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I was low on Saturday. For hours and hours of Saturday. I cannot tell exact numbers for the exact time because on Friday my CGM sensor died and I removed it ceremoniously (i.e. ripped it off in the shower) and didn’t replace it. A few BGL checks give me some information, but not a complete picture. Because that’s the imperfection of modern BGL meter technology.
At about 6pm as the kiddo and I were sitting down to our 145th 6th episode of the Gilmore Girls for the day and eating home-delivered noodles out of a box I started to feel crapola which is the a highly technical term for ‘jeez, I’m low’.
BGL check showed that I was about 2.7 on the crapola scale, so I downed a juice box, and ate my way through my carb-laden noodle box. That should have fixed it. Several times over. But it didn’t.
At about 10pm when I was thinking that an early night was in order (because: effing jet lag) I started getting ready for bed and realised that I was low. Again. Or still. I wasn’t sure. Another juice box and I figured I’d be right.
And then an hour later, warm in bed, reading some Truman Capote, I was still sitting just under 3.0, so I drank more juice. By this stage, I was pretty sure that spikes were about to start growing out of my head. 
Around 12.30am when Aaron got home from his gig, I was sitting up in bed, munching jelly beans.
‘Hypo?’ he asked.
‘Yep. For hours.’ I said. ‘Hours and hours.’
This was one of those lows that is so non-eventful. It is what healthcare professionals and all diabetes books refer to as a mild hypo because at no time was I in any way afraid that I couldn’t manage it myself. I just munched on or chugged down glucose, willing my BGL to get moving upwards.
I didn’t feel scarily low – there was no profuse sweating or shaking or numbness. I felt slightly woozy when I stood up or moved suddenly, but nothing scary. My heart rate didn’t increase. I didn’t feel out of control. I wasn’t afraid.
And it was all for no apparent reason. Hard as I tried, I couldn’t explain why the low just would not budge– I’d not done any sort of prolonged physical activity or forgotten to eat. I’d barely bolused for my uber-carb meal.
If I had sensor in, the squiggle would have been pretty straight for hours and hours and hours – frequently dipping below the low-alert level into the nasty red part that would have had alarms squealing and me swearing.
But all I have are a couple of BGL checks with numbers in the 2s and 3s until I decided I was sick of looking at numbers in the 2s and 3s so stopped checking. Plus I was feeling better.
The next morning, there was no reminder of the night before. I woke up without a hypo-hangover. No headache. No screaming high BGL. In fact it wasn’t until I looked over to my bedside table and saw the empty juice boxes that I remembered. I got up and collected the remnants for the recycling bin. Just another day. Another night. Another hypo. Nothing to see here. Boring as all get out.
Today, I am at the Diabetes Victoria and Baker IDI Health Professional Symposium and the first session has me thinking – and sitting down the back of the auditorium banging out this post.
The keynote presenter for the Symposium is Professor Herzel Gerstein talking about hypoglycaemia. He made a wonderful point in the Q and A portion of his presentation, one that I think is frequently overlooked.
The language (yes, I’m talking language AGAIN) we use around hypoglycaemia is misleading at times. Generally, we have severe hypoglycaemia and mild hypoglycaemia.
Severe hypos refer to those we need assistance to treat. It may inolve unconsciousness or seizures. Severe hypos sometimes need paramedics’ assistance, or a trip to the hospital.
Mild hypos are those that we can manage ourselves without too much hassle.
The problem with using these two terms is that it makes it sounds as though mild hypos are nothing. They’re just a part of living with diabetes, deal with it, off you go.
That may be the case in practical terms. A so-called mild hypo may mean grabbing a handful of jelly beans, waiting a few minutes and then off you go. Or it might be slightly more than that and take longer. But whatever it is, it’s termed ‘mild’ because no assistance was required.
But the thing with ‘mild hypos’ is that they do have the potential to weed their way into your psyche and suddenly become very significant.
If those mild hypos mean that you are often running late for things, you start to wonder if others are questioning your reliability. If those mild hypos have you needing to sit things out for a moment, you worry your friends or your kids or your family think you are disengaged, not wanting to participate. If those mild hypos result in you being a little vague for a while in work meetings, you start to fear your boss or colleagues think that you are not paying attention, not interested, don’t understand.
These are not ‘mild’ things. These are really significant and mean worrying and stress and anxiety and anger and sadness and fear and guilt and all the other things that diabetes makes you feel. There is nothing mild about it!
