It’s not what you think…
Not your run-of-the-mill post title, I know. Before you get too excited, let me clarify, this is not a dope-high… not even a happy-all-is-right-with-the-world high. This is a diabetes high. And it’s ANYTHING but pleasant. That has been my life for the past few weeks!
I’m not sure what’s going on other than I had a little bit of a cold/almost-bronchitis for a couple weeks, which I was able to get over without any prescriptions, praise the Lord! But it seemed to jack up my sugars like a mild illness never has before.
Oh, then there are those middle-aged woman hormones. I think my hormones running amok will be the death of me one day!
So anyway, yeah, I’ve been on a rollercoaster with my blood sugar lately. It is exhausting and I don’t need any help being exhausted, thank you!
Diabetes and all its fun stuff…
They don’t teach a whole lot about the nuts and bolts of diabetes management to nurses, or at least not the nurses that I know personally. One of the most helpful things they do teach, however, is that for a low blood sugar (hypoglycemia) you treat “fast” and for a high sugar (hyperglycemia) you treat “slow”. Now, I’m not positive if it’s actually taught this way, but I would say you don’t necessarily “treat” hypers slowly, but they are MUCH slower events than a hypo.
With a hypoglycemic event, you HAVE to get sugar into the bloodstream in a hurry! There’s no time to wait, no time to explain why you’re ripping open the bag of Skittles you just pulled off the shelf and putting handsful in your mouth, no time to tell why you cut line to grab a Mt. Dew out of the checkout cooler and are chugging it without paying first. No time to explain to a stranger with whom you’re conversing at a conference why you suddenly ran over to the refreshment table and threw a cup of punch down your throat without a word. No time to explain that, Hey, I’ve been standing here trying to keep up with the conversation (or worse, talking endlessly, probably in circles) not paying attention to the nagging tiredness and now I realize I’m low, could we put the convo on hold for a bit? That is always the worst for me. I get so embarrassed and it never fails that I don’t realize I’m going low until it dawns on me that I can’t concentrate on what the other person is saying or I don’t remember the point I was trying to make, but my mouth keeps going for some horrible reason. Worse, sometimes I begin to sweat and can’t seem to find a good time to interrupt to say, Excuse me, but I have diabetes and I need to grab something to eat. Drives me flippin’ nuts when that happens!
HypER vs HypO
On the other hand, there’s a hyperglycemic episode. These can sometimes come on quicker than it would seem (if you read medical info!) and soon I have the telltale “sick headache”, the throbbing in my legs and arms, the nausea. I’m probably pretty grumpy, too. I feel so crappy physically, it puts me in a royally bad mood. If you’re lucky, I’ll just be uncharacteristically quiet. If you’re not, I may come across as being a little more callus or hateful than normal. When I’m at home dealing with a hyper, I absolutely hate the waiting. I can just feel all these complications happening… the throbbing in my limbs is the blood circulation slowing down which will bring on an amputation. My eyes being sticky and dry is the dreaded diabetic blindness coming on. The aching head is my brain struggling with sugar-thick blood that’s slogging down circulation. Running to the bathroom endlessly is my kidneys being overworked and pushing me headlong into kidney failure. Every moment I have to wait feeling this way is like a panicking nightmare of watching as my body slowly kills itself.
Imagining the worst…
Maybe other t1d’s don’t experience this during hyperglycemia, but I sure do. It’s not so bad if I just have a one-off episode because I miscalculated a bolus or carb count, but when it’s chronically high, it is torture. My mind is full of images of hospital beds, IV tubes and monitors, bandaged stubs where my feet used to be, becoming harder and harder to see, all the while, I see another giant red X on a calendar marking another day I’ve just lost because my stupid sugar is too high.
THAT is what happens in my brain when my sugar is high. And there is not one stinking thing I can do to speed the insulin up, nothing I can do to lower the amount of sugar in my blood. All I can do is treat (give insulin) and wait.
And all of this is IF I don’t go into DKA or diabetic ketoacidosis. If I go into DKA, then it’s a whole other nightmare and a hospital stay. The only time in all my forty-two years of living with t1d that I’ve been hospitalized for DKA was about 4 years ago when a cannula kinked and I wasn’t getting insulin from my pump, but didn’t realize it until it was too late. I showed up in the ER with horrific stomach pain and no clue why. Soon the vomiting of neon green fluid began and I was promptly (ha—after an hour or two!) diagnosed and admitted to intensive care!
So yeah, I’ve been doing a lot of thinking about how short I may or may not be cutting my life because of something I can’t do anything about. It really stinks, too. I mean, it’s bad enough to want to kick yourself when you’ve indulged too much… you know, went ahead and had that one cookie or bite of cake but the bolus you gave didn’t cover it fully OR your body just won’t use the insulin you give it in a timely manner (what I suspect is going on with me). I swear! Sometimes it’s like I treat and treat to correct a high and it seems like NOTHING happens and then four hours later, my sugar takes a nosedive and I have to treat a low. I HATE THAT!! ARGH!!!!!
ahem Sorry. But I really REALLY hate when that happens. So like I said, it’s bad enough when it’s something I did that has my sugar up but when I’m sick or it’s a medicine (like steroids or antibiotics) I’m having to take that jack my sugar up? I go down a really dark road in my mind. A road littered with amputated limbs, dialysis machines, and blindfolds. A road where I can see my hubby and kids gathered around my casket. It’s ugly and scary and I don’t quite know how to stop it when I’ve been fighting the highs for days.
How I wish it had been explained to me…
When I was a kid, these two things confused the heck outta me. The words sound and look so similar but they couldn’t be more different. If only someone had taken time to explain to me what the differences in the spelling and meaning were, I’d have spent a lot less time being clueless. So I’m going to explain it to you the way I wish someone had explained it to me.
Glycemia has to do with glucose or more specifically, blood sugar. This is the ending of both words so all we have to focus on is the prefixes, hyper- and hypo-. When you’re a non-genius kid and no one points this out, you have a terrible time differentiating between the two!
Okay, so hyPER should remind you of a kid who is overactive. People say the kid is HYPER–too much energy “too much sugar”. The other thing you should remember is that an episode of hypERglycemia can land you in the Emergency Room more often than a hypo.
On the other hand, HyPOglycemia is when the sugar is too LOW. “PO” rhymes with “LOW” and that’s pretty much the extent of my little remembering tricks for that one. Ha ha…
I said a hyperglycemic episode can be more serious than a hypo (“land you in the ER”) because it’s fairly cut and dried how to remedy a low blood sugar. Unless you go so low that you lose consciousness, you can eat or give a glucagon shot to correct a low, A stubborn high, however, is a bit harder to recognize, can sometimes lead to ketones which is one step closer to DKA even if your sugar isn’t “all that high”. And once you are in DKA, it’s very hard to correct without medical intervention. Your entire body chemistry changes once you become acidic from the high level of ketones. So for anyone who wondered why I said that, this is why. In my experience, it’s the highs that can be the most dangerous.
I guess this isn’t really an “explanation” of hyperglycemia as much as it is a look at it from my side. This is what hyperglycemia is to me. Big. Bad. Mean. Deadly. Threatening. Hateful. Slow. Nauseating. I could live my whole life and never miss dealing with it. Not ever!