Easy Flow Chart for High BG Management

This is PERFECT!! Show this to those people, in- and outside the medical field, who think managing diabetes is just a matter of following a particular method…
In case you need to print it out and show it to someone who might not understand just how incredibly easy it is to manage diabetes on a daily basis. (I can’t even type it without laughing.) I…

Source: Easy Flow Chart for High BG Management

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dirty low down

Okie dokie, folks. For the one or two of you that read here… if you read my last post about all the allergy and sinus meds I was put on last week, this is a weird and wacky update to that.

The very next day after starting all those meds, I began to have repeated severe hypoglycemic episodes.  (that just means “really low blood sugar“)
fading face
Since I’ve had type 1 diabetes for over 40 years now, I tend to not always know when my sugar goes low.  My body simply doesn’t show signs or symptoms of a hypo, which is bad.  It’s REALLY bad.
23316310372_7dff9163ef
Usually, the body gives you some clear and strong signals that the blood sugar is getting too low.  The above chart shows some of those. Over time, however, your body starts going,

“Meh, low-shmow…I don’t have time to process that crap!”
Sincerely,
Your Body

and doesn’t tell you that your sugar is or has dropped.  That means you’re left walking around, feeling normal (or as close to it as you get) with no idea that you’re in danger of passing out or dying because your sugar is way too low.

That’s what started happening to me last week.  I mean, I’ve been quite hypoglycemia-unaware for many years now, but last week, the lows just kept coming in quick succession!  (you can click the link in this paragraph to learn more about hypoglycemia unawareness)

I haven’t had any lows like this, (under 30) in quite awhile, so it was shocking when I saw that first one in this Episode Of Lows that was 27!  Keep in mind that the brain needs sugar/glucose to function (thus the confusion often experienced during a hypo) and since a normal level is between 70-100 (possibly up to 150 after a meal), getting that low means your brain is not functioning properly.   We all know the brain runs all our automatic systems such as the lungs, heart, and circulation therefore, if the brain stops working, we are not far from death.  Zero (0) blood sugar doesn’t necessarily mean instant death, but you would be close enough to it that your chances of getting out without at least coma are slim-to-none.
blood-sugar-range
Here’s the thing, though…I had helped my husband load a heavy-ish, awkward piece of exercise equipment to take to my mom’s, then helped him unload it and chatted briefly with Mom before returning home and beginning to show the first signs of fatigue and slight confusion.  I felt absolutely no symptoms up to that point.

That was the beginning of my almost-week-long roller coaster ride. I had many more of those severe, scary, unrecognized lows. I was testing my blood sugar about 10 times a day at this point. I called my endocrinologist to ask what to do by the time I had struggled through 3 days of this. Obviously, you don’t call the doc every time you have a low, but these were beyond my ability to pinpoint, explain or control, so we had to get some help!

I spoke with the DNE (diabetes nurse educator) who happens to be my doc’s wife, and she had me lower all of my basal rates (I have five rates set currently) .05 units each. So that would have been a total of 1.2 units per 24-hour period. Not much. But she told me that I should do it again if I was still having lows the next day. I was, so I did. That was now 2.4 units/24 hours lower. After another day of struggling, I lowered the basals another .025 each. That put me at 3 units/24 hours lower.

Like I said, by this time, I was testing what seemed like constantly. My low-lows were always 50 and below, with most of the being in the 30’s.
glucometer reading 38
I finally broke down and called again after I had such an awful low that I thought I was dying.

Hubby and I had run a couple of errands…our baby son and his wife were asked to go back to Haiti and needed so much that the church raised the funds to send them, so they had left the day after Thanksgiving. We went to pick up Baby Son’s truck so it wasn’t sitting in the church parking lot all week and to pick up a few things at Lowe’s. My sugar was 53 when we left, so I was nursing a can of Coke to raise it. I sat in the truck while Hubbs ran into the store. Mom was calling wanting us to come up and eat leftovers for supper, so I explained what we were doing and told her we’d be there when we got back.

We drove out to pick up the truck, I moved over to the driver’s side and we started home. I was feeling really tired, but that’s not at all unusual. It was dark and I hate driving in the dark, so I didn’t dilly-dally around. I drove straight up to Mom’s, which is the drive just before ours and is also where the Baby Kids live in a basement apartment. For some reason, I thought we were taking his truck up there. When I realized Hubby had driven home, I turned around and drove back down the hill to pick him up. We got to Mom’s and started filling plates to heat in the microwave.

My dad was sitting in the next room watching TV and peeling something or other for Mom while she, Hubby and I were in the kitchen.

I got my plate out of the micro and started to eat when Hubby insisted that I test again. *sigh* So I did, and lo and behold, it was 32!! GAH!

