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Posts tagged ‘low blood sugar’

Nov 12

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Pell Bridge Run.

When my friend Liz asked me to do a race with her in November, I was more concerned about whether or not I was home to participate instead of concerning myself with the specifics of the race itself.

“November 10th?  Sure, I’m home that weekend.”

And then I looked at the details:  it was a a 4.2 mile race over the Pell Bridge in Newport, RI.  At 6.30 in the morning.  On a Sunday.

A Facebook message to my friend:  “Liz, I finally followed directions and signed up. But this shit starts at 6.30 in the morning? Blargh.”

But what sounded like the absolute suck was a really amazing experience, watching the sun rise as several thousand runners crested over the bridge, moving towards a common goal.


Performance-wise, I struggled, but that’s okay.   Lots of rookie mistakes in play:  a terrible night’s sleep (< 4 hours), a new infusion set put in morning of, a fasting blood sugar of 298 mg/dL that required an aggressive correction bolus (so that I would come down in time to not have the desire to pee on the peak of the bridge), and too much insulin on board (IOB) when I met the rest of the racers at the starting line.  Thankfully, I reduced my basal rate at 4 am when I woke up, so I didn’t have my normal dawn phenomenon rate in play.

CGM check 20 minutes before the race:  158 mg/dL with an arrow pointing straight down
Meter check for confirmation:  139 mg/dL.
Bananarama:  Ate a banana without bolusing for it, and chewed a Shot Blok to get some carbs coursing through my system before setting off.
Packing heat:  And I had my Spibelt with two sleeves of Shot Bloks, my Dexcom receiver, and my meter.  I was ready for anything.

At 6.25 am, five minutes before the starting gun, I was 108 mg/dL on the Dexcom with an arrow pointing due east, so I hoped the banana/Shot Blok combo was enough to see me through.  But as the gun fired and runners started up the bridge, I felt that telltale heat washing over my body in waves of oncoming hypoglycemia.  I popped another shot blok, but shaky hands told me I needed to consult my CGM, so 3/4 of a mile into the race, I acknowledged the 50 mg/dL  and the down arrow winking back at me.

“You can go screw,” I thought.

I had to slow my pace down to fuss through the low, but after a few minutes (and thanks, in part, to the adrenaline that surely helped spike me closer to range), the down arrow disappeared and was soon replaced by a gently sloping northeast arrow on my Dexcom graph.  I continued down the bridge, and then through downtown Newport, towards the finish line.

It was early, it hurt, I was a little sluggish post-low, but my legs responded to my requests, and I kept going.

Thoughts of “I can’t do this,” were replaced by, “Oh hell yes I can.”

I’m not a fast runner.   Not a graceful one, either (more of a plodder).  But I get there.  And even though diabetes was a bit to blame for delaying my sprint across the finish line, it is fully to blame for bringing me to the starting line.

(And this run gave me a great Big Blue Test to log – 139 mg/dL at the outset, 158 mg/dL at the close, after 4.2 miles, 44 minutes, and about 40 grams of carbs.  Exercise for the freaking WIN!)

Related posts:

Spot Off. Not What She Thought I Was Doing. Ketchup and Mustard.

Nov 7

29 Comments

What A Low Blood Sugar Feels Like.

What a low blood sugar feels likeAcross the board, a low blood sugar seems to be considered as anything under 70 mg/dL.  Revisiting the American Diabetes Association’s website this morning offers up a list of symptoms of low blood sugar, like:

  • Shakiness
  • Nervousness or anxiety
  • Sweating, chills and clamminess
  • Irritability or impatience
  • Confusion, including delirium
  • Rapid/fast heartbeat
  • Lightheadedness or dizziness
  • Hunger and nausea
  • Sleepiness
  • Blurred/impaired vision
  • Tingling or numbness in the lips or tongue
  • Headaches
  • Weakness or fatigue
  • Anger, stubbornness, or sadness
  • Lack of coordination
  • Nightmares or crying out during sleep
  • Seizures
  • Unconsciousness

(As with most diabetes-related lists on the Internet, the further down the list you read, the worse shit seems to get.)  The “what happens if a low blood sugar goes untreated” answer is short, and to the point:  “If left untreated, hypoglycemia may lead to a seizure or unconsciousness (passing out, a coma). In this case, someone else must take over.”

