It's my time...to change my habits.

Numbers have been consuming my life in the past two weeks. Every time I turn around, a number pops up that leaves me feeling out of sync, exhausted, and completely burnt out. Averages like 241 or even 301 are consuming my logbook. Seeing numbers below 170 are a rare occurrence, with most riding in the upper 200 and 300 range.

The other side of the numbers is the insulin levels. I've raised my Lantus to 32 units in the evening now. And from that, I've had my first low in a week (and it was only a 72 after not eating for quite some time). I've also almost doubled my Humalog, which seems to be the biggest deterrent to those pesky 300's that I was seeing so regularly.

Since the Humalog and food boluses seem to be the major issue, I'm debating whether or not I need to change my routine. Right now, I'm just using my usual vial and syringe. I'm not truly calculating my carb ratio at any specific rate. Typically, I'm just counting the carbs to the best of my knowledge (eating out a lot this week) and adding a few extra units. Oddly, that's worked for the past day or so.

But I know that I need better habits if I'm going to be fighting numbers like 324 or 267 for the rest of the Accutane cycle (probably 5 months long). I need to be diligent in a way that I usually don't need to be.

I really need to work on bolusing correctly for my food. Not only do I need to take more boluses BEFORE my meals, instead of after (after all, I can always do more insulin if I decide to have seconds), but I need to work on bolusing for the smallest amount of carbs. Obviously, the tiniest consumption of carbs is making my blood sugar sky-rocket...which means that insulin is necessary for every morsel that goes into my mouth.

I also need to get my carb to insulin ratio right and actually use it. Instead of just guessing at what sounds good (and risking highs/lows and a lack of patterns), I need to come up with a better system to handle these changing dosages.

I'm very tempted to go back on the pump just for boluses (which I've done successfully in the past). Using the pump for boluses fixes a lot of those issues. For one, it's much easier to remember to bolus when the device is constantly connected to my body. Plus it calculates any carb ratio that I tell it to without me straining my brain (and risking faulty math abilities). It also keeps a record of every one of those boluses so that I know exactly how much insulin I'm taking and when I'm taking it.

Even though I know that bolusing on the pump will probably give me pretty decent success with these post-meal highs, I'm hesitant to throw my body into any more tailspins than I'm already in. With my surgery coming up and the side effects from both the birth control and Accutane, my body is physically going through dozens of changes. Adding infusion sets to changing (sensitive) skin, messing with insulin levels, and making drastic blood sugar changes doesn't sound fun.

But neither does another day of blood sugars above 200. It doesn't sound fun to risk infection or impaired wound healing from my surgery next week. Nor does it sound fun to throw my entire body chemistry off with prolonged highs (those hormones are already struggling enough).

So if I don't see at least one day of decent numbers below 250, I'll hook back up to the pump this weekend (JUST for boluses!). That would give me at least a few days of tweeking before I'd head into surgery and recovery on Thursday. What terrific timing for all this, huh?