Memories; The First Low

Diabetes Blog Week Prompt, Day 3: Today we’re going to share our most memorable diabetes day. You can take this anywhere.... your or your loved one's diagnosis, a bad low, a bad high, a big success, any day that you’d like to share. 

I love that these topics are really getting me thinking...there have been so many diabetes memories, both good and bad. I could post about Dylan's diagnosis. Or about Cyclebetes, the cross-Canada cycling event I was lucky enough to participate in not once, but twice. I could write about one of the many amazing JDRF events we have partaken in, or about the day we started pumping. All worthwhile choices.

But no. Today, the memory that keeps flashing to the forefront of my brain, is of Dylan's one, and only, REALLY bad daytime low. Sure, he's had hundreds of lows, in fact, lately he gets them daily. But this low...this bad boy was different. It had attitude. It was the type of low that keep a d-parent living in fear. The type of low that makes you want to hold on to your child and not let him or her out of your sight. EVER. 

One day, within the first year after Dyl was diagnosed (he was 4 years old at diagnosis), he was spending the day with grandma at her house, which is about a 10 minute drive from our house. (For the record, she is and always has been knowledgeable about Dyl's diabetes, and is one of the few people I've always been comfortable leaving Dylan alone with.) After spending the afternoon together, she was driving him home when she decided to make a quick stop at the library to drop off a few books. She pulled up in front of the building and noticed Dylan had fallen asleep in the back seat of the car. Side-note: this was a very common occurrence, and still is now. Dylan frequently falls asleep within the first minute or so of travel time. Knowing this, she left him in the car and ran the 10 or so feet to put the books in the outdoor return slot. She hopped back in the car and drove to my house. When they pulled in our driveway I could see her, from the kitchen window, struggling to get him out of the car. Again, this wasn't uncommon. He would sleep so soundly for short drives, that we would often have difficulty rousing him once we reached our destination. I saw her pulling him out of the booster seat and trying to get him to walk up the flight of stairs to the back door. And that was when I knew something was very wrong.

Normally Dylan would be disoriented after snoozing in the car, but he would still semi-wake up and stumble into the house. This time he wasn't. My mom was literally dragging him; she had both arms hooked around his chest in a sort of sideways embrace, and was attempting to pull him up the stairs, his legs and feet dragging behind. As I opened the door to help her, she apologized, explaining that he had fallen asleep in the backseat and she couldn't rouse him. 

I immediately knew the truth. He wasn't sleepy, he was hypoglycemic. Between the two of us, we brought him inside and sat him on the couch. I tried, unsuccessfully, to give him dex, but he wasn't responsive enough to chew the tablets. I grabbed a juice box, rammed the straw through the metal hole, and squeezed the juice up through the straw so that it dribbled slowly into Dylan's mouth. For the first few seconds, he didn't swallow, the juice running out of his mouth and down his chin, spilling onto his t-shirt. Then suddenly, as I was about to prep the glucagon for my first real use, he swallowed a few sips of juice. Then a few more. And slowly, as if by magic, the life returned; the color slowly returned to his cheeks, the clarity to his eyes, and the control to his limbs. He was back. 

Nothing, I repeat, nothing, can prepare a parent for that experience. I thought I was ready - I had done all the training, been through the procedures, I knew what to do in an emergency. But nothing I had read or studied could have prepared me for the real deal. That afternoon was the first time I TRULY understood just how unpredictable, powerful, and terrifying, diabetes could be. 

What is Type 1 Diabetes?

Day 2 Prompt: Introduce your condition(s) to other Health Activists. What are 5 things you want them to know about your condition/your activism? 

When people learn that my 12 year old son has type 1 diabetes, the usually make certain assumptions about that the disease is, or where he "got it" from. Sadly, misconceptions are rampant when it comes to type 1 and the volume of incorrect information floating around is abundant. Sometimes it seems easier to tell people what type diabetes IS NOT, rather than what it is. 

It is NOT:

• caused by eating too much sugar, either as a child or adult, or by sugar at all
• caused by any lack of care or neglect on the part of a parent or caregiver 
• a casual disease that comes and goes. It is 24/7/365.
• a result of being obese or overweight, nor does it have anything to do with weight at all
• contagious, meaning you can't "catch" it from someone else
• a disease with diet restrictions. My son can eat chocolate, sweets, starchy foods, and sugar, just like your child (though when eaten in excess it WILL cause cavities, and lead to obesity and other health issues, just like in your child). We just need to balance his carbohydrate intake with insulin.
• curable.

