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Low Interrupted

At first, I was thinking that I would toss out this post, or save it for later, in order to respond to the news from the Diabetes Research Institute. I know that a post like this, full of words on a screen, risks getting lost in the mix. But maybe it won’t.

If you read my last post, you know that A-Flizzle surprised me with a birthday trip to Jacksonville to tour the Budweiser brewery, hang out with Jacquie and the gang, get a massage, and go to one of my favorite restaurants in the whole wide world called 13 Gypsies. And my blood sugar spiked sky high. So now you’re caught up. As Paul Harvey would say, this is “the rest of the story.”

I’ve been sitting on this post for a few weeks now. It’s been a really hard thing for me to share. It’s the post I’ve been waiting to write for, like, 23 days.

My blood sugar was sky high, but I couldn’t very well call in diabetic and cancel a quality birthday celebration. Nor did I want to. I bolused for the high, but having been unplugged from my pump for as long as I was, there was really no telling how much insulin it would take to turn things around and get my BG’s back to normal. I knew I would need to feather the insulin over time in small doses so that I didn’t get a big ball of insulin hitting me all at once. It sounded like a good idea, at least. Until it just wasn’t working. Not even a little bit. Not even at all.

So, I did what any abnormal person with a nonfunctioning pancreas would do in the situation: I rage bolused the $h!t out of that high to show it who was boss. And I did too.

Later that night, after we had gone out to a rooftop bar and then to one of our favorite hangouts in 5 Points, Birdie’s, A-Flizzle and I trekked back to our hotel to call it a night. We settled in, I stretched out on the bed, propped my head up on a stack of pillows, and started watching one of the greatest movies of all time that just happened to be on TV that night: Con Air. What? You know you love it!

A-Flizzle was sound asleep, and I was laying there in bed messing around with my iPad and watching Cyrus the Virus battle The Man of Nomadic Eyebrows from the Land of Forgotten Forehead (aka, Nicholas Cage) for a shot at freedom via a crash landing on the Las Vegas strip (don’t blame me, I didn’t write it) when it hit me. Hard. And I remember every single part of it.

In an instant, I had absolutely no clue where I was. I couldn’t figure out what I was doing, even though I was doing nothing. I couldn’t think. I couldn’t concentrate. I couldn’t help overanalyzing every next thought that was popping into my head, and I had no control of what was popping into my head next.

I sat up and threw my legs over the side of the bed. My bare feet hit the cold wooden floor. I sat there, in a complete panic, trying to figure out what was going on. I knew what was going on. I just couldn’t quite figure out what was going on. But everything was so serious. I couldn’t figure out what was happening, what was next, what I should do.

I stood up. I walked over to my BG kit, and sat it on the table. I walked off. I started pacing around the room, stomping hard, trying to figure out what in the world was going on. I could see A-Flizzle in the middle of the king size bed, sound asleep. I tried to yell for her, but I couldn’t. No sound would come out. I started hitting my diabetes tattoo, indicating, trying to make noise and get her attention. Anybody’s attention. But it wasn’t loud enough.

And that’s when it hit me: I was low. Really, really low. And I was standing in the room with the one person that I trust more than anyone, and I could not for the life of me (literally) figure out how to get her attention. What would be so simple any other time, to simply yell or reach out and shake her awake, I could not figure out how to tell my body to do. I just knew that this was really, really serious, and I had to figure out something through my garbled thoughts.

I paced around the king sized bed like a tiger walking a perimeter, establishing his territory. Back and forth, from one side to the other, for I don’t even know how long. All the while I’m trying to figure out how to wake her up. I was fading. The panic was wearing me out. I was starting to think about what A-Flizzle would do without me, and how much it would crush her to lose me when she was right there, so close. What would happen to my Hopper (dog), Squirt (cat), and Bindi (A-Flizzle’s dog) back home without me. How their little hearts would break when I didn’t come home from a weekend away. How my Hopper would continue to look for me at the door long after Amanda got home, just waiting on me to get there to give him a doggie hug.

