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Reduced to Rubble.

Walking down the hill towards the restaurant, I felt the low start to kick in.  The symptoms started their awkward osmosis, triggered once I felt the buzzing of the Dexcom but eventually flooding my body with that tingling confusion, knees that buckled just a little with every step, and eyes that wouldn’t focus but darted around in my head like over-caffeinated birds.

“I’m low and I’m an idiot.”

“Why?” said my husband, Birdy in his arms as we walked down the unfamiliar city street in Montreal.  “Are you okay?”

“Yeah, but we might need to go to a closer restaurant, instead of the one that’s way down that road.  I left all my glucose tabs in the hotel room by accident, and I don’t have anything on me.”

Picking up the pace, despite my increasingly clumsy feet, we reached the a nearby restaurant and were quickly seated.

“Here are your menus, and your waiter will be with you in a moment.”

“Thanks, and could I please have a small orange juice, without ice, as quickly as you can?  Thanks so much,” I said to the host in one breath, hypoglycemia filling up all the space around my head like the Radiohead video for No Surprises.  A minute or two later, a glass of orange juice was on the table.  I drained it in a few gulps.

“Do you want to order, or do you need a few minutes?” Chris asked, reading through the menu while keeping an eye on me.

I picked up my menu and opened it, but the words didn’t make any sense.  Staring hard at the entree section, I tried to make heads or tails of how the letters were arranged, but they didn’t look like English.  The Dexcom wailed again and I checked my blood sugar on my meter – 48 mg/dL.  “Am I so low that I can’t freaking read right now?” I thought.  (And then realized I was holding the menu that was written in French.  After switching menus with Chris and reading through the English menu, things made much more sense.)

“I can’t think right.  I see all the thoughts in my head spinning around and I want to grab one, but they go by like socks in the dryer.  Everything is a blur of laundry right now,”  I admitted.  “I need a minute to figure out what I want to eat because right now, I want to eat everything and then cry.”

Stupid low.  Haven’t had many stupid lows lately (thanks largely in part to better planning and keeping a close eye on the Dexcom graph), so the ones that do creep in seem to hit harder than before since symptoms are felt more strongly.  I don’t mind carrying a bigger bag than normal, or going running with a Spibelt crammed tight with glucose tabs, and I don’t even mind the exceptionally awkward moments of having my pump tubing stuck accidentally through else’s seatbelt on a plane, but I do loathe the way that lows reduce me to rubble, and how the simple matter of forgetting to plan caught me off guard.  Usually quick on my feet and able to think rationally, lows make sentences hard to slap together, and reason nearly impossible to catch.  The friction between ‘thought’ and ‘action’ is grinding and hot, leaving my brain a few seconds behind until the glucose stores refill.

As quickly as it came on, it was over.  The Dexcom showed a gently upward-sloped arrow, and the hypo-fog lifted.  Birdy asked if she could have “just a small sip of your orange juice, Mawm?” and I handed her the glass, happy to not need it.

in rainbows.  man, I love Radiohead.

15 Comments Post a comment
  1. Suzanne #

    I feel your pain – I was at the CDA conference this weekend too, and experienced many lows. For some reason, Montreal does that to me – I’m not sure if it’s the hills, all the walking, or just being out of a regular routine. I’m glad it didn’t last too long! :)

    10/21/13; 9:46 am
    • Tim Steinert #

      It’s the exchange rate.

      10/21/13; 2:57 pm
  2. Jon Paul #

    I enjoy all you do for the diabetics!

    10/21/13; 11:12 am
  3. ria #

    rainbow through the clouds
    I needed that !

    10/21/13; 11:52 am
  4. Jodie #

    I know just how that feels.

    10/21/13; 2:25 pm
  5. andee #

    My sister studied exercise physiology in college and she taught me that in a crisis situation with nothing to eat if you sprint as hard as you can for 30 seconds your liver will release more sugar and it can help increase your blood sugar. It seems really counter-intuitive and I would never recommend someone trying it without a back-up but if has worked for me when I’m an idiot and forget tabs when I’m out exercising.

    10/21/13; 5:10 pm
    • I’ve heard the same from a few diabetes & exercise specialists, and have only tried it once, myself. It seems counter-intuitive, but it does work (or at least did, that one time for me).