I think this is a really important issue for healthcare professionals to remember. By brushing away mild hypos as just a short-term-complication-everyone-has-them notion, the actual impact on the person living with diabetes is ignored. it’s minimising just how big a deal mild hypos can be and not providing any strategies for coping and managing with the emotional side of these episodes.
A mild hypo may not necessarily be terrifying in the moment, it may be quite manageable at the time, it may not affect anyone else or draw too much, if any, attention to the person having the hypo. And this is good!
But don’t for a minute think that it doesn’t mean a silent feeling of dread (and possibly a silent word of thanks to the hypo gods that it was nothing more!) or feelings of significant distress afterwards.
Last week, I tweeted that I really should start a new Twitter account that tracks all the stupid things I have done (and continue to do) while having a hypo.
I’ve spent the last couple of days collating just a few of the things I have done. These are recent things. I think, perhaps, I have managed to wipe out a few memories of other stupid things I’ve done when low.
- Stood with the fridge open, staring at juice boxes, jars of jam, and bottles of full strength soft drink for 10 minutes while eating a cucumber. Because that is the perfect way to bring up those BGLs really, really fast!
- Sorted through M & Ms, removing the green ones that I had convinced myself would lower rather than raise my BGL. I’ve done this many times.
- Referred to my daughter as a penis. Kind of. One day, just before we went overseas at the end of last year, I had one of those days where I just could not get my BGL above 4mmol/l. I was rushing around trying to tie up loose ends before we left. I asked the kidlet to help me with something and when she finished and I went to thank her I got a little confused. We have many nicknames for our girl. Two of my favourites are ‘Sweet Pea’ and ‘Sweetness’. In my hypo-fug, I said ‘Thank you Sweet Pea-ness’. As I wrote in the text message I sent to Aaron just after I said it: ‘Say it out loud.’ (She reminded me of this just yesterday. And then felt the need to tell my parents about it when we were visiting. Add this to the list of things that have me in the running for ‘mother of the year’.)
- Written on the wall in the kitchen.
- Stood at the juice aisle of the supermarket repeating ‘Drink the damn juice, Shelby.’ Go ahead and imagine the looks of the people around me.
- Just the other day I poured my morning coffee over my jeans. While I was trying to take a mouthful. How? Really, how is this possible? My legs and my mouth are nowhere near each other!
- Answered the phone. In Italian. If you ever call me and hear me pick up with ‘Pronto’, know that I need sugar. Stat.
- Cried uncontrollably. Just because.
- Laughed uncontrollably. Just because.
- Bored a service station attendant almost to tears, gushing because I had discovered he sold green apple Mentos. The conversation went along the lines of ‘ Apple. Mentos. You have green apple Mentos. I love green apple Mentos. I’ve never seen them in Australia before – only in France. Actually, I’ve not really seen any green apple sweets in Australia. It’s not really our thing. Is it? But in France? They love it. There is green apple everything. Did you know that? Okay. I am going to buy some of these. A lot of them. All of them. Can you just sell me all of them? Whatever you’ve got – I’ll take it!’
- Yeah, so bought about 40 tubes of green apple Mentos.
- Had to call out to a sales assistant to help me get out of a dress I was trying on in Seed. I simply could not work out how to undo it and lift it over my head. (Thankfully, the staff at the Carlton Seed store know me well…)
- Sat on the dog. I do this all the time when I am low. It’s as though my hypo-brain stops registering small fluffy animals as things to not sit on. Jasper now just looks at me as if to say ‘Again?’ The puppy is still indignant about it.
- Tried to remove a just-baked cake from the oven. Without oven mitts. Didn’t end well. For my hands – or the cake for that matter, which was dropped on the floor, fell out of the (hot) tin and crumbled on the floorboards.
- Used a whole bottle of shampoo washing my hair in the shower. I stood in the shower for over half an hour washing, rinsing, washing, rinsing, washing, rinsing, washing, rinsing until there was nothing left in the bottle. Low blood sugar = very, VERY clean hair.
- Rearranged furniture. Because hypos sometimes (and somehow) give me superpowers, it is the right time to move a couch, or a (full) filing cabinet, or a bookshelf (no need to remove the books). And of course, there is no way that this exercise will result in a further lowering of BGLs, will it? Of course not! (Hypo boy does this too!)