All I could think was, “This might be the one. That one low blood sugar that I don’t survive. The big one.” I was also thinking, “Dammit, I don’t want to go to the hospital on my friggin’ birthday!” I started punching the corner of the bed because I was so frustrated that I couldn’t get my body and brain to communicate and work properly. Then I thought of big ones, like the big earthquake in California that everybody always talks of but hasn’t happened yet. The hurricane that will come and sink Florida. The importance of having an emergency plan, a parachute. A parachute? A PARACHUTE! For when I fall!

No Brain

I managed to figure out that if I passed out from the low, it was my pump that would continue to give me insulin and keep me low. I snatched it from my PJ pants pocket, and unhooked it, not bothering to suspend it, and threw it on the bed. I went over to my bag, and found the glowing bright red rectangle that contained glucagon, and held it tight in my left hand. I knew that if I passed out, A-Flizzle would likely hear me hit the floor, and hopefully see the glucagon in my hand and know what to do. If she didn’t, at least my pump was off, so hopefully I would survive long enough for my blood sugar to come back up naturally before…well, before I died.

As I was digging in my bag for that, I uncovered a Level gel. I ripped off the top with my teeth and managed to get most of the gel in my mouth through the lack of motor skills and shaking that I didn’t realize was happening.¬†Once I got the Level gel in me, and gave it time to work, I was finally able to figure out how to reach over and wake A-Flizzle up to help me. By then I was back on the edge of the bed, drenched in sweat, shaking, still holding the glucagon case in my left hand, and completely physically and emotionally exhausted. Half asleep, her training that I taught her in case I ever go low kicked in, and she was able to retrieve two more Level gels and help me get them down before I had to lay down, else pass out from exhaustion. Still, I wasn’t up to a normal and safe BG level yet.

A-Flizzle set a timer on her phone to wake us up every 15 minutes for me to test my BG again. After an hour of that, I was still only at 70. Not too low, but certainly not high enough to go to sleep after such a bad low. I took one more Level gel, and then I was out for the rest of the night. I woke up the next morning at 96. Normal. And completely hungLOWver, worn out, physically and emotionally exhausted from the night before.

I’m thankful that I taught A-Flizzle what to do when I go low. I’m thankful that we have a plan and always know where things are to treat a low, even if half asleep. It’s so important to have something available to treat a low blood sugar, and know where it is even in your subconscious. That is what may save you in the event that you have to build your own parachute. I know it did me. It’s been extremely hard for me to admit to myself, but I know that I wouldn’t be here right now had I not had those gels, known where they were, and the fact that they were easy for me to get into when it was literally life or death for me.

Tomorrow, the DRI is set to share some big news about steps toward an eventual cure for diabetes. I really hope it is everything that we hope it will be. I’d be lying though if I didn’t admit I’m skeptical. Don’t confuse that with negativity. I’m positive that there will be a cure someday, and I’ll be the first one to celebrate tomorrow if there is something to celebrate. I’ve just heard that a cure was coming since my mother was told that there would be one when I was diagnosed at age two, 32 years ago. A cure for diabetes is exactly what every one of us with diabetes, and every parent of a child with diabetes, wants in this world. Nobody should have to see their life flash before their eyes on their birthday because of a low blood sugar like I had to. However, hoping and praying and wishing doesn’t get us closer to that day.

I’ve learned to keep myself grounded in reality. Maybe that’s a defense mechanism so that I’m not constantly let down, but experience says to be patient, diligent, and steadfast today so that we can make it to tomorrow. The absolute best thing we can do is take care of ourselves today, support each other in the diabetes community, both online and offline, and not let our fellow person with diabetes stumble. You can do this, and so can I. Then, when that cure does arrive, whether it’s tomorrow or twenty years from now, we’ll be ready.

