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Posts from the ‘Blood Sugars’ Category

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.

LOW.

BEEP!BEEP!BEEP! from the Dexcom receiver on the bedside table.

I heard it beeping for a long time.

Woke up with sweat pouring off my forehead and running down the side of my face, pooling up in my ears and in my collarbone.  The pillow was soaked.  My hair was soaked.  An outline of me underneath me, the line drawn with the panicked sweat of hypoglycemia.

Panic.  But tempered panic, since I was so deep into the low that I was slow in recognizing anything.  My status updated slowly:  This is a low.  This is a bad, bad low.  Eat something in a hurry or you’ll probably die.

The juice box on the bedside table was hard to assemble.  Plastic sleeve around the straw, poking the straw through the foil hole … all actions I’ve done before but it took 30 seconds apiece for me to figure out how the whole thing worked.  I drank the juice as fast as I could, in just a gulp or two and then I settled back into my self-made sweat lodge.

A few minutes later – maybe two, maybe twenty – Birdy arrived fresh from a nightmare, clutching her blanket and asking to sleep in our bed because she was scared.  I don’t remember gathering her up, but I do remember putting her on the outskirts of my dampness, snuggling her up against her still-sleeping father.  I was scared, too, still arranging blankets, trying to find a cool, dry section.  I looked at the Dexcom, and it only told me I was LOW and had been LOW for a long time.

Normally, I get up and brush my teeth after a low blood sugar.  Sometimes I use the hairdryer to dry my hypo-damped hair.  This time, I couldn’t move my ankles without feeling the dizziness flooding up to my hairline.  I used the edge of my t-shirt to mop the sweat from my ears.  So gross.  But necessary.

This morning I woke up chilled to the bone, the result of falling back asleep soaked to the skin and then drying off in the cool, fall night.  The Dexcom told me I had risen up safely to 109 mg/dL, and my meter confirmed that result.  My family bounced up and was ready to start their day, and I followed behind them, nursing the hypoglycemic hangover, grateful for technology that woke me up and for portion-controlled hypo treatment, but pretty fucking pissed off that diabetes was the nightmare last night.

 

What Influences Blood Sugar? (Hint: Everything.)

“So the food you eat makes your blood sugar go high, right? And the insulin makes it go lower?”

I clearly remember asking this of my certified diabetes educator, way back in the day, as I was trying to make sense of the things that could influence my blood sugar.

It wasn’t until I was a little bit older, with access to different diabetes technologies, that I saw just how many things left their mark on my blood sugar.  This morning, with only emotional stress as an influencer, I watched my blood sugar take the straight road north on my Dexcom graph:

My emotions have their way with my blood sugars all the frigging time.  The math isn’t always repeatable.  Easy morning + healthy breakfast + in-range fasting blood sugar = in range post-breakfast blood sugar.  Stressful morning + diabetes – rational thoughts = rising blood sugar.

Getting the number after the equal sign to remain “in range” takes more work that I’m willing to admit at times.

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