I am a prick when I am low
I have been many things, husband, father, coworker and patient. I am also a person with type 1 diabetes. I have lived with type 1 for 42 years and I have to admit I am at least one more thing. I can be a prick when I am low. It’s true. I acknowledge it. Of course I often prick my finger to test my blood sugar, but I am also a prick
Low Blood Sugar?
Having a low blood sugar is like being in an automated car wash without a car. Having a low blood sugar feels like all the stimuli are coming at one thousand miles per hour and yet all you can think about is food. It causes those around us to suffer sometimes. I have many low blood sugar stories, some funny, some sad, and a few dangerous. It is the accumulation of stories that show up after 42 years of taking an artificial hormone that allows me to live.
Low blood sugar is caused by not adequately matching food, exercise, and insulin. An insulin user can go low if they eat too few carbohydrates, exercise more than estimated, their body is assaulted by emotional stress (good or bad experiences), too much insulin is delivered, or a thousand other inputs that get out of balance. No matter the cause; the result can be extreme sweating (I hate that one), rapid convulsive movement in hands or legs, unconsciousness, blurry vision, confusion, hunger, crying (I hate that one as well) or in some cases no discernible symptoms at all. My most typical symptom is anger. I tend to get defensive when I have a low blood sugar and I can turn into a raging lunatic.
But A Prick?
I can turn into a raging maniac based on the stimuli around me. I have been known to throw things, yell, take off my clothes, laugh wildly, hit, and disobey those trying to help me. I once opened and ate a box of Kellogg’s Frosted Flakes in the store. When the manager asked why I was doing that I said the most important thing I could think of. Because they’re GREAT!!!!!!
However, when I get upset is when someone remarks about my care while I am low. These phrases always start with same words, If you, you need, you should, if only followed by some prescription for what I did wrong or could do better to manage diabetes. It angers me to hear these things, as if I wanted this outcome, or the speaker could do better.
Inputs and Outputs
Taking insulin is not strictly an input/output arrangement. The human body is much more complicated than the sum of its inputs. I know this because sometimes I eat the same food, do the same exercise and take the same insulin and I get widely varying results. It seems unfair that if I am sitting at home I can go low because my body metabolized its inputs differently. Sometimes stuff happens.
Yes, we can control some parts of the equation. I can put in less insulin, I can eat more or less carbohydrates and I can stay home while the family goes on a walk or swim, but that is like sitting on a four legged stool with two legs cut off. Most of the time I get it right. I can usually keep the stool balanced but often, I make a mistake and my blood sugar goes too high or low.
What I have learned after 42 years of managing diabetes 24/7/365 is that no one can do it perfectly. We miss and sometimes those misses are big. When that happens, I may need some help. And if I ask for that help, know I do not mean to be a prick, but if I am also know my apology is sincere. After all I hate pricks those on my finger or the one that comes out when I am low.
Doesn’t sound like much fun, Rick!
Oh Karen: Lows are awful, and funny, and dangerous, and mean, and all the rest. I am so glad it is something few people have to experience.
Rick, this is a genius piece of writing. I find your assertion hard to believe, but then I think on my reaction to pain/difficulty, and know that I am sometimes a pain/difficulty. I cannot fathom what it is like to live with the combination of RA and Diabetes, but I appreciate the education. As an advocate, you are GREAT!!!
Thank you for the very kind words Jody. I think what is the most dangerous about having an insulin induced low blood sugar is how close we can come to fatal consequences. We (our diabetes community) has a young mother who is a doctor in the hospital in a 2+ week coma as result of a low blood sugar. We can lose people from an untreated low blood sugar and sometimes we lose self-control of our circumstances which makes it more dangerous. But like most things that are common to a group; those of us who use insulin find ways to normalize these occurrences with humor.
Rick! Thank you so much for writing this. I find being low the scariest thing on the planet. And avoid it at all costs. Like last night when I hit a blood vessel and my blood sugar went down fast even after a ton of food…
Rachel: I believe insulin is one of the most dangerous medications on the planet. Largely because of all the factors (most out of our control) that impact how the body uses it. I do get upset when someone says if you had counted your carbs correctly, or not taken the walk, or suspended when I play with the kids, I would not have had a low blood sugar. It is so easy to say and so