Keep Calm And BG On

D-inked

For this (sort of) Wordless Wednesday, I bring you the live tweeting and photo adventure of getting a diabetes tattoo. Big ups to Matt Manning at Monument Tattoos in Tallahassee, Florida for listening to what I was looking for and translating that into a wicked awesome piece of body art with a practical purpose. One of my low blood sugar tells is that I sometimes lose the ability to talk and communicate properly. This is especially problematic when I need to get someone’s attention and make them aware that I need a little help. The idea behind a diabetes tattoo was that it would be something that is always on me, and I could hopefully indicate (e.g., point to it, gesture at it, hit someone over the head with it) in the event that I need some assistance. And it would look awesome as sh**. Your diabetes may vary.

Monument Tattoos - Diabetic - 07-20-2012
Photo courtesy of Monument Tattoos

Hangry

It’s hard to describe, and even differentiate sometimes, the difference between having a low blood sugar and just running on pure empty from not eating all day.

All week, since Daylight Savings Time kicked in, I have been trying to outrun the clock and get to work on time. I love DST, don’t get me wrong, but it’s really hard to get up in the morning when it’s still dark outside.

Okay, who am I kidding? It’s hard for me to get up in the morning whether it’s dark outside or not.

Yesterday morning was no different. Running late, I brushed my teeth, grabbed my work gear, made certain that I wasn’t walking out of the house with flip flops and pajama pants on, and hit the road.

I realized when I grabbed my messenger bag out of my car that it was lighter than usual. Turns out I had left my lunch (leftover white bean chicken chili from dinner the night before) at home. It happens, right?

This wouldn’t normally be a problem, but I have a habit (a good habit, if you’re viewing things from my employer’s perspective) of getting to work and throwing myself into things and not stopping. I’m notorious for working through lunch, skipping breaks, and looking at the clock to surprisingly discover that it’s mid-afternoon and I haven’t seen the outside of my office all day. The only thing that I will consistently break for is coffee.

I Break For Coffee

After my second cup of coffee…okay, third cup…maybe fourth cup…I realized that I was pretty much plowing through my day of meetings, emails, phone calls, and one-armed library dragon training. Once I was done, and those dragons were tamed well enough to stamp due dates in library books like they were born with that one lonely arm to do just that instead of burn villages and terrorize innocent monks (Trogdor!!!), I called it a day and headed home.

Now, I knew I had been moderately low all day. I’m back to wearing my Continuous Glucose Monitor (CGM) again, after a slight hiatus from all the beeping and bonking and wee-ooo-wee-ooo-wee-ooo alarms waking me up in the middle of the night, and it had warned me off and on all day that I was hovering around 75 mg/dl. Still, I didn’t stop to treat it or deal with it. I just kept working.

When I got home, A-Flizzle and our pal EriCAH were there, so I started preparing dinner. Yay, food!

I kept noticing that I was agitated with everything, but I didn’t have the sense to question why. Cutting the chicken and vegetables, I was seething. Trying to figure out how to make the chicken stock thicker, I was fuming. When I realized that we only had a single serving of rice, I was mulling over what it would be like to throw the refrigerator off a cliff. It was so ridiculous that I was getting on my own nerves. I must have been driving A-Flizzle and EriCAH crazy.

That was when I realized I had reached my limit. I was low. I was hungry. I was angry. I was HANGRY! And I was making dinner and the food was too raw to eat immediately. Oh, the agony! The horribleness! The tragedy!

Eventually dinner finished, and we all got to experience my chicken thai curry science project of a meal, but it was a great example of how normal for some people isn’t normal for those of us with diabetes. There are times that we absolutely MUST stop and eat. Going all day long without eating is dangerous, and in hindsight, I’m probably lucky that I didn’t have a sneaky low that left me sitting in my office in a pile of sweaty, shaky, confused nonsense with a co-worker telling me, “Drink your juice Shelby!”

I’ll probably do it again though. Because I’m stubborn like that.

4th and 38

Saturday started a new season of magical awesomeness that is college football. Specifically, Florida State University football!