- Gotten ready to go out and left the house wearing shoes that didn’t match. In my defence, they were both black.
Thankfully, there are many things I’ve NOT done while hypo. I am pretty committed to the ‘Treat before you Tweet’ mantra and have managed to stay off social media when my (already limited) filter has the potential to go completely AWOL. I’ve said a few not-too-nice things to/about ‘wellness experts’ when not hypo; I dread to think what I’d say if I forgot to keep myself nice.
Okay – you’re turn. What are some of the things you have done whilst low? Go!
I am on a 7am flight to Adelaide for a day-long meeting. This is just plain rude and given that I’m on about 5 hours sleep (self-inflicted), I am coffee-d up to my eyeballs just so I can stay awake.
So, on the flight, sitting in seat 15B, I have had a little snooze, (maintaining my ‘only ever been awake for take off twice’ record by being sound asleep as we taxied and took off), and am now staring, zombie-like, at my iPad trying to make sense of the words I am typing. (Good luck to the nosey woman in seat 15C who is totally not surreptitiously reading what I am typing.)
And I’m yawning. A lot.
Recently, I have noticed a new hypo symptom. When low – having dropped slowly, I get very yawn-y. It happens completely out of the blue – a sudden onset of lazy, gaping oscitancy.
The first time this happened, I was with friends and all of a sudden, it started. I couldn’t stop yawning. One after another after another. I kept apologising, saying that the last few late nights must be catching up with me.
Shortly after, I checked my BGL and I was low – not staggeringly so, but low nonetheless. As soon as I treated and my BGLs rose, the yawning stopped and I felt fine.
It happened a few more times before I put two and two together. Sudden yawns = slowly decreasing BGLs.
When it happens, there are absolutely no other symptoms. The shaky, sweaty adrenaline rush hypos that come from either a rapid drop, or waking up suddenly overnight are completely absent. Instead, it’s a listless, snail-like feeling of sluggishness and a realisation that I am yawning. A lot.
This new low symptom is manageable and now that I have worked it out, I can use it quite effectively. As soon as I notice the yawns have started, I treat.
As someone who at times has impaired hypo awareness – love it when a BGL check shows a 2.5mmol/l and I am feeling perfectly fine – I’ll take any symptoms at all. And for me those hypos that sneak up on me are particularly symptom-less. So this is quite a welcome new development.
Of course, on days like today – when my day started on an early morning flight after a night of minimal sleep – it gets confusing. I’m yet to work out how to differentiate if a yawn is a hint I’m low. Or a silent scream for coffee.
I woke up on Saturday morning and for an exquisite 15 seconds, I didn’t remember the night before. Then I moved. Then my body remembered.
Gingerly, I swung my legs to the side of the bed so I could get up and to go to the bathroom. The pain under my left breast was making it difficult for me to breathe, much less move.
My feet gently touched the ground and I pushed myself to standing. I steadied myself and once certain I wasn’t going to fall over, I walked to the bathroom. Flashes from the night before running through my head.
Awake. Asleep. Awake. Asleep.
Forcing food down my throat, falling back to sleep.
Waking and feeling like I was drowning.
Not being able to remember which way to turn from our bedroom.
Trying to stand up to get to the kitchen and not being able to support myself.
Finding myself in the kitchen staring at an empty bottle of orange juice.
It was the middle of the night. The kidlet was, thankfully sound asleep and didn’t stir, despite my crashing and clumsy movements. At one point, I dropped a glass on the wooden kitchen floors, but even the loud crash didn’t wake her.
Aaron was at a gig and still hours from home.
After almost two hours, I started vomiting. My BGL was still sitting under 3mmol/l. I lay down on the bed and thought that I would need to get to the hospital.
Eventually, I called my parents and asked them to come over, thinking that one could stay with our daughter while the other took me to A&E.
By the time they arrived, I was a mess. I couldn’t stop crying; I felt nauseous and faint; my heart was beating fast and hard in my chest and I breathing was difficult.
‘Renz, darling. What do you want us to do?’ they asked. ‘Do you want to go to the hospital?’
I didn’t know. I didn’t know what was the right thing to do. I couldn’t concentrate enough to make a decision. I was distracted and kept thinking about what would have happened if I had passed out on the floor in the hallway, crashed to the ground and had the kidlet wake to find me there. I felt guilty for getting my parents out of bed and out of their house in the middle of the night to rescue me – and then not be able to tell them what I wanted and what I needed.
