or minus 10 points) (oh, my poor husband; i kept waking him up ever time i tested and had to turn the light on :sleepy::tired_face:

i am on 150% basal now (last night i thought i was, but realized this morning that i was only on 140% so i raised it) i was 73 before bfast and spiked to 176 after 2.5 hours.i ate exactly what i always do for bfast so i doubt it was an ICR issue. am drinking loads of water, etc.

still have a fever


#6

I don’t have anything to say on sick protocol, but I’m so sorry you’re sick. :slightly_frowning_face:


#7

Sorry you are still not feeling well.
But it sounds like you have your BG under control.

Another thing for us is we do not try for your super control BG when sick. I allow it to raise up. When my T1 is sick, I will not give corrections when it gets “down” to 150 and will start backing off the extra basals and bolus.
Biggest reason is at a certain point, the body will be “well” even it doesn’t feel like it. I think the symptoms last longer than the illness. Everybody obviously is different. But when your body stops trying to keep pushing the BG up, if you have a bunch of extra insulin on board then it can go down fast and be a persistent low for hours until the insulin gets used up.

If this does happen, it is a case where a 15-unit mini-dose glucagon can be helpful to soak up the extra insulin particularly if your stomach just can’t handle gobs of carbs.

So, running in the 150 range gives an extra buffer.

But - not so much advice for you but more what we do. Everybody is different. Everybody has their own target range.

In any event, hopefully the illness passes soon so you can get back to your normal life.


#8

Have you experimented? There are people who don’t see any effect, and then there are some who do. I’m on the guardian, and Tylenol supposedly messes with its accuracy, but I don’t see any difference. However, on the Libre, it’s ibuprofen that causes problems, and I can definitely see the difference when I take it. Tylenol is pretty powerful stuff against a nasty cold… maybe you could try one and do an extra couple of finger sticks to see how your Dexcom is holding up.

Hope you’re feeling better this morning…


#9

We do not use Tylenol or any product containing acetaminophen either while on the Dexcom. (Have to be careful as acetaminophen is an added ingredient in many products particularly many “cold” medications.) Particularly when sick I do not think it is worth it. More important things to deal with.

If any relief is needed, we use Motrin and Sudafed.

As a side note, the Dexcom G6 has removed the contraindication for acetaminophen.


#10

I know it’s real, it just has never been an issue for my Guardian… which is not known for it’s accuracy anyway. So maybe it’s an issue, I’ve just never recognized the even LESS accurate numbers.

With the Libre, where Ibuprofen is the problem, it was amazing for me to see the change. My Libre, which is a high reader anyway, was as much as 50 or 60 points off and throwing out arrows left and right for absolutely no good reason. Seeing that really confirmed the fact I just don’t see it with the Guardian.


#11

i’m with you on this one, thomas. i stay clear of anything containing acetaminophen. i use Excedrin, and Benadryl and something to help me sleep through the worse parts. (Sudafed makes me jittery like coffee does, and i cant stand that feeling…even Excedrin has caffeine in it, so i only take 1 tab at a time)

and PS: i cant wait for that G6 to come out so there is no need to worry about any of this contraindication.


#12

Be sure to check the active ingredients in Excedrin. There are various “types” but I am pretty sure it is common for Excedrin to contain acetaminophen. It would clearly and explicitly be identified as such in the list of active ingredients.

That is actually one of the big issues with acetaminophen in that it is included in so many other products where people may not realize it. And then people will at times take the Tylenol (ie - acetaminophen) at the max dosage not realizing they already are taking acetaminophen with other OTC medications. Which then can contribute to an accidental overdose which has the potential to cause liver damage. This is the reason the FDA reduced the max daily dosage of acetaminophen a few years back in 2011.


#13

and yet, interestingly, many hospitals still hand out 2 extra strength Tylenol to patients… exceeding the recommended maximum 500 mg dose. Stores often don’t carry the regular strength either… or, if they do, there’s a small number of them. For people who don’t know, there’s little indication that those extra strength ones are not the wisest choice.


#14

thanks for this. i just checked my bottle of Extra Strength Excedrin and it does indeed have acetaminophen. thank god it hasnt been a problem with my dexcom accuracy. i wont be taking that medication anymore!!! now i am going to check out my Bayer Aspirin and see what’s in that.

mu husband found me a Robotusin for Diabetics (without sugars). i read the ingrediants VERY carefully; no acetaminophen in that one. PHEW. especially b/c it has been working very well so far. check it out.


#15

I eat garlic raw and use young living thieves oil, one drop in water… twice a day. Sometimes I will drink oregano oil instead… one drop in water once a day. It’s powerful … It shortens the length of my illness I’ve found. Feel better