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Posts tagged ‘low blood sugar’

A Matter of Apologies.

“I was low.  I was frustrated because of the low blood sugar.  I’m sorry.”

“It’s okay,” and I can tell she means it by the look in her friendly, brown eyes.

I used to be very terrible at saying, “I’m sorry.”  I would hold on to frustration and anger in a way that was not good for me or anyone around me, making a grudge or the need to feel like I “won” the disagreement take precedence over a relationship.  I’d keep “I’m sorry” under my tongue because I didn’t want to admit that I’d done something that hurt someone’s feelings.  I felt embarrassed to admit my shortcomings.  It felt awkward and bad.

It took a long time for my head to figure out that my heart was better off if I let the sorry fly, but once I came to that realization, I tried to embrace as often as I could.  (I also had to work on the “does this interaction make me better or worse as a person?”  This is still a work in progress.)  Now I’m less terrible at saying, “I’m sorry,” and I feel better for it.

As much as I hate to admit it, my blood sugars are not only influenced by my emotions (stress, anyone?) but they influence my emotions, as well.  The way my numbers make me physically feel can cause me to act like a total crumb.  It’s another reason to be aware of what my blood sugars are, and if I enter the Crumb Zone, apologize for it.

I find myself apologizing to my daughter at times for entirely blood sugar related reasons.  Sometimes I snap because I’m taking yet another bolus to correct yet another high and my body is riddled with sugar and rage, and I will be far less than patient with my little one as a result.  Other times I raise my voice because I’m trying to treat a low blood sugar reaction and she’s at my elbow asking to [insert rogue request from active 5 year old here].  Losing my patience during the course of run-of-the-mill parenting is something I am not proud of, but losing my patience because diabetes is leaning on my parenting style is something I want my kid to understand as best she can, because I don’t want her ever thinking my seemingly random outbursts are tied to her in any way.

It’s a weird balance between feeling like I’m blaming diabetes for my actions and simply explaining my actions.  Am I in the Crumb Zone (or Mayor of Crumb City, if you’re nasty) because of diabetes?  Nope.  Diabetes doesn’t get credit or get blamed.  But sometimes this disease is part of the explanation, and I want my family to have a sense for how, and why, I’m wired a certain way.

There are moments when Birdy assumes my attitude problem is diabetes-rYes, this whole post was an excuse to use the Siah-in-a-banana picture again.elated when it’s not, and I’m forced to fess up.

“Are you in a bad mood because of a low blood sugar?” my daughter asks, pointedly.

“Not at the moment.  Right now, I’m in a bad mood because I just realized I left a banana in the car while I was on my trip last week.  And now I’m afraid to open the door and confront the banana stink.”

“It’s okay,” she says.  And then adds, “Ew.”

 

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.

Shit.

“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.

“Shit.”

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?”

“Yes.”

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

“Sure.”

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.

 

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.

 

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