I decided not to go to A&E. The thought of having to spend at least 6 hours on an emergency room bed was even more overwhelming than having to continue to deal with what was going on. The danger period seemed to be over – at least I was remaining conscious now.
At 3am, my BGL had finally hit 3.2mmol/l. It was three hours since I first woke and started eating. I still didn’t feel confident enough to sleep even though I was exhausted. I turned on the television, just in time to see Ryan Reynolds being attacked by a snake in Buried.
At 4am, just as the movie ended, my BGL was 4.1mmol/l. I felt it safe enough to go to bed.
I spent most of Saturday dozing, trying to rid my body of the aching and exhaustion and my mind of feelings of desperation. But they remained.
I had a constant headache that moved in waves from dull to pulsating. I needed to rest after doing anything remotely energetic. I mowed the front lawn – not more than a postage stamp of grass – and needed to lie down for half an hour afterwards. Pushing the hand mower back and forwards caused the pain in my ribs to throb.
I ached all over, I felt fragile and tears kept forming in my eyes. I looked at my daughter and had to keep pushing away the thought of her finding me unconscious.
By Sunday morning, after a good night’s sleep, I felt a lot better. I still had a dull ache in my head and a twinge in my left ribs. But overall, I felt better. My body had started to heal and I felt like I had some energy back.
I spent Sunday afternoon at a local street festival, enveloped by gorgeous food, loud music and bright colours. We sat and watched some Bollywood dancing and then climbed the stairs to an upstairs bar to hear a hard swinging big band belt out some Frank Sinatra (and this). Occasional flashes of being hypo would pop into my head and I’d smother them by distracting myself with the energy around me.
Today, a couple of days later, there are no lasting physical scars. The pain has gone. The nausea has gone. And the headache is no longer there.
But I am so fragile. I feel damaged and I feel broken and I feel beaten. I am frayed with exhaustion.
And yet. It’s another day. And I’m here. On I go.
Have a look at pretty much any diabetes website, and the instructions for treating a low blood sugar will look something like this:
Eat six jelly beans OR 100ml of lemonade (not diet) OR three teaspoons of sugar. Wait 10 minutes, recheck your BGL and if still low, treat again.
That is lovely and pretty and neat and sensible.
Hypos are not lovely and pretty and neat and sensible.
And hypo-brain cannot compute anything, much less how to measure out 100ml of liquid. Or how to count to six.
Also, waiting 10 minutes when you are pretty sure that you are about to die unless you mainline sugar is not gonna happen.
The reality of treating a hypo is messy, disorganised and agitated. It might look a little like this:
Eat six jelly beans. Then another six. Then another six. Oh, what the hell, eat all the jelly beans in the house.
Find lemonade. Try to open bottle. Cannot open bottle because cannot work out which end is the top and which end is the bottom of bottle. Eventually work that out and with superior hypo-strength, open bottle easily. Because you have been shaking bottle (trying to work out which end is up), lemonade explodes and splashes everywhere. Skull whatever is left in the bottle. Lick counter top of all lemonade. Look at the floor and consider licking the floor, but realise the dog beat you to it.
Open fridge and see that there is a juice popper in there. Unable to work out how to use the straw, so grab a sharp knife (possibly stabbing yourself in the process) and pierce a hole in the top of the box. Throw head back and squeeze contents of juice box into your mouth, and down your face and down your top (all the while convincing yourself that of course you look like a sexy swimsuit model in a soft-drink commercial!).
See a jar of Nutella on the countertop. Open it. Grab a spoon. Look at spoon. Realise spoon is superfluous. Use fingers and scoop chocolate-hazelnut goodness directly into your mouth. And around your mouth. And probably in your hair. And up your nose.
Decide it might be the time to check your BGL now. Meter shows result of 34.5mmol/l. You realise the blood on the strip is mixed with Nutella, lemonade, juice and jelly bean residue and therefore probably not accurate. Wash hands; wipe on legs. Re-check. 2.9mmol/l.
Clearly you are still about to die.
Open pantry door and curse yourself for all the healthy food in there. Grab a bowl of cereal, grab milk from fridge and pour over cereal, and force it down your throat, wishing that you had Crunchy Nut Cornflakes or Coco Pops instead of stupid, healthy high-fibre crap that tastes like cardboard, but you have convinced the kidlet is delicious and the best possible start to the day.
