hypoglycemic event – The LADA Diva

A few years ago, we had a lap simmer at the pool who wound up floating face down in the water and not moving. It was my responsibility to blow my whistle and alert everyone to the emergency and jump into the water and rescue her. I remember rolling her over onto her back and noticing how grey her face was. We pulled her out of the water and commenced to perform CPR.

I had a bitch of a time trying to open her airway enough to actually accomplish blowing air into her lungs. As my coworkers performed compressions on her chest and attached the AED pads, I struggled to lift her neck high enough and pull her head back to get some air into her lungs. I think at one point I managed to blow air into her stomach, but I am still doubtful to this day that I ever managed to get air into her lungs. We later learned that the emergency doctors at the hospital had diagnosed her as being “morbidly obese” and this was the reason for my inability to effectively administer oxygen.

Fryer was the scheduled Building Supervisor, but he was busy performing his ‘daily hot tub inspection’ in the sauna outside. He never heard my whistle. He had no idea we were in the middle of a medical crisis and needed all hands- on deck. Those of us who were working hard to try and save this woman’s life in a timely manner had to send one of the water exercise instructors outside to fetch Fryer.

Fryer later recalled what his first thoughts were when the woman we sent to get him stood in the doorway of the sauna; he almost said to her, “either get in, or close the door,” but she finally managed to tell him there was an emergency inside. According to Fryer’s recollection, he sighed and made his way into the building he was being paid to supervise. The first thing he saw was every one of his employee’s being paid to work down on the opposite end of the pool performing CPR upon a patron. Fryer finally began helping the team after the AED administered a shock, after 911 had been called, and after the pool deck was cleared of patrons. Essentially, Fryer was able to make his way over and help me try to pry open her airway in the hope of providing her with the optimal chance of survival by providing her system with oxygen. Even with his help the attempt was unsuccessful.

Fryer did participate in a round of compressions, but without wearing personal protective equipment, which can be viewed as superfluous, but anyone with experience providing healthcare in a First Responder’s role knows how much emphasis is put on the need to protect one’s self as paramount in any situation. I felt offended at the time watching Fryer, and another long-time employee, performing compressions without wearing gloves. Particularly after this other employee had pushed me aside in order to perform the compressions. I mentioned his lack of gloves, but he ignored me as all of his concentration was upon the task of performing the compressions.

We were busy wiping liquids and flecks of what were later identified as tapioca pudding from the patron’s mouth as we tried to open it wide enough to accept receiving oxygen. After all the years of feeling anxious being tested by Fryer for my skills of performing CPR, First Aid and rescue techniques, and the way he would hammer home the need to always wear gloves, I felt almost betrayed by noticing what was missing, but being ignored when I tried to point it out to my ‘superiors.’

Our patron lived. The paramedics arrived and took over and eventually escorted her to the hospital. I remember feeling embarrassed watching my boss, who loves to tout the necessity of looking “professional” to all the new lifeguards every summer, standing in his bathing suit and talking to the paramedics. My belief in the merits of professionalism has never been in accordance with Fryer’s application of the concept. A few months later the woman was back and swimming laps in the pool again, this time with a continuous glucose monitor stuck to the back of her arm. But, with all being said and done, we did our job and we did it well. Fryer included. I do, after all, believe he did everything he could to the best of his ability.

My story does not end there, though.

My story continues with the next day finding me coming home after work and curling up in my chair to take a short nap. That short nap turned into a nightmare ending with me being in the emergency room until two in the morning.

My housemate came home a few hours after I sat in the chair to find me incoherent and mumbling. My memory is of having woken up hours later than I expected freezing in my chair and not being able to get up and grab my blanket. I remember my housemate walking in the room and asking me what was wrong. All I could manage was to try and tell him that I was cold and wanted the comforter from my bed (I remember trying to lift my arm to point towards my bedroom and failing). But he couldn’t understand me. He was smart enough to call the paramedics and I sat in my chair watching the blue and red flashing lights stop outside the window. It is the only time in my life (to this point) that I have had to have the paramedics called on me.

One of the paramedics rampaged my kitchen looking for carbohydrates they could feed me to help raise my blood sugar. To this day, I have no idea why he went into the cupboard and found the one hamburger bun someone had left behind from a barbeque the summer before. I cannot understand, for the life of me, why he did not hand me one of the three different kinds of granola bars I keep in the cupboard, or any of the dried fruit sitting next to the granola bars. Instead, the paramedic took the hamburger bun, an egg and a slice of cheese from the fridge, and then took the time to cook me a sandwich!

By this time, I had contacted a friend from work to give me a ride to the ER, and to alert someone I would not be going into work the next day. When she walked in through my kitchen door and saw the paramedic cooking an egg on my stove, she immediately recognized him and asked, “Hey! Want some bacon with that?”