Type 1 Diabetes is an autoimmune disease in which the insulin-producing beta cells in the pancreas are destroyed, causing the body to stop producing insulin, and blood glucose levels to rise. Without insulin, the body cannot survive, so type 1 diabetes IS fatal if untreated. Fortunately, it is treatable with insulin, which can be delivered either via syringes or subcutaneously using an insulin pump. While insulin therapy is far from a cure for type 1 diabetes, it provides patients with a tool with which they can live a long and healthy life.

It is a disease that never sleeps. It IS manageable, but with vigilance and constant care. Blood glucose levels must be checked throughout the day and night, and insulin must be given multiple times per day to keep blood glucose levels within an ideal range. Variations in blood glucose levels throughout the day are to be expected, but readings outside of the target range (highs and lows) should be treated immediately. Food intake must be closely monitored (carbohydrate intake causes a rise in blood glucose), as do activities that burn carbohydrates, such as exercise. Other factors that can, and do, affect blood glucose, include temperature, stress, illness, and hormones.

There is no cure for type 1 diabetes, so utmost attention to diabetes management is critical and lifelong.

Ok, so that's a few more than 5 things. It is what it is.

Exercise Induced Lows

Today's NHBPM prompt asks for a descriptive account of a memory. I've deviated a bit from the task, and written more of an evolution of a problem, rather than a specific, one-time memory.

In case you're not familiar with my blog, or my story, let me start off by stating that I do not have diabetes. My 11 year old son, Dylan, was diagnosed with type 1 diabetes in November of 2005, at the age of 4.

I, however, have struggled with hypoglycemia for as long as I can remember. Throughout my childhood and teenage years, low blood sugar was a regular occurrence for me. If I skipped breakfast, my blood glucose would tank by 10:30 or 10:45 am and I would start shaking uncontrollably until I ingested fast-acting sugar. I slowly learned the importance of breakfast, but then in my twenties, the causes of my hypoglycemic episodes expanded. Suddenly I couldn't handle large amounts of simple carbs anymore. I had to eat protein at every meal and keep simple carbs to a minimum. Over time, it became an easily manageable problem.

In my late twenties I took up running and at first everything seemed ok. But as my endurance increased and my runs consisted of 10-25km each, I was faced with a new cause of hypoglycemia: inefficient carb-loading. For the first few years of my running career, I could get away with a pre-run snack of a banana and a whole wheat bagel with peanut butter. And I would carry a bottle of Gatorade, and a tube of dextrose tabs, with me at all times to cover my regularly occurring mid-run low. That worked for a while.

Then last year the lows became more extreme. Suddenly the recovery got slower and I would feel weak and shaky for half an hour after treating the low, making the rest of my run near-impossible. At this point some people might have considered giving up running, but I love it. And not just for the exercise; running is my stress relief, my time to myself, and my time with nature. So I gave up the nature part and started doing all of my runs on my treadmill. Boring, yes, but still effective.

In May 2012 I got involved with the 90 day challenge and everything changed. The shakes I was drinking daily left my blood sugar stable all day and my lows stopped happening. Suddenly I could run outside again, plus I could run faster and further than ever before. It was amazing! I went 6 months without a hypoglycemic episode...until today.

I upped my exercise regime quite substantially this week, adding some intense strength training, and speed intervals to my running. The increase was clearly too much too fast, and my body responded with a brutal low. It kicked my butt. I had to stop moving, take in 45 grams of fast-acting carbs and wait half an hour before feeling somewhat better. I had almost forgotten how scary it feels during that waiting period. Almost...

The First Time I... ~ HAWMC, Day 28

The First Time I... Write a post about the first time you did something. What is it? What was it like? What did you learn from it?

The first glucagon shot I ever administered to Dylan was one of the scariest moments of my life. Dylan was having his second hypoglycemic seizure (though his first with me; he was with his father the first time he had a seizure). I had been trained on administering glucagon way back when Dylan was first diagnosed with type 1 diabetes, but had never actually needed to use the shot.

The rest of this post is an excerpt from the previous post Dear Seizure. It has been adapted slightly.
"I rolled Dylan onto his side as best I could, while trying to console my daughter, who was 4 at the time, and sobbing, while my husband raced downstairs to the kitchen to get the glucagon shot (in hindsight, I now keep one in my bedside table). He couldn't find it. "What does it look like?" he called from the bottom of the stairs. "Hurry," I screamed, "It's in a long, thin white box."