See half-empty packet of dried apricots. Cannot ever remember buying a packet of dried apricots. Cannot focus eyes to see use-by date on packet of dried apricots, but assume they do not ever go off. Eat three of them before realising that dried apricots should probably be orange in colour, not grey. Throw remainder of packet back in cupboard. For use when next time low.
Notice a jar of honey. Open, throw head back, squeeze jar, emptying about 100ml down the back of your throat. Choke slightly.
Eat five nectarines. Swallow stones of two of them.
Pull flower off stem of gladioli in middle of kitchen table. Start to eat. Just because.
Look at sponge on sink and wonder if there would be any glucose stored in there that could help get this effing low over and done with. Consider eating it.
Start spooning sugar directly from sugar bowl into mouth. Lose count at spoon number 15.
Check BGL. 3.4mmol/l. Looking good! Decide to make toast just to be sure.
Eat toast spread 1 inch thick with jam. Also eat a dozen spoonfuls of jam straight from the jar. For good measure.
Collapse on nearest chair, realising you have just eaten your body weight in glucose. But still wonder if you have beaten this low.
THAT is the reality of treating a hypo: the frantic, adrenalin-fuelled grab for anything and everything in sight. There is no concept of having to deal with the aftermath – because we believe that if we don’t eat and eat and eat there will be no aftermath. With our heart thumping, our blood rushing and all our senses on heightened alert, we eat until we either cannot eat another thing, or feel confident that we have eaten enough to bring our BGL back up to a safe level.
To feel safe. That’s all we want. Desperately want. To feel safe.
The plan was simple – take the train into White Night; start at the northern end of the city, head south, check out all the attractions we came across and jump back on the train when we’d had enough. I figured that 11pm would be that point.
As it turns out, I was sitting in Hamer Hall at 11pm, watching Ghostly Machines and not even starting to feel at the ‘enough’ point.
In fact, I had my second wind!
Only an hour earlier, however, I was sure I was about to fall asleep standing up.
Around 7pm, just before we left home, I checked my BGL. It was sitting quite pretty at 6.2mmol/l. But because I am an incredibly smart and experienced person with diabetes, two thoughts ran through my mind:
- It’s warm outside – really warm. I will probably – nay, certainly – go low.
- Don’t forget hypo supplies.
Fast forward about five minutes as we were walking to the train station. ‘Hey,‘ I turned to my beautiful friend, neighbour and partner in missing islet cell crime. ‘Do you have any hypo stuff? I left mine on the kitchen bench.’ (See? Incredibly smart and experienced with diabetes.)
I was fine – I wasn’t low. But as soon as we got off the train, I decided that the three kids’ idea (i.e. constant pleas) of slurpees was a really, really, really good one and would serve two purposes – cool us down and stave off any approaching lows.
Half an hour post slurpee, I checked my BGL and the sugary drink had done more than prevent a low – 22.1mmol/l. Nice! Really nice.
So I bolused accordingly and didn’t think about it again for a bit, in the back of my mind thinking that I needed to make sure that the correction bolus did its trick.
We meandered along the Yarra, marvelled at the beautiful lily pads and watched them light up as dusk hit.
We watched the Bollywood dancers sashaying to wonderful music as they floated down the river on a barge, flashes of light flooding the Yarra’s banks in pink.
And we stopped by the food trucks for a quick snack. It was about 9.30pm by this time and we were all absolutely killing it! There was no sign of tiring yet. And I was feeling fine, so I figured that my BGL was fine.
Next stop was the National Gallery of Victoria and it was here, sitting on a carousel in the foyer area that a wave of exhaustion hit. It was sudden – so sudden! I started yawning and couldn’t stop. My legs felt heavy and my head was fuzzy.
‘I think I’m fading,’ I announced. ‘How about we stop for a coffee?’
We made our way to the café outside the Arts Centre. My head was getting fuzzier by the minute and the yawning was incessant. My mouth felt dry.
We sat down, waiting for our drinks and I pulled out my meter. ‘I think I must be really high. My body feels like lead. My BGLs must be stratospheric!’
Because I am smart and good at diabetes, I knew this would be the case. My mouth was dry, my legs were aching. I knew that there would be a number in the 20s. I knew that I was going to need a super correction bolus and two litres of water to deal with the thirst. In fact, I thought I could probably just pull out my pump and give myself a few units of insulin, up my basal rate for an hour or two and then I’d be right.
