In which we complain about bloodsugar induced panic attacks …
I doubt this is terribly important, but I want to at least reach out to those other people with type one diabetes and see if they, too, feel panicky when their blood sugars are low. Yesterday I had about fifteen of them. This is a problem.
Granted, I have been feeling a lot of lows for the last few weeks. Sometimes I do the wrong thing, and manufacture higher glucose (like in the 200s) reads in order to not have to deal with the lows, to not have to drink another juice (which I am growing to hate). I’ve also been experiencing a lot of high energy and optimism which is causally pointable-outable to several factors. Life is going well for me; I’m alive and hungry for more of it.
Yesterday morning I woke at 6:00 a.m., bouncing out of my skin as usual these days. By about 8:00 I was ready to use the energy in a health-preserving way. I checked my sugar and it was in the 180s (it was in the 90s when I woke up). Not trusting it to stay stable simply by wishing it to be so, I ate a half sandwich, lowered the basal rate on my insulin pump (to 25% for 2 hours) and headed out for a 3 mile walk at 9:00. A half hour into the hike it was 146. I drank a juice. 45 minutes into the hike it was, again 146ish (really close). I considered another juice, but I was hoping that the half sandwich, the original 180 BG, the lowered basal, and the current juice would hold me through the rest of the hike. It did.
But, despite my munching and no-schedule day, I had sugars in the 80s an 90s all day. At one point it was in the 200s so I gave a correction bolus … which later resulted in another low. Very uncomfortable. Throughout the day I ate fruit, salads, cheese, nuts, french fries, and chips and salsa. Granted, I didn’t eat as much as I should have, and i just snacked rather than having a proper breakfast, lunch an dinner (befitting of a single woman without children). The exercise and the general high-energy status quo of my body-mind kept me in need of all of the sugar I could take, but I seldom have such constant need for juice. I also find that I don’t necessarily need that much food, on days when I am working, at least*. Stress seems to add about 50-100 to my glucose levels, but I haven’t tracked this exactly. Yet.
By evening I was fighting. My heartrate was up and I could not get to sleep. I cried several times and felt the kind of fear one feels in a panic attack. I could barely control the worry thoughts relating not only to diabetes but also more social aspects of my life. I checked my sugars two more times and drank more juice and lowered my basal to 15%, hoping to get the blood glucose level a little higher so I could actually sleep through the night. When I woke the next morning it was 78.
The funny part of this to me is that while on my bouncy-wonderful walk in the morning, I was drafting a letter (in my head) to the CEO and President of the medical organization which employs my family doctor, my endocrinologist and my ophthalmologist in order to express the gratitude I feel toward these people working so hard to help me get diabetes to a level of control I need and want. I had a somewhat disappointing appointment with the endocrinologist recently. I presented him with a handwritten account of day-to-day happenings with my glucose for about a week in the hope of understanding patterns better, but it didn’t seem to impact his thinking much (though I don’t really know). Still, we’ve agreed to have me wear a Continuous Glucose Monitor (CGM) for a week later in August to track the numbers more closely and go from there. I also had a stunning annual physical with my family doctor and it looks like I am doing really well in all other health categories besides the one which concerns us all the most. That morning, ironically, the nurse for that doctor had to fetch me a juice before the physical because I was low.
So, more science is needed. In a way, I am grateful that I am feeling lower rather than higher. I am happy that I have high energy rather than low. I probably wouldn’t be publicly sharing about a day of high glucose, and there have certainly been those before too. Those don’t seem as life-threatening in the moment, though, as any person with type one diabetes will agree.
As I was laying there in the night watching my mind run away with my heartbeat eating the little sugar I kept giving it, I couldn’t help feeling so alone. I thought about texting a couple of friends, but didn’t want to make it their problem. Plus, it doesn’t matter how much I try to explain myself when I am suffering in this way, it gets so confused because of the complexity. Doctors like to look at the numbers, and derive conclusions from those. I provided numbers to my Endo in narrative form, and when I expressed frustration with the phrase, “I feel like … ” he replied, of himself, “I don’t go off of feelings (presumably referring to his preference for numbers).” So I picked up my sheets of paper and, once again, to show him the map of my daily experience. But it’s just too exhausting … trying to explain to an outsider what I can only feel on the inside. My friends and family would do their best, I know, and offer questions and support, but why burden them with an unending mystery I will be attempting to answer all of my life. They risk my frustration at them, for not understanding — but really, really wanting to — which causes me to not reach out to them. If I turn my inner experiences into a social enterprise, much is lost in the translation. Especially regarding what it all means to the experiencer …
Phenomenology. Next chapter.
So I cry now, thinking of this particular breed of loneliness, and how it reminds me of other ways I feel alone. I know I am not though. I’m still optimistic. Life is better than it was this time last year and the year before. I am winning at health. For today, at least.
(*Still trying to map out my needs based on day-off and working day phenomena. A lot more consistency is what the doc orders, which is difficult in my line of work, but I’ll try. Also, I can’t easily obtain the exact numbers written here, so these are pretty fair recollections instead.)