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Posts tagged ‘hypoglycemia’

The Last Straw.

“Mommy … I had a nightmare.”

She shows up in the middle of the night sometimes, evicted from her warm bed down the hall due to a nightmare.  “I had a dream about a blue monster with no arms and popcorn on his feet.”  She’s clutching her blanket, her water, a flashlight, and a stuffed animal; clearly she’s in for the long haul.

I moved over in the bed and she started to climb in.

“Oh and mom?  You’re low,” she said, handing me the vibrating pump.

The fog of feeling sleep lifted immediately and I recognized the symptoms of this hypo.  Sweaty hairline, fumbling fingers, my sight reduced to a tunnel, and my hearing razor-sharp, hearing the shuffle of my daughter’s feet, the steady breathing of my sleeping husband, and – finally – the buzzing buzzery of my CGM alarm.

“Do you need something?” Chris asked from beside me.

“Yeah – can you grab one of those juice boxes from the shelf?”

Birdy was already snuggled in beside me, nestled close against my hypo-damp shoulder.  A few seconds later, Chris returned with a juice box in hand.

Habit, habit, habit – I am a creature of it.  When my blood sugar is low, I go through the motions to treat it, and if anything gaffs up the routine, I’m thrown.  Lows in hotel rooms rock me because the bedside table is five inches farther from me than at home.  When I am home, having the glucose tabs on the table itself instead of in the drawer can be enough to confuse me thoroughly.  (Lows make me the least-sharp knife in the drawer.)  In this case, I grabbed the juice box firmly and reflexively used my other hand to reach for the little plastic sleeve with the straw tucked inside.  Only I grabbed it a little too firmly and juice shot out all over the bed, because my forward-thinking husband had already stuck the straw inside the foil hole.

“Shit …”  My pillow was wet with juice.  And so was my daughter, because I managed to (ocean?)-spray her in the face during this transaction.  “I didn’t know the straw was already in there.”

“Do you need another juice box?”

“No, this should be okay.  Only a little bit flew out.”  I drank the rest of the juice box, per routine.

“MOM. This is not OKAY.  I am all WET.”  (Even at 3 am, my kid can be indignant.)

“Sorry, baby.  You can go back to your own bed, if you want?  That bed doesn’t have juice in it.”

She thought for a minute, then buried her head under the blankets to issue a muffled response.  “No WAY.  The monster had popcorn feet.  NO WAY am I going back to my bed.”

 

 

All Night Long.

Some nights just plain suck.

In related news, I brushed my teeth ten times last night.

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.

 

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.

 

Sparkly, Like Her Shoes.

As a family, we went to dinner and Birdy’s sequin-covered shoes sparkled furiously in the afternoon sunlight.  Her shoes were downright distracting and I found myself low-staring at them, focusing on the individual sparkles being projected onto the tablecloth at the restaurant.  My brain had hit an uncomfortably steady pace with the anxiety of being under 60 mg/dL for more than two hours, adjusting to the panic but still needing an outlet.  Staring at the glitter on my daughter’s shoes calmed my brain down just enough.

We ordered and ate, and a meal plated with carbs and less-than-normal bolusing still didn’t battle back against the low alarm from my Dexcom.  I felt like a failure, asking Chris to grab a glass of juice from the waitress as my empty dinner plate sat in front of me.

“I’m still low.”  I tested my blood sugar again, hoping to see a number that didn’t require more glucose tabs, hoping the Dexcom was wrong, but a bright 43 mg/dL grinned back at me.  I knew the food would hit but not fast enough.  “Yeah, I need juice now.”

In a quiet hurry, I heard the background noise of hypo management done from a distance.  “I need a glass of juice.”  “Would you like lemonade?”  “No, juice.  Do you have orange juice?”  “We have apple juice.”  “That, then.  Please.”  Chris sat back down at the table while Birdy bounced and played beside me, her shoes throwing sparkles onto the table that were spreading out everywhere, my eyes starting to cave to the low blood sugar.  Peripheral vision was being replaced by these starbursts that were sparkly, like her shoes.  I felt my body pulling in tight and rallying glucose, sending it to the places that were necessary and not caring that I couldn’t hold a fork or keep my mouth from twisting into a resting bitch face/uncomfortable grimace.

Dinner tumbled into a pile of apologies and distractions because I couldn’t get my wits about me, and even once my blood sugar was stable (back up to 72 mg/dL), it still wasn’t staying up, and tumbled again a few more times before bed.

It doesn’t look like much, from the outside.  It’s hard to explain how silent the panic is, how evacuated my brain feels when the hypos hit and stay for too long.  I don’t know how to show someone a Dexcom graph that looks like this and explain how it’s not just the blood sugar number, but the cumulative effect on my body – the exhaustion in my muscles from being clenched in fight-or-flight mode, the sleep my brain needs after a five hour low blood sugar experience, my inability to find the words for what I want to say because my mind is just like, “We’re DONE.”

I woke up with a blood sugar of 230 mg/dL this morning, the product of answering low alarms with frustration and marshmallows, and I corrected the number with the predetermined, carefully calculated amount of insulin.  And I hoped that, for today, diabetes would leave the sparkles on my daughter’s shoes.

Hypo Effery.

BEEEEEPBEEEEEPBEEEEEP!!

My purse start vibrating in a panic.

79 mg/dL and two arrows down – how the hell did that happen?  I just dropped my daughter off at preschool.  My blood sugar was 139 mg/dL before leaving the house with a steady, easterly arrow.

I pulled the car over and put on my hazard lights so I could bust out my glucose meter.  (Oh hell yes I treat low blood sugars purely based on a Dexcom reading from a trusted sensor, but this sensor is on Day 14 and due to be changed this afternoon, so my trust was getting rusty.  Trusty?  Rustworthy.  Bah.)  Meter said 68 mg/dL.

The symptoms, which weren’t strong when I pulled over, were starting to edge in.  Shaky hands and blurred vision (almost wrote “blurred bison,” which sounds like a band name) paved the way for clammy skin, which let the fog of hypoglycemia settle into my brain.

Fine then.  I reached into the glove compartment for the ubiquitous jar of glucose tabs.  Chomp, chomp on four of them only to realize they aren’t Glucolift but instead the generic chalkified glucose tabs from CVS and became grossed out.  The low symptoms were intensifying as I sat on the side of the road, so being picky about my glucose sources wasn’t an option.  Chomp, chomp on another tab, wishing I could somehow keep a soft-serve ice cream machine in the glove compartment instead.

Moments pass.  I’m still buckled into my car, eating snacks, watching cars whiz by.  The Dexcom finally shows an upward climbing arrow.  My hairline feels less clammy.  The shape of the steering wheel and the radio control knobs come back into sharp focus.  Better.

“Did you check your GPS?” my mom asks me whenever we’re about to get into the car together.

“Mom, it’s a CGM.  And yes, I did check it,” I reply, usually laughing because no matter how many times I tell her it’s a “CGM,” she still calls it a “GPS.”

But as I think about what may have happened if the low symptoms hit in full while I was driving instead of after I had pulled over, GPS might me just as accurate, giving me the location, in context, of what the hell my blood sugars are doing.

 

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