When my daughter hears my Dexcom beeping, she understands the difference between the alert signaling a high blood sugar and the alert signaling a low.  If the high alarm goes off, she doesn’t react, but if the low alarm goes off, she perks up immediately and asks me if I need a “glupose tab.”  The immediacy and seriousness of low blood sugars is noticed by my three year old because she’s seen me go from normal, functional Mom to confused, sweaty, and tangled-in-my-own-words Mom in a matter of minutes.

The symptoms of low blood sugars don’t just vary from PWD to PWD, but often vary within the PWD’s own lifetime.  When I was very small, my low blood sugar “tell” was when my mouth would go numb and my face felt like I’d had Novocaine hours earlier and it was just starting to wear off, with that tingly, prickly feeling.  Over the years, I’ve had a lot of lows with varying symptoms:

“My brain is fully functioning.  I know words.  I know sounds.  I know exactly what I need to do and what the number 42 means but my body has betrayed me and won’t move as I have asked, like I was a robot who had been over-oiled.” – Sad Robot

A video during which I went low.

“My mouth isn’t even mine.  It’s just this thing, this portal to shove giant sugar tablets into.  I can’t work up the saliva to chew, so the tab sits in my mouth until it starts to dissolve a little, and then my body remembers what to do with it.  ‘Chew the damn thing.’  Tragedy of a low – no saliva.  Nothing to help mince these tabs down into something useful.” – Bullets

“‘Thanks, and could I please have a small orange juice, without ice, as quickly as you can?  Thanks so much,’ I said to the host in one breath, hypoglycemia filling up all the space around my head like the Radiohead video for No Surprises.  A minute or two later, a glass of orange juice was on the table.  I drained it in a few gulps.” - Reduced to Rubble

“I remember my mom sitting on the kitchen floor with me, breaking graham crackers into smaller bites and putting them in my mouth, dinner burning in pans on the stove.  I remember my mom’s eyes being very wide but she wasn’t crying.  I remember a glass of juice.  I remember it was hard to chew because I was crying but I wasn’t sure why, and then there’s a sharp edit in my memory, where I don’t have any recollection of what happened next.”  – Memories

No two lows feel or look the same, but a few grams of carbohydrate (plus the willpower to wait) can swiftly save the day.  With quick recognition and treatment, lows pass as quickly as they come on (most of the time) but they are always in the back of my mind.  When it comes to diabetes concerns, the fear of hypoglycemia has been constant for the last twenty-seven years.  My purse is never (okay, rarely, but never without on purpose) without glucose tabs, and I’ve had the “this is glucagon, and here’s how to use it” conversation with more people than I can count.

What are your low blood sugar symptoms?

 

Related posts:

What A High Blood Sugar Feels Like. Memories. Reduced to Rubble.

Oct 30

24 Comments

Ketchup and Mustard.

Blood sugar excursions are one thing (little trips to the grocery store, short flights to Canada … those sorts of excursions are fine) but the long-haul ones are not okay (BOS -> MEL).  I can deal with a sticky high of 180 or 200 mg/dL without getting fired up, and lows are less frequent these days, so I’m not as irritated by them.  Issues seem weekly rather than daily, which is a lovely change of pace.

Except for yesterday.

Holy shit, Yesterday.  You sucked.

The day began with a low alarm in the morning – not a deep one, but a shallow low, easily managed by turning down my basal rate for 45 minutes and popping one glucose tab.  Before breakfast I was 107 mg/dL.  After breakfast, I was 302 mg/dL.  The eff?  I have a breakfast bolus recorded in my pump, but it clearly didn’t make a dent (either that, or the stress of the morning sent me cruising up into orbit).  My goal of bringing my blood sugar down within a few hours was thwarted by a thorough combination of a bloody infusion set (was that why my breakfast bolus didn’t register?), insulin that may have been borked (my pump cartridge was a potluck of dregs from older bottles), the regular stress of work coupled with exacerbated stress of having a high blood sugar … it was gross.