He went to garage to get a single-serve bottle of Coke for me, Mom put ice in a cup, poured it full and slid it to me. I drank a bit of it down and started eating the dumplings, broccoli casserole and dressing on my plate (fairly carb-laden foods) when I started to feel just weird.
fainted
Of course, I didn’t pause to think about it, I just kept trying to eat. Kept trying to appear “normal”, like I was okay…and I really thought I was at that point. I don’t know if I was really participating in the conversation or not at this time. I had drunk almost the whole glass of Coke when a wave of dizziness hit me and I got that panicky feeling of knowing my sugar is really bad low. I remember sort of grabbing at the glass and downing the last bit of Coke in it. I then tried to go back to eating, then I placed my fork back on the plate. (I dunno why those things seem so clear to me) I can remember the thought that I needed to stop acting so out of it flashing through my mind and for some reason, I took off my glasses and laid them on the bar in front of me. I remember Mom telling me I needed to chew. (??–Yeah, that’s something I might forget to do, but why she thought telling me was going to help, I dunno)
fading woman
That’s when things got really weird, really scary… I got extremely aware that something was seriously wrong with me, but couldn’t formulate what it was. I guess I knew it was a low, but I couldn’t complete a thought unless it raced 90 miles a minute through my brain. I recall thinking, I need help. and then realizing that Mom and Hubby were with me. I guess that was a relief to me, and then I noticed that they weren’t talking. Like, at all.
invisible-girl
I looked over at the two of them, both sitting to my left and there was no expression of acknowledgement. Just silence. I recall thinking, They can’t see me!! What’s happened? Where am I if they can’t see me? Am I already dead? Then the thought that, no, I think surely Hubby would be a bit more emotional if I was really dead on Mom’s kitchen floor. (it’s amazing what the glucose-starved mind will come up with) I heard Mom in the other room saying something about checking my blood pressure, so I thought, Maybe I’m in the hospital already?
vortex
About that time, I got this bizarre sensation of being sucked into nothing…like I was being pulled out of the room, but not to another place, just OUT. The thought that I was actually dying at that very moment was beginning to stir up a panic when my dad walked up on my right site and plopped his blood pressure monitor on the bar and said, “Are you gonna let me do this?” I think then I realized that I wasn’t gone, dead, or invisible and so I stuck my arm out. After that, I slowly returned to normal, Hubby and Mom started talking to me, I ate a little more of my food and BOOM! I was ‘back’.

But the feeling that I had been dying hasn’t left me yet.

Contrary to what people say, my life didn’t flash, I didn’t instantly think of my children or loved ones. That makes me feel like a turd because, c’mon, I didn’t think about who I was leaving behind? Maybe that’s because, thank my gracious God, I wasn’t actually dying? I hope that’s it. My brain was obviously WAY busy trying to figure out what the heck was wrong with me and how to fix it.

Anyway, I’m happy to report that the past couple days have been severe-low free!! After the above incident, we called my doc again that night. He happened to be on call, so we got to talk directly to him. He had me lower the basals another .125 each. That made a total of 6 units per day that I lowered my insulin use. He confirmed what we suspected, this is very rare. He said it seemed as if I had become more sensitive to the insulin, which is awesome. less insulin saves money and makes it easier to lose or maintain weight.

I’m thrilled. Puzzled as to why it happened, but thrilled that it has. I had asked my friends and family to pray because it was getting really scary. Who knows how low my sugar was on that drive up to Mom’s the evening after Thanksgiving? Even after treating a moderate low! That’s the reason why, when my boys were much younger, I would keep my blood sugars a bit high…I couldn’t stand the thought that I might go low when I was in the car with them. I mentioned to a few people the thought that God might be healing me.

That’s a frightening thing to say “out loud” (or in a text). Because, what if He isn’t? And then, I felt like a failure as a Christian for doubting. But it wasn’t that I doubted He could, because for a short period of time after a traumatic accident, He DID take away my need for insulin altogether! So I know He can, I guess it’s scary to hope He will when He might not, ya know?

Anyhow, my belief is that God is healing us all…it just may not happen here in this life. Ultimately, every child of God will be in perfect health with no pain or worry.

Ahhhh, I am eager for that!

Hebrew 7:11“Now if perfection had been attainable through the Levitical priesthood (for under it the people received the law), what further need would there have been for another priest to arise after the order of Melchizedek, rather than one named after the order of Aaron?”

EDIT::: I feel like I need to clarify a bit. Sorry to expand an already long post, but for those who want to know more, read on…

So when I say, “BOOM! I was ‘back’.” it isn’t quite like that normally. Maybe I seemed to bounce back a little quicker because I was at my parents’ house because I fret a lot about making them worry about me/the diabetes.

