Category Archives: Lows

Recognize your inner superhero.

June 6, 2014 – 9:27 am

Is it the warm weather, or is it just that I’m getting older? I’ve recently experienced a couple of lows that were just energy-zapping. Those “I see it coming, here it is, I don’t want to move, now I need to move, and eat a bunch of stuff/drink juice/inhale glucose tabs” lows. Then, when it’s over, I experience the “I’m so tired I just want to curl up in the corner where the sun is shining through and sleep for about ten hours” hangover.

That’s what it feels like too… like a hangover. Knocked on your butt, your body is punishing you for too much insulin. Or too much exercise. Or not enough carbs. Or because your body has a history of punishing you, and every now and then it wants to assert its authority for no bloody reason at all.

That’s when we become heroes. Doesn’t make sense, does it? But think about it.

We find ourselves in a dangerous situation. Life-threatening, even. A crisis all our own, like our human body has encountered its own kryptonite. Things might be touch-and-go for a little while. But we fight back. We use whatever means at our disposal to drive the enemy away. We MacGyver solutions, we will ourselves to persevere.

And then we go right back to our regularly scheduled lives.

Hopefully, this little scenario doesn’t play out too often in your life. When it does, and you overcome, don’t forget that you are a force of nature. Diabetes cannot stop you, and you are living proof. In fact, diabetes has tried to stop you, and you didn’t let it.

It’s not in your most recent hypoglycemic episode. It’s not in your last hemoglobin A1c. It is evident in the life you lead, the job you perform, the people and organizations you help succeed, in the family and friends that surround you, and the simple fact that you are still here.

I see you. I read about you. I live with the same disease you do. Trust me when I say that when you overcome those lows, you are succeeding at something that would humble even the most confident of individuals. I recognize that about you. I hope you recognize that about yourself.

By the way, you might want to check yourself in the mirror. I thought I saw a little of your superhero cape showing in the back.
 
 
 

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Just stop it already.

April 14, 2014 – 9:45 am

What a beautiful weekend of weather we just experienced here in the Mid-Atlantic. Sunny days, highs in the 80s. The Great Spousal Unit and I worked on getting things uncovered and cleaned up on our screened porch off the back of our house. These are the days that feel just fantastic outside.

So I was certainly excited at the possibility of getting on my bike for an actual outdoor ride for the first time in six months. I had too much to do on Saturday, so I knew Sunday was the day. On Sunday, there were pressing issues at home that required my attention. But I planned things out so I could do my ride beginning at 2:00 in the afternoon.

I had a high-carb lunch about 12:30. I made sure not to bolus too much, knowing I would be out in the hottest part of the day burning off those carbs. I got my bike out, checked everything to make sure it was okay, inflated the tires, and changed my clothes. To be sure, I did a quick glucose check before I got started.

The result: 55 mg/dL

What made it worse was the fact that I still had a unit and a half of insulin on board. So I knew that even after stopping my pump and ingesting a few more carbs, it would take a while before I could raise my BG to the level that I would feel safe riding for an hour. I decided to just bag the ride and try to head to the gym on Monday morning before work.

I don’t generally go around feeling like everything is my fault. But if I ever do, it’s at times like this. I can’t tell you how much I wanted to ride this weekend. And when that 55 came in, I was pretty unconsolable. I’m feeling pretty out of shape (pretty much like I have at this time every year for the past thirty years), and I hate when I miss opportunities like this weekend.

But… I’ve got to just stop it already. Sure, Sunday’s ride was a bust, and I think it’s okay to be very unhappy about that. But I also know I can’t change it now. The only thing I can do is the absolute best I can do today. Yesterday was a point of disgust for me. I’m not above using it for motivation to crush those feelings of feeling crushed today and the rest of this week.

I hope you’ll join me in feeling that way, both about my preparation for the ADA’s Chesapeake Bay Tour de Cure in May, and about your daily journey with diabetes. It’s not about your diabetes. At least it doesn’t have to be about your diabetes. It can be about the great life you’re living. Or at least about the inspiration you provide in trying your best every day despite this stupid diabetes. Just stop it already. You are worth the journey. And you are worth far more than whatever you’re going through.
 
 
 

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Weird middle-of-the-day low.

November 25, 2013 – 9:22 am

On Friday, Mike Hoskins over at Diabetes Mine wrote about how hypoglycemia (low blood glucose) feels to him. If you have diabetes, you have your own experiences with hypoglycemia. Nearly everyone’s reaction is different. I almost left a response after reading Mike’s post, but I thought I would write about it here instead.

This is a case where pre-bolusing didn’t work for me.

Friday morning, I was in a hurry to get to work, and I ran out the door without preparing my lunch. This isn’t something I do very often; only about 8 or 10 times per year, I’d guess. Anyway, to save time, I ran out the door with the expectation that I would just grab lunch at a local deli near where I work downtown.

So lunchtime comes, and my BG reading says 82 mg/dL. Not too bad, right? I know I’m buying out for lunch, and that usually comes with more carbs than my normal lunch. Hence the pre-bolus. I knew what I was going to order, and I bloused for it as I was headed downstairs.

I got downstairs and walked the two blocks to the deli, ordered a grilled ham and cheese and a bag of chips to go (this is why I don’t eat out for lunch often). I got my order and started walking with it back to the building where I work. So far, so good.

But when I got back to work, the fire alarms were sounding and I was told I couldn’t go back into the building.

Now I start to worry. I’m worried because I know hypoglycemia is either here or close. And immediately, I started to form contingency plans in my head:

– What if I can’t get back into the building in the next few minutes?

