Category Archives: Lows

What good is new technology if you can’t pay for it?

My great nephew celebrated his second birthday this past weekend. I celebrated another day on the blood sugar roller coaster.

It was a busy day. Maureen’s sister and two of her children had been visiting for a few days, and they left Saturday morning for the trip back to Ohio. So we were up at 6:00 a.m. to see them off. Maureen also had to pack and leave for a few days taking care of some pets in another part of town. Add in another event on the other side of town prior to the birthday party.

I don’t know if it was the choreography of putting the day together, or my eat-whatever-you-can-whenever-you-can-eat-it dietary selections, but I was sitting over 200 mg/dL for hours. The correction doses of insulin I had been giving myself were finally paying off around 4:30 in the afternoon as I headed off to the birthday party.

My glucose level was coming down, though not fast enough to cause alarm. I was at 109 mg/dL when I arrived. I added a pre-bolus for dinner, and thought I was set.

But as luck would have it, I didn’t time dinner perfectly. It was a little later than I thought it would be, and as we finally sat down to eat, my eyes glazed over and I got that “Stop Talking and Eat!” look from Maureen.

Everything righted itself eventually, but I’ve had a couple of days like that back-to-back now. It shows me that I’m good with my diabetes management, but I’m not perfect. That’s usually a good time to remember that there are tools and technological advancements on the way that promise to help reduce the burden of days like this. In the case of artificial pancreas research, Someday is a lot closer than ever before.

Then, almost in an instant, the next thought popped into my head: But… what good is a great new device if you can’t pay for it?

The U.S. House of Representatives passed their version of “repeal and replace” health care legislation on Thursday. What was already expensive could get prohibitively expensive should the Senate follow suit. We know there are already people using Facebook groups to try and get the insulin they need. Test strips are $1.00 or more per strip, which adds up fast. The retail cost of a new insulin pump is thousands of dollars.

For people who desperately need insurance to help defray some of these costs, purchasing insurance through a high risk pool that costs more (someone my age living with diabetes might have to pay $20,000 or more per year) creates an impossible dilemma.

There are 14 doctors and nurses serving right now in the House, and 3 doctors serving in the Senate. In the House vote, 10 of 14 voted for this legislation. Do No Harm, my ass.

From govtrack.us


Managing diabetes was already expensive before Obamacare. It was still expensive under Obamacare. It will be prohibitively expensive under this new legislation. The House of Representatives, at least, are exacting an impossible price on Americans simply because they hate the previous president.

But I’m not giving up without a fight. And I will remember at the ballot box. I’m going to call and send e-mails consistently, even after this fight is over. If I’m going to have to manage my diabetes every day while protections for myself and my loved ones are being taken away, only because they’re expensive, I’m not going to let them rest. I will make their victory a difficult one. I will make their victory unworth the price they have to pay to get it. What about you?

Let Congress know that you’re not going down without a fight. And if they try again, you’ll fight again.

CLICK HERE to download the DPAC app. With the DPAC app, you can get timely alerts, contact elected officials without going to a website, and insert your own diabetes voice into the conversation faster and easier than ever before.

THIS PAGE has every member of the House of Representatives listed, links to their websites, and most importantly, their phone numbers.

THIS PAGE lists contact information for every member of the U.S. Senate.

Please call!

Juice boxes in the middle of the night.

You know, it’s really hard to get juice from a juice box in the middle of the night.

Think about it… you have to find the juice box (usually in the dark), you have to grab the plastic straw from the side of said juice box, you have to remove the plastic wrap from around the straw, and then you have to poke the juice box with the straw in the tiiiinny little space allocated for that procedure.

That is really difficult to do at one o’clock in the morning when you’re shaking, you’re sleepy, and your vision without all of that would make it hard to see what you’re aiming at anyway.

Well, that was exactly the scenario the other night, and as you can tell, I was successful in the end. But diabetes was also successful in scaring the crap out of me.

My last bolus prior to that was about five hours earlier. Still time for the insulin to affect my blood sugar, but past its peak, I believe. Feel free to correct me if I’m wrong. My last BG check was at 10:30, right before bed. For the record, my meter read 135 mg/dL. Not high, not super low, but okay considering my basal rates do a good job of keeping me pretty steady throughout each 24 hour period.

Yet every once in a while complacency bites me in the ass, because diabetes acts different from the way it acts under 90 percent of the other circumstances I’m used to. Those are the dangerous moments. Those are the frustrating moments. Those are the critical moments when I just have to ignore everything else and concentrate my focus on doing the one or two things necessary to keep myself alive.

And make no mistake, keeping yourself alive is exactly what you’re focused on in moments like this.

Maybe the circumstances leading up to this event can help explain why my blood sugar tanked in the middle of the night. But even if they could, it’s like much of the science surrounding diabetes. There’s a link, but you have to look really hard to find it, and when you do, you find that the details are so complicated that it would be hard to remember all of it later on.

