Like all Type 1 diabetics, for me occasional lows are just a part of life. In the struggle to get the insulin dose just right, sometimes I miss. Unexpected things happen. There are so many factors, some still unknown, that can affect blood sugar and I can do the same thing every day and sometimes get completely different results. 2+2 doesnâ€™t always = 4.
Last weekend I was feeling a little under the weather. Not really sick but exhausted like Iâ€™d overdone it and just feeling extra tired. I was at the end of a 3 week job that had consumed more of my life than I expected and I was just tired. Sunday morning I made a very rare decision to not go to church feeling like I really needed the extra rest instead. For reasons I still donâ€™t understand, my blood sugar ran a little high all night, around 170-180. So I eventually increased my basal insulin trying to nudge it back down.
I slept in really late that day, much needed rest. But all diabetics know being out of normal routine can make blood sugar a little more unpredictable. And since I was sleeping in a lot later, I wasnâ€™t watching my blood sugar as closely as normal, watching for it to come down in range so I could reduce my basal insulin back to normal.
Once I finally got up, my blood sugar started dropping. I reduced my basal insulin and ate what was already a late lunch. For the next two hours my blood sugar persisted at 50-60, not low enough to worry me but more of a nuisance that no matter how much I ate, it just wouldnâ€™t come up. These kind of stubborn lows arenâ€™t that unusual and just take some patience. And the normal expectation is that all the correction carbs will finally catch up and there will be a high later. That is what has always happened to me before after these stubborn lows.
When I finally got my blood sugar at a steady 100, I started thinking about dinner. Yes somehow even with all of those correction carbs I was still hungry! And I figured at that point that a normal meal would be good to hold that blood sugar more steady than it had been all afternoon (which is also usually true). Since it was my last night at this exhausting job, I decided on a treat. I ordered a burger and fries from my favorite place since I had a free delivery deal. I wanted to celebrate making it through this long and tiring job.
When the food came I decided that especially with the protein, I wasnâ€™t going to pre-bolus or even give myself insulin when I started eating, I was going to wait until I saw that the food was raising my blood sugar. This was a decision unique to me and my circumstances and something that had worked many times in the past. So I ate my food and watched my CGM for the rise that would come. It came about 30 minutes later and I went ahead and gave myself a bolus of insulin for the 80 carbs of the meal not giving a correction for the 150 blood sugar. Still nothing out of the ordinary, the same thing I do every day and something I had done for this very meal multiple times before that had worked perfectly.
About a half hour after I gave the bolus, I went outside to take care of a few chores. I was still right about 150 and I knew that getting up and moving around would help speed up the action of the insulin I had given but in my mind that was a good thing. The number of things I had to do I felt was the perfect amount to get this meal insulin working well against the carbs. But as I was finishing up outside, I suddenly felt very dizzy and just knew my blood sugar was dropping and dropping FAST!
I quickly rushed up to the house as black spots tried to overtake my vision. I pushed through, grabbed my blood glucose meter and applesauce and laid on the couch. As I quickly downed some applesauce I tested my sugar. 37. While Iâ€™ve been lower than that before and still able to manage, something in my gut told me this was different. I really believe God whispered in my ear, â€œyou need help.â€ So I quickly texted a friend that I was in trouble as I fumbled to call 911.
I remember the 911 operator asking me for my address and I fumbled through talking and trying to get the numbers and words to come out coherently. When she asked me for my phone number I couldnâ€™t get the numbers out in the right order. She finally repeated what her screen showed my number as and I confirmed. Then she asked me the problem and I told her I was diabetic, severely low and about to pass out. She said she would send help and to stay on the line with her. I donâ€™t remember anything past that. I saw later that I was still texting with a couple of friends but I have no memory of it now.
I donâ€™t remember the EMTs arriving or much of their time there but I was told about it later. When they arrived I was semi-conscious able to follow commands but not really aware. They first tried liquid dextrose (sugar) on my gums and in my mouth but it didnâ€™t work. Then they found a Powerade in the kitchen and had me drink the whole thing. My blood sugar still wasnâ€™t getting out of the 30s and I wasnâ€™t regaining full consciousness. They found some cookies and tried to get me to eat some with mixed success. Still I was not coming around and my blood sugar wasnâ€™t coming up. So they started an IV and gave me dextrose right into my blood stream. That finally worked and as my blood sugar started coming up I started becoming more alert.
The first thing I can remember is extreme nausea as I was handed a bag to get sick. The overwhelming amount of sugar they were pumping into me made me extremely nauseous. Then I became aware that my clothes were drenched in sweat, more than Iâ€™d ever felt before. Then I saw that a friend was there and they were talking about taking me to the hospital to get checked out. So I was loaded into the ambulance for the (long) ride to the hospital.
It was during that ride (thankfully no sirens) that the EMT talked to me and told me all they had done. He asked me if I knew how close I had come to dying. He said they had real concern about how hard it was to get my blood sugar up. He said he believed that if I had not called 911 before I passed out, I would probably have died. I found out later they had been working on me for 45 minutes never getting me above the 30s until the dextrose IV. My friend at the scene (who got there just after the EMTs) told me how she really felt like she was watching me die.
I did get checked out at the hospital but we still donâ€™t really know what happened that night or why. My insulin pump was thoroughly checked and determined to be working properly. While we will continue to run more tests, it is possible that we may never know why. The human body is immensely complicated and there are still mysteries we donâ€™t understand. Maybe I was fighting a little bit a sickness? But why the carbs from my food never hit my blood sugar that night remains a mystery.
I have lived with this disease for 14.5 years and this situation is probably every diabetics worst nightmare but it was a first for me. And I have learned some good lessons from it. Even as I was dialing 911, I worried that I was overreacting. I worried that the carbs I just ate would work and by the time the EMTs showed up I would be fine and embarrassed that I called them. I was scared that I was making a big mistake calling and it would turn out to be nothing. I almost talked myself out of calling. But since then Iâ€™ve learned that if there is even the smallest possibility that help is needed, I need to call for help.
I also learned that if something feels off, even if my analytical brain is telling me everything has to be fine, listen to that feeling. I canâ€™t explain even now what felt so different about this low. I really think it was God placing that feeling in me that something was really wrong and I had to call for help. But it made no logical sense that this low was any different from the hundreds Iâ€™ve had before and managed on my own just fine. And Iâ€™m very much a logical person and not prone to act by feelings! But if I hadnâ€™t listened to that feeling I likely wouldnâ€™t be alive to write this.
These lessons apply to you even if you arenâ€™t diabetic. If you think there is even a small possibility you need help from 911, go ahead and call! Donâ€™t fear being embarrassed if it turns out to be something minor, itâ€™s far better to be embarrassed than dead. And if something just doesnâ€™t feel right, even if logic is telling you you are crazy, go with that feeling. Again itâ€™s better to be wrong and safe then ignore it and be dead.
While I know itâ€™s going to take some time dealing with the trauma of that night, I will get past this. I will focus on how thankful I am that God is giving me more days on this earth. I will learn to get comfortable again dealing with lows and not fear every low is trying to kill me. I will use my experience to help others know what to do if it happens to them. And just like always I will choose to be thankful even for this crazy scary disease called Type 1 diabetes. Because it helps teach me just how precious life is.