geanniegray.com

a blog about life with diabetes, depression & dysfunction & how to manage them with HOPE!

the worst one yet: a hypo story


So yeah, in this post I mentioned that the reason it was delayed is because I ended up in the hospital that evening.  I promised to tell you about that, so here goes…

I’ve been really REALLY sick since the end of August.  If you’ve visited at all in that time frame, you probably know this already.  I was just miserably sick with some sort of bronchial-slash-allergy illness from Hades!  I was on and off antibiotics and steroids and all sorts of allergy medication, nebulizer meds, inhalers and nasal sprays.  I was using an oil diffuser, vitamins and herbals, teas, Vicks on my feet… you name it and I tried it.  For the longest time, I just could not seem to get better at all, or I’d get better for a couple of days and then go back or get worse.  Finally, FINALLY, I started to feel like I was over the hump and improving a little.  I had started immunotherapy and either that was helping or The Sick just got tired of me at last and went to torment someone else.  I honestly don’t know.  I just knew I was thankful to feel almost human again!

That was a couple of days before Thanksgiving.  I felt good enough to help plan the meal.  I even baked a turkey sans stuffing specially for Corey because poor Mom couldn’t seem to understand that even if she only put stuffing inside the turkey, it could still cause his celiac to flare and had loaded hers full of regular, gluten-laden stuffing.  I also made him some gluten free dumplings, gravy and dessert before going up to Mom’s to make my usual batch of dumplings for the rest of us.  It was a great day, the best Thanksgiving we’ve had in a while.  My cousin Gabe was able to be with us and about six other random friends of ours or our kids were there with us unexpectedly.  I was thankful that my parents didn’t flip out having so many people over, but they seemed to enjoy it once the initial shock wore off.   We were there until almost 11 pm playing games and having a really good time.

That was on Friday.  Yes, I know Thanksgiving is on Thursday but for whatever reason, Mom had decided we would do our Thanksgiving dinner on Friday, and so we did.  So I got through the weekend fine and continued to feel better.  So much better I was beginning to tackle the house, which has been in a horrific state of neglect for MONTHS now.

Then on Monday, I once again was feeling really good.  It’s not often I have days like that, and especially after being sick for so long, so I was relishing the fact that I didn’t need a nap before noon and that I was actually able to finish several tasks without getting wiped out or discouraged.  It was starting to seem possible to get the house in shape enough to get ready for Christmas!

I had gone to get my allergy shots around 9:30 so being dressed and out and actually getting an errand completed by that time of day was a major accomplishment!  I switched out some laundry, folded and put a load of it away, unloaded and loaded the dishwasher, washed the big dishes and put them away and scrubbed the sinks.  I felt like I had conquered the world!  The only downer at that point was that my sugar had been hovering around 200 for much of the day.  I ate leftover dumplings with Tommy for lunch around 11:30 and had struggled to get the number down ever since.  By 2:00 it was still up and of course, my CGM was “screaming” at me every five minutes.  It just kept alerting me that my sugar was high.

Really?!?!  Yeah, I know already!  I really love my CGM and it’s a great tool to have, but I wish there was a way to make it not continue to make that noise after you already know it’s doing whatever Dex is alerting you about while you’re trying to correct the problem!  Gah!  I had started a post earlier and now it was finally finished.  I just needed some photos to compliment the theme, so I was busy searching, uploading, transferring and editing so I could publish when I suddenly got extremely tired.

It wasn’t a “low” tired, but then again they never seem like “low” tireds.  sigh  I just figured that all my energy had been spent and it was time for me to recharge.  By this time it was about 3:30 – 3:45.  While I’ve been sick, I got in the habit of just laying down whenever I felt tired and napping instead of fighting it.  I figured if I slept for 45 minutes to an hour, I’d feel lots better and could get some more done around the house.

That’s the last thing I remember before the ambulance.

