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Wednesday, February 13, 2013

Lows & Fears of WalkingTheDragon


So I may have mentioned once or twice on here that I’m “terrified of lows”. And I’m sure no one likes the: sweaty, confused, shaky, shaky, shaky, cold, hot, sweaty, crying…

I hadn’t cried in a long time until yesterday night. Not boasting – just saying – because once upon a time (8 or 9 years ago, when I was a teenage girl) I cried a lot (back then I also didn’t have diabetes, so I’m not sure what there was to cry about J) …

Some of you may know that last week (see: “frustrated”), I switched from Humulin R and N to Levemir and Humalog. Overall, it’s going fine. I’m trying to work out the basals, which is kind of working (i.e. I woke up at 6:40 this morning, and was at a BG level of 146 mg/dl with no corrections overnight, which would never happen on N J). On the other hand, fast-acting insulins scare me a little because of how fast BG can drop an hour or two after use, so I really have to get better at dosing with 100% accuracy and (more importantly?) waiting to eat after bolusing to improve post-prandial #s (which have sucked ass for the last few days)…

And then there is that one word: exercise. I suck at it, and can be only be defined as “inconsistent” when it comes to it (and some other things). I am 5’4” tall (1.63 m) and 115 lbs (52 kg) (on a good day), and also: I’m out of shape (read: can’t run 10 minutes without being out of breath). But, nevertheless – capable of running… SO – yesterday, when I got home and was feeling stressed about: comprehensive exams for my Ph.D. at the end of the month, never having enough time to clean the house anymore, diabetes, my beautiful puppies being more lonely during the semester.. I decided to (wait for it: exercise!). Not really. More like run around for 20-30 minutes with my dogs (read: lunges, sprints, laughter, throwing objects)… But it was fun, and (as I found out 2 hours later) totally counts as exercise (as do cleaning and sex).



I was around 140 before dinner (cgm #, because I am slightly lacking in test strips for a few days). Not giving much thought to the puppy play, I proceeded to dose 3 U of Humalog immediately before a dinner of: couscous (~44 g carb), chicken (negligible), and broccoli (tends to be negligible for me, as many vegetables are). Noticing about 30-45 minutes after, that I wasn’t peaking (at all, according to Dexcom), and considering the puppy play, I ate a small apple (a fibrous wonder of ~9 grabs of carbs). Also, I had some beer (about 2 lite beers, ~6.5 g carbs, and yes, I know OH lowers BG J).

Given my ratio of 1U:15 g carb, I thought I kind of nailed it. Nevertheless, 1.5 hrs after all this, I felt “OFF”. (I hate and love that feeling, because it’s a warning, but it’s terrifying). My brain felt “jello-like”? According to the CGM, I was @ 127 and steady. According to my Accu Chek I was 88. OK. I had a little juice, thinking “no big deal, just a bit of juice will do it.” (Don’t overtreat in the 80s, even post-prandially, don’t overtreat in the 80s…) BUT, about 10 minutes later, my Dexcom started yelling that I was 66 and falling, and all of the sudden I started feeling: sweaty, confused, shaky, shaky, shaky, cold, hot, sweaty. Oh, and also: my heart was beating out of my chest - HARD. At this point, I had more juice, and then (all of the sudden!) I found myself to be a crying mess, asking my husband to “bring me more juice in case I needed to drink more.” And I started crying more and more….

“Are you OK?”, he asked. “Yes, I’ll be fine, it’s just a low, it will pass”, I said. And then…


Then – I broke down and I told him about that time in Costa Rica 4 years ago, when I pre-dosed 3 U of R for dinner when I was 37 (I tested after I dosed, because I was rebellious and stupid, and determined not to let diabetes completely and totally rule my life). I told him how I chugged the sodapop that night at the hotel, bottle after bottle). And I told him how I was too proud to say anything, and how I had to be in control of myself, because I would never let anyone help me…

And then, saying all this through my tears, I remembered all of the sudden how BRAVE (young?) I used to be. It’s as if my stupidity back then inversely correlated with a sense of any fear. EVER. [Also I felt more in control of myself today, because I had plenty of juice as well as Glucagon. I have been carrying Glucagon with me only the last 1 year out of the last 6 years of being a Type 1 Diabetic]. I felt (slightly) better. Then I tested, and I was only 84 (after all that juice) and I drank more juice, still not feeling 100% (I’m also pretty sure that my meter of the last 4 years needs to be retired, because that felt like a 55-60 BG). Also I knew that I completely over-treated a low that was in the 60s at best.

I don’t know how you do it, #doc. When I read (once upon a time) Kerri Morrone Sparlings’s (@sixuntilme) post that she wrote at a BG=55, I wondered “wtf? If I was 55 right now, I would be destroying the contents of my fridge”. But, that is BRAVE: to trust your body and your math skills in time of crisis and not over-treat.  I know I can deal (even at a BG of 37), because it’s happened and I’ve lived. Nevertheless, I know it can end badly. And that’s the terrifying part…

Nevertheless, I love my diabetes. When I was diagnosed and finally accepted treatment, a teacher told me: “If you want to live a long and healthy life, find a disease – then nurse it.” Kind of stuck with me.  

I’m trying really hard to be grateful that my body pretty much  always alarms me right away if I’m under 80 (if I’m paying attention).  And I am hoping I can become a little bit more BRAVE like my younger self again. And with that: Don't live every day as if it were your last. Live every day as if it were your first. (Paolo Coelho).

~KeepWalkingTheDragon


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