When our brains are overloaded with math, prescriptions, doctor visits, and remembering to bolus at the right time (among other things) already, it’s easy to see why most of us don’t get too invested in the causes of our hypoglycemia. It’s very complex, and each scenario could be different anyway. If there’s something that really stands out, like over-blousing or insulin stacking or not factoring in exercise, we identify it and correct it next time. Anything deeper than that, and we’re likely to lose track of it.

Solving lows like this is often like learning the engineering behind sending a rocket into space. There’s so much to know, you can’t possibly learn it all on your own. And unlike science, diabetes changes over time, so even if you learn everything behind today’s low, it might not help you with the one you experience six months from now.

I’m glad everything turned out okay in the end. I worry about those who experience the same circumstances where things don’t turn out okay.

And I still worry about what I don’t know.

Imperfections.

What is it about diabetes that just knocks us off our game now and then?

Nothing about diabetes is wonderful, unless you count the people you meet who are dealing with the same things, either by living with diabetes themselves, or living with someone who lives with diabetes. The rest of it pretty much sucks.

Still, sometimes we put on airs of “I’m a tough hombre” because we deal with everything this disease throws at us, and yet we get through it… we’re strong enough to suffer the slings and arrows that diabetes sends in our direction, and often we emerge from the battle stronger than ever. How many people with completely healthy bodies do you know who can put up with what we put up with on a regular basis?

I can’t say that’s how I was feeling the other night when I went to bed. But it had been a long time since I’d experienced an overnight low, and nothing about that Thursday night was any different from a thousand Thursday nights before it.

Insert diabetes… begin chaos.

I woke up around 1:30 a.m., feeling sweaty, and a little irritable. If I’m sweaty at this point, it means my blood glucose level has already sunk pretty low. Normally, when this happens, I just need to get up, go downstairs, get the juice from the fridge… I’m good. This night, I didn’t, couldn’t, get to the fridge. Instead, I sucked down a juice box sitting next to the bed. Then another. Then a package of peanut butter crackers. Then some candy. Then some peanut butter. Another juice box. In all, it took around half an hour for me to actually feel like myself again. Like I could even stop to check my BG. Prior to that, it was all about feeling well enough to remain upright.

Therein lies the problem with feeling like you’ve nearly nailed your management of diabetes. You get surprised when you least expect it. It’s also the point where a lot of People With Diabetes feel a lot of guilt. I was a little guilty in this instance. I had a snack that evening that I probably over-bolused for. It happens. It happened Thursday night. But unless I make a habit of it, I’m not going to feel bad about it. That kind of thing doesn’t work for me. And while I don’t want to tell you what to do, I think you should consider what I’m saying here.

This might sound a bit harsh, but when it comes to diabetes, guilt is for suckers.

It’s not that we’re perfect… no way are we perfect. But what’s done is done, and feeling any guilt about anything that happens to you because of a disease that you did nothing to contract is like blaming your parents for your eyes being brown. Sure, your parents had a lot to do with it, but your eyes are still brown. After the moment passes, we still have diabetes.

So Friday came, I went to work (tired and hungover and a little afraid of my next bolus), and I continued living. That’s the final victory.

If you want, think of it this way: our imperfections are only a trivial botched play in the middle of an otherwise victorious game. If we live, we win. I want to improve my game so I’ll be successful more often. But I’m also going to realize that sometimes, a botched play is going to happen anyway, and the best way to deal with a botched play is to make it trivial by making the rest of the game spectacular.

I’d rather concentrate on the spectacular.
 

Frustrated, but okay with it (sort of).

Do you ever experience a low where someone really goes out of their way to help you, when you don’t really need it, and it’s kind of annoying?

This wasn’t help during a low… this was, unfortunately, hindrance.

About three minutes earlier, I felt like I might be low, and tested out at 58 mg/dL. I started to eat some candy I keep in a jar on my desk at work. I suspended my pump, for what that was worth, and I was sitting quietly, not doing anything. Just concentrating on the one thing I needed to do in that moment, which was eat the candy (or, as some might call it, Stephen-eat-the-cheeseburger), and nothing else. Then someone came by, and noticed I was low. Before I knew it, I heard “Come with me… do you have something in your desk?… Here, I got your juice… drink it. NO, DRINK IT… NOW”.

My co-workers have come a long way in their understanding of diabetes, and especially their understanding of the dangers of hypoglycemia. But a few days ago, I came to the realization that there is a big difference between basic knowledge of highs and lows, and knowing about the nuances of diabetes.

I was definitely low in this instance. No doubt about that. But I was already treating, and as we all know, ingesting something now does not mean my BGs will come up at the very moment that fast-acting carbs are ingested. It takes fifteen minutes or so. Nothing I can do about that.

