Aye Carumba!
How many correctional boluses can you sink in without an effect?
Well, if you have the flu as I have just learned the hard way, the answer is: just keep bolusing, just keep bolusing
When you are sick, the body goes into all this kamikaze fighting mode, and somewhere in the process, your insulin requirements increase significantly. For me, I have a pre-paid action plan: my sick day basal program in my pump, which automatically ramps up my background insulin levels by 30% continuously and despite the changing levels I have programmed in throughout the day.
Once I slowly cotton on to the fact that I am sick, I whack on over to the sick day plan and hope that the added insulin helps to keep the levels in range.
Because what you really don't want to have happen when you are sick is elevated glucose levels. That means the body can't operate efficiently, which also means it can't kill off whatever is making the glucose levels rise in the first place. The sooner you get the levels down, the sooner your body can recover, and the sooner your levels will start behaving more normally. And you feel better. Feeling better is kinda nice.
I know all this theory. I remember someone briefly telling me about 'sick day management' somewhere around that magical period of my life when I was newly diagnosed and thinking that I had to eat every four hours or I would die.
But I don't think I have had the flu before. Well, not like this. I cannot believe the amount of insulin I was pumping in, all without effect. My summary figures don't show the full story: they appeared as if I was having a couple of big eat days. But I wasn't eating at all. Well, hardly anything. I wasn't even drinking. I was just reloading up on insulin and stuffing it into me.
My pods usually last three days with some leftover insulin in them. They barely made it through two days. Thats using almost 100 units per day!
I was also having aches all over, coughing up a bunch of phlegm, and feeling super tired.
I don't like to state the obvious, but I was also very hot.
Two bed-ridden days with continued fever and no sign of a declining glucose level, and I was sick of all this. I was ready to head into hospital to get dripped up to try to sort it out. But as I am wary of any medical expert, partcularly one working in an emergency department on a weekend, I put a call-out for some expert advice first. Thankfully, my doc got back to me on a Sunday afternoon and gave me this pearl of wisdom:
'when we hospitalise type ones with the flu, we put them on a drip of between 6 and 10 units per hour. Of fast acting. Don't underestimate just how resistant you can become when you get sick like this.'
Thats all I needed to hear. I can self medicate, but sometimes I need some reassurances on taking it to the next step.
I cranked up the basal to 200%, which was max efforts. This only equated to around 1.6 units per hour. Not enough. So I ran a continued extended bolus program, starting with 6 units per hour, back to back, then dropping it down to 4.5 and then 4 units per hour.
And I waited.
I already had something like 10 units on board from previous bolus corrections. But the continuous flow of high-rate insulin kicking in seemed to turn it around. I was up to around 21 units on board at one stage. Without any food in me.
I also took some panadol for the fever, which brought the temperature down. And I force fed the fluids.
I don't know which part did the trick, but by Sunday evening I was getting glucose levels under 200 (11.1), I felt better, and had cooled down a bit.
The last two days I have continued to stay at home, trying to shake this thing for once and for all. I still have a chesty cough and runny nose, and get tired and dizzy a lot. But the temperature has gone and I am confident things are on the improve.
I am still having to deal with insulin resistance. I think it is a combination of still being sick, but now its mostly from being inactive.
Can I go back on my bike soon? Now thats the sort of resistance that is actually useful..
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