Friday, September 26, 2008

Subconscious Maintenance

It's 10:30 on Friday night and I'll admit that I'm definitely tipsy, bordering on downright drunk (please excuse all typos, grammatical errors and ramblings).

I am a victim of subconscious diabetes maintenance.

Before I go to bed, I take three pills and my nightly dose of Lantus insulin. One pill I take upstairs, two I take downstairs at the same time I take my insulin.

I follow the exact same routine every single night and don't really vary.

So tonight I went out to dinner with my husband and had two martinis and a glass of wine over the course of three hours. Somehow, for some god forsaken reason, I got into a discusssion/debate/argument with my husband over the Greek system. Please keep in mind that I have been out of college for over 18 years and my husband has been out for slightly less than that. There's absolutely, positively no reason either of us should feel that passionate about sororities and fraternities and the reasons people join them or don't, but somehow, we were. We kept arguing and debating back and forth about the individual merits; his university versus mine; his situation versus mine; his experience versus mine. (For the record, he was in a fraternity, I was not in a sorority.)

So, during this hour-long back-and-forth, I think I started preparing for bed. I remember taking my two pills from the insulin drawer, filling a crappy tupperware cup from the dish drainer with water and swallowing them, and measuring out insulin in my syringe.

When it came time for my husband and I to call a truce and go to bed (still slightly irked at each other and definitely still tipsy), I could not remember if I had actually given myself the injection. Did I take my insulin shot or not?

I'm on a one-dose a day regimen of Lantus. I get one shot at night and that carries me through the next day. If I don't take it, I run the risk of being really, really high the whole next day (especially when I've already been running high) and basically starving myself all day to keep from going any higher. If I accidentally double the dose, I'll be shoveling food in my mouth all day to keep the lows at bay.

And the thing is, I'm due to drive three hours by myself tomorrow to another state. Not exactly the best time to be monitoring a constant low or a constant high.


And ugh again.

I follow the same routine every single night, so individual memories no longer stick out in my brain. Was it tonight or last night that I opened the new bag of syringes? Was it last night or tonight that I remember flicking the bubble out of the syringe? Was it last night or tonight that I have the sensation of sticking my finger over my injection spot and massaging the insulin all the way in so nothing leaks out?

I can't remember.

I'm at the point where one shot no longer distinguishes itself from another and I can't for the life of me remember if I gave myself a shot or not.

I'm like a detective (a little drunk, tired, third rate detective), trying to search for clues in the mystery of "Was there Lantus or not?" I remember thinking earlier this week that I would need to change out my bottle of Lantus this weekend. In my insulin drawer, the bottle of Lantus is missing. Does this mean I gave myself a shot and threw the bottle away, knowing I would open a new bottle tomorrow? Or does this mean I set myself up to take the shot, left the bottle on a random countertop somewhere, and never took the shot? I went through the garbage can and there's a bottle in there, but is it from last month or this month? I usually keep the old bottle just in case. (I always figure old Lantus is better than no Lantus if I should somehow be forbidden to get my prescription filled.)

So now I'm left with the decision with what to do. Do I trust my memories from being from tonight? Or do I assume I've consumed a little too much alcohol to think rationally and I need to start from scratch on all the pills and the insulin?

And if I can't decisively make that decision, what's the worst of all evils? Too much insulin or not enough? I think I'm rational, sober, enough to think that less insulin is better. I can adjust my eating and live with some horribly high numbers for a day if I don't take the insulin, but it will be tougher to fight constant lows with a double-dose of insulin if I take it (again) and especially when I'm driving. I don't want to have to freak out every four minutes if I feel a twinge and instantly wolf down a Nutrigrain bar.

I feel absolutely stupid and young and irresponsible for getting myself into this situation. It's just such a rote thing that I do, giving myself this nightly shot, that I don't really have a conscious thought about it. I just do it, like I go to the bathroom before I go to bed without thinking about it.

So. I think with this entry I've convinced myself that I will not take an insulin shot. That I've already given myself one. That I've already taken my anti-anxiety med and my Avapro and that I'm set for the night.

And I guess time will tell. If tomorrow I wake up and my sugars are through the roof and they get higher and stay that way through the day, I'll know I was wrong and I didn't take my shot tonight. If I have a panic attack midway through the day because the car is passing over a bridge, I'll know I didn't take my anxiety meds.

If I make it through the day relatively normal, I'll know my memories are from tonight.

Either way, I know I need to make more of a conscious action of giving myself a shot and swallowing pills, no matter how many martinis I've had. My husband and I have this thing we do when we pull out of the garage. We live in the city and if you leave your garage door open, you're bound to get robbed (we lost two bicycles, a ream of toilet paper and a shovel at various times). We linger in the alley and one of us says, "door down" and the other one repeats "door down" so we're absolutely sure the garage door is closed. Maybe I need to do that with my nightly medicinal routine. "Shot done." "Pills swallowed."

It's times like this when I'm torn. Do I want my diabetes to become so much of a part of me that I don't always consciously acknowledge it, or do I want my diabetes to become so much a part of me that I'm 100 percent aware of what I'm doing every second of the day, even under the influence of 42 Below vodka?

As always, more to come...

1 comment:

AmyT said...

I was always super scared about duplicating shots too, when I was on them. Another problem the insulin pump has solved for me! You can always look at your records to see what you dosed...

Take care,