But it’s very hard for people who don’t live with diabetes to just sit there and wait, or even understand what it means to sit there and wait those fifteen precarious minutes. Especially when they’re worrying about you.

I have to tell you… it warms my heart to know that the people I work with are so eager to help when I hit a bad low. By the same token, it takes more than just literally shoving a juice box in my face and expecting me to be okay. The truth is, I would have been okay eventually, even if I was the only one there.

The thing is, it’s easy for me to be frustrated, because my low wouldn’t have been so difficult had I been left to my own devices. I was sitting in a chair at my desk, eating candy. My pump was off. I knew it was going to take a bit, but I knew I would eventually be okay. I didn’t need the extra grabbing and juice shoving and holding the juice so all I had to do was drink it. I also could have done without the “It’s because he’s stressed… the stress is making him low” comments.

But… how can I be unhappy about the level of concern and effort put into this moment? In reality, I cannot expect someone who doesn’t live with diabetes to know the difference between what 74 mg/dL feels like, and what 44 mg/dL feels like. And they really wanted to help me. How can I complain about that?

In the end, for all of the frustration, it’s just another brief episode in life with diabetes. I need to go through the mental checklist, examine the moment, and see if there’s anything I could have done better. To not do that would be folly. If it turns out it was just one of those crazy lows that happens from time to time despite our best efforts at diabetes management, then I just have to let it go. And thank everyone who tried to help me.

And be happy that there are people who want to help when I need it, even if I don’t need it all the time.
 

Saturday Night.

It was Saturday, about 6:00 p.m.

My BGs had been running high all day. It was time for dinner, and since I try to pre-bolus whenever possible, I washed my hands (like I almost always do), did my pre-dinner check, and saw that I was 138 mg/dL.

I was just making a sandwich and eating a tomato for dinner… no big deal, except that bread seems to spike my post-prandial numbers a bit. So I bolused based on that 138 number and continued watching the L.A. Dodgers and Pittsburgh Pirates game on TV.

Pre-bolusing being what it is, I had expected to wait 15-20 minutes before eating. About ten minutes after my bolus, I felt what I thought was a sign that I was low: A feeling of shakiness, sort of like I was sinking, and a suddenly overwhelming hunger.

But I had been high all day. I was 138 mg/dL just ten minutes before, right? In the next five minutes, the following occurred:

– I went back into the kitchen to test again. The result: 48 mg/dL.

– I grabbed the juice bottle from the refrigerator and, carefully, a glass from the cabinet. Somehow, I got the glass and the juice on the counter just before I slunked down on the kitchen floor.

– Now I’m trying to (again, carefully) get the glass and juice off of the counter and onto the floor next to me so I could drink it. I didn’t know if I could get back up again until I could get my BG back up again.

– After trying for what seemed like a long time, but really wasn’t, I was no closer to getting the glass or the juice off the counter, but I had managed to lay flat on my back, feeling very sleepy, if that makes sense.

– Somehow, something inside me made me realize that I needed to get up to the counter to get my juice. I had no other choice. Again, it seemed to take a long time to stand up, but it wasn’t a long time after all.

I finally got my juice, and within 15 more minutes, I had eaten my sandwich and was feeling almost normal again. Except for the post-low hangover that comes with an episode like this. And it was significant.

Immediately after, I called The Great Spousal Unit, who was away, and let her know what happened and that I was okay.

Then I took to Facebook and recounted what happened. I also replied to some of the replies I received, and posted a little more too. I was so grateful to have people who understand help me feel better after an awful experience like that. Still, I generally don’t spend my Saturday night hanging out on Facebook, and that made me ask a few questions.

Was I really trying hard to connect after almost being permanently disconnected? Was I trying to keep a lifeline (so to speak) open in case of another low? Was I just trying to show how strong I am and that I was okay and no one should worry about me because I’m tough as nails?

Maybe it was a combination of some of those things. Plus this:

When you nearly lose your life (because, for worse or for worse, hypoglycemia is a near-death experience), you want to connect with the special people in your life and forget about anything else that doesn’t really matter.

Hypoglycemia sucks. Diabetes sucks.

As a person with diabetes, I am in a unique position to let the rest of the world know that we need the best accuracy possible from our glucose meters. We need Medicare coverage for seniors who simply must keep their continuous glucose monitor technology. We need artificial pancreas technology that will help read our glucose levels and adjust pump settings automatically based on reliable algorithms designed with patient safety as its first priority.

And we all need to have people to reach out to, to make us feel less alone when we’re at our most vulnerable. God bless those who don’t have anyone to turn to.

If you have no one to turn to when diabetes wrecks your evening, I encourage you to find the Diabetes Online Community. Search the #DOC hashtag on Twitter. Do a Google search for diabetes blogs. Or send me an e-mail. Don’t be alone.
 

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