I can remember hearing unfamiliar voices.  I can remember the sort-of fading-in of voices asking me questions … it was like tuning in a radio station.  I couldn’t understand the words for a time until I got them “tuned in”.  Then I would hear someone talking about me.  Saying what my blood pressure was, talking about turning “her” or that “she’s starting to come around”.  I think that last sentence is what caused me to realize what was going on and open my eyes.

Somehow, I knew I was lying on the floor of my bedroom with my head at the foot of the bed next to the closet doors.  I remember wondering how so many people were able to fit in such a small space then I began to wonder what in the world had happened.

About that time, I heard Corey’s voice and spoke his name.  I’ve gotten in the habit, ever since I started having those sudden severe lows, of stating what I can see or hear in an effort to let people know that my brain is operating, at least a little.  Then I saw Taylor’s face and spoke her name.  Both of them said things like “it’s going to be okay”, “you’re okay” and “it’s alright now”.  I started trying to ask what happened but must not have been doing a good job when a man to my right leaned over and told me his name was Daniel.  That’s when I knew I was in real trouble, or at least I had been.  I could see his EMT uniform and the creepy blue gloves on his hands.  Beyond that, I couldn’t tell anything else was going on with my body other than I was freezing.  I began saying, “Cold.  Cold.  COLD.”  That’s when they counted and I could feel them lift me with a blanket and plop me onto a gurney.

I could see I was being wheeled through my kitchen and out the door onto the porch.  It hit me then.  The realization that I’d been the cause of yet another medical bill.  I began saying, “I’m sorry.”  And I was, both for racking up another bill to pay and for worrying my kids like this.  Corey told me there was no reason to be sorry.  I continued telling them I was cold because folks, a post-hypo freeze is nothing to be toyed with.  One nurse later told me a severe hypoglycemic episode can put you near hypothermia!  I believe it!

They loaded me into the ambulance and both Daniel and Corey climbed in on either side of me.  I began asking Corey what had happened.  He started off by saying I had probably busted my nose, but it was okay.  That was puzzling because my nose didn’t hurt.  I touched it and it felt fine.  I didn’t know what he was talking about.  Then I felt the stiff remains of dried blood on my face, then the stickiness of something else… Corey gently wiped at my face with a tissue.  “It’s okay.  You’ve got some blood on your face.  We’ll get it off in a minute.”  I said, “Sticky.”  He said, chuckling, “Yeah, I got a little syrup on your face.  We’ll wash it off soon.”  Then I asked him again what happened.  He said, “You got really, really low, Mom.  But you’re okay now.”

I listened as he and Daniel talked about me and then about the job.  Daniel remembered hearing about the EMT Cadet program that Corey had been part of before it shut down.  He said, “I could tell you’d had some sort of training by the way you handled things in there.  She’s up to one-nineteen now.  That’s much better.”

When the ambulance stopped, I remember noticing all the red brick and then seeing Casey, Melissa and Taylor standing outside the open doors as Corey and Daniel began to move me out into the cold air.  Then I saw Tommy, who I hadn’t even had time to wonder about.  They got me into a little room in the ER and another guy came in and tested my sugar.  “Sixty-nine,” he said.   Then he asked Daniel what my sugar had been last time and decided to give me a second dose of D50.  I’m not sure why this was done since by then I was able to eat and drink.  After researching about D50, I learned that it’s not good on the veins and Lord knows, I have bad enough veins to begin with!

I finally began to get warm after about 2 hours.  And my sugar began to rise too.  I had found out by now that Tommy had had Corey remove my pump as soon as he found me passed out.  I connected back to it and bolused for the 170+ sugar.  From that moment on, I would have to fight for every single unit of insulin I received during my 22-hour stay.

