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Posts tagged ‘hypoglycemia’

Pulled Over.

I had just buckled the girls into their car seats and was ready to make the drive home from day camp, and as I turned the car on, I reflexively grabbed my Dexcom receiver to take a peek at my blood sugars before I started driving.

Shit.  68 mg/dL with an arrow straight down and a blood drop signaling a need for calibration.

“Hang on guys,” I said to my daughter and her friend, who were already singing camp songs in the backseat.  “I need to wait a minute before we head out.”  I pricked my finger quickly to check my blood sugar and, sure enough, saw the 63 mg/dL on my meter waving its arms at me.  No worries – I always have a jar of Glucolift in my center console.

Except this time.


“Hey girls. Do you guys have anything left in your lunches?”

“Yeah, I have strawberries and a pouch left in my lunch.  Do you want it, Mom?”  Birdy offered.

“Yep.”  I climbed out of the car and went back to the trunk to rummage around through her lunch bag.  Pulling out the snacks, I gobbled them while standing at the back of my car, a mom on a mission to bring her blood sugar up before driving.

We sat in the parking lot for ten minutes or so, and I watched the CGM graph arrow relax and point sideways.  A glucose meter check showed me at 78 mg/dL, so I felt I was on the rise.  We started the ride home.

Except the CGM alarm went off 15 minutes later, only this time it showed double-down arrows and the BELOW 55 mg/dL message on the screen.


Certain parts of Rhode Island are relatively rural, and sometimes you have to drive for a while before you pass a gas station or a convenience store.  I immediately started calculating when I’d pass the next place to stop.  I also assessed my symptoms (none) and instinctively reached over to disconnect my insulin pump from my hip.  I thought the two little kids in my car.  I thought about where I could pull over.  I worried about what was safer: driving for another minute or pulling over and not having any food in the car.  And I hoped that worrying so intensely would make me feel stressed and hopefully jack my blood sugar up a little more.

But then, just ahead, I saw the familiar orange and brown sign of a Dunkin Donuts coffee shop.

“Yes.”  I put on my blinker and pulled into the drive through lane of the coffee shop.  “Girls, I need to stop here and get an orange juice, okay?”

“DOUGHNUTS!!!!!” they yelled in unison.

“Not this time, guys.  I need to get some juice and wait a few more minutes before we can keep going.”

Minutes later, I was in the parking lot with an empty bottle of orange juice and two patient kids in the backseat of the car who were peppering me with questions about diabetes.

“Why did we have to stop?”

“Because I needed juice to treat a low blood sugar.”

“What’s a low blood sugar,” asked my daughter’s friend.

Birdy piped up.  “It’s when you have diabetes and you have too much insulin or not enough food in your body and you need glucose tabs or juice or doughnuts but not today because these doughnuts have gluten in them.”  (All in one breath.)

“No doughnuts?”

“Sorry, guys.”

“Can we drive soon?”


“Okay, can we sing until we start driving?”


We sat in the parking lot while I waited for the orange juice to do its thing, keeping an eye on my CGM graph and an ear on the two little kids in the back of my car who were belting out songs they learned at camp and who trusted me to take good care of myself in order to take good care of them.

Only no doughnuts, because gluten.


My IOB and Me.

There’s a lot of data that PWD (people with diabetes) spin through on a daily basis – carbs counts, insulin units, blood sugar results, blah, blah, blaaaaaaah there’s so much shit sometimes.  I’ve been encouraged by my endocrinologist to download my data and review it every week or two in order to assess trends over time, but I don’t do that as often as I should.  I’m more of a monthly downloader, and I definitely download every night-before-the-endo-appointment, but a systematic review of my diabetes data is one of those things I could do more consistently.

However, the data is crucial to my health success.  I just tend to lean more heavily on the daily data than the month-long reviews.

Like my beloved IOB.  IOB stands for “insulin on board” and it’s a tool in my insulin pump that calculates how much insulin from my most recent boluses is still “active” in my system.  And I don’t know if most pumpers love their IOB data as much as I do, but I LOVE mine.  Love.  Stupid love.  It’s part of the trifecta of diabetes that I rely on every night before bed.

The checklist is short, but always, always the same: every single night before I go to bed, I check my blood sugar on my meter, comparing that number against the CGM graph.  Then I click through on my CGM graph to get feel for how the day has mapped.  And then I click through on my pump to check my beloved IOB to see how much insulin might be in play.  (Okay, honestly I check on my daughter in her bed first.  She’s usually asleep with her hair tousled into a huge mess against her pillow, with Loopy curled up against her legs.  But then I do all the diabetes garbage.)

Checking the IOB in conjunction with the CGM graph and my glucose number gives me a fighting chance against middle-of-the-night hypoglycemia.  And in the last year or so, it’s been a check that’s worked really well.  Several times (last night, for instance), I will look at my data sources and determine that a low might be teased out overnight, and I can pop a glucose tab or run a temporary basal rate on my pump for an hour or two to keep me in range.

