It’s Not Just That One Decision (a.k.a. The Butterfly Effect)

If you take the last five or ten decisions you have made, everything from what to eat or drink to whether or not you should do something right now or later, and look at the matrix of just how many different combinations there could be.

It’s mind blowing. Literally.

  • What to eat for dinner?
  • Ok, just a few more crackers.
  • Change my infusion set tonight.
  • Wake up high the next morning because of extra crackers (damn it).
  • Take an aggressive correction bolus because I believe I’m resistant in the mornings.
  • Get to work and have a big breakfast (loading up for basketball).
  • Use my “Set Change” custom bolus because I changed my set last night.
  • Check BG an hour before basketball and am 279 mg/dl. Shyte.
  • Get to basketball and realize I only have two test strips with me!!! Shyte.
  • Fight off the urge to test before basketball, wanting to save that strip for a bit later.
  • Use the first test strip and clock in at 62 mg/dl, and only 45 minutes into a 120-minute ball session.
  • Down 32 ounces of Gatorade and 6 or 7 glucose tablets. Sit out for a couple of games to recover.
  • Feeling better, play some more.
  • Sink game-winning shot on the second to last game of the day.
  • Sit down to use my precious last available test strip.
  • 42 mg/dl
  • Shyte shyte shyte.
  • Let someone know (in case I fall over).
  • Start to chomp on glucose tablets. Must have had about 15 or so.
  • Feel better, head to the locker room, and call it a day.

Overall, a pretty traumatic day at the gym, but I made it work.

Looking back on all of this, I realize that it is never just a single decision that has an impact on any particular moment of the day. It’s a group of decisions. Think about it. That’s a pretty big concept. Where are the boundaries? At what point does any given decision stop having the potential to affect the current point in time? This ties into my 20/20 Hindsight post.

This situation even goes back as far as playing ball the day before and not noticing that I needed to restock my bag, resulting in feeling very crippled in only having two test strips available (I usually test 4-6 times in those two hours alone). I felt like someone stuck in the wilderness in the middle of a cruel winter, with only two matches available to start the fire that would save your life.

What if I had counted my carbs correctly the night before (or not eaten those extra crackers)? I probably would have woken up pretty close to my target. Maybe I would not have taken such an aggressive correction bolus. How about if I hadn’t changed my infusion site that same night? I would have then been using a different insulin-to-carb ratio for breakfast, resulting in less insulin on board during basketball. What if I had eaten differently for breakfast? What if, what if, what if…

To a certain degree, we cannot live our lives in a “what if” way. But yet, we have to, at least the best we are able. The humongous “ripple” even the smallest of decisions have on current or upcoming events is almost, at times, inconceivable.


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Scott K. Johnson

Patient voice, speaker, writer, advocate, and Senior Community Manager at Blue Circle Health. Living life with diabetes and telling my story. All opinions expressed are my own and do not necessarily represent my employer’s position. Read more…

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