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?

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That Time Low BG Made Me Mad at the Moon

Low blood sugars in the middle of the night are far from pleasant. But they’re especially grating when you’re just trying to have a sleepover with your best friends and your CGM alarms loudly and urgently, rousing more than just me from a peaceful slumber.

Dammit, diabetes…you’ve done it again.

I don’t know how or why the low happened. I went to bed around 1 A.M. – we had stayed up late talking, drinking wine, and eating snacks – and at that time, my blood sugar was 156. You can’t get much better than that, and it felt even sweeter because we’d eaten pizza for dinner earlier in the evening.

I thought I’d be fine overnight. I might come down a smidgen due to the unit and a half I took to cover a slice of fabulous flour-less chocolate cake (utterly heavenly), but I made the assumption that I wouldn’t come crashing down.

I should know by now…never assume with diabetes.

So it happened at about a quarter of four in the morning – a witching hour, in my mind. I woke to the frantic buzz buzz buzzing of my CGM and quickly acknowledged it, then reached for my tube of glucose tablets. I did it as silently as I could, seeing as I was sharing the room space with my three gal pals. From what I could tell, my super slow glucose tablet chewing didn’t even cause my friends to stir. It seemed that I’d successfully managed to avoid waking anyone up, thank goodness.

I was just starting to fall back into a doze when the frantic low CGM alarm blared – BEEP beep BEEP beep BEEEEEEEEEEEP. Ugh! Upon hearing the first beep I snatched up my receiver, silenced the alarm, and scooped up my test kit and my phone. I tiptoed out of the bedroom from which we were all nesting to the living room, where I searched through my backpack for the Skittles I’d purchased earlier in the day…because that’s right, this 3:45 low blood sugar hadn’t been my first in the last twelve-hour window of time.

Digital Imaging Specialist
Low blood sugar in the middle of the night can make you feel weird things…such as anger towards the moon.

I plopped myself on the couch and started furiously chewing Skittles. I remember looking out to the sliding glass doors and to the balcony and to the parking lot and then finally up to the sky to see the moon shining brightly at me. It was positively dazzling, yet infuriating with its cheerful gleam. I wanted to yell at it to stop looking so happy. I muttered to myself, “this sucks,” and reclined a bit on the couch while I waited to come up from the low.

Everything was fine within 15 minutes. I was on my way up and could safely go back to bed. And again, I congratulated myself for not waking anyone up.

Or so I thought.

“Did anyone hear my CGM go off in the middle of the night?” I asked my girlfriends, approximately six hours after the incident when we were all awake and about to head out to breakfast.

“Yes! I was wondering what that loud, aggressive noise was,” said one. I cringed, an apology lingering on the tip of my tongue, when she continued with an “are you okay? Don’t worry about the noise, I fell back asleep soon after.”

I was grateful for her reassurance, but also for her concern. It felt good to know that ultimately, she didn’t give (apologies for language) two shits about the actual sound that my low blood sugar caused, she was just worried that I recovered from it okay and could get back to sleep soon after.

I smiled to myself. Hours before, I’d been cursing the moon for merely existing and dealing with an annoying, random low blood sugar. But now, I was cruising at a great morning BG and I was on my way to get a delicious breakfast with my gal pals. Diabetes has its moments, but I sure as heck appreciate it when it cooperates during the ones that matter most. So in hindsight, the 3:45 A.M. low was nothing more than a temporary annoyance, and I was just glad that the worst thing it did was interrupt my sleep (and mine alone) for 10 minutes rather than ruin actual precious time spent with my friends.

Hypo and Tongue-Tied: My Woes at Work

“Okay,” I thought to myself as I sat down for my 90 minute meeting, “My blood sugar’s sitting pretty around 100 or so. I should be able to make it the whole meeting without experiencing a drop, since the last time I gave myself insulin was about three hours ago…”

The fact that I had the audacity to think that my body/blood sugar wouldn’t play any tricks on me is laughable.

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This was my recent struggle at work. Usually, diabetes doesn’t interfere with my work whatsoever. I’m sitting, somewhat stationary, at a desk for eight hours every Monday through Friday. There was an adjustment period to the sedentary life when I first started working at my job, but it’s been more than four years now, so my body and my blood sugars are used to it. Plus, throughout the workday, I go out of my way to fit in extra steps, whether it’s using a restroom on a different floor or parking my car far away from my building’s entrance. Combined with my higher activity levels before/after work and regular workweek eating habits, I’d say that I’ve struck a balance in terms of physicality and diet that makes for an optimal environment for my diabetes to function normally/predictably.

So when I DO experience a high or low when I’m at work, it throws me off…but only for a relatively short amount of time. I’m talking like 15 minutes or so here. That’s right about the amount of time I need to come up from a low. If it’s a high blood sugar, I need even less time to rebound. I simply bolus, drink plenty of water, and move on to my next task. (Only in cases of 300+ blood sugars do I get really nervous – it’s only happened a couple of times, but I’ve had to leave work when that happens either due to feeling sick or needing to go home to deal with it.)