The hospitalist had me disconnect from my pump.  Don’t get me started on how little most hospital staff know about diabetes.  In this instance, since at that point we weren’t sure what had happened and thought maybe it had been a pump error that caused the severe low, I was okay with removing my pump.  However, I was NOT okay with the hospital’s method of dosing.  Nor with their schedule for testing my blood sugar.  According to them, if it wasn’t done on their glucometer, it wouldn’t be scanned into the system.  Whatever.  I still don’t want to wait til  you think it needs testing.  So when I check and it’s 198 and I tell you I need some insulin, don’t tell me it’s not time, you’ll bring it with my supper or you will be right back with it (then don’t come back for three more hours).  It was INFURIATING trying to manage my sugars in there.  

Also, don’t confuse your medical degree with my decades of first-hand, 24/7/365 experience of dealing with my own disease.  Thank you.

I’d forgotten how horrible diabetes-in-the-hospital can be.  When I complained to the hospitalist about the fact that my sugar was approaching 400 and I had asked several times for insulin, she told me in the ER (because apparently, if you work in the ER, you only know abut ER stuff??) they usually see diabetes patients with sugars well above 600 and have no clue they are running that high.  I informed her that —I— was not one of those patients and when my sugar got above 200, I felt sick and I wanted to keep it under that.  She agreed and said she’d write it in the chart.

I don’t know what “it” was, but the treatment I got regarding my insulin in no way resembled control.  I won’t keep going on about this.  Maybe it’s fodder for another post instead, but the reality of ill-educated medical staff when it comes to diabetes is just epidemic!

Okay, so when Tommy and I started going back through the history on my pump, we saw that I had somehow (“somehow”) given about 20 units more insulin after my meal of dumplings.  Obviously, I had needed more than I estimated, but not THAT much more.  When we looked at the times of the boluses, we could see that I’d given several of them either in my sleep or at such a low level that I didn’t realize what I was doing.  All I can figure is that I went to sleep frustrated over trying to give enough insulin to get my blood sugar down and had heard my CGM go off so many times that day that when it continued alerting, now for lows instead of highs, I would automatically bolus thinking it was still saying I was too high.

That and also what the pump trainer said… after bumping up my basal rates in tiny increments over the last several months, having the lung infection then being on all those meds, and then finally getting well, my body went back to its former insulin needs quicker than I expected or could adjust for them.  So it was another perfect storm as far as situations that combined to cause this horrible low.

I’m just immensely thankful to be alive.  I’m working to train myself out of the habit of just hitting that bolus button before testing and actually not to use it at all, but instead use a temporary basal rate to correct highs and an extended delivery (a square or dual-wave) bolus when I eat so all the insulin isn’t hitting my system at once.  Tommy, bless his heart, has been off all week watching over me and helping me test these adjustments to see exactly what works best.  He gets extremely stressed and fretful if my sugar gets to 60, which is something I’m not used to.  He’s usually the most calm, collected person I know, but after seeing me bleeding, lying in the floor seizing and thinking I was dying right in front of him, he now worries any time my sugar even hints at going low.

I am truly blessed with the best family ever.  If not for my hubby, who had called to check on me when I was around 50, but I don’t recall talking to him.  When he thought I was treating my low myself, he hung up with me, but then got busy with his work and didn’t call again until 30 minutes later when his app alerted him.  When he couldn’t get me on the phone, he called Corey to see if he could go check on me.  As soon as Corey found me, he called his dad and just said, “You need to come home, Dad, it’s bad.”   Tommy called 911 immediately and tore out of the work site heading home.

I’m not sure when Taylor and Casey arrived, but I’m pretty sure Corey called Casey and he called Taylor so she could come straight to the house when she got home from work.

Hopefully, my sharing these kinds of things will help you understand how hard it can be to manage and regulate diabetes.  That it’s not a cut-and-dried medical issue, not one-size-fits-all treatment and not even this-works-every-time because ultimately, Diabetes does it’s own thing sometimes and it doesn’t have to make sense.

It’s a cruel, exhausting disease so when you meet a person with diabetes, be kind.  Be sympathetic.  Be nice.  Shoot, just be that way all the time, but please extend a hand to the PWDs in your life.  As the meme goes, be kind to PWDs, we deal with enough pricks already.

Blessings,

G~



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