That morning (yes, the morning of this exact same day), my friend had decided to cook some bacon for breakfast in her pajamas. Unfortunately, the smoke from her breakfast caused the smoke alarm to go off. Normally this is not a problem, and it wouldn’t have been this day also, but my friend failed to hear her cell phone ring when the alarm company called to check if the alarm was authentic or not. When the alarm company couldn’t reach my friend, they started calling her list of emergency contacts. The first two contacts didn’t answer for one reason or another. By the time the third person on the list was contacted, the alarm company had also dispatched the fire department.

My friend, having finished cooking the bacon and clearing most of the smoke out of her house, finally heard her phone ring. The third person on her emergency contact list had left work and was rushing to my friend’s home and calling with the desperate hope that it was all somehow a horrible mistake. Luckily the third contact was able to turn around and head back to work, but, as my friend laughed on the phone while standing in her smoky kitchen in her pajamas, she realized the sirens she heard in the distance coming closer were coming for her.

She managed to throw on her robe and meet the first responders at her front door. After she apologized for causing such a fuss by taking the time to cook bacon for breakfast, my friend offered the firemen some of her bacon. She went back inside to her kitchen only to confront both of her cats on the counter eating the last of the bacon.

We sat in my living room laughing about the absurdity of life as we all waited for my blood sugars to rise and stabilize. My friend finally took me to the hospital and stayed with me until the doctor cleared me. A simple hypoglycemic event such as mine (even though anything so serious should not be hallmarked as simple) should not have kept me in the ER for more than a couple of hours, but this trip was accompanied by an irregular heart rhythm that needed to be monitored. All I really remember from the night was having my friend continuously bring me new blankets from the dryer down the hall because I was so incredibly fricking cold!

Diabetes affects me in very unpredictable ways. It is only recently I have even begun to comprehend how strongly stress can affect my ability to manage my disease. The stress of saving a woman’s life the day before was enough to send me into a cascade event culminating in the need for paramedics to intervene. I am becoming better at learning how to manage my diabetes and maintain my health as much as possible, despite the stressful curve balls life enjoys hurling at me. It is a relief to know that a monumental element within my life, which used to contribute to my increased levels of stress, has finally been eradicated. I am quite positive that walking away from the pool has increased my expected lifespan by a couple of years. I am extremely grateful to be in a position where my health and well-being are the driving force behind my days, from the moment I wake up to the moment I close my eyes in exhaustion.

Low blood sugars can be scary. They certainly scare the hell out of me when I’m alone. A few weeks ago, I was walking to the store when I realized I was no longer walking in a straight line. My blood sugars had begun to drop so suddenly that my cgm was unable to keep up and give me a warning. By the time I made it to the street the store was on I could feel my thigh muscles begin to twitch–a sign that a seizure is close at hand. I had one applesauce packet with me in my purse and I swayed on the street corner sucking it down, praying I would make it through the parking lot without collapsing. There weren’t many cars out, but I stood on that corner for a few minutes staring at the one way street I wanted to cross, the one way cross-street with oncoming traffic, and the street lights trying to convince myself that it was safe to step out into the street and not get hit by a car. I was scared that I would be confused and step in front of a moving car by mistake. I had to chuckle, though, at the image of me standing on the corner, swaying like a drunk, and all the people in their cars hoping I wasn’t too drunk to step out in front of them suddenly.

I finally made it into the store and went straight to the bakery section. I knew where I was at the time, but I was unable to recognize my surroundings. Thankfully, I shop at that store often and I was able to subconsciously find my way to accessible carbohydrates. There was one chocolate donut in the bakery case and I reached in and put it in my mouth without pausing. I was into my second bite when I looked up and saw a young woman behind the counter staring at me with a look on her face. She asked if I needed help and I simply shook my head as I went for a third chunk of chocolate donut to stuff in my mouth. I thought about twisting my arm so she could see the med alert tattoo I have on the inside of my right wrist, but, even in the midst of confusion from a bad low, I knew it was useless to try and explain WHY I needed to eat that donut as if my life depended on it.

It has been years since I’ve had a low bad enough to incapacitate me, or cause me to be unable to administer a correction without assistance. Most of the time, I hate sharing these stories because I hate how they make the non-pancreatically challenged people around me react. Either I am bombarded with suggestions on what to do to take care of myself, or with suggestions on how to prevent it from happening again–all of which are useless because they come from people who have never had to count a single carb in their entire life. Friends, family, strangers on the street…it doesn’t matter who it is, I hate being told what I should be doing by people who are not diabetic.