Because I’m good at diabetes.
As it turned out, I’m really not. My meter read 2.9mmol/l. I grabbed the soft drink that had just been placed on the table, gave an apologetic look to the kid who was about to drink it, (kids of mums with diabetes don’t even look phased when this happens!), and skulled half of it.
I dumped three sugars in my coffee and skulled that too.
I wasn’t high. I was low. Really low.
It was hot, we had been walking, I hadn’t had a drink since the slurpee (about two and a half hours earlier) – all things I didn’t factor into contributing to feeling thirst.
Within about 10 minutes, I was buzzing again. The yawning had stopped. I was wide awake and sugar-fuelled!
We headed into Hamer Hall and watched an incredible show of light, sound and movement on the empty stage. And then walked along Flinders Street, the beautiful old buildings lit up like magic. We wandered through a Melbourne laneway, lay down on the cobblestones and watched the projection on the roof of a building. And we heard more music and saw more movement.
I checked my BGL when we got home at around 1am: 6.2mmol/l. Exactly the same as when we left home. In six hours, my BGLs had put on a show, fluctuating between 2.9 and 22.1, starting and ending in the same place. I still had a great night. I still saw some amazing things. White Night 2015 was fabulous – despite the diabetes show.
White Night 2015. Beautiful, magical Melbourne.
Before even opening my eyes, I could feel it. It started in the pit of my stomach – a kind of fluttering – and rose to my chest, where my heartbeat started to quicken.
I was low. Not horribly so – I could comprehend where I was and what was going on. But nonetheless, I knew that I would need to act soon. Well…soon-ish. I snuggled under the doona focusing on my heartbeat; willing it to slow down a little.
Even though our apartment is warm – beautifully so – I didn’t want to have to remove myself from the warm bedding, put my feet on the cool parquetry and pad to the kitchen.
My eyes were still shut and I wished that I had a jar by my bedside full of jelly snakes – like I do at home – so I could just reach my arm out.
But I’ve not found any sweets here that I like to use to treat lows. Jelly Belly jelly beans take too long to chew, and often I find myself gagging as I chew, chew, chew before swallowing. Gummy bears are pure evil and leave the most horrendous after taste. And I don’t like over-the-counter glucose tabs. (This is where I remind myself that I should organise a Gluco Lift order before heading home…..)
No. I would need to get up, go to the kitchen and find something there.
I opened my eyes and turned to the bedside table to check the time. And there, right in my line of vision was a tall glass of orange juice. I sat upright, very quickly.
‘How did that get there?‘ I asked
‘I put it there,’ said Aaron, who was awake and reading a magazine. ‘You’ve been low a couple of times in the mornings, so when I got up to get myself something, I brought it in for you.’
I looked at him gratefully.
It takes a village – I’ve said it before. Diabetes is constant, it doesn’t end, and each and every day there are dozens of things I do to stay healthy and try to be on top of things. Most of the time, I just do them – on my own, without fanfare or even comment.
So, it’s little actions like this make me truly appreciative. It’s not ‘just a glass of juice’; it’s someone noticing something about my diabetes and doing something to help. Not because they were asked to – I am pretty sure that I had not even mentioned that I’d woken low a couple of mornings – but just because they thought it would help.
I guzzled the juice – downing it in just a couple of gulps – and cuddled back down into the warm bed. Within a short time, I could feel my heart rate had returned to normal and the fluttering feeling in my stomach had disappeared.
‘Thank you, hon,’ I said. I knew that he wouldn’t want me making a big deal of it (he would be the one saying it’s ‘just a glass of juice‘). But it made one diabetes thing for the day less of a pain to deal with.
Today is the first day of Summer, but in true Melbourne style, we’ve already had a few scorchers. Also in true Melbourne style it is pouring with rain right now and if you walk outside there is steam rising from the hot footpaths. Humid, muggy, steamy and sticky is the outlook for the day. I love this city!
The temperature yesterday was a sweltering 35 degrees Celsius. The hypo was relentless.
This is the 16th Summer I will have lived with diabetes. Actually, if you add in a couple of New York Summers as well, it will actually be the 18th.
That’s a lot of time to remember that warm and hot weather affects my BGLs. Alas, remembering is not something I am particularly good at.
Hence, the warm weather hypos.
