It’s easy to read posts on diabetes blogs and get the sense that we’re not letting diabetes slow us down at all. That we’re invincible. That, sure it’s an annoyance, but we’ve totally got this.
I don’t think any of us set out to cultivate this idea in our interactions with others, but diabetes is a disease that’s easy to look past, particularly because it is such a 24/7 affair. We lead such normal lives doing normal things the overwhelming majority of the time that it’s conceivable that it’s like that—normal—all the time. Test your blood sugar, wear a pump, refill prescriptions at the right time, and diabetes is all taken care of. Even if we don’t like to do all of the nonsense associated with diabetes, most of us do it so naturally that it doesn’t look difficult. And because the effects of fluctuating blood glucose aren’t something you can usually see, it’s hard to tell when someone is having a good or bad diabetes day. To the external viewer, it’s all just “normal life” with a little bit of finger-pricking and insulin-pumping thrown in.
And I’d say the majority of the time this is true. Even if we can’t get our blood glucose to do exactly what we want—and this can be very frustrating—it’s a relief not to worry the people around us unnecessarily. Sure, in the back of most of our minds is the understanding that every diabetes decision has consequences, but who can have a good life giving that thought constant attention?
I don’t like to write about the challenging times, because I don’t like them when they happen and because I know it makes others concerned on my behalf. I can’t stop that from happening, and I get it. But it would be wrong for me to avoid posting about the troubling moments, even if it causes worry in others. Mortality is worrisome, which is why we do our best to ignore it most of the time. Seeing someone struggle is difficult, especially when you want to help them and can’t and when it causes you to think about all the “what ifs?”
All this lead up for a very short story . . .
Yesterday afternoon I ate delicious cookies from the café. I love these cookies, but I still have trouble accepting (and acting on) the fact that they have in excess of 25 grams of carbohydrate each. It doesn’t seem possible that something so small can be so potent, so I usually under-dose the amount of insulin I truly need.
Consequently, at dinner time my blood sugar was 281 mg/dL (15.6 mmol/L). Which sucked. I was hungry and grumpy. Lisa had gotten delicious ice cream treats at Dairy Queen for dessert, and I didn’t want to wait to eat them. But I did, because 281. The plan was to give insulin for the full amount of dinner plus the correction, wait about an hour for my blood sugar to come down, eat dinner, and then go on like nothing had happened. And that’s what I did until everything went wrong.
As we were watching the Bruins-Canadiens hockey game, the announcer started to sound odd, and my body felt wrong. I was hyper-aware of everything and able to concentrate on very little. (People with diabetes will know what I’m talking about.) I checked my blood sugar: 44 (2.5). This is the lowest I’ve been in a long, long time. And I still had over 8 units of insulin flowing around my bloodstream, taking care of the carbs from dinner and trying to lower my BGs even more.
The combination of low blood sugar, lots of active insulin, and my fuzzy-headedness triggered us to get ready for the “just in case” scenario. As I was eating glucose tablets and holding on to the world, Lisa got the glucagon emergency kit. Fifteen years ago, when I got my first kit, Lisa let me know her feelings about it. “So help me. If I ever have to use this to save your life, I’ll probably kill you afterward.” Or something like that. 15 minutes later I was still at 49 (2.7). We discussed where to give the shot: thigh, arm, or butt. We settled on the upper arm.
Fortunately, I didn’t pass out. No one had to use the glucagon. Crisis averted.
But this is diabetes: 99% banal. It’s just that last 1% . . .