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Posts tagged ‘hypoglycemia’

What’s On Your Bedside Table?

What do you mean, all the glucose tab jars were in the car and you were out of juice so you stashed one giant marshmallow on your bedside table in case of low blood sugars?

Potentially a bit gross, but practical.  Serves as a throw pillow when not in use.

Looking Back: Lows in Public.

On the road this week, so I’m looking back at a post from June 2012 about experiencing hypoglycemia in a public place.  It’s never fun to be low, but I’m always grateful for the patience and compassion of others who help see me back to being in-range.

*   *   *

I heard the Dexcom BEEEEEEP!ing in that frantic, “you’re low” kind of tone and my brain was swimming with confusion, so I went to the bar at the dinner event and asked for an orange juice.

“Do you want vodka in that, as well?”

“No, definitely no thank you.  Just juice, please.”

The bartender filled up a small tumbler with orange juice and I downed the contents of the glass in one giant gulp.

“Thanks,” I said, and wandered off, fishing my meter from my bag to get a true assessment of how far down the rabbit hole I’d fallen.

There isn’t ever a convenient time for a low.  I suppose the ones that happen when I’m at home and are only in the 60 mg/dL range and can be treated with the logical and tempered rationing of glucose tabs are better than the ones that happen in public.  When you’re at a dinner event and you’re trying to meet people and make a favorable (or at the very least, coherent) impression, it’s not the most opportune time for a 38 mg/dL to make an appearance.

Once I saw the number on the meter, I became this strange, hypoglycemic bear, foraging for food and ready to growl at anyone in my way.  The very nice waiter who was bringing appetizers around to the attendees ended up with an empty plate after I had my way with him.  (Which sounds worse than it actually was; he only had three snacks left, but I snagged them and might have bared my teeth at him in the process.)  My low symptoms were peaking, with tears in my eyes and confusion on my tongue and every skin cell buzzing with panic and adrenaline.

I do not like being low in front of people.  I don’t like that momentary weakness and the vulnerability and that empty, lost look I’ve been told takes over my eyes.  I don’t like that lack of control.  I don’t like when my knees buckle while I trying to keep myself upright.  I don’t like the look of “Are you okay?” that comes over the faces of most people, because it’s one of the very few times I have to answer, “No, I’m not.”

Thankfully, I was at a diabetes-related event, surrounded by people who either had diabetes, cared for someone with diabetes, or worked to cure diabetes.  So when I casually mentioned to Jeff Hitchcock that my blood sugar was tanking and I didn’t know what was going on, I was ushered quickly and covertly to a seat at a nearby dinner table so I could make sense of things.

“I’m fine, you know.  I had juice.  I’ll be fine in just a few minutes,” I said, folding and refolding the napkin on the table while I waited for my blood sugar to respond to the juice.

“I know,” he said, his voice calm and reasoned.  “We’ll wait.”

As it always does, the panic subsided.  My blood sugar came back up into range (and went up just a bit more than it needed to, thanks to downing that whole glass of orange juice).  And I was able to rejoin the dinner conversation without needing a three-minute lapse between thoughts, thankful for people who “know.”

Looking Back: Telling Off the Paramedics.

A few things: 

This post is almost ten years old, which is unsettling on its own accord.

It also documents the only time in my 27 years with type 1 diabetes that paramedics needed to be brought in to assist, and mostly because my roommate needed help getting me to eat, not because I was unconscious.

I miss Abby and her magical, glucose-sniffing powers.

The day after this low blood sugar happened, I drove to the fire station and thanked the paramedics profusely for their help, and apologized just as profusely for my actions. They said they see it all the time. The fact that they see it all the time and continue to do what they do to help people makes me respect their profession, and all HCPs, even more.

Apologies for the language used. As you know, I wouldn’t swear unless I was low.

*   *   *

Abby. My cat.

She has never missed a low blood sugar. There have been times when I was so low that beads of sweat collected on my forehead, making my face clammy and my t-shirt damp with panic. Usually my body wakes itself up in time, leaving me just enough energy to stumble out to the kitchen and pour a glass of juice. But sometimes I don’t wake myself up.

That’s where Abby has never failed me.

She will sit on the pillow above my head, wailing like a banshee. “Meow!” She paws fiercely at my head and nudges my face with hers. I usually come around as she is pressing her nose fervently into my ear. “Me-ow!” More insistently now. She won’t stop wailing until I am trudging through the living room towards the kitchen. Siah hasn’t figured out this trick yet. But I’m sure she will in time. Or maybe Abby is just in tune with the way my body starts to panic.

Sometimes I feel waves. The ones that gently undulate and lap at the shores of my consciousness. I focus what is left of my resolve on remaining awake, waiting for the juice to take effect. Those are the worst ones. The ones where I am afraid I am going to pass out.

I’ve never passed out. In almost two decades of diabetes, I have never been unconscious. Of course it may happen. It could happen to any of us. But I have come close.

There have been some tricky lows, though.

