I Overdosed on Insulin

After 2.5 years of T1D, a lot of managing my disease happens almost on autopilot.  Generally giving myself insulin is just something I do before I eat, and because I know the right dose for most of my meals it doesn’t take more than a second of thought to get it done.  Sometime between 8 and 9 every night I also take my “nightly,” the basal insulin that maintains my blood sugar throughout the day beyond the insulin I need to cover food.  Autopilot, day after day.  Such automatic movements that I absentmindedly screwed the whole thing up.

At about 8:30 last Friday night at a hockey game, I gave myself my usual nightly shot.  But right as I injected the full 27 units into my stomach I realized I’d used the wrong pen.  Without thinking, I’d given myself enough fast acting insulin to cover approximately 135 grams of carbohydrate.  To put that into context, that’s the equivalent of 2 large orders of french fries at McDonald’s or 4 slices of a large pizza from Domino’s.  Or even more fun, an entire pint of Ben & Jerry’s Chocolate Fudge Brownie ice cream.  But I hadn’t eaten any of those things, so suddenly my friend and I had a bit of a crisis to address.  This was a major T1 “oh shit” moment.

I’ve read stories online about people using the wrong insulin and I’ve admittedly been pretty judgy about them.  How could you possibly do something so stupid when the 2 pens are so unmistakably different in appearance?  That’s what I get for being quick to judge.  I’m far from perfect, so what makes me immune to making a colossal mistake?  Nothing at all, and it bit me in the behind.  I ran on autopilot, overdosed in a big ugly way, and…can’t honestly say it will never happen again in half a lifetime of T1D.  I felt stupid the first time, I’m sure I’ll be mortified a second.

What happened after I overdosed?  I immediately ate a handful of really unpleasant “tropical fruit flavors” glucose tablets, followed by multiple handfuls of peanut butter M&Ms and then most of a giant order of french fries from Michael Symon’s B Spot restaurant.  I was going to eat my burger with the bun, but even in a crisis I couldn’t do it – the bread to meat ratio was too high and ruining a really good burger!  In the end we got through the whole thing without needing a trip to the ER.  My sugar bottomed out at 59 around 9:45 PM and finally started climbing around 2 AM until it spiked to 249 a little after 3 AM.  It was not a good night, but there’s no truly great outcome of that kind of mistake.  The end result was I survived and that’s what matters most.

What did I learn from my OD?  That handling T1 has become so routine I often don’t give it any thought.  There’s good and bad in that.  Mostly I’m calling it a good realization that a miserable and stressful disease is typically just part of the routine for me.  At the same time I need to be more mindful about the decisions I make.  I was reminded that I’m generally pretty calm in the face of a crisis…and that watching someone else’s health emergency is terrifying, as evidenced by my friend admitting she was panicking.  And I learned yet again that T1 won’t stop me because there’s nothing here I can’t handle.

Happy New Year, everyone.  Here’s to a healthy, happy 2017 filled with good decisions and with ridiculous blunders kept to a minimum.  I’ve been quiet on the blog for the last 2 months, I’ll try to get back into the swing over the next few weeks.  Thanks for being part of a great 2016.

27 units of Novolog was a bad idea!