My buddy J called me up on Friday and said, “Dude!”
I replied, “Dude!”
He said, “I have two tickets to Saturday’s game against Louisiana-Monroe! You want to go?”
I said, “Dude! Sweet!”
He said, “Sweet!”

And that is how we arranged to go to the game. We’re men of a very extensive vocabulary, clearly. We also hold multiple undergraduate, graduate, and doctoral level degrees between the two of us, so don’t get it twisted that we can’t be verbose when we feel like it.

I spent all night Friday night and Saturday trying to keep my blood sugar from bottoming out. I didn’t get up and go to the gym or spin class on Saturday morning, or go for a bike ride, or anything like that. I was just low, and dipping lower for no apparent reason. You’d think I had diabetes or something…I mean, wait…

It was the first game of the season, and everyone had apparently arrived ahead of me for the game, so I ended up having to park a mile or two away and walk to get there. After hiking through the snow, uphill, and against the wind (or really just through the Florida summer heat), I met J outside of the stadium, and before we went through the entrance gate and the fun that security show and tell can be when you have diabetes supplies that go everywhere with you, I stopped to do a quick blood sugar check. I was feeling a little weird after the walk, but no symptoms that were extraordinarily odd.

3…
2…
1…

38. (See also: Holy f@#ing $h!t!)

I noticed my hands where shaking when I was trying to put my diabetes trash (alcohol swab and strip) in its special place inside of my BG kit. I noticed how hard it was to zip my kit back closed so the contents didn’t go falling all over the sidewalk. I wasn’t confused, or unable to function, or emotional, or not able to communicate. I was just clumsy…er, clumsier than usual.

As we headed toward security and the entrance to the stadium, I reached in my pocket and fished out my emergency glucose tab keychain with the four glucose tabs that live within. I started popping them in my mouth as we were getting in line, and I deliberately chose the line closest to the FSU police officer just in case I didn’t catch that 38 in time and all of a sudden needed help as I was hand modeling my diabetes junk with the security personnel.

I never told J that I was as low as I was. I haven’t necessarily hidden my diabetes from him the few times we’ve hung out, but I also haven’t taken the time to explain or throw up a sign with neon lights about it either. With this 38, at a time when I was so excited to have a good time, I needed my diabetes to take a back seat and behave and leave me alone.

Fortunately, I caught the low in time. Once we were through the gate, after I had already eaten my four glucose tabs, I headed to the concession stand and bought me a big fat pretzel and a cold drink. I didn’t have any other problems for the rest of the game, and I had an awesome time. It didn’t hurt that FSU clobbered Louisiana-Monroe 34-0.

Still, I can’t help but wonder what might have happened had I not stopped and tested, had I not choked down the nastiness that is glucose tabs, and had I been walking up the stadium steps toward our seats when that 38 became one of those ugly lows that puts me on the ground.

Moral of the story: Always, ALWAYS having something with you to treat a low. And GO NOLES!

FSU vs ULM - 09-03-2011

Double Vision

So last night after work was fun. I left the office on time and made a beeline to the grocery store. That means I went directly to the store, without passing Go, and without collecting $200, for those of you that aren’t familiar with insect street slang. I wandered around the store looking for Italian bread crumbs, tomato sauce, and rat poison. Yes, I have strange grocery lists. You should see what happens when I go shopping for birthday gifts.

After the grocery store, I stopped by my house to let the dog out and change out of my work clothes, then went over to A-Flizzle’s house so we could make dinner. We were trying an eggplant parmesan recipe that she found. Don’t worry, I couldn’t find rat poison at the store, so there was no foul play involved. Or fowl play, for that matter. Vegetarian, for the win!

When I got there, A-Flizzle had all of the ingredients and baking dishes and bowls and forks and spoons and knives (oh my!) out and ready to start putting the meal together. One problem: I couldn’t read the recipe. As I tried to study the paper, all I could make out were fuzzy words like “mix” and “lightly” and “weight watchers.” Wait a minute…Weight Watchers? Are you trying to tell me I’m…oh, nevermind. It’s just a recipe.