It wasn’t until about 2 pm that I was back down to the 200′s, and that was after pulling the infusion site and taking an injection.  And it wasn’t until about 3 pm that I saw a number under 100 mg/dL.  Which started the second half of my day, spent trying to bring up a low blood sugar that wanted its own bedroom.  I bounced between highs and lows for hours, not able to properly correct at either end of the spectrum due to a magical combination of user error and pancreas error.

When I looked at my Dexcom graph last night, it was way too much ketchup and mustard (aka “highs and lows”) and not nearly enough time spent in range.

“Damn hamburger Dexcom,” I muttered.

A normal day with diabetes doesn’t wring me out, but yesterday did.  Concentrating on work was really difficult, because my high-brain was too sluggish and too thick to let synapses fire.   Writing was impossible.  Sitting at my desk for more than twenty minutes was impossible because I kept having to take breaks to get more water and then to pee.  (I went for a run and a mile and a half into it, made the wise decision to turn around.  A good idea since, by the time I got back to my car, the need to pee was amazingly all-consuming.  Oh hydration!)  My whole body felt like it was submerged in Jell-O, and I tried to swim through it for the majority of the morning.  Instead of making beds/doing laundry/cleaning dishes/writing/answering emails/phone calls, I wanted to climb into bed and sleep off the blood sugar hangover, but that wasn’t an option.  Life doesn’t wait for diabetes.

I made lots of mistakes yesterday – should have pulled the site/taken an injection earlier, should have assumed my blood sugar would rise more after turning down the basal, should have checked an hour after eating instead of two.  So many things I should have done, or done differently.  But my brain isn’t very clever when it’s on the glucose roller coaster.

Oh yeah, and diabetes.

This morning, my fasting blood sugar was 104 mg/dL, a welcomed change after yesterday’s 398 mg/dL, 42 mg/dL, and all the numbers in between.

“Don’t mock me, you little jerkface,” I said to my meter.

If the frigging thing had a tongue to stick out, it would have.

 

Related posts:

The Price of Being Stubborn. Despite Insulin … Spot Off.

Oct 21

15 Comments

Reduced to Rubble.

Walking down the hill towards the restaurant, I felt the low start to kick in.  The symptoms started their awkward osmosis, triggered once I felt the buzzing of the Dexcom but eventually flooding my body with that tingling confusion, knees that buckled just a little with every step, and eyes that wouldn’t focus but darted around in my head like over-caffeinated birds.

“I’m low and I’m an idiot.”

“Why?” said my husband, Birdy in his arms as we walked down the unfamiliar city street in Montreal.  “Are you okay?”

“Yeah, but we might need to go to a closer restaurant, instead of the one that’s way down that road.  I left all my glucose tabs in the hotel room by accident, and I don’t have anything on me.”

Picking up the pace, despite my increasingly clumsy feet, we reached the a nearby restaurant and were quickly seated.

“Here are your menus, and your waiter will be with you in a moment.”

“Thanks, and could I please have a small orange juice, without ice, as quickly as you can?  Thanks so much,” I said to the host in one breath, hypoglycemia filling up all the space around my head like the Radiohead video for No Surprises.  A minute or two later, a glass of orange juice was on the table.  I drained it in a few gulps.

“Do you want to order, or do you need a few minutes?” Chris asked, reading through the menu while keeping an eye on me.

I picked up my menu and opened it, but the words didn’t make any sense.  Staring hard at the entree section, I tried to make heads or tails of how the letters were arranged, but they didn’t look like English.  The Dexcom wailed again and I checked my blood sugar on my meter – 48 mg/dL.  “Am I so low that I can’t freaking read right now?” I thought.  (And then realized I was holding the menu that was written in French.  After switching menus with Chris and reading through the English menu, things made much more sense.)

