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Larry Bird, No One Invited You.

My symptoms of low blood sugar used to run the gamut:  numb mouth, dizziness, sweating, crying at will, shakiness, inability to see completely clearly but a heightened sense of hearing ... fun stuff.  The symptoms of a low blood sugar can really suck.

But you know what sucks even more?  Not having any symptoms at all.

A few days ago, I was making lunch for BSparl and trying to clean up the kitchen (never a good idea at the same time), and my hands felt a little fluttery.  But nothing really worth paying attention to for more than a second.  BSparl devoured her rice cereal and mushed up bananas and then she was down for her nap. 

As I closed her bedroom door, I heard the Dexcom BEEEEEEP!ing from the kitchen counter.  There's a different sound associated with the "low" and "high" alarm, and I was surprised to hear the low alarm sounding.

"I feel fine."  I said, matter-of-factly, but not sure I meant it.  I did feel just slightly ... off.  Abby (the cat) meowed as she circled around my ankles.  But a swipe with my blood sugar meter showed me at 33 mg/dl.

Oh come on, Larry. I love you, man, but not like this.  Not as a blood sugar.  

The problem was that I didn't feel low.  At all.  I didn't have even a whisper of a hint from my body that my blood sugar was rapidly heading towards chaos.  If it hadn't been for the Dexcom, I'm not sure I would have tested.

Instead, I found myself standing in front of the fridge and sucking down grape juice straight from the bottle.  (Note:  Don't drink the juice at my house.  I've licked all the bottles.)  Auto-pilot kicked in and I treated that 33 mg/dl as though I could feel every bit of it.

Oddly, I didn't start to feel low for another five minutes or so, when my blood sugar started to come up a bit.  Such a strange thing, but when I'm coming up from a Larry low (read:  in the 30's), it doesn't throttle me until my blood sugar starts the journey back upwards.  Around the 50 mg/dl mark, I started to hit the sweats, the adrenaline panic, and that weird, white fog of precision that envelopes me when I'm low. 

This lack of symptoms has me very nervous lately.  I know that my numbers have been both pinging and ponging all over creation lately, but it's downright creepy when I'm at a blood sugar so close to chaos and I feel like I could happily climb into my car and start driving, or pick up my daughter and start dancing, or wait just a little while longer before deciding to have a snack.  My body doesn't give me the hints I need anymore, and I'm not sure why. 

Diabetes is messing with my head.

My paranoid (and hyper-sensitive) Dexcom continues to wail even after I'm back up to 70 mg/dl, but I find the noise comforting.  I know I'm back in range, and I don't have that feeling of confusion or fogginess.   

"I feel fine," I said again, only this time I meant it.  

I wish every day could look like this.  But it, um, does not.  Lots of times, I see a big letter M.

Comments

The DexCom has saved me more times than I can count, and it's most helpful when I'm asleep. It caught a 44 and woke me up from a pretty deep sleep (that beep is not a cool alarm clock, btw). Even though I tell it to STFU sometimes, I'm really grateful it's there :)

You're not the only one who does that - when I'm on a surprise SuperLow, I also don't feel bupkes until I hit the 50s on my way back up. I've always been like that, and have *zero* idea why it would work that way.

If I drop too fast, I won't feel it either. Its so weird how I can feel like I'm dying at 55 and absolutely nothing at 40.

Oh, man, same thing happened to me on Sunday. Felt slightly off. Checked: 35.

I've always been able to feel my lows and it really really bothered me that I was so close to disaster without feeling like I even had a problem.

Thank god for Dexcoms.

I just added "Larry Low" to my Diabetes Dictionary. I think that's a great way to describe a BG in the 30's. Much better than the colorful metaphors I usually use to describe it, at least.

