When Diabetes Isn’t Responsible for an ER Trip

If something unexpected happens to me in terms of my health, I can almost always safely blame diabetes for causing whatever it may be. But when I absolutely, definitely cannot blame my diabetes, I can’t help but feel angry at my body for rebelling at me in ways that it shouldn’t. Particularly when those ways end up with me making a trip to the emergency room.

Let me set the scene: It was a Tuesday evening, around 7:45 P.M. My partner and I were watching an episode of Stranger Things (we’re not caught up yet so please, don’t spoil it for me). Suddenly, I felt an itch on my upper left arm. Like anyone would, I scratched it. But then it got more intense. Like, really, seriously itchy. I rolled up my sleeve so I would be able to scratch with greater ease, and was surprised to feel some bumps emerging on the itchy patch of skin.

I peeled off my sweater and stepped into better lighting in the bathroom so I could examine the area better. There was a large patch of red, inflamed skin on my arm that was covered with bumps that looked like hives. I was dumbfounded. Unsure of what triggered the hives, but alarmed by how swollen and irritated my arm looked, I shot a couple text messages to my EMT father and nurse best friend, who both advised me to get my arm looked at stat.

HUGGING THE CACTUS - A T1D BLOG
Stranger things have happened in my life with diabetes (just had to sneak a pun in there)

And that’s how I found myself in a crowded emergency room, tearful and furious at my body, on a random weeknight. Part of me was relieved that my diabetes didn’t seem to have anything to do with this (but see my recent post on Metformin and you’ll understand that I have some theories about that being the cause). But the other part of me was so pissed off that my body just couldn’t be normal for once. I felt that my body was lashing out at me like an unruly child, declaring its anger towards me in the form of an incredibly itchy, ugly rash. I couldn’t help but stew over the whole situation the entire time I waited to see a doctor.

Long story short, a dose of Benadryl cleared up the hives within an hour. The doctor was unable to determine a cause, since I couldn’t think of anything new introduced to my diet or any new scents/lotions/detergents used in my household. And insect bites got ruled out because the doctor was certain that a bite would be more localized and not spread in a giant patch on my arm. I’m still perplexed at how it happened, but I guess I just have to make peace with the fact that it did and be grateful for 1) making a total recovery from it and 2) not experiencing any issues with my blood sugars as a result of it.

When diabetes isn’t responsible for an ER trip, it means that it’s okay to still be upset about it, but also glad for not having to explain the intricacies of diabetes to every doctor and nurse that walks into the room…because I can’t think of a single PWD that would ever feel happy about taking on that happy task.

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Starting Off on the Wrong Foot

“How are you today, ma’am?” The man behind the Dunkin’ Donuts counter smiled and looked at me expectantly, as I started back at him blankly.

I wasn’t sure how to answer. My mental state wasn’t great, that was for sure. I’d just come from a visit to a walk-in clinic, where I’d had X-rays of my foot taken to see whether or not it was fractured.

The previous 24 hours had been a bit of a whirlwind. I’d worked and gone to my first-ever kickboxing class, which was an awesome experience. I’d had dinner with my partner and started playing video games soon after as a way to unwind after the long day. That’s when pain in my foot flared up, suddenly and significantly.

Could I have injured it in the kickboxing class, without even knowing it? Was I overdoing it on exercising, in general? How and why did the pain just start up like that? Almost immediately, I plopped myself down onto the couch with an ice pack and extra cushions, hoping that I could stop the pain as quickly as it started.

No such luck. I went to bed early that night, but the pain was so severe that sleep was virtually impossible. I tossed and turned for hours, wondering what the hell was going on and coming up with a plan to get it checked out A.S.A.P.

That’s how I found myself at a walk-in clinic, a little over 12 hours after I first felt the pain. I was evaluated by a nurse practitioner who told me that “the likelihood of a fracture was low” (thank goodness) and that it was “probably tendinitis.” I was given instructions to rest, ice, and elevate my foot for the weekend, and take non-steroidal anti-inflammatory drugs (otherwise known as NSAIDs, like Ibuprofen or Aspirin) as needed.

Hugging the cactus - a t1d blog
I’m trying to put my best foot forward as I deal with this injury.

That meant hours and hours of being sedentary.

That meant no exercise of any kind – I even had to keep walking at a minimum.

That meant my spirits were crushed.

I was glad that it wasn’t worse, and proud of myself for not waiting to seek medical treatment. But that didn’t mean I was thrilled with the outcome. Basically, I had to take the wait-and-see approach. Time will tell how long the pain lasts, and I can’t stand not knowing. I also can’t stand not being able to be active. Daily exercise is a key element to maintaining good blood sugars. Sitting around idle doesn’t do my diabetes any favors, but it’s not like I had any other choice.

I left the clinic, trying to process this information. This certainly wasn’t the way I wanted to kick off the long Memorial Day weekend. It definitely could have gotten off on a better foot. (Okay, okay, I’ll stop with the puns.) I found myself at a nearby Dunkin’ Donuts minutes later. I hobbled in, hoping that an iced coffee might lift my spirits somewhat.