I stopped trying to read and went to my Adidas backpack (aka, man bag) that I carry everywhere with me and fished out my BG meter. Sure enough, 47. Well that explains why I couldn’t read anything. I found my glucose tab keychain and ate glucose tabs, and then went back to the kitchen and struggled through the recipe. The more I tried, however, the more my vision blurred, and eventually I was seeing complete double. I already have glasses! Cut me some slack here diabetes!

30 minutes later and an eggplant parmesan in the oven, I tested again, and BG was 74. Still, I had complete double vision. Defeated, I went and stretched out on the couch and just closed my eyes, determined to give my body a few minutes to catch up and get right.

Pump Double Vision

Just Sunday, A-Flizzle and I were out and about and I had a BG of 37 with absolutely no symptoms at all. She said to me tonight, “How is it that you can have a BG of 37 with no symptoms whatsoever and I’m the one freaking out, but then your blood sugar is 74 and you can’t even see clearly?”

Wait for it…

“Oh, I know why. It’s because you have diabetes.”

She’ll be here all week folks. Don’t forget to tip your waitress.

Low Blood Sugar Confessions

If you’ve had diabetes for very long, then you’ve probably found yourself at some point with a low blood sugar that scares you enough to do some wild things to get your numbers back to normal. In hindsight, what you had to go through to treat that low can not only be a learning experience, but also hilarious, gross, or just plain entertaining. Sharing is caring, so I thought I’d list a few times over my many years with diabetes when I went too low and desperation took over, and the whacky events that followed.

Secret Stash
I was at work late one night in my office, alone, and had a low BG. This was before the days that I developed the good sense to carry glucose and glucose tabs around with me. Not being able to find anything in my own desk to eat, and no one to tell that I needed help, I dragged myself to an office a few doors down and went through a coworker’s desk until I found these awful, dry, sugar-crusted jelly bean type fruity shaped things of a questionable age, and ate half the container. They were really terrible, but they were pure sugar and got the job done. I sat there at the desk until the shakes and sweating finally went away. Once I could think semi-clearly, I was afraid my coworker would be mad at me for raiding their secret stash, so I arranged the treats so that it didn’t look like I had eaten as many as I did, and then put them back where I had found them. I hope they weren’t a gift. If they were…um…thanks?

Enjoy Coca-Cola
Something that has always amazed me is how I can go low while sitting at the table eating a meal. It’s the most bizarre and frustrating thing. I’m eating already! What more do you want?! One day I went to lunch with a coworker, and we were having a seemingly normal discussion, until I realized that my half of the conversation was coming out in me making farting noises instead of words. My coworker had a background in nursing and was looking at me strange and knew that something wasn’t right, but had not made the connection to low blood sugar yet. Knowing me at the time, I probably hadn’t divulged that I even had diabetes up until that point either. The waitress had just dropped off drinks at the table next to us, so in my autopilot survival mode I reached over and took the the regular Coke of the poor guy sitting there who just happened to be at the mercy of my low BG lunatic craze by proximity. It was a quick save, and the guy was quite understanding, but it made for a really awkward remainder of the lunch hour.

Coca-Cola

How To Meet People at a Conference
Diabetes likes to come out and play at fancy events. I was at a dinner at a conference one evening with my boss, and it was in one of those big dark rooms where you sit at round tables with ten other people who are all wearing the same dorky name tag lanyards around their necks. I thought I was feeling low, but didn’t have enough light to do a BG test in the room, so I grabbed my kit and excused myself to the restroom. Later, I recall becoming aware of the fact that I was sitting at the wrong table on the opposite side of the room eating dinner with a bunch of complete strangers, with no concept of how much time had actually passed. I guess autopilot had taken over and I had grabbed the first opportunity I could find to get food in me. Fortunately, I was wearing a dorky name tag lanyard, so I fit right in. Embarrassed, but not about to let anyone else know my low BG blunder, I excused myself from that table and crept through the dark back to where I had started. My boss commented, “We wondered if you were coming back. Is everything okay?” As I unrolled my second set of silverware and prepared to have dinner number two, I replied, “Oh yes, I met some interesting people and got to talking and time got away from me.” Liar, liar, pants on fire! I should have been crowned King of Denial that night.