But things were different the other day when I was in the middle of a meeting with a colleague and I could feel the slow and steady drop of my blood sugar. Despite having monitored it closely prior to the start of the meeting, it started to coast down. Here’s the real kicker, though – I’m pretty in-tune with my body and could feel that this was not an urgent low. I figured my blood sugar was somewhere between 65 and 75. I didn’t have my CGM or meter to confirm, and I felt like I could keep the meeting going…so I didn’t do anything about it.

And in hindsight – even if it is 20/20 – I wish I had done something.

Why? Mainly because I felt that I was virtually useless in my meeting. As I reviewed each page of the 80+ slide PowerPoint, I could feel my thinking start to deteriorate. Words were tumbling out too quickly and nonsensically. I wasn’t sure if I was making a whole lot of sense to my colleague. And that’s a feeling that I can’t stand. I don’t like thinking that I may have wasted her time due to my determination to “power through” a low. It’s a perfect example of low blood sugar causing a symptom other than shakiness, sweating, or sluggishness: In this case, it also caused stubbornness.

When I finally made it back to my cubicle, I slumped down into my chair and grabbed a juice box from my low supply stash while my CGM buzzed over and over, letting me know that I was indeed low. Within approximately 8 seconds, the juice box was crushed, and I couldn’t help but think how next time I had a meeting, I’d bring one with me…just in case.

My New Low Blood Sugar Symptom

In the last 21 years of diabetes, my low symptoms have been pretty predictable and easily recognizable: shakiness, sweating, dizziness, and sluggishness are all signs that I need some sugar, stat.

But lately, I’ve started to experience one brand-new and totally weird low blood sugar symptom. I’ve decided to dub it “fuzzy tongue”.

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“Fuzzy tongue” or “terrycloth towel tongue” is now one of my low blood sugar symptoms.

I don’t know how else to describe it other than that it feels like my tongue and lips are covered in a terrycloth towel as my blood sugar starts to fall to a certain level, usually 75 mg/dL or lower. Simultaneously, it’s a numb and tingly sensation that feels so disorienting and makes the process of chewing glucose tablets or drinking juice a little more difficult, because it feels weird to eat or drink when my entire mouth feels like it’s covered in cloth.

In fact, the first time it happened, I took to Twitter to ask the rest of the DOC if there was anyone else who had experienced something like that before. And I was comforted by the many responses I got back that assured me that I wasn’t alone in feeling this strange symptom:

“Yes, from certain lows. Sometimes I feel like my [whole] body is buzzing and fuzzy, if not fizzy. Other times, it’s like my body says, “BTDT! Got the glucose tabs! Move on!”

“YES! This is a new symptom for me too (after 17 years of treating lows)..Thought I was allergic to honey the first time.”

“This is a common one for me. Tongue and lips. I hate it”

“Sometimes I get tingly lips or tingly fingers!”

“That’s almost exclusively how I can tell that I’m low”

“YES! If it’s a prolonged low, I get tingly lips and tongue. It’s super weird and really uncomfortable.”

“I get more of the tingling/partial numbness in the lips (‘fuzziness,’ I suppose) that some have described. Usually this occurs with a bad low (under 50 mg/dL).”

Those are just a few of the replies that my initial tweet received. I found these particularly interesting, though, because one person identified it as a new symptom, too, and others implied that it’s always been an indicator of low blood sugar that’s more likely to occur with “bad” lows. In addition to helping me feel a bit more normal about the discovery of my new low symptom, I also found this to be an example of the ways in which the DOC is uniquely unified. To an outsider, this whole Twitter thread probably makes zero sense and comes across as bizarre. But to someone part of the DOC, it’s just another conversation that brings T1Ds trying to get to the bottom of a ‘betes mystery together.

So even though “fuzzy tongue” is uncomfortable, I’m glad to know I’m not the only T1D who’s felt it…and I’m very glad that my body has found another way to alert me to a low blood sugar, especially since it’s a way that makes me want to correct it more quickly than ever before.

14 Words That Describe how Glucose Tablets Taste

My shaky hands pop the lid off the tube of glucose tablets. A puff of dust floats out from the tube – a cloud of sugary residue from the ten tablets stacked neatly on top of each other. A friend watches me remove two tablets. Unfazed by their gaze, I chew them quickly, knowing that they’ll kick in soon and give my blood sugar the boost it needs. My friend waits until I’ve put the tube away to ask me what glucose tablets taste like.

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Ugh…I can practically taste the sugar dust by just looking at this photo.

This exact scenario has unfolded a number of times over my years with diabetes. I don’t know why people are so fascinated by glucose tablets and their taste. Is it because I describe them as sugar pills? Is it something about the way they’re encased so tidily and conveniently? Do the pastel colors look especially appetizing to some people?

Whatever the case may be, I’ll put an end to all the curiosity surrounding glucose tablets right here, right now. Here’s my list of 14 words that describe the taste and texture of “magic sugar pills”, also known as glucose tablets.