“I can’t think right.  I see all the thoughts in my head spinning around and I want to grab one, but they go by like socks in the dryer.  Everything is a blur of laundry right now,”  I admitted.  “I need a minute to figure out what I want to eat because right now, I want to eat everything and then cry.”

Stupid low.  Haven’t had many stupid lows lately (thanks largely in part to better planning and keeping a close eye on the Dexcom graph), so the ones that do creep in seem to hit harder than before since symptoms are felt more strongly.  I don’t mind carrying a bigger bag than normal, or going running with a Spibelt crammed tight with glucose tabs, and I don’t even mind the exceptionally awkward moments of having my pump tubing stuck accidentally through else’s seatbelt on a plane, but I do loathe the way that lows reduce me to rubble, and how the simple matter of forgetting to plan caught me off guard.  Usually quick on my feet and able to think rationally, lows make sentences hard to slap together, and reason nearly impossible to catch.  The friction between ‘thought’ and ‘action’ is grinding and hot, leaving my brain a few seconds behind until the glucose stores refill.

As quickly as it came on, it was over.  The Dexcom showed a gently upward-sloped arrow, and the hypo-fog lifted.  Birdy asked if she could have “just a small sip of your orange juice, Mawm?” and I handed her the glass, happy to not need it.

in rainbows. man, I love Radiohead.

Related posts:

Memories. Low Hangover. Not What She Thought I Was Doing.

Oct 14

13 Comments

Hypoglycemic Blues.

This past weekend, I was in Omaha (pronounced in my head as “OMAHA!!!!” almost every time), Nebraska for a TCOYD conference, joining in as speaker for the event.

One of the topics in OMAHA!!!! that we talked about was the integration of medical devices, sharing anecdotal stories about life with out diabetes-related robot parts.  Panel moderator Dr. Jeremy Pettus shared a video he made about how using a continuous glucose monitor, illustrating the difference between catching a low when you’re deep in the trenches of it (whoa, 49 mg/dL) versus catching it when it first starts (like 8o mg/dL and dropping).

The ways a CGM has helped improve my quality of life are becoming hard to count:  I feel safer when I drive, when I sleep, when I was pregnant, when I am traveling, when I eat new and strangely-carb’ed up meals … and now I’m more appreciative of how it helps keep me from over-treating those frigging overnight lows.

Thanks, Jeremy, for taking the time to explain this CGM benefit while sporting your pajamas.  Bold move, doctor!

Related posts:

Short Dexcom Break. Sleep, Perchance to … Sleep. Crocheting Out of a Low.

Aug 22

18 Comments

Not What She Thought I Was Doing.

When you get into the car after going for a run and see a blood sugar of this:

… it’s way past time for glucose tabs.  So when you reach into the Spibelt you’re wearing to retrieve the glucose tabs that you stuck in there, encased in a plastic bag once used for diaper discards instead of the travel tube because you forgot that at home and you didn’t want to have the Dexcom receiver covered in glucose dust, it might look, to an innocent bystander, a little like you’re eating dog poop from a doggy clean-up bag.

“They’re glucose tabs!  I have diabetes, and I’m having a low blood sugar reaction,” I blurted out to the woman standing a few feet away, staring at me as she stood with her car door and her mouth opened.

“Oh thank goodness!”  She laughed, relieved.  “Because I thought you were … you know, I thought you were doing something you aren’t doing.”

“Nope.  Not eating dog poop.  Thanks, though.”

Related posts:

Raspberries. Looking Back: PWD in the Wild. Crocheting Out of a Low.

Aug 20

15 Comments

Going Solo.

Seven weeks is a long time.

It’s a lot of garbage days (I hate, hate taking out the garbage, especially since we have a crew of vindictive raccoons who have made it their agenda to bust into the garbage cans of everyone on our street, spreading trash all over the place and laughing maniacally whilst wearing hats).  Seven weeks is a lot of grocery store visits and pharmacy trips.  It’s a ton of bills.  Seven weeks is so long that your brain turns to inoperable mush.