Case in point: the other day, right in the middle of this whole “too many severe lows” situation, Mom and I were supposed to go out for breakfast with my mother-in-law and one of Hubby’s aunts who was in town visiting. So all four of us had planned to meet that morning at a restaurant. I don’t know if she called just to remind me or if it was some other reason, but apparently, she called and all I would say to her is, “I’m alright. I’m alright. I’m alright.” over and over. Obviously, I was NOT alright because I have absolutely no recollection of even answering the phone. She ended up having to come to the house and get me out of bed and nurse me out of a low. Apparently I worry SO much about making her worry that I’ll lie even when I’m all-but unconscious! So, that COULD be why I “came back” so fast the other night.

The thing is that lows are not always the same. Obviously, I no longer always even feel them. In the early years of my diabetes, I could count on getting shaky and sweaty and nervous. Then later, those became intermittent with numbness around my lips and tongue. Then there were the “sleep lows”…when I went low in my sleep and would wake up or be awakened soaking wet from sweat. Sometimes I still do that and I don’t always wake up. But later, I’ll recall rolling over or half-waking and noticing that I’m sweaty. I’ll think to myself that the house seems really hot and usually just toss off the cover and go back to sleep. Sometimes Hubby will wake up and find me like that. Other times, I recoup from minor lows on my own.

One thing that’s become habit for my hubbs is to feel my face whenever he wakes in the night. Sometimes it’s less than gentle and irritates me but I try not to get really mad. It’s not fun to wake from a dead sleep with someone pawing your face while they aren’t fully awake either. Ha. But I know he’s just checking on me. Poor guy, I can’t count the number of times he’s gotten up in the wee hours to coax food and drink down my throat, sometimes with me fighting him. Then changing my soaked bed clothes, occasionally putting me in the tub and then even switching sides with me so I don’t have to sleep on the damp sheets til morning. He is my greatest support and caregiver.

Some people want their moms when they are sick, but I want my husband.

The other weird thing that’s stayed fairly constant is the bone-chilling freeze that I get after a super-low with mega-sweating. Once my sugar starts to normalize, I will feel as if my insides have turned to ice and I’ll be so cold that I want every source of warmth available on me. How many times has Hubby wrapped me in his arms to warm me up during The Freeze? I can’t even guess. How many times has he pulled blankets out of the closet to pile on me? Thank God, that doesn’t last long, but while it’s happening, it feels like I’ll never be warm again!

So, don’t think that lows just happen and then are over all at once. No two lows are the same and no two diabetics will have the same symptoms or react the same to treatment. That’s the insidious nature of type 1 diabetes. It tends to have a mind of its own and does whatever it darn well pleases.

My hope, in taking the time to write this stuff out, is that it might help someone understand more about diabetes and the diabetics in their life. Or perhaps it will make other T1D’s feel less alone in the daily battle that is our lives. Whatever else you deal with, however hard the days and weeks and years get, always know there’s hope. Don’t ever lose hope. ❤

step into my shoes …

I often struggle to explain my “medical stuff” to people. Not that I go around dumping the whole morbid story on everyone I meet. But for those I am around often, they kinda need to know I have diabetes. For others, it just comes up in conversation.
Type 1 Diabetes

I don’t mind telling people and I appreciate folks who want to know and will allow me to educate them about diabetes. But it can be really hard to explain. It’s one of those things you can’t actually understand unless you’ve dealt with it. Sometimes it just takes having someone who knows explain it to them. Other people just won’t ever understand because they don’t have the ability to sympathize or put themselves in someone else’s shoes.
education
There are also the times you have to go to a new doctor. Then dumping the whole mess is pretty crucial, but there’s no real rhyme or reason to it so it comes out a big, jumbled pile of bits and pieces of my medical history. I start telling them one thing that relates to the reason I have come to them in the first place (ie: a sinus infection, etc) then they’ll ask another question or it will lead to needing to explain background. It’s just hard to relate 40-plus years of medical history in a few minutes, no matter how much training the “doctor” has, it just doesn’t happen quickly or easily.

    Let me stick an aside in here for anyone who happens to read this and has an inkling of what this is like, if you have a good way of doing this, could you please share? I’ve thought of trying to list everything on paper, but it’s not easy, especially at this point when I can’t even remember many of the doctors’ names or what they tested or diagnosed. I can’t remember what year things happened in unless it was major like the 2 weeks in the hospital with Stevens-Johnson Syndrome in 1994. That I can remember since I spent another 2 years recovering from it. But the many, MANY times I’ve been to an allergist or ENT for ear and sinus infections and the various tests they ran and treatments they prescribed? Um, no. Sorry. My mind can’t hang onto that much stuff!