  1. Chalky.
  2. Dusty.
  3. Artificial.
  4. Dry.
  5. Fruity.
  6. Slightly medicinal.
  7. Mildly acidic.
  8. Sweet.
  9. Brittle.
  10. Dissoluble.
  11. Powdery.
  12. Tangy.
  13. Stale.
  14. Crumbly.

So based on those descriptors…do they still sound remotely appetizing…? Probably not. Though I didn’t use the most flattering language to describe them, they’re still responsible for saving my butt – literally – countless times. And for that, I can forgive glucose tablets for not being the most palatable things.

Must Be Hypo, Super Low

Today’s blog post is part 2 of my re-imagining of two classic Christmas carols! Last week’s rendition was all about high blood sugar, so of course, this week has to be about the opposite: low blood sugar, also known as hypos!

This blog post is for my extended family, who will simultaneously appreciate and cringe at my spin on the holiday classic, “Must Be Santa”. Unfamiliar with the tune? Click this link to listen to the original, and maybe even sing along using my oh-so creative lyrics, below!

Must be hypo, super low
Must be Santa – I mean, hypo.

Must be Hypo

Who’s got a blood sugar that’s dropping quick?
I’ve got a blood sugar dropping quick
Who needs a juice box to do the trick?
I need a juice box to do the trick
Dropping quick, do the trick
Must be hypo, must be hypo
Must be hypo, super low
Who’s got too much insulin on board?
I’ve got too much insulin on board
Who has a massive candy hoard?
I have a massive candy hoard
Insulin on board, candy hoard
Dropping quick, do the trick
Must be hypo, must be hypo
Must be hypo, super low
Who’s got a red sweaty face that glows?
I’ve got a red sweaty face that glows
Who is cursing at their CGM, “no, no, no!”
I’m cursing at my CGM, “no, no, no!”
No, no, no, face that glows
Insulin on board, candy hoard
Dropping quick, do the trick
Must be hypo, must be hypo
Must be hypo, super low
Who very soon will come back up?
I very soon will come back up
15 carbs, perhaps a Reese’s cup?
I ate 15 carbs, thanks to my Reese’s cup
Reese’s cup, come back up
No, no, no, face that glows
Insulin on board, candy hoard
Dropping quick, do the trick
Must be hypo, must be hypo
Must be hypo, super low
Must be hypo, must be hypo
Must be hypo, super low
Must be hypo, must be hypo
Must be hypo, super low

 

An Incident I Won’t Forget

Low blood sugars are funny. Not ha-ha funny, but peculiar in how they affect me physically and mentally.

A few weeks ago, I had an experience with a particularly scary low. It frightened me so much that I’m only just getting around to writing about it now, because I needed some time to gather my thoughts on what happened.

I’ll set the scene: I was home alone. I had eaten a carb-heavy dinner and decided to do a 30-minute, high-intensity workout. This was definitely far from my best idea ever, because due to the high-carb intake, I had a lot of insulin on board. That, coupled with the exercise, meant that my blood sugar was bound to crash soon after completing the workout.

And it sure did.

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Falling rapidly.

I had just stepped out of the shower and wrapped myself in a towel when I began to feel it. That sudden wave of weakness, shakiness, and dizziness. I walked to my bedroom, grabbed all of my diabetes supplies and my cell phone from my purse, and sank down to the floor with everything in front of me. I knew it would be wise to just sit there for as long as I needed, because I was afraid to go down the stairs (and possibly fall down/hurt myself in the process) in that state.

I checked my CGM, which confirmed that I was dropping quickly. I stared at the screen, panic flooding throughout my body. It occurred to me that I should probably do a finger stick check to make sure I was really that low, so I did, and saw that I was 60 mg/dL.

 

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The scene of the incident.

Now, I’ve absolutely been lower than 60 before. It’s never a pleasant experience. But rather than using that as a comforting thought, I couldn’t help but dwell on how terrible I felt and how frightened I was to be home alone with at least four more units of insulin still working in my system.

All I could do was chew four glucose tablets, suspend my insulin delivery, and wait.

In that period of time, I was totally immobilized.

I’ll never forget how alone I felt, how out of control I felt.

I felt powerless against my diabetes. My own body.

I’ll never forget the fear that consumed me, that nearly prevented me from helping myself in this situation.

I’ll never forget texting my mother and my boyfriend, telling them what was happening, and expressing how scared I felt.

I’ll never forget bursting into tears when they didn’t reply quickly enough.

I’ll never forget turning to my T1D Twitter buddies for help by sending a tweet about what was happening, or how swiftly and comfortingly they responded to me.

And I’ll never forget how I let my mind drift as I wondered whether I’d be okay.

It sounds totally dramatic, especially for a low that, in the grand scheme of things, could’ve been much worse. I can admit that.

But I can also admit that this is one of the few times in my life that I felt truly terrified of my diabetes, and swept up in the fact that things can change so quickly with this condition that it can quite literally knock you off your feet.

Obviously, I recovered just fine that night. The glucose tablets did their trick and my low symptoms subsided. It took longer for me to calm myself down, to breathe normally, non-panicky breaths. At least my puppy was around to soothe me.

I was fine, I will be fine. But I won’t forget this incident, ever.