There was one that I had in January of 2003, while I was living with my ex-boyfriend. The alarm clock went off in the morning, but I didn’t stir. He got up to turn it off. Usually I lean right over and grab my kit off the nightstand so I can test my blood sugar, but that morning I wasn’t moving at all. He had dated me for six years and he knew the signs of a serious hypoglycemic episode, so he immediately woke up and tested me himself. My bloodsugar clocked in at 44 mg/dl. He went downstairs and grabbed a glass of juice.

“Kerri, get up. Drink this. You’re low.”

Nothing from me.

“Hey. Drink this.”

Most often, I sit up, obligingly grab the glass, consume the contents with graceless gulping, and fall back upon the pillow until the tides of my sugar rise enough for me to sit up and say, “How low was I?” This time, I took the glass from his hand, told him to leave me alone, and proceeded to pour the juice all over the bed.

I’m known for being slightly combative when low.

He got another glass of juice. And the phone.

“Kerri, you need to drink this. If you don’t drink it, I am going to call the paramedics. “

After being told, repeatedly, to go fuck himself, [Note: I'm still embarrassed by this.] Roommate dialed 911. Three paramedics showed up, one slightly chubby. I am in bed, at a minimal level of functionality. I don’t remember what happened from here on in, but Roommate told me I was belligerent.

Roommate told them I rang in at 44 mg/dl. They grabbed the red and white tube of InstaGlucose from their med kit and advanced on me. In the throes of my low, I fought them off as best I could. They outnumbered me considerably; it took three paramedics to hold me down well enough for Roommate to administer the InstaGlucose in my fitful mouth. The paramedics let me loose. As the sugary substance absorbed into the inside of my cheeks, I turned to Roommate with a resounding “Fuck you!” I whirled to the most portly of the medics and growled, not unlike Linda Blair, “You too, fatty!”

I came around very slowly. I don’t remember much of how I ended up downstairs, but I am told that I wandered down the staircase and stood at the front door, clutching my blanket around my shoulders and murmuring, “I want my Daddy.” Because that’s not at all embarrassing.

Roommate told the medics that I would be fine in a few minutes, having just tested me and yielding a result of 68 mg/dl. “She’s on the upswing. She doesn’t need to go to the hospital.” To confirm my agreement, I had to sign a release form, stating that I refused to be brought to the hospital. I signed, half in a fog.

Fast forward to me in the shower, getting ready to go to work. The medics are gone. Roommate is sitting on the bathroom counter, monitoring me. I start to remember what happened. We talk about how everything is okay now, and how sometimes a low just sneaks up and destroys me.

I’m feeling much better. A little embarrassed that I was such trouble, but no harm, no foul, right? I smile sheepishly. Safe now. Abby was prowling about on the bathroom floor, making sure everything was okay now.

“Yes, Kerri. You did okay.”

And as the warm water washed away the traces of InstaGlucose from my arms and eased the tension in my muscles, I gasped in shock as I cried, “Oh my God! … I called them fat fucks, didn’t I?”

The laugh from the counter top confirmed.

Missed Manners.

So this popped up as a Q&A in a recent Miss Manners column:

“DEAR MISS MANNERS: I am a businessman who frequently flies both domestically and internationally. I also happen to be an insulin-dependent diabetic.  I currently do my glucose testing in my seat. It does involve using a lancet device to get a drop of blood to test, but is fairly unobtrusive. Of course, all lancets, alcohol preps and test strips are stored in my test kit for proper disposal later.
Am I being rude to perform this test next to a stranger? Injections I perform privately in the plane’s lavatory. In the airport, I use the counter by the wash basin, since most water closets have no room for insulin vials and other supplies.
Many people seem to stare and resent the fact of performing such a function in this space. I have also had children ask, “What is that man doing? Isn’t that a bad thing?” (They’re obviously thinking of their drug education classes.) Am I too self-conscious?

GENTLE READER: Absent an emergency, medical applications (like bodily functions and grooming) are properly done out of sight — meaning in private or in a restroom — unless they can be done so surreptitiously as to be unrecognizable as such. Miss Manners does not object to a pill taken at dinner, so long as it is not accompanied by a dissertation on your cholesterol.
The technology associated with diabetes is fast approaching this standard, although Miss Manners draws the line at drawing blood. Restrooms exist to provide a proper location for such necessary activities when away from home, and those who use them have no business monitoring the respectable, if sometimes unaesthetic, activities of others.
You may chose to tell children that it is a medical procedure, or ignore them and let their parents do that. Miss Manners would hope that any parents present would also resolve to teach their children to be more discreet with their curiosity.”

Hmmm.  My response:

DEAR MISS(ED) MANNERS:

I am a person with type 1 diabetes, and I’ve been testing my blood sugar regularly for the last 10,000+ days.

