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.

Should I Have Called 911?

Unintentionally, I set a personal record the other day. I experienced my lowest low blood sugar – 34 mg/dL. I was alone. And it was terrifying.

Around 1 A.M., I woke up to my CGM buzzing and alerting me to what I presumed was a mild low blood sugar. I definitely felt like I was low, so I quickly ate three glucose tablets without checking and confirming my low on my blood glucose meter. And soon after that, things got really weird.

I tossed and turned for 15 minutes as I tried to fall back asleep. But I just couldn’t get comfortable. To make matters worse, a bizarre, numb sensation invaded my left arm. As I became more and more aware of it, my breathing started to run a bit ragged – almost like I was having a panic attack. Between the breathing and the numbness, I knew something was very wrong.

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What would you have done in this situation?

So I bolted upright in bed and grabbed my meter and kit to do a blood sugar check. And that’s when the number 34 popped up on the screen. I swore out loud, and almost immediately began sweating profusely. As beads formed around my hairline and streams trickled down my back, I reached for my bottle of glucose tablets as well as my phone. I ate three more tablets – wondering why the three I’d eaten 15 or so minutes ago seemed to have no affect – and contemplated dialing 911. After all, I was completely alone and there was no telling whether I’d pass out or need assistance from someone. In that moment in time, I craved talking to someone, anyone, who might be able to stay on the phone with me while I waited for my blood sugar to come back up.

Like a complete idiot, though, I decided not to call 911 and instead took to Twitter…*insert face palm here*. I know what you’re thinking, why the eff did I do that? Two reasons: 1) I wasn’t exactly thinking clearly and 2) I knew that someone, somewhere, within my diabetes online community would be awake and possibly willing to talk to me.

Thank goodness my intuition was right…my sweet friend, Heather, who I had the pleasure of meeting IRL five years ago, responded to my tweet a few minutes after I posted it. She offered to call, but by this point in time, I had made it downstairs and into the kitchen just fine and was helping myself to a cupcake I’d baked earlier in the day (oh, how convenient my passion for baking can be…sometimes). I exchanged a few tweets with her back and forth, and before I knew it, 45 minutes passed from the onset of my scary low blood sugar symptoms. I ambled back upstairs to my bed and checked my blood sugar before getting settled back into it. I was surprised to see I was only 72; after all, I’d consumed about 50 grams of carbohydrates in the last hour, and for me, that’s a lot! Most of my meals don’t even contain that many carbs!

Bemused and exhausted, I slumped against my bed frame and distracted myself by scrolling aimlessly through social media channels. My body and my mind craved rest. Much to the relief of both, I was able to get it before long, once I got confirmation from my CGM and my meter that I was finally above the 100 mark. I knew that I’d likely go up much higher (and I certainly did, waking up at 289 the next morning), but at the time, I just didn’t care. All that mattered was that I was going to be okay.

I’ve been reflecting on the incident on and off the last few days. I’m trying to process what happened and how it happened – was it my new Metformin that triggered it? Was it stress that I had experienced earlier in the day manifesting itself? I drank one beer before I went to bed, could that have done it? Did I take too much insulin before bed, even though I was certain I hadn’t? Lord knows that it could’ve been any combination of those factors, or none of them…but I can tell you this: I haven’t taken Metformin since it happened out of fear. I’ll talk to my endocrinologist soon and revisit my dosing plan with her. I can also tell you that, even as I continue to process the entire ordeal, I’m feeling so lucky that I was lucid enough to take proper care of myself. I know there are many other T1Ds who can’t say the same and have experienced much more awful low blood sugar incidents, so I’m simply counting my blessings right now.

What would you have done, had you been in my shoes? Would you have called 911, a family member, a friend? Would you have waited it out?