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Posts from the ‘Blood Sugars’ Category

Twitter Rant.

The lows that have been creeping in lately need to stop.  They are inconvenient at best, completely debilitating at their worst and the in-between is a muddled mess of glucose tab dust and frustration.  Yesterday I had a diabetes technology fail coupled with a highly symptomatic hypoglycemic event that occurred simultaneously with a phone call to the Joslin Clinic … which sent me over to Twitter with an agenda of rage.

First, it was my Dexcom receiver that went berserk on me, telling me on both my Animas Vibe and my G4 receiver that my blood sugar was 202 mg/dL with double arrows down but after my feet weren’t responding to the “MOVE!” commands from my brain, I grabbed my meter to double-check. And saw a blood sugar of 43 mg/dL.

I immediately went for the glucose tabs and housed several of them. The low symptoms were intense – confusion, anger, tears, and a hand too shaky to hold the jar of tabs properly, so I held it with two hands, like those stock photos of baby panda bears drinking from a baby bottle.

Then the phone rang, and I answered it because: 1. When I’m low, I make bad decisions, and 2. It was the Joslin Clinic calling and I always answer their calls because Joslin.

Yes, my insurance company is requiring a c-peptide test to confirm my type 1 diabetes status in order to cover my new insurance pump.

The irony was not lost on me.

I felt like a crumb for ranting but sometimes I’m a crumb.

And then the anger/adrenaline surge subsided and I was in that “weak with post-hypo panic, stupid body, knew I’d be fine in a few minutes but what the fuck” sort of fallout.

Eventually, as it always does, my blood sugar came back up and my brain tuned back into things happening on the planet. My CGM/Vibe/meter were back in alignment, showing me in the 80′s and holding steady.

But I’m still waiting for Joslin to call me back. You know, to confirm the type 1 diabetes I’ve had for 28 years.

Missing Meter.

The initial search through my bag was kind of nonchalant.  “Where is my meter bag?”  Bright pink with a smiling bear on one side, it’s a hard bag to misplace, even in the seemingly unending abyss of my purse.

But the flurry of leaving the house that morning to catch an early flight left me mentally snowed-in.  I brought it with me, right?  I know I checked my blood sugar that morning, and I had a clear memory (didn’t I?) of pricking my finger on the plane after we had reached cruising altitude, so where the hell was my glucose meter?  I had it just a few hours ago?

“Where is my glucose meter?”

The search went from casual to frantic in a matter of minutes, when I realized that my meter bag was nowhere to be found.  Not in my suitcase, not in my book bag, not in the rental car.  No memory of where the hell it could be, and all the moments I’ve ever checked my blood sugar on a plane were melting together.  Did that happen today, or had I been working off info from my CGM graph all day long?

Just as Chris and I confirmed that my meter was, indeed, MIA, my Dexcom sensor alarm went off, warning me that my sensor was going to die in two hours.  And the “low battery” alarm went off a few minutes later on my pump, reminding me that it needed a new battery.

“Everything is breaking and I’m an idiot.  I’ve never, ever left my glucose meter behind before.  Ever!  On so many of my trips, I’ve packed an extra meter, but even on the trips where I didn’t, I still didn’t lose my meter!  I’ve never lost my glucose meter before, in like three decades with diabetes.”  I was rambling, but frustrated.  The device I needed most to properly dose the drug I needed most?  Missing.  Data crucial to my safe survival?  Inaccessible without purchasing a backup system.

(And, as luck would have it, I had just refilled my meter bag with a brand new bottle of 50 test strips and a fresh AA battery for my pump.  Reminded me of the time I replaced my car’s exhaust system, filed the tank up with gas, and then proceeded to total the car.)

Thankfully, finding a pharmacy that sold the brand of glucose meter I had strips at home for was easy enough.  (I didn’t want to have to replace the meter, again, when I got home.)  And thankfully, we have the means to purchase a meter and a bottle of test strips without insurance coverage.  But holy shit, I was shocked to see the sticker price for a bottle of 25 test strips.

“Forty five dollars?  For 25 test strips?  That’s bananas!”  I said the pharmacist.  “How do people afford these things without insurance coverage?”

She shrugged.  “They don’t.  They buy the CVS brand and the strips that go with that one.  Most people don’t pay for the top tier strips out of pocket.”