Testing my blood sugar is not a bodily function; It’s a practice required for proper diabetes management. It’s not grooming; it’s a medical necessity.  I travel a considerable amount and when I am in transit, I do what is required to take care of my diabetes from the comfort and safety of my seat. I take great care to be discreet in testing my blood sugars, and I properly contain and dispose of my supplies throughout my travels.

I wish I had the option to afford myself the rule of “drawing the line at drawing blood.”  Hell, if I could test my blood sugar without pricking my finger, it would be a great day, indeed.  Restrooms exist to provide a place for travelers to urinate or defecate, and I would prefer not to perform my subtle medical procedure where people are known to perform those actions.  You have no business monitoring the respectable, responsible activities of people with diabetes who are trying to stay alive.

The technology associated with diabetes is fast-evolving and has grown by leaps and bounds since my diagnosis 27 years ago.  But if I took your cue and relegated myself to bathrooms to tend to my diabetes needs, I’d be in the bathroom(s) all the time.  (And everyone on the plane would hate me for taking up the bathroom every hour or so.)  Instead, I discreetly test and medicate as needed, so as to avoid a more serious diabetes issue, such as a severe hypoglycemic reaction wherein I could seize and potentially bite my tongue (causing blood to spill) or accidentally relieve myself (causing urine to spill).  Which is more offensive to you – the controlled, unobtrusive checking of my blood sugar or the unpredictable, emergency effects that may transpire as a result of not checking?

You may choose to tell your readers that it is in bad taste to perform this medical procedure in a public place, but I disagree.  I would hope that you would resolve to teach children and adults alike that taking care of your health is something to be proud of, not ashamed of.  Offer whatever advice you’d like, but at the end of the day and during the course of every day, I will do what I need to do to live with this disease.

 

On Sale.

The post-holiday discount aisle at CVS …

"In Case UR Low"  Or maybe "4 UR Hypo" ?

… is perfect for restocking low blood sugar supplies.

Endless Lows.

I do not know what makes them stick like this, the lows that creep in and stay creepy for hours at a time.

“Is this thing serious?” I asked.  Then I’d prick my finger to confirm that, indeed the Dexcom was serious, and I was in fact still low.

There are times when high blood sugars are stubborn and refuse to come down, even when I rage bolus and exercise.  But I can tolerate a sticky high because, even though it’s not comfortable, I can still function properly-ish.

The endless lows, though, work me over in a way that’s entirely different.  Last night, I came home from the gym with a downward drop in my Dexcom, and it lasted for two and a half hours.  Which meant that, for two and a half hours, I had a combination of numb lips/tongue, shaky hands, mental fogginess, and that urge to cry without reason.  I had to constantly tell my daughter, “I just need a few more minutes, because my blood sugar is low.”  I was thankful that Chris was home to help me negotiate parenting stuff/reminding me to eat something else.

What makes this happen?  How can I chomp down ten glucose tabs and a banana and some applesauce over the course of three hours and barely see a blood sugar budge?  It took over a 150 carbs to make a dent (And that dent peaked up to 200 and then promptly fell again.  What the eff?).

“What are you now?” Chris asked before bed.

“202.  And I’m fine with that,” I replied with finally-not-numb-lips-and-a-shirt-collar-dusted-with-glucose-tabs.

Half a Juice Box.

Turn on the light.

Fall back asleep.

Press the button on the CGM to make it stop BEEP!ing.

Fall back asleep.

Unzip the meter case and take out my glucose meter.

Lapse back into sleep again; was it sleep or was I passed out and what’s the difference when it’s 4 am and your blood sugar is under 40 mg/dL?

Opting for a juice box instead of the open jar of glucose tabs on my bedside table, I fumbled with the straw and once it hit the foil-covered mark, I drank as though my life depended on it.  Because it felt, in that moment, like it did.

I was 98% sure I would be completely fine in a few minutes, with no lasting effect of the severe low except maybe a hypoglycemia hangover.  But until the juice hit my system and my brain stopped panicking, the remaining 2% of doubt invaded every bit of me.

“I wasn’t afraid I was going to die,” I told Chris, explaining the next morning why I was so tired.  “It was more like I was really aware of how close I was to a dangerous physical state, and I needed to make sure I didn’t cross the threshold, whatever that might be.”

“I wish I had heard the alarm.  We need to do something about that – you need to keep it in a glass even when I’m home, so I can hear it when you don’t.  I need to be able to hear it, too,” he said, giving my shoulders a squeeze.

“Yeah, but what’s weird is that all I could think about, as I was waiting to come up and feeling pretty awful, I kept debating whether or not to drink the rest of the juice box instead of just drinking half.  I wanted to drink the whole thing, and then fifteen other juice boxes and maybe a sandwich, for good measure.  But instead, I was sweating and shaking and confused and at the bottom of the well, you know?  And the only moment of clarity I had was limiting myself to half of a juice box, knowing it would bring me up just enough and not too much.”

Having the first half saves my life, and having the wherewithal to not drink the second half saves me high blood sugars when I wake up.  It’s a humbling moment, realizing what hangs in the balance of half a juice box.

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