Chris came home yesterday, after being away for seven weeks on a film shoot.  I don’t discuss much about his job here because it’s his news to share, but for the last two months, it has been hard not to discuss his absence, since it was affecting everything about my life.  Normally, our respective business trips are short.  For me, being away for a full week is a tremendously long time, and that is an anomaly.  For Chris, his travel jaunts are less frequent but usually longer, sometimes dipping into the eight – ten day away range.  This is something we’ve learned to handle, as a family.

But seven weeks?  Eff that.

Seven weeks is a long time to spend thinking about single parents and to build up even more respect for them, as the experience redefined “challenging” for me.  And I only experienced simulated single-parenting, my husband away but with a timeline for return.  It was while he was gone that I revisited the post-pregnancy feeling of not knowing whose needs to tend to first:  mine, or my daughter’s?

Unless I was away for work, I went to sleep every night with Birdy sharing a bed with me.  (Which was fine, except for the nights when she had a nightmare and would wake us both up, hollering about “the lemons are watching me!!” or the mornings when I’d wake up with the help of her tiny hands prying open my eyelids.  “Good morning, Mawm!”)  Every morning kicked off with a Birdy focus, unlike regular mornings, where the first thing I do is test my blood sugar and then go retrieve the kid, knowing I have Chris as back-up.  Good diabetes habits that I have forced (and then enjoyed) for the last year or so went a bit pfffft as Birdy became the focus and I was flying solo.

“But your health needs to come first, so that you can best care for your daughter.”

Shut up;  I tried.  Everything was a circus.  For five of the weeks of Chris’s trip, I was finishing up final edits on a book I’m writing (submitted to the publisher two weeks ago – more on that later!), which meant that once Birdzone was in the sleepzone, I was up until all hours, combing through pages to tweak content.  And the last two weeks of Chris’s trip included two trips for work, leaving my daughter under the capable (and so appreciated) watch of my mother.  “A good night’s sleep” was a laughable goal.  “Exercise” became either chasing my daughter while she rode her bike at a breakneck speed or brief stints on the ellipmachine in the basement (because going to the gym/for a run while she was awake wasn’t an option, and most times I was so spent that I couldn’t eek out much in terms of exercise).  Emails went unanswered.  Deadlines were pushed.  Pigtails were installed at uneven angles.  Bananas ripened and rotted due to neglect.

(But we always had gluten-free banana bread baking, because that has become a favorite past-time of the Bird’s.  So there was that.)

Diabetes became like a second kid, only one I don’t want to snuggle with.  It needs to be walked.  Fed.  Checked on and monitored.  It’s a needy little sucker.  When it whined and needed tending to, I had to explain to my daughter why we needed to wait a few minutes.

“Do you have whoa bwoodsugar?  Your Dexcom is howering [hollering].” Birdy asked me when I was popping glucose tabs into my mouth, car keys in my hand.

The term “whoa bwoodsugar” took on a whole new meaning when I was solely responsible for my daughter.  Being a parenting soloist for seven weeks made diabetes management pretty freaking tricky.  I’m thankful Chris is home now, because for the duration of his absence, my target blood sugar went from 150 mg/dL instead of 100 mg/dL, in efforts to avoid hypoglycemia while I was the only adult in the house.  My meter average followed suit, which was a frustrating increase after so many months in a comfortable zone, but I knew it was a temporary fix.  My job was/remains to take good care of my kid, and that’s hard for me to accomplish when I’m low as all hell.  It was an enlightening (read:  WTF) experience, and one that, for all of its challenges, I’m glad I proved to myself that I could handle, thanks in large part to friends and family, and the blessings of a flexible job.

But, for a dozen different reasons, I’m so glad Chris is back.  Because, at the end of the day, he’s the one who gave those hats to the raccoons in the first place, so he should be the one doing battle with them.

 

Related posts:

My Little Orange Bracelet. Low Hangover. Diaries of a Diabetic Girl.
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