Sitting On My Desk For Breakfast

This morning I got to work and went through my usual routine. Laptop was running slow, scouring the internet for every update it could find. Had a hot pot of Colombian coffee brewing. Had a blueberry muffin sitting on my desk for breakfast.

I checked my blood sugar, coming in at 161 mg/dl. Not horrible, a little higher than my target, but I’ll take it. Went ahead and combo bolused for the correction and for the blueberry muffin for breakfast. Trying to get better at bolusing 15-30 minutes before eating, so I took a few minutes to check the news and weather from my iPad. Weather said today would see a high in the 40-50 degrees Fahrenheit range. Chilly for north Florida, but it beats the snow. Coffee was done brewing, so I went and got me a cup, and chatted with my coworkers. Blueberry muffin still sitting on my desk for breakfast.

Got back to my office and saw that I had new voicemail on my work phone. I had two messages from eager vendors wanting me to buy stuff from them that I’m not yet convinced that I need. Laptop was still doing its update thing, so I couldn’t get into my files yet to figure out what my next steps were going to be with the vendors. Instead, I cleared off a spot on my desk to set up my new keyboard dock and charger for my iPad. Makes a great backup, and much easier to produce content from my iPad when I have a keyboard than without it. Coffee was hot and delicious as I got everything situated where it was supposed to be. Blueberry muffin was unassuming, sitting on my desk for breakfast.

I’m a sticky note person, and I think they breed like rabbits in my office when I’m not looking. There are sticky notes everywhere. It’s colorful chaos. To make room for my iPad keyboard dock and put it in a place on my desk where I can actually use it, I had to go through probably 40 sticky notes that had accumulated on my desk. I kept about five, just to be safe, and threw the rest away…I mean, recycled them. Blueberry muffin was being resilient, sitting on my desk for breakfast.

Finally my laptop decided it would show up for work and stop with the updates, and I was able to get into my email folders and files and start looking into the vendor proposals. One of them contained a list of a few hundred titles that needed reviewing before I could make a decision as to whether I needed them or not. Usually I know what I need better than the vendors do, but the offer includes one of those end of the year sales, and I love a good deal. Meanwhile, as I’m crunching numbers and having a good ol’ time in my spreadsheets, blueberry muffin was sitting on my desk for breakfast.

It got to be mid-morning or a little later, and I was cranky. Why didn’t my coffee work this morning? I’m going to upgrade to Italian Dark Roast if this Colombian good stuff doesn’t get its caffeinated act together. Why can’t I think clearly? How come I’m fighting the urge to bite someone’s (anyone’s) head off?

…wait a tick…

Blueberry muffin sitting on my desk for breakfast…great. I bolused and forgot to eat. Stupid. BG was 45 mg/dl. CGMS finally bit the dust after six days this morning, so it couldn’t tell me what was happening. And I was just working away, dum-dee-dum, completely oblivious.

I will get better at pre-bolusing, and that is just one aspect of my diabetes that I want to get better at. My BG’s have been all over the board lately, and I have been on the glucoaster way too much. I’m a perfectionist, and I have a strict idea of what “control” is for my diabetes, but even so I fear my A1C is going to be horrific tomorrow morning when I have my endo appointment. But, that’s diabetes, and that’s life. I can’t carry the blame all the time. I shouldn’t have gotten carried away with work, but I love my work, and it happens.

But I tell you this, the next blueberry muffin I get will be getting a stern talking to if it decides to remain quiet after 30 minutes of sitting on my desk for breakfast!

Blueberry Muffin (photo by Minimalist Photography on Flickr)

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