I blinked, bringing myself back into the moment, and smiled wryly at the Dunkin’ cashier. “I’m okay,” I said to him. It wasn’t just a response to his question, it was also a reassurance to myself. I’m okay and I will be okay. I won’t let this get me down.

Hello, 26…and Goodbye, Health Insurance

Well, today is my 26th birthday. As I alluded to a few months ago in another blog post, I’ve pretty much been dreading this particular birthday.

Love always wins.

Today’s the day I’ve got to switch health insurance carriers. I’m going off my parents’ plan and signing up for the employee plan offered by my company.

Am I nervous? Yes. Am I scared? Hell yes. But am I alone? Hell, no. I’m lucky enough to be able to say that I’ve got so many resources in my life – family, friends, the DOC –  who will help me navigate the confusing world of health insurance.

I’m also well aware that many, many other T1Ds have been in this position before me. While it’s impossible to forget the horror stories about people who have been unable to afford their medication due to a lack of insurance coverage, or who have a hard time paying for insulin and other diabetes supplies in spite of having health insurance, there’s so many more people who have found ways to make it work without having to sacrifice their health or general well-being.

So I’m going to focus on how blessed I am to have resources all around me, as well as a job that offers decent health insurance (or just a job, period…there’s plenty of jobless people out there who have double the hurdles to jump over compared to someone like me). Today, I won’t dwell on my fears and anxieties about health insurance. Instead, I’ll celebrate another year of life and enjoy the day.

Is it Weird That I Love Looking at Lab Results?

Is it just me, or does anyone else anxiously await checking lab results after getting blood work done? And am I the only one who excitedly reads through results, looking for anything abnormal so I can see which area of my health I need to work on? It’s kind of like whenever I handed in a paper or took an exam in college – I always logged onto the student portal multiple times in the days after to check for posted grades. I do the exact same thing with my patient portal.

I know, I know, I’m weird. I prefer to call it quirky.

Lab reslts
An *utterly fascinating* screenshot of some of the allergens I’ve been tested for in the past.

I started thinking about this little idiosyncrasy a few days ago, after I got lab results back from my allergist. She had me go into a lab to get 10 vials of blood drawn so it could be tested to see what types of allergies I had. Fun!!! In the days following, I checked my patient portal dozens of times to see whether the results were up. And when they finally were, I was obsessed with poring through them and seeing how much sense I could make of them.

And I’ll admit, I love looking at lab results because I have a historical view of just about anything and everything I’ve been tested for in my life, and that includes my A1c levels. On more than one occasion, I’ve fallen down the black hole of comparing and contrasting my results over the years. It’s interesting to see how I can trace back certain A1c levels to different events going on in my life at the time it was checked, and more than anything, I enjoy seeing how much I’ve improved in the last decade.

So if this habit of mine sounds plain strange to you, then I don’t want to be normal…I want to be informed. I always want to be informed when it comes to my own health, because ultimately, I’m the one responsible for it, as well as the one who will do everything in her power to improve it.

What is “Controlled” Diabetes?

There are few word pairs I loathe more than “controlled” and “diabetes”.

How the hell can diabetes be “controlled”? It’s not a video game to be played with a controller. There’s no character selection or “start” button. And it most definitely can’t be shut off with the flick of a switch.

On the contrary, it’s my opinion that diabetes is a bit of a wild beast that can’t simply be tamed. It doesn’t care if you follow the same routine every single day – it’ll act up for no damn reason whenever it pleases, much to the dismay of a person dealing with it.

Diabetes will do what it wants, when it wants. It will wake you up in the middle of the night because of a low blood sugar. It can throw your whole day off track because you make your plans around it. Diabetes itself comes with so many variables, between the devices and the effectiveness of medication, that it can oscillate no matter how hard you try to keep it steady. How can something like that possibly be under control? People with diabetes, like me, are given tools that are intended to help manage diabetes, certainly, but we have yet to receive something that allows us to influence it completely.

get lost in stockholm

If I had to take a stab at guessing what people thought “in control” diabetes looked at, it would be more than just the “perfect” flat-lined CGM graph. It would be more than going to bed each night and waking up every morning, having just enjoyed an uninterrupted, sound night of sleep. It would be more than having the freedom to make spur-of-the-moment choices regarding a daily routine or diet.

But for now, I’ve accepted that my diabetes is something I manage rather than control…but I also accept my refusal to let it control me.

A Diagnosis of LDM

What is LDM? According to my mother, it stands for Lovely Diabetes Mystery. The “lovely”, of course, is sarcastic, whereas the “diabetes” and “mystery” relate to a random, unforeseen diabetes medical incident – which occurred to me on Sunday, October 7th.

I woke up that morning with some abdominal pain. I rolled over soon after waking to check my CGM, and was startled to see that I’d be in the 300s for most of the night as I was sleeping. I quickly bolused for it using my PDM, and shut my eyes, hoping to get some more rest and to wake up again without stomach discomfort.

No such luck. About an hour later, I opened my eyes and looked at my PDM again, and I had barely come down. I tested to confirm, and sure enough, I’d only gone down a few points. I was worried, which was exacerbated by the weird nausea I was having. Could this be a sign of something more serious?