“But the accuracy is …”

“It’s what it is,” she said.  She finished ringing up the meter and strips (and AA batteries for the pump), bringing my grand total up over $100.  For a meter, 25 test strips, and batteries.

“This is the price for maintenance,” I said to Chris.  “For the stuff that keeps me healthy.  I can’t imagine what the cost would be to do more than “maintain.’”

After reuniting with a glucose meter, our trip continued on without issue.  But throughout the rest of the week, I thought about having access, and having the financial means to replace things I accidentally lose, and being grateful.  I thought about the Spare a Rose campaign and how far $5 goes.

This holiday season, I’m more grateful than ever for more things than I realized.

(And when we came home on Friday evening and I went into the bathroom, I saw my glucose meter sitting on the bathroom counter, halfway hidden underneath a hand towel.  Never again!)

 

Hypo Management.

“Ninety-five percent of the time, I’m fine.  The lows are ones I can treat myself, even if the number is really low.  Usually my symptoms are shakiness or like this brain fog.  When the lows are really gross, I usually cry at random.  Or I throw things.  No real in between.  But the majority of the time, I can take care of things myself, and then it’s over.  Like nothing happened.”

I tried to explain this to a friend who was asking when it’s necessary to intervene during a low blood sugar, but explaining the slide from “fine” to “holy effing low blood sugar” sounds confusing when I say it out loud.

That’s the weirdest part, for me, that whole panic-then-peace part of severe hypoglycemic events.  My lows have historically come crashing in at a breakneck speed, which is part of why using a CGM has been a pivotal change for me.  Getting a head’s up on when a low is happening, or being able to treat it even before it becomes a problem, has helped me feel safer in the face of hypo unawareness (a lack of low blood sugar symptoms) and fast-dropping numbers.

My endo suggested that I raise my low alarm on my Dexcom from 65 mg/dL to 80 mg/dL in efforts to catch lows earlier, and in the last month or so, I’ve had far fewer chaotic hypos.  Instead, I’m grabbing the lows before they even become low, snagging a 70 while it slides versus waking up in the trenches of a 40.


Low alarm at 80 has been the best suggestion in a long time. #diabetes

A photo posted by Kerri Sparling (@sixuntilme) on

Small little tweaks here and there make differences I couldn’t have imagined. … that, and I’m burning through my supply of glucose tabs with a little less vigor.

 

Tootsie Roll of Doom.

Low blood sugars can sound like stories told ’round the campfire, with great embellishments and drama as to who can tolerate the lowest number without tipping over.

“Low?  I wasn’t just low.  I was so low that my eyes were swimming away from my face and my meter said 52 mg/dL but I still got my own juice.”

“52?  I was 41 mg/dL without any symptoms at all and then my hands fell off so I ate them.”

“Pfffft.  I was 30 mg/dL and eating popcorn and I was coherent enough to eat individual kernels of popped corn until 100 hours passed and I had steadily climbed back up to 115 mg/dL without a rebound high.”

Impressive.

Most of the time, my lows are symptom free and I can function properly.  I feel lucky that, in the last 28 years, there have been more functional hypoglycemic episodes than ones requiring assistance.  I’m glad I can treat my own lows.

But sometimes numbers hit differently.  A blood sugar around 65 mg/dL usually feels a tiny bit off, but nothing too jarring.  No shaky hands, clumsy tongue, loss of peripheral vision stuff going on, mostly just a Dexcom alarm going off, forcing me to take a closer look at my graph and thinking, “Huh.  Time for a snack.”  (This lack of hypo symptoms is what prompted me to look into a continuous glucose monitor in the first place.)

At other times, the 65 mg/dL comes in like a freight train, barreling towards me with symptoms hitting full force, which happened yesterday while I was brushing my teeth.  A waves of confusion washed over me and put a twitch in my hands, making my desired grip onto the bathroom counter hard to come by.  My tongue went numb and I forced myself to spit the toothpaste into the sink, knowing the next mission was more challenging: get downstairs and eat something fast.

The first thing I saw was a giant Tootsie Roll in Birdzone’s Halloween bucket.  (Flashbacks to being a kid growing up with diabetes, where the Halloween bucket was always saved as a “for low blood sugars!” salve but instead was something I dipped into without admitting it, until there were only Almond Joys left.)  Normally, Tootsie Rolls are a candy that repulses me enough to steer me clear, the low symptoms were intensifying and my knees felt wobbly, so I unwrapped the candy and shoved it into my mouth.  And then I learned of a new hypoglycemia symptom that was in play this round:  a confused jaw.