– What if I’m expected to walk down the street and gather with my co-workers at our assigned evacuation spot?

– What will my co-workers think of me if I start gobbling down my lunch in front of a potentially serious gathering of hundreds?

– What if my glucose gets too low before I can figure all this out?

– What if it’s some other kind of emergency and my co-workers are stuck inside while I’m stuck outside? Now I’m concerned about them. How can I help?

To answer these questions, my mind started racing through all kinds of potential scenarios. Sometimes when I’m low, this type of thing races through my head like wildfire in a pine forest. My mind knows that I’m supposed to eat, eat, eat. But that part of my instinct was trying to be squashed by something that almost borders on paranoia.

After a couple of minutes of waiting, but what really seemed like half an hour or so, the alarms were turned off and I was able to get back into the building and enjoy my lunch. A weird middle of the day, for sure.

What does this episode tell me? It tells me that I need to do a little self-examination, and see if I can come up with ways to trigger my brain to eat in those circumstances rather than worry about anything else. For me, I know that hypoglycemia sometimes impairs my judgement. But if I can focus on something, anything that helps me remember what I have to do even while mind games are going on inside my head, I’ll be all right.

In the meantime, you better believe I packed my lunch today.
 
 
 

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Post-mortem on Monday morning’s low.

April 24, 2013 – 11:00 am

I really wrestled with whether I should write again about my severe low early Monday morning. In the end, I’m writing this wrap-up because when something like this occurs, it’s important that I (and The Great Spousal Unit) examine what happened, and if I can, do something about it. Only then can I move on.

So here are some bullet points on Monday morning’s hypo event:
 
 
– First of all, many thank yous to everyone who left a comment here or on Facebook. I appreciate the fact that you were so concerned for my well being. Even when I’m making stupid mistakes. Read on…

– Looking back at my pump, I saw the most obvious problem… I bolused twice for dinner. Once before dinner (which I forgot about), and about an hour later. I remember thinking that I hadn’t bolused, and like an idiot, I didn’t check my pump and bolused again. Plus, my glucose was really climbing at that point, and I was very concerned after being high in the afternoon. On top of that, I bolused for a snack about an hour and a half after dinner. So yeah, I seriously stacked my boluses. I won’t ever bolus again without double-checking the pump first. I’m feeling really, really stupid about this. Really, there’s just no excuse.

– I was fighting really high BGs all day Sunday (in the 300s), with the breaks from that only coming just before meals. The morning spike was probably due to a high carb breakfast. I had a low carb lunch, but later found tubing that was clamped off by my pump’s belt clip. I changed the tubing, and worked on fighting the highs off the rest of the day. I was sinking pretty good before dinner, then had another large post-prandial spike an hour later. When I went to bed, I was still at something like 218 mg/dL, but I really had way too much insulin on board at that point.

– I slept through all of the Dexcom alarms. Or, I slept through turning them off. I don’t know. I do know I remember one alarm early on (probably around 1:00) that I heard. I turned it off, ate a few Glucolift tabs, and went back to sleep (I know, I didn’t check the BG). I don’t recall hearing another alarm. Maureen sleeps next to me, and she doesn’t recall hearing an alarm either. But she was sleeping as soundly as I was.

– Speaking of the Dexcom… I’m getting some very useful data on how my glucose trends through the day. That’s the good news. The bad news is that I’m obsessing over it too much. I don’t want to say I’m treating solely based on what I’m seeing on the receiver’s display. I’m not sure I’m ready to be honest with myself about that. But Maureen mentioned just today that I “need to stop paying so much attention to that thing”.

– I have a nice bruise on the side of my head, and a cut on my ear. Probably from falling out of bed, but I really don’t know. I guess I should be happy that’s all the physical reminders I have from this.
 
 
The final analysis: It was an epic fail on my part. I cowboyed my way through the day instead of being patient.

Many times, I’ve commented on blogs and told people in person that you can’t worry about the past. It’s only a reference point. What counts is making the most out of today and tomorrow.

Now I have to go practice what I’ve been preaching.
 
 
 

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I fell out of bed.

April 22, 2013 – 9:32 am

A little bit before 3 o’clock this morning, I fell out of bed.

Hypoglycemia, of course.

I slept through all of the CGM alarms (set to “Attentive”). Maureen was unable to revive me, and she called 911. For the first time ever, I was completely unconscious through the entire episode, until I woke up with 5 Emergency Medical Technicians holding me down after injecting glucose into my IV.

It was, unquestionably, the most severe hypoglycemic event of my life.

Sometimes, I struggle to find words to describe how lonely it can be living with diabetes.

Today, I’ll explain it this way: A little before 3:00 a.m., I experienced a severe hypoglycemic reaction. After being revived by EMTs and spending another 45 minutes or so recovering, I climbed into bed to sleep for a little over an hour. Then I woke up, shaved, took a shower, got dressed, ate breakfast, made my lunch, brushed my teeth, and dragged myself into work, even though my head is pounding and I’m so tired I can barely hold my head up.

I rode on a train with hundreds of other people who had no idea why I sat there with my eyes closed and my head in my hands for twenty minutes.

I’m working in the middle of a city of over 600,000 people who have no awareness of what I experienced last night. Even if they did, most of them would not truly understand what it was like.

And I can’t escape the surreal feeling that right now, I sit at a desk in the middle of 15 colleagues who are blissfully unaware of the fact that a few hours ago, I nearly lost my life.
 
 
 

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