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Posts tagged ‘low blood sugar’

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.

LOW.

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.

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.

 

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.

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.

Looking Back: Dining Out.

I love going out on the town for the night
And having a meal by a soft candlelight
(Because I know, at a restaurant, meals are yummy;
For the food isn’t prepped, touched, or cooked by me.)
But to dine with type 1 can be quite complex,
Because restaurant food has a whole set of specs
That require some SWAG’ing; carbs seem to inflate
As you wonder what’s really down there on your plate.

“Excuse me, but does the salmon have a glaze?
Is it covered in sugary, caramelized haze?”
I ask of the waiter, tuning in as he states
That the glaze can be brought on the side of my plate.
My soda arrives, and I ask, “Is this diet?”
As I bring the glass up to my lips just to try it.
“It is,” he responds, and he watches my face
As I try to assess the fizzy soda’s taste.

Moments later, I notice that something is wrong.
I’m not sure my thoughts are where they belong.
My brain is all foggy, my hands feel so weak,
I’m having some trouble with words while I speak.
Did I bolus too early?  Did I miscount the carbs?
Is it something I did to make Dex go on guard?
There are glucose tabs right here in my purse,
But I know that I’ll feel better if I have juice first.

My husband is almost up, quick as a blink
To go to the bar to grab something to drink.
But it’s not a big deal; I chomp tabs while I wait
For the waiter to come back and fill up our plates.
He comes back for our order, but I’m not quite ready.
My Dex shows my numbers as slightly unsteady,
With double-down arrows beaming; so unkind.
“Can I have an orange juice, if you don’t mind?”

I see his confusion. The gears start to grind.
I hear the thoughts churning inside of his mind.
“She didn’t want glaze, and her soda was diet.
The bread was right here, but she didn’t try it.
What’s up with this girl? Selective sweet tooth?
Whatever. My job is to bring her the juice.”
He walks off to the bar to bring back something sweeter
While I quickly confirm the Dex trend with my meter.

“Here you go,” and I down it in one giant gulp,
Not caring for class, or a straw, or the pulp.
“Thank you so very much,” I reply with a smile
And try to regain some semblance of my mind.
My husband distracts me with soft, gentle chatter
While the orange juice fixes the thing that’s the matter.
And the moments that pass are quick in real life
But it’s hard for him, watching a low change his wife.

A few minutes later, things are as they were.
I’m no longer sounding all drunk, with a slur.
The waiter comes back with his menu pad out
And we tell him the entrees we’d like to try out.
Our date night moves forward without any trouble.
(The waiter’s confused, but i don’t burst his bubble.)
It’s not a big deal; it was just a quick thing.
But it’s always a riddle, what diabetes will bring.

(This poem was originally published back in January 2012.  It’s from the past.  And I am in Canada, where the poutine lives.)

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