Chewing on that Tootsie Roll candy was a disaster.  It was slightly cold, making it tough to work through regardless, but the massive chewy scope of the thing was too much.  In the fog of a low, I clamped down on the stupid thing and felt a familiar popping sensation.  The Tootsie Roll was working to raise my blood sugar, but in the interim, it had pulled off one of the frigging composites from my tooth.

Once the low had subsided, I called the dentist to fess up and make a fix-it appointment.

“What happened?  Did you bite into an apple or something?” asked the receptionist.

“No, it was actually a Tootsie Roll but …”

“Oh, Halloween candy.  Yeah, we get a lot of calls this time of year for stuff like this.”

And in my head, I was all, “Wait, no it was a low blood sugar and it was THIS BIG and I finally had symptoms – they were rotten – in the 60′s which is why I went for the Halloween candy …”

… but instead, I was all, “Yep.  Tootsie Roll of doom.”

 

#DayOfDiabetes Went a Little Rogue on Me.

I started the day strong, but after hours of a frustrating high blood sugar and seemingly bolusing saline instead of insulin (but it was insulin – I checked), I hit a big NOPE when it came to documenting the end of my #dayofdiabetes. I didn’t want to keep documenting my frustrations, not because I was ashamed of them, but because I was FRUSTRATED, you know?

Even though there isn’t a hashtag for my day today, I’m still here. I’m still doing this diabetes thing. And despite some frustrations, I remain fine.

HypoPedicure.

“Mom, can I [something something] ?”

“Sure, kiddo,” I responded.  But I had no idea what she was asking me – her words were swirling around in the fog of my brain.  My blood sugar was 38 mg/dL and my Dexcom was wailing.  Chris was a few feet away, stirring something on the stove while he kept an eye on his wife.  “My blood sugar is really low, so I’m going to sit here for a few minutes.”

“Okay, that’s fine.  Do you need some glucose tabs?” she asked, sitting on the floor near my feet.

“I already had some.  I’ll be okay in a minute.  Don’t worry.”

What was directly in front of me hard sharp edges of focus, but everything on the peripheral was hard to see.  My body was concentrating on chewing and swallowing and trying to slow down the speed of my heartbeat in my ears.  I knew stable blood sugars were coming, but they needed a glucose jump-start.

“Okay, Mom.  I’ll just do this while I wait.”

And it wasn’t until later that night, after she had gone to bed and once I was readying myself for sleep, that I realized she spent the duration of my hypoglycemic episode painting my toenails bright pink with a glitter topcoat, globs of glitter and pink stretching all the way up to my ankle.

When Good Insulin Goes BAD.

Ninety percent of the time, my high blood sugar has an identifiable reason, and there’s a cluster of common causes.  Did I under-estimate the carbs in a snack and therefore under-bolus?  Did I over-treat a low blood sugar?  Did I eat without bolusing at all (it happens)?  Is there a lot of stress floating around that I’m responding to?

Most of the time, those questions cover the why.  Once in a while, my highs are for rogue reasons, like an air bubble in my pump tubing.  Or when I eat something carb-heavy right after an insulin pump site change (it’s like that first bolus doesn’t “catch” somehow).  Or I forgot to reconnect my pump.  Or if the cat bites through my pump tubing.

But rarely, if ever, is one of my high blood sugars the result of bad insulin.

Except it totally happened last week, when two days of bullshit high numbers had me mitigating every possible variable … other than swapping out the insulin itself.  (And clearly I’m stubborn and/or in denial about the quality of my insulin’s influence on my blood sugars?)  I rage-bolused.  I exercised.  I low-carbed the eff out of an entire day.  I did a site change at midnight to take a bite out of the highs.  Nothing.  The downward-sloping arrow on my Dexcom graph had gone on hiatus.

(Always a punched-in-the-gut feeling to see the word HIGH on a Dexcom graph, accompanied by an up arrow.)

But ditching the bottle of insulin entirely and swapping in a new Humalog vial?  That did the trick in a big way.  For once, it was the insulin.  Next time, it will surely be the cat.

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