My mother convinced me to do a manual injection with a syringe. We both figured that that would help bring my numbers down faster, and that if I started coming down quickly, then it could mean that the pod I had just applied the day before was not working properly. We agreed that I should probably change it, to err on the side of caution.

However, I didn’t get to change my pod until much later in the day. That’s because of what happened soon after I took my manual injection.

I went to use the bathroom, certain that the churning of my stomach meant that I was about to be sick. I was standing in front of the toilet when I started sweating – profusely. On top of that, my vision went all fuzzy, and I felt totally disoriented. I knew something was wrong, so I called out for help.

My mom raced into the bathroom to find me seated on the floor, dripping in sweat. I placed myself on the floor deliberately because I was worried I might pass out and injure myself. She started cooling me down with a wet facecloth, and searched through the drawers to find a thermometer to check my temperature. She also grabbed her test kit and my lancing device, because naturally, we both assumed that perhaps my blood sugar was dropping rapidly from the insulin injection, and it might be a hypoglycemic event.

But when we checked my blood sugar, I was still in the high 200s. I was pretty scared at this point and just wanted the sweating to stop and for my vision to clear. That’s when my dad came in and made the executive decision to call an ambulance for me.

A police officer, three firefighters, and two EMTs showed up my house. I answered questions in my confused state. My vision restored and the sweating stopped, but I still felt weak and woozy. They put me into the ambulance. I was given an IV bag and medication for the nausea. It was my first time in an ambulance and it was not exciting, just weird. I didn’t like riding backwards or experiencing the twists and turns along the way.

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I was bored in the hospital; so naturally, I created this boomerang of my IV drip.

We arrive to the hospital. I’m whisked away into the ER. I answer a series of questions from various medical students and nurses and doctors. They draw blood for tests. I give them a urine sample for more testing. I keep on explaining the concept of my OmniPod to each one of them. No one seems to have seen it before, besides one med student who has a sister who works for Insulet. Small world!

We monitor my blood sugar closely. My tests come back normal. I eat my first foods for the day around 2 P.M.: sugar-free jello and two hard-boiled eggs. Yum…

I get an injection of insulin at the hospital. We don’t have a vial of Humalog with us – it was the one thing we forgot to grab from the house. But my dad drives home to retrieve it so I can change my pod at the hospital. My mom does it for me. I feel helpless.

The old pod comes off and we notice a definite bend in the cannula. Okay. One thing explained. I wasn’t receiving my full insulin dosages due to the bend, and unfortunately, I have no way of knowing how much insulin I was truly receiving. All I know is that it wasn’t enough, and that’s why I was running high.

I receive a diagnosis: vasovagal syncope, or pre-syncope. It’s explained to me, but I still don’t really get it. So I text my best friend, who is also a nurse. She tells me that it’s very common and can be triggered by a variety of things. The pre-syncope aspect makes more sense to me, seeing as I never truly passed out.

I’m discharged and feel so very tired. It was a long day. The following days are filled with follow-ups and message exchanges between myself, my endocrinologist, and my primary care physician. My healthcare team and I think that we come up with a plausible explanation for the hullabaloo: My body knew something was wrong. It knew that my blood sugar was abnormally high, and it knew to send signals to me that I needed to take care of it. Hence, the abdominal pain. My dehydrated state exacerbated things, and when I started sweating and lost more fluids, it was a lot for my body to experience.

Sheesh. What an ordeal. Like any diabetes-related experience, it taught me a lot, but I certainly don’t want anything like that to happen again. Shout-out to the healthcare professionals, but especially my parents, for taking damn good care of me throughout the whole episode. You’re the bomb diggity.

For Feet’s Sake!

First and foremost, let me apologize: I’m sorry for all of the cheesy puns that are about to follow.

Now that’s off my chest, let me put my best foot forward and write about feet.

People with diabetes are told to pay extra special attention to their feet. There’s a few things to look out for, such as circulation and nerve issues. So recently, when an old foot injury flared up, I knew trouble was afoot and I better do my best to heel it.

A couple years ago, I broke a very tiny bone (roughly the size of a corn kernel) in my foot called the sesamoid bone. It was classified as a stress fracture, so I wore a bootie and did non-weight-bearing exercises for six weeks while it heeled. I also decided to take a break from high-heel shoes and cushion my sneakers with gel inserts, which wound up being an important step in recovery. Before long, my foot was feelin’ fine and my soul was joyous.

Untitled design

Fast-forward to the present day, and the injury seemed to be waltzing its way back into my foot. For feet’s sake, I thought it was a thing of the past! Luckily, I’d kept my gel inserts from the first time around and started wearing them again. I didn’t want to toe the line with this foot pain – I addressed it and monitored it closely, and will continue to do so.

For now, my foot is toe-tally better. I’m reminding myself that it’s important to pay attention to my body’s signals and handle them accordingly. Foot health is absolutely not something to mess around with, and like everything else related to diabetes, I’ve got to hop to it and take good care of my feet. Can you digit?