So I joined some online diabetic communities thinking I would be able to connect with people who could easily understand what I am experiencing. Unfortunately, it isn’t that easy, even in the virtual world.

I joined the Latent Autoimmune Diabetes in Adults community on Facebook thinking I had finally found the population of diabetics who would understand me and my particular circumstances; not adults who had grown up fighting diabetes, and not parents of children who are fighting diabetes, but other adults who had to wake up one morning and start living their adult life as a diabetic. I thought the fact that people seemed to post questions and comments meant that I had found a way to connect with people who shared a compatible need for connection and communication. Instead, I found a community of people who seemed to whine as much as type 2’s: When will I have to start taking insulin? How do I prolong my honeymoon? What should I eat to not have to take insulin?

None of these questions concern me or my experience with diabetes. I was completely dependent upon insulin from the first moment I learned I was diabetic. My pancreas and I never had a honeymoon. I never had the option of eating anything that wouldn’t raise my blood sugars. Hundreds of diabetics from across the planet are able to connect with each other and share the experience of trying to avoid taking insulin with their food. I wish I could be one of them, but I never will be.

24-hour graph with peaks and valleys, but all within a decent range

I posted one question to the community in search of other brittle diabetics like myself with a picture of my 24-hour graph showing extreme peaks and valleys in my glucose levels. I had a few people suggest I eat less carbs (without asking, of course, what my normal routine of low-carb cooking was) or suggest that I not eat so many carbs for a correction (not knowing that a 21g granola bar has the ability to send me from a 52 to 257 in less than thirty minutes). Again, I was simply receiving advice from people who are clueless, only this time they also have a malfunctioning pancreas–only their pancreas still works well enough to allow them the hope of thinking they may not need to become dependent upon insulin before the cure is found.

I didn’t get very many responses, and none of them truly helped to make me feel connected, but I did have one very interesting exchange. One woman had posted a picture of her 24-hour graph stating she “wasn’t very happy” with it: a long steady line that had a small bump going up to 175 and coming back down. My peaks had easily reached upwards of 350 and my valleys were down in the 50’s, so when I read her comment I wanted to smack her through the internet and hopefully knock some sense into her. Instead, I tried to be courteous by replying, “Damn! That looks good to me. I’m jealous!” Another women commented a few hours later berating the first woman for being so insensitive as to complain about her graph. I thought, “Finally! A chance to start a conversation!” but, before I could respond, the entire conversation thread was deleted. Great. So, not only am I still not connecting with people who are able to share similar experiences, but now some invisible and disconnected individual is censoring my post and disallowing me the opportunity to engage in a meaningful conversation that, at the very least, has the potential of increasing other people’s awareness and perceptions about diabetes.

I have finally come to accept that there is most likely not another diabetic in the world who can easily comprehend or share in the particularities of my personal brand of diabetes. As much as the memes try to remind me that I am not alone, I nevertheless feel very lonely in a world where my experiences are incomprehensible to everyone else. For example, last night I went out for dinner and drinks with a good friend and I slightly overestimated my carb count for the calamari.

By nine o’clock my cgm started vibrating and beeping while we sat next to the fire in my yard. I was at 42 and felt perfectly fine. I started counting backwards from 100 by three’s and didn’t miss a beat. I told my friend I should maybe count back by four’s since I’m used to testing my coherency with three’s–I still did not have a problem doing the math. I started ranting about how frustrating it is to be so damn low and not feel a single symptom to give me a warning. I went inside and pulled out my stash of emergency carbohydrates: applesauce and dried fruit. I wasn’t the slightest bit hungry since I had eaten a full meal earlier at the restaurant but I drained the applesauce packet while ranting about the need to eat when I’m not hungry, and the fact that I have to waste so much garbage by using single serving pouches to accurately control my carbohydrate intake. This is not how I want to live my life, but what choice do I have if I want to stay alive??

Two hours after the first glucose test, 17g of applesauce, and no basal (I usually keep my temp basal for an hour at a time)

My blood sugar slowly rose up from the applesauce and I never suffered any confusion, loss of balance, or twitching muscles. My friend was scared because my numbers were so damn low, and I could tell I was acting a little erratically, but, overall, it was a hypoglycemic event that wasn’t much of an event at all. Definitely not the kind of hypoglycemic event that would have occurred for other diabetics who were to drop so low. Or, maybe, there are others out there like me; people who suffer alone, and in silence, thinking they are the only diabetic whose diabetes does not operate the way every medical professional who treats diabetes says it should. Maybe, just maybe, I’m not alone either. Maybe I’m not the only brittle diabetic who can accurately count backwards from 100 by three’s or four’s while suffering a severe hypoglycemic event.

The LADA Diva

Category: hypoglycemic event

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