My overnight lows are way less frequent than they ever have been before, and that means I clean juice and sweat from my sheets way less often, so there is a practical bonus aside from the whole “not going wicked low while sleeping” thing.

There’s the takeaway:  IOB monitoring helps cut back on laundry.  Use all the money you save on detergent to buy a bionic pancreas!


Robot Arms.

[You can read my Dexcom disclosures here.]

The low alarm slammed into my ears from across the bed, coming from my Dexcom receiver on the bedside table.  A half second later, it echoed from my cell phone, where the SHARE app threw out a loud warning of its own.


I reached over and clicked on my phone, which was closer than my receiver, going to the app to look at my blood sugars.  I “follow” two PWD friends in addition to following my own data, so the screen showed three different profiles.  The two that weren’t me were fine – nothing to worry about.  They were perfectly safe.  Everyone was safe!

Everyone but me, because my data stream claimed “LOW.”  Somehow that number wasn’t registering in my head.  It wasn’t mine.  Clearly.  Wait, what’s happening?

I rolled over and went back to sleep, entering the fifteen minute cycle of hear beeps, respond to beeps by clicking a button, head back on pillow (drenched with sweat, but somehow the low still was recognized by my consciousness), repeat.  My daughter was asleep next to me (she had appeared in our room around 4 am) and for a split second, my brain wondered who belonged to the brown, curly ponytail spilling across the pillow.

And then all at once, the alarms made sense; their intention clicked firmly into place.  Their sounds reached across and tapped me on the shoulder, pushing me with frustration towards the juice.  I uncapped the little bottle and drained half of it, relief hitting the hypo-panicked parts of my mind.  It only took a few minutes to paddle back from confusion, and within minutes, I was fine.

Once I was downstairs in the kitchen, I checked my email on my phone while the coffee brewed.  I spun through the data on my SHARE app, seeing the long, red tail of the low that had wrapped around me for over an hour.  I felt frustrated by the fact that despite well-timed alarms, sometimes the lows themselves remove my ability to respond.

Some hypoglycemic moments are quieter and laced with a gentle fog of frustration, one that makes me reach for glucose tabs and forget how many I have already eaten but ha ha ha that’s okay, everything will be fine in a few minutes.  But the lows that come while I’m asleep and my body wakes up in the trenches of leave me entirely confused and oddly content to sit in a puddle of my own cold sweat, a bottle of juice within reach on the bedside table but my brain is too damn stupid to encourage my hand to reach over.

Eventually, science and technology will find a way to add two arms to my CGM receiver that, in the event of a low, will reach over and slap me, then hand me the bottle of juice.  Then those robo-arms will hand me a towel to wipe my forehead.  And once it’s over and done with, they’ll hug me quickly but firmly and tell me to suck it up because there’s shit to do.

Does Not Compute.

“Do you guys have any fun plans for the summer?”

The question was simple enough, but not even close to a level my hypoglycemia-addled brain could handle.  I had trouble formulating a response, and the lag time was embarrassing.  We’ve only moved to the neighborhood a few months ago and haven’t solidified relationships with our neighbors yet, so being wickedly low in front of someone new wasn’t my favorite way to disclose my diabetes.

Thankfully, a disclosure had already happened, to a certain extent.  When she had asked me about my work travel this past week and what I did for work, I said that I worked in patient advocacy and that I’d had diabetes since I was a kid.  She nodded in recognition and shared that her college roommate was also T1D, so my disclosure was pleasantly subtle and streamlined.  No big deal.  What I hadn’t anticipated was going low during the course of our conversation.

And I was low.  Wickedly low.  The kind of low that made my face feel like it was full of Novocaine and that my hands were like birds at my sides, twitching and flapping absently.

I scanned the trees in the front yard for some kind of hint.

“Pssssst.  You guys!  You, trees!  Do I have fun plans for the summer?  HELP!”

They only waved their leaves at me.  “We have no idea!  Go get something to eat, dummy!”

“We go to Maine.  MAINE.”  I said it twice with way too much emphasis on the second one, an angry seal barking out their summer plans.  My neighbor didn’t seem to notice that my eyes weren’t able to focus on her, and I’m fairly certain she didn’t hear my Dexcom receiver hollering at me from the front steps of the house.  But I knew that another minute or two was the chasm between attempted conversation and calling for medical help, so I had to embrace the awkward.

“I’m so sorry; I know I mentioned that I have diabetes and you said your college roommate also had diabetes.  So I’m really, really low at the moment and I need to go inside to grab some juice.  Would you excuse me for a minute?”  I was trying to be polite and not let on that my thoughts were knocking around in my head like socks in a dryer.  She nodded and I took off for the kitchen, where I downed a glass of grape juice as quickly as I could.  My CGM only told me I was “LOW” and I cursed myself for not responding faster to the beeping.

Coming back outside, we stepped back into conversation without much pause, watching our kids play in the front yard.

“Sorry about that,” I said.  “No problem at all,” she warmly responded, not missing a beat.

And I kept an eye on my CGM graph, watching my blood sugars rise and kindly deposit thoughts back into my head.

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.


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