Each year, I curse the arrival of the warm weather hypo. Each year, I spend a week or so at the beginning of the warm weather season wondering why I am chasing lows all day. Each year, I remember after said week or so that it is warm weather hypo season. Each year, I act as though it is a new phenomenon. Each year, I eventually remember what to do when this season is upon me and finally start to effectively manage the stupid lows. Each year, I also remember that I am not particularly good at diabetes.
Hot dry weather is different to hot humid weather. The humidity is worse for me because it causes me to perspire more. Getting sweaty is, amongst other things, a hypo symptom. At times. It takes a while – and a shedload of BGL strips – to work out if the sweatiness is due to the heat and humidity or low BGLs, (or other fun stuff in which case, I’ll possibly end up hypo anyway – digression…).
Overnight high temperatures result in overnight low BGLs. I am sure there is some mathematical algorithm to show this – something with lots of x=458690 jelly beans about convex segments, real valued functions or vector spaces of multiple dimensions or something – but I am not smart enough to actually understand what an algorithm is, nor really care what x equals. Also, did I just write vector spaces?
Warm weather lows are particularly sticky – they sneak up on me and then don’t leave. In fact, they can hang around for hours and hours. During one horribly nasty low, I drank two litres of pineapple juice over a three hour period and ate and ate and ate lollies. My pump was disconnected – there was absolutely no insulin on board. And still I was stumbling around 3mmol/l for most of the day. (In my stupor, I like to pretend I am cured of diabetes.)
Today – the first day of Summer – I am officially announcing it warm weather hypo season, which, of course, coincides with another season – the Christmas/holiday season. But believe me, when you think I am saying ‘season’s greetings’, I am actually saying ‘season’s eatings’ – and I am shovelling glucose down my throat and dreaming of bowls full of jelly!
I was standing at the counter of a beautiful patisserie. In front of me was a stylish French barista with his attractive French accent wearing his exquisite French clothes. He was trying to upsell me pastries to go with the coffees I’d just ordered.
‘Try the tarte tatin. Or the pain au chocolat. And the éclairs are especially good today.’ His voice sounded a little muffled as if coming through an antique speaker.
I agreed to a couple flaky pastries, one with jewel-like berries, another with apricot jam.
I was about to walk away when he said – ‘this is for you’ and in my hand he placed a log of nougat.
I looked at it and broke a piece off, biting into the soft, gooey, chewy confection. It was sweet. So sweet.
I sat down at a nearby table, waiting for the pastries and coffees to arrive. They were placed in front of us and all I could focus on was eating and tasting the delicious pastry. The jam oozed from one and I scooped it up, licking it from my finger. I greedily picked a strawberry from the other, exposing the frangipane underneath.
I pulled my coffee towards me and added a couple of sugars. Then a couple more. And a couple more. I stirred. And I stirred and I stirred the sugar into the bowl of milky coffee. More sugar. More stirring.
And then.
Then I woke up and realised with great clarity that I was low.
My hypo had infiltrated my dream. I was imagining a feast of carb-laden foods that would, of course, address the low blood sugar muddling my thoughts.
I sat up, adrenaline surging, realising just how low I was and grabbed the jar on my bedside table.
‘Are you okay?’
‘Mmm – just low. I was dreaming about French pasty.’
Diabetes has a way of twisting its way into my subconscious. On nights where my BGL is high and I need to get up overnight to pee, I wake suddenly, remembering dreams of water and pools and swimming in the ocean.
When I am low, I dream of gingerbread houses, fluffy marshmallow clouds and giant bowls of Skittles. Once, I dreamt that I was being chased by a huge jelly snake. Another time, the chair I was sitting on became a cupcake. I woke in the middle of one night confused and disoriented after dreaming I was in Enid Blyton’s Land of Goodies at the top of the Faraway Tree. (Obviously all that climbing had sent my BGLs plummeting!)
Alarms on my pump blend their way into dreams so that suddenly I hear doorbells ring, or metronomes ding. Once, my dream turned frightening – I was running (ha – as if!), running, running during an earthquake. The ‘shaking’ ground was actually my pump vibrating.
The other night, after I ate my jelly beans and felt the adrenaline rush subside, I lay back down and started to fall asleep, willing myself back to the patisserie. And thinking about how when it was morning, heading to a local French bakery for breakfast sounded like a perfect start to the day. It seems that I like to spend my time dreaming just how I like to spend my time awake. Food and coffee. Coffee and food.
Diabetogenic 