      10/21/13; 9:57 pm
  6. You’ve precisely described the total disorientation that occurs. How very fortunate that Chris was there, knew what to do and willing to do it. I have “embarrassed” my family by having lows in public places, so am very glad you didn’t experience that.

    10/21/13; 5:47 pm
  7. Tim Steinert #

    At times my hypo awareness is low. I have found myself really affected by a 62 and yet be unaware anything is wrong at 28. The strangest thing, though, is getting angry when you’re low. It’s only happened to me once and it came as quite a surprise–literally the next day after I read about it.

    10/21/13; 8:11 pm
  8. BettyAnn #

    I feel an affinity towards the dex that is hard to describe and bizarre given that it is inanimate. On occasion it has woken me from a deep sleep and saved my life I am sure. I realized reading your post that watching the arrow and graph heading up as the fog lifts from my brain is so comforting. It gives a visual to the feeling that I’m going to be okay. I can roll over, then and go back to sleep.

    10/21/13; 10:05 pm
  9. My first ever low on my unfortunately timed road trip with friends shortly after my dx felt just like that. We had to switch brunch locations, I needed emergency OJ, and I wanted to eat ALL the things but the menu made no sense (except it was all in English).

    10/21/13; 10:12 pm
  10. Emily Hastings #

    Hi Kerri,

    Long time reader, infrequent commenter.

    Sorry about your scary low – I can’t really relate, as I have steroid induced diabetes (which only requires treatment if I’m on mega doses of IV steroid, or septic, or both – then I usually end up on sliding scale insulin) and I only really get little lows first thing in the morning when I haven’t had my steroid yet. I don’t test much at home unless I’m rapidly altering my steroid dose (no point – I’m so stable) and I certainly don’t test first thing before my meds (if you’re steroid dependent – ie if you’ve been on steroids for so long that your adrenals have forgotten how to make their own steroid – then you don’t do in the morning until you’ve got those little red pills down you and waited the 20 – 30 minutes it takes for them to start to kick in and make you feel like a human being) so the only way I know about the little pre-steroid lows is from being in hospital and having nurses wake me up to test me at 5am and then make me drink Lucozade and eat biscuits because my sugar is 3.5 mmol/L (errrr… about 63 mg/dL, if my sums are right? Ie, not that low… or at least, not that low for me, given that I know it won’t go any lower (I’ve never gone lower than 3 mmol/L of my own accord… only when I’ve been on sliding scale) and that as soon as I take my steroids at 6am, it will start to go up… and I frigging hate Lucozade (too sweet) and can’t eat/drink anything till I’ve had my steroids… one of the symptoms of low steroid is nausea and vomiting). I did once experience a mega low (1.1 mmol/L…. about 20 mg/dL) when someone messed up my sliding scale insulin dose, but I had pneumonia, couldn’t breath, had septicaemia with a temp of 41 centigrade (about 106 Fahrenheit) and was in the ICU on non-invasive ventilation, so it’s a little hard to remember and to separate out the ‘low’ feeling from the rest of it. I remember I was shaking really violently and couldn’t stop, although that could have been the temperature, but I think I was fairly out of it, I can’t remember much else.

    Anyway the real reason why I’m commenting is not to give you a potted version of my colourful medical history, but to respond to something you posted about in September. I know, I know, bit late – but I was in the hospital at the time, and just about had the energy to read my fav blogs (kept me sane) but didn’t have the energy/concentration/coordination to respond. Anyway, I thought I would respond now, as even if it’s no longer helpful to you, it might be helpful to others in the same situation. You were talking about having to have a Dexcom break because of skin irritation from the dressings. I can relate to this – for the past six years I’ve had a port-a-cath (a permanently implanted IV access device to allow IV access in emergencies (to which I am prone) because my veins have been wrecked by twenty years of severe chronic lung disease and frequent hospital (and ICU) stays, and it’s no longer possible to get an ordinary peripheral cannula into me. When the port is ‘needled’ and in use, it needs dressing, sometimes for several weeks at a time. Currently, having had problems with ports getting infected and causing sepsis, I have a PICC line instead, and that requires dressing all the time, with dressing changes once a week. I have two main problems – getting the dressings to stick to me (I appear to have Teflon skin… not helped by the fact that I get sweating episodes, due to autonomic neuropathy (caused by a long ICU stay, not by diabetes)); and skin irritation under the dressings, which can range from mild redness and itching to blistering that looks like I’ve been burned. I’m atopic – ie allergic to everything – which doesn’t help. We’ve tried every dressing going – tegaderm, C-view, Hydrofilm etc etc – and they’re usually fine for a few days and then I start reacting.

