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Bad Insulin + Bad Infusion Site + Humidity = Dehydration

Posted Jun 07 2010 7:25am
It all started on Wednesday night as a reward for a solid brick consisting of a 1 hour trainer ride with 4, 5 minute, 5a efforts followed by a 90 minute run at a 3 - 4a pace (10 minutes of a cool down) I ordered some chicken fried rice and tofu in green pepper sauce for dinner.  At first my blood sugar seemed to respond perfectly well to the 140 grams of carbohydrates I assumed were in the meal.  But then my glucose levels started to rise slowly; after giving myself an additional 12 units of insulin I should have realized that something was up but of course I just went along with it knowing that chinese food has a tendency to play tricks with blood sugar.

I woke up on Thursday with a blood sugar in the mid 180s and fought off his for the rest of the day and for boluses it seemed I needed 1.5 times the amount of insulin I normally would take in.  On Friday when I woke up in the 200s I kind of figured my insulin was going bad so I took my new vile out of the fridge and switched infusion sites.  When I inserted my silhouette site I felt like the canula didn't go all the way in, but like an idiot didn't pay much attention.  My blood sugar finally dropped below 90 so I assumed that the site was in perfectly fine.  After swimming Friday night I had grilled chicken on a split sprout tortilla - a total of like 30 grams of carbohydrates with a very low glycemic index.  Since my blood sugars had been so whacky I bolused up for this meal with 5 units of insulin (normally i'd have a bolus of 2.5 units for this meal); my blood sugar continued to slowly rise, after giving myself 6 more units of insulin with no blood sugar response I felt my site and realized the canula had totally come out - ugh.  A quick infusion site change had my blood sugar totally come back into range.

Saturday was my big workout for the week a 3 hour ride followed by a 1.5 hour run - done at approximately Ironman pace.  The preceding night I had gotten kind of dizzy a couple times but assumed it was just because my blood sugars were running so high, when I woke up on Saturday I felt a little off but thought it was just due to my 6am wake up.  My bike started off great, even in 80 degree heat and 80% humidity at 8:30 am (that's alot of 8s!).  I took my Mavic Cosmic race wheels off so I get more of a speed boost on race day and swapped in my much heavier training wheels.  Even with the training wheels I was holding a solid 23 mph pace on the flats and climbing comfortably in upper zone 3, low zone 4.  At one point during the ride I stopped to pee and when it came out bright, bright yellow I probably should have realized I was in a bit of trouble.  I bought some more water and had a gatorade low calorie at the country store and finished up the last hour of my ride.

I took in some gatorade at my apartment, tossed on my fuel belt and headed out for a run.  12 minutes into my run my entire body started to tingle, my hands went a little numb, I could barely see straight and my chest felt like someone was stabbing a knife into it.  I quickly found some shade and had to brace myself against a tree to make sure I didn't go down.  I drank a fuel belt bottle and waited, and waited, and waited for my heart rate to get into a recovery zone.  Normally stopping my run for 30 seconds will have my heart rate quickly drop below 120.  Standing in the shade, braced against a tree my heart rate wouldn't drop below 144!  WTF!!!!  I stood in the shade for what felt like an eternity until I could see without blurriness and set back for my apartment at a 10:30 pace.  Even at a fat man shuffle jog my heart rate was in the upper 160s.

Finally back at my apartment I pounded 30 oz of low calorie gatorade and collapsed on my floor with a bag of ice on my neck.  Once I finally cooled off a bit I started drinking bottle of water after bottle of water.  After 100 oz of water I finally peed again and it still wasn't clear!  Quickly googling the symptoms of dehydration  I realized that the water level in my body was down somewhere between 5% and 8%; not good.  The combination of an intense workout on Wednesday, high blood sugars in the 48 hours preceding Saturday and insane humidity on Saturday had me in a bad spot hydration wise.  I made the smart choice by cutting my brick short on Saturday and at this point whatever fitness I have is the fitness I have for CDA, it's much more important to stay healthy than to push through a dangerous wall.  It was also amazing how much more "ok" I was with having to cut a workout short for something other than blood sugars.
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