So yeah, in case I’ve never said before, I hate going to new doctors. I feel like I need a moving van to haul all my medical ‘baggage’ into the exam room. I have felt like the doctor was thinking, “What the heck? How many different diseases or medical procedures can one person have?” or “She has GOT to be making this up.” or “This lady and her ton of medical problems are more than I want to deal with.” Now, perhaps NO doctor has ever had those thoughts about me, however, if I were a betting person, I’d bet you that some of them did.
Insulin
Does that make me paranoid? Maybe, but here’s the thing that you won’t be able to understand if you don’t have a chronic auto-immune disease…going to a doctor, and I’m talking a general practitioner not a specialist, with more than a couple different complaints or health issues is like being an alien. Many doctors don’t want to deal with you. You are too complicated. Others immediately decide that you are somehow non-compliant, in other words, you’re not doing all you can to take care of yourself. You aren’t “trying hard enough”.

For instance, this new doc I went to see this week… well, she’s an ARNP but I really liked her. My mom and my youngest son had recommended her to me because she was so thorough and took her time with them. She did the same with me, but because I was there for a persistent cough, she started with that then started looking through the lab work I had in August. She was telling me everything looked good and asking me if I was on any meds for cholesterol since those labs were good, etc.. then she flipped a page and asked me if I was taking Metformin. Of course, I was puzzled about why she’d ask me if I was taking an oral medication for Type 2 diabetes when I’m on insulin and have Type 1 diabetes. I said no, thinking in the back of my mind that maybe there’s some other use for Metformin that she was going to suggest. Then she mentioned that I should be on it to help with my sugars. That’s when it dawned on me that she didn’t realize so I said, “That’s why I take insulin.”
real bad. really?
She flipped another couple pages and then began to profusely apologize. She is a really great, down-to-earth person who has a thick “southern” accent and talks really fast because, or so it seemed to me, her mind is going so fast her mouth can’t quite keep up. *smile* She made a “total fail” comment and just kept apologizing til I said, “Don’t worry about it. I come with a lot of baggage to go through.” and she said, “Well I sure appreciate all the grace you are giving me.”

However, when she then backed up to my lab work and began to retract all the “good job” comments she’d made to me just seconds ago, I felt myself getting really frustrated. And don’t get me wrong, I STILL really like this lady. I think she’s on the right track, is very thorough and wants to help me feel better and be healthier. But this is one of those things that has always just ticked me off so bad. Where she’d thought I had good lab results because they were all within normal range like for cholesterol and blood pressure and such…those were “normal people” parameters. Not diabetic ones. No, a diabetic has to have even lower levels, even better “scores” on these tests.

Yes, I have to test my blood sugar multiple times a day. I have to take shots and count every carbohydrate that I put in my mouth and dose medication for them. I can deal with that. But tell me that I have to have a cholesterol level that is 10-30 points lower than everyone else? That runs all over me and frustrates me more than the unfairness of my daily must-do’s to live.
math-bolus
Is that weird? Am I the only T1D who gets madder than a wet hen about this kind of thing? I dunno, but I left there feeling so conflicted.

This doc is sending me to an allergist she trusts to reevaluate my allergies and asthma issues. She suggested I see my chiropractor to help with the tightness (that she noticed while feeling my lymph nodes, by the way) in my neck and shoulders. She also suggested a $60/hour massage therapist…not gonna be affording that any time soon. When she looked at my feet, which many doctors don’t even do, she got pretty disturbed and told me I needed to wear tennis shoes and not my comfy Chacos and that I needed to go to a podiatrist and “get that skin off there”. I didn’t tell her that what she was seeing was much better than normal! My feet are always really dry with thick callouses and crevasses/folds. And I also didn’t tell her I’ve worn nothing but my Chacos all summer long and I’m not sure what I’ll wear when it gets too cold for them because they are THE MOST comfy shoes I’ve had in years! I’ve worn them hiking through the woods and in the river while kayaking. They are my favorites and I’m not giving them up for some less-than-comfy tennis shoes. So there.

Actually, her response to my diabetes was pretty much the usual for a GP who doesn’t deal solely with diabetics. The idea that all my labs and sugars should be perfect and that I should always maintain a perfect A1c is unrealistic at best and I’ll let her in on that when I go back in two weeks. Is it possible to attain perfect numbers? Yes, it is. Is it feasible to maintain them always? Nope.
perfect bg
Okay, so this has been a long rambly post about how I feel living my life with type 1 diabetes and all its lovely friends…Graves Disease, Neuropathy, Kidney Damage, Early Cataracts, Retina Degeneration. Those are the just a few of the ones who have already showed up to the party.

I don’t want pity. But understanding? That I will take with gusto and gratitude.

Thanks.