The only time I preferred Larry was in 88 when his Celtics lost to my Pistons, and that was long before my Indiana Pacer years... But yes, never in BGs. That's just wrong. The unawareness is the worst, but seems to become more common and (un)pronounced as I go on. Now at 26 years, I often have those same feelings of "everything's fine" up until those Lows in the 30s, 40s, or 50s flash across the meter screen. I'm thankful to have the tools and mindset to test when awake, but it's the night-time that worries me most. As far as juice: I do the same, and that's why we can't keep jugs in our house. Rather, we use the juiceboxes - which not only are "my own," but also limit the amount I can consume in a Low-enduced frenzy. Of, course, it doesn't stop me from drinking five of them at once...

I often find that I feel the symptoms more when I'm falling, rather than just at the number. For example, I double-down 65 mg/dL feels much worse than a steady 45 mg/dL. Also, I feel more of my symptoms when I get anxious about being low. Very state-of-mind thing. If I think I'm low, it's very likely I will become low from just the thought.

Thank goodness for CGMs!

You know I find it so interesting to hear that not only others experience the lack of awareness around low blood sugars, but also that we all seem to use the words "I'm fine".
I have been told by my CDE that for whatever reason this is the most common phrase used by diabetics when explaining either out loud or to themselves that they are low.
My friends know that when I can only spit out the words "I'm fine" that they need to help me get some juice or sugar asap! It's like the brain is compensating via the mouth and all that it can say is "I'm fine". These words are an attention grabber in my house, especially when there are no other words attached afterwards.
Another thing I have come to do is anytime I have an inkling that I should maybe test even if I just tested 5 mins prior I will test immediately because I have found that it is often my brains way of saying somethings up (or down) and you need to be aware of it.

Good thing Dexcom was there to help you through this one.

So sorry you were caught unaware. Those are the worst. It's the exact reason I test before I try to drive, shower, cook, even just to climb the stairs in my house. I don't use a CGM for reasons too involved to explain but during those lows I sure wish I did.

Hey Kerri...

Hypo unawareness is one of the primary concerns I have about starting Sugar on the Dexcom.

She has been SO GOOD at catching her lows - usually in the 60's - but I'm afraid that she'll begin to "rely" on Dex to alert her instead of paying attention to her internal cues.

We did a Dex trial and I feel like, as the week progressed, that she wasn't picking up on being low at all. To be fair, however, we also made some major pump adjustments, so I'm having a hard time discerning if it was just because she ended up having so many more lows than usual and it felt "normal" to her or if it was because she was waiting for Dex to alert her that something was wrong.

Since returning the Dex trial, she has returned to identifying her lows.

It's so bizarre.

And I'm kinda scared of proceeding (even though we ordered it, and insurance is going to cover it at 100%)

I don't have D, but I'm wondering if this is possible? Like, do you think you would have noticed anything else had you not subconsciously known Dex was there to alert you? Does that even make sense? It's so hard to be a T3 and not know exactly what she's feeling. I'm just out here trying constantly to hit a moving target and praying I get it right most of the time.

Anyway, I actually posted about this concern a week or so ago. I've been hoping to get some feedback from people who actually USE a CGM.

Thanks.

http://www.candyheartsblog.com/2010/12/great-cgm-debate.html

Wendy - I actually went ON a CGM in the first place because I was having trouble feeling my low symptoms. This was back when I was thinking about getting pregnant, and it seemed like the tighter my control was, the less I'd feel those low ranges. I don't think a CGM makes you hypo unaware. But that's just my opinion - I'm curious to see if anyone has felt their hypo unawareness increase as a result of CGMing?

I have had those days too. Infact these days i never have a symptom. Which makes things complicated.I have have been as low as 17 at work and was holding conversations with coworkers and no one even noticed i was low. Good thing i was testing frequently back then. I am lucky that my diabetic alert dog Dutchess is there to keep me out of trouble. Glad you have the dexcom.

This is the problem with us T1's having A1c's that are in the 6's I believe! I personally feel my lows sooner with the CGM, I think because SEEING the number (I still look at the dang CGM every half hour) makes you feel the number....

It seems that whenever I read your blog at work my bloodsugar drops. Congratulations, you are now an indicator in my life. Maybe I shoudl just work, nah.

I HATE when you only start to feel the low after you've started climbing back up again. Makes me feel like maybe I'm NOT climbing, but falling, so I always over-treat. Gah!