OMG, in that brief time, I thought I was going to lose my son. I have never been so frightened. I sat there helplessly watching my baby seize, unable to do anything to help him. Suddenly my husband reappeared in the doorway and I felt the hugest sense of relief seeing him standing there with the diabetes supplies, while I thought, "We weren't too late." He had been unable to locate the shot itself, so he brought upstairs the entire rubbermaid container, in which we keep ALL of the diabetes supplies, and dumped it out on the carpet. I grabbed the glucagon and began to prep it, desperately trying to remember my diabetes training from almost 2 years prior, when the nurse had shown us how to prepare the shot.

My hands were shaking so badly and everything around me seemed to be spinning. I was crying. The only thing I could think of was "please don't die, Dylan, please don't die." I tried to stick the needle into the vial and hit the metal rim instead of the rubber dam. The needle bent to a ninety degree angle, but it didn't break off. I pulled it back straight and tried again. It went in. I shot all of the water in and shook the concoction, way too quickly, and it was all bubbly and foamy. I didn't care, I was desperate and my baby was still seizing. I drew at much as I could into the syringe and when I saw that the syringe was half full, I rammed the needle into Dylan's thigh so hard that if he could have screamed, he certainly would have. I injected what fluid I had in the syringe and then repeated the process, drawing up the last bit of glucagon in the vial and injecting it into his thigh again.

Finally, after what seemed like an eternity, the seizing slowed and then stopped. Dylan was still unresponsive, but after a few minutes his eyes started to focus and he looked at me. In that moment I knew the seizure was finally over. It would still be a long night ahead, as I monitored Dylan and checked his blood every 15 minutes for the remainder of the night, though within 30 minutes of the glucagon shot, he was up to 16.9 mmol/dl (304 mg/dl)."

Running & Low Blood Sugar

Currently I am training to run a half marathon in early May; well, that is the goal anyway. Over the past few days I have started to accept the fact that it just might not happen because I may not be ready in time. I HATE HATE HATE the idea of putting it off, but I ran a half last year totally unprepared, and promised myself I would never do that again.

Why is there a chance I won't be ready by May? It's not for lack of trying, or because of missing motivation. It's not even due to fact that I've been super busy lately. It's in part because of injury (I strained my lower back about 2 weeks ago and it has been a slow recovery), but mostly because of crappy blood sugar.

Running has become scary for me lately. It seems that on almost every run, my blood sugar bonks about 20-30 minutes in. I've tried adjusting my pre-run meal, but have seen little improvement. I've tried downing masses of juice immediately before going out, and while I'm sure my blood glucose rises pretty quick, it plummets even faster. The result? Shorter runs, and too many runs on the treadmill, where I can keep a bottle of dex tabs beside me at all times. Too bad that all the 30 minute treadmill runs in the world aren't going to help me run 21.2 kilometers on the road.

Frustration is mounting. I love running, but these lows come from out of nowhere. One minute I feel great, and the next I am shaking, dizzy, and unable to put one foot in front of the other. It sucks. So I am testing out a new (to me, not new to the market) nutritional supplement/protein powder that claims to do wonders for balancing blood sugar levels. It's low calorie, high protein, and is loaded with vitamins and minerals. I officially start taking it next week, when I get back from my mini spring break vacation, and will take it every day prior to training. But out of curiosity, I took some this afternoon and jumped onto the treadmill for 30 minutes. 15 minutes came and went, no low symptoms. 20 minutes, 25, and 30. Not only did I not feel even slightly low, I felt fabulous. I ran 0.2 miles per hour faster than I have been lately (not much, but hey, it's something) and I finished the half hour knowing I could have run another one. This supplement is looking good so far. The real test will start next week when I begin taking it daily.

Symptoms of Hypoglycemia

Dylan describes his lows as getting "weak knees," meaning that his legs feel like they're going to give out. He also gets shaky, and very pale, with pronounced dark circles under his eyes. Very different from how I feel. (See Exercise Induced Hypoglycemia from earlier this week) In fact, the symptoms of hypoglycemia can vary considerably from one person to the next, so it's critically important to be aware of all of the various possibilities.

When Dyl was first diagnosed, his endo gave us this awesome sheet with pictures of what hypoglycemia can look like, and a similar picture is on the wall in Dylan's classroom, so that his classmates are familiar with how he may appear with low blood sugar.

Any or all of these symptoms are possible, as are others not on this sheet. In fact, symptoms of hypoglycemia can be mild, moderate, or severe, and may include any or all of the following:

Mild Symptoms...

• sweating
• shaking
• hunger
• pallor
• dizziness
• headache
• mood changes

Moderate Symptoms...

• irritability
• blurred/double vision
• confusion
• poor coordination
• headache
• fatigue/sleepiness
• nightmares (if sleeping)

Severe Symptoms...

• unconsciousness
• convulsions/seizures
• coma
• (and if not treated quickly, death)

Know the signs.