    The magical ingredient that I have found makes a BIG difference is Cavilon. I don’t know if you can get this in the US although I guess I’d be surprised if you couldn’t. It comes as a spray and as lollipops soaked in it (it also comes as a cream but obviously that’s too greasy to try to use under dressings – it’s a barrier cream for use in skin folds to prevent moisture lesions). I prefer the Cavilon spray. You spray it liberally all over the areas where the dressing is going to touch, leave it for a couple of minutes to dry, and then apply your dressing. The BIG bonus for me and my Teflon skin is that it dries slightly tacky, so it makes the dressing or whatever stick better. As I said, I prefer the spray, as you can cover a large area quickly, but the lollipops work just as well. They come presoaked in the solution and you just paint it on the area you want to protect, leave to dry, etc. Actually, the lollipops might be better for you, if you wanted to paint the area around the sensor where the adhesive was, without painting the area where the sensor was going to go.

    Apologies if you’ve already heard of/tried this. Just thought I’d mention it, seeing as its made things so much easier for me. I literally would not be without the stuff. Incidentally, I’m intrigued by the mention of steroid inhalers – do you spray them on your skin? Having chronic lung disease, I am of course very familiar with steroid inhalers in their more conventional mode of use, but I never heard of using them for skin irritation – I guess steroid creams would be out as the greasiness would stop stuff sticking. I’m intrigued – I may have to try.

    If you can’t get Cavilon spray and you want to try, email me your address and I’ll send you some.

    Oh, one more thing (it’s 3.30am here and I always get over verbose in the early hours when I can’t sleep!) – literally years and years ago, I think when you were talking about getting seven days use out of infusion sets or something, you mentioned a product that you applied to your skin to make it more sticky. I’ve been through your archives but I can’t find the post. Do you know the stuff I’m referring to? Could you possibly let me know it’s name? The Cavilon does help in that respect, but I need all the help I can get.

    Many thanks
    Emily

    10/21/13; 10:39 pm
    • You are WONDERFUL. Thank you, and I’m looking into your suggestion tonight. I’ve used Skin Tac in the past (not currently): http://www.torbot.com/ecom/product/featured/70/ I hope this is what you were thinking about. Also, I still use Opsite Flexifix tape: http://sixuntilme.com/blog2/2011/10/opsiteflexifix_you_can_stick_around.html

      10/21/13; 10:44 pm
      • Emily Hastings #

        Hi Kerri,

        Thank you for those websites – I will investigate. I had my first PICC line dressing change this afternoon (it was put in last Tuesday) and so far it looks like the line is staying in me and the dressing is staying on, yay! I think it’s a combination of some innovative PICC line dressings, which are super sticky, using the Cavilon, and really through skin prep – cleaning the skin quite aggressively wherever the dressing is going to go with some alcohol/chlorhexadine wipes to strip the skin of its natural oils and dry it right out, which will help the dressing stick better.

        I have the 3M website, who make Cavilon (I should have included it last night… sorry…. sleep deprivation…)
        http://solutions.3m.co.uk/wps/portal/3M/en_FB/Cavilon/skin-care
        This is the UK site. They do have a link on there for ‘The Americas’ which eventually gets you through to the US site but it’s layout and emphasis are very different from the UK site and to be honest confused and scared me in equal measure…. I pressed the wrong button and got directed to the ‘Defense’ department…
        Anyway, I’m sure you should be able to get some, either through the US site if you can manage to without accidentally buying an AK47 or through the UK site if you talk nicely to them about shipping it to you. As I said, any problems, let me know and I’ll gladly send you some. Hope it helps.
        Hope you and your dear hubby and your Birdie are well and the ol’ sugars are doing as they should,
        Emily

        10/22/13; 2:20 pm

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