The first trimester lows you warned about are no joke...I used to be a complete basket case if my blood sugar was 50 or lower. Now? I hardly ever even FEEL 50. Crap. I was flat-out talking sense the other day with a reading of 21!!!

Kerri, how the heck do you get your levels so stable??? Give me some of your luck D:

omigosh... that's a 2! (on the Canadian scale... whatever you call that... mmogl??) I hate those lows that sneak up on you and you can't feel them until you're on the way back up. UGH!!! But... loving your Dexcom pix. TEXTBOOK!

I know that feeling all too well- one minute "I'm fine" and the next I have a screaming Purple Medtronic Monster. I also have the adrenaline anxiety when my sugars are rising- I recently had a 38 that I didn't feel the symptoms of until it was back on the rise. I like to compare my personal diabetes to the show "Lets Make a Deal"- sometimes, it likes to dress up in idiotic costumes and make me laugh- picking the prize curtain of that day (or hour)... and other times it dresses up as a big chicken costume that laughs AT ME and gives me a great big Zonk.

It funny how the longer we've had T1, our sensations change. I can remember distinct feelings and symptoms for different stages of diabetes. Now, when I feel the nauseous pit feeling, my blood sugar is actually in the 170s. I made some basal changes and found out that my blood sugar had stayed in the low range from 40 to 60, and I hadn't felt a thing at all. The funniest feelings are when I'm at the gym or out busting my butt; I'm low and still feel like superwoman. I wonder if it's my body just getting comfortable with being out of whack and that's what scares me the most.

Yup, I've been there. It's totally crazy to feel fine but test just because the CGM is beeping and see a major low like that. :( Thank goodness for our CGMs!!!

You're not alone! I've run into that a few times in my D-life. You have no symptoms at all and believe your sugars are at an awesome number.

Before I got pregnant (yay, still can't believe it's real yet!) I could feel lows coming from miles away. Scary thing now that I'm almost 22 weeks pregnant = NO symptoms at all. If it weren't for my Dexcom, I would have crashed and burned many, many times already the past 5 months. Only occasionally now do I have the sweats and yucky stomach feeling when I finally start rising from a low. Pregnancy is awesome, but also oh-so-scary, and every day is different with diabetes.

I hate to feel so stooopid, but could someone please explain the Larry Bird references in plain English?

Kerri, I love reading your blog and the licked juice bottles made me laugh!

I Have been a Type I for 33 years. The symptoms, (or lack there of) only get worse over time. This sucks.

A current low is sometimes Retro-active in how you perceive it... especially if you are dropping quickly. As stated above, if you are at a steady blood sugar ... SYMPTOMS are Minimized. This is the deal with Insulin >> We rise and FALL with our blood sugar reading way WAY TO FAST.

As forrest gump would say... "That's all I have to say about That."

Yep this has happened to me and I don't have a dexcom! I've been saved by the fact that I'm a neurotic BG tester-but it definitely is scary!

OMG I've drank straight out of so many juice and milk (also raises BG quick!) bottles in my fridge, I can relate!

Wow, astonishing 12 hour CGM graph! Tell your secrets :)

Just had one!! Sneaky bugger! Starting to warm up now. Why is it that we get so hot.. and then when our sugar comes up, we're freezing cold, and then level out??
I was at Wal Mart yesterday and a nurse was checking sugars & blood pressures. I love to mess with those people!!!! I sat down and said 'sure, you can check my sugar' and it was 13.2 (240-ish) and her eyes got as big as soccer balls! Then she asked 'how do you feel?' I felt fine... I was just getting over another low after lunch. Threw her off!! I think she was ready to call an ambulance!

that is a quite impressive 12 hour trend. i get one of those about 3 times a year.

good luck with the hypo insensitivity. the only thing i can get to help with that is to keep my BS running above 150 for about 2 weeks - that can help reset your sensitivity. easier said than done, i know.

I am new to your blog and I love it! I more wish the people in my life would read your blog. I actually have forwarded your words to people - just to let them see why I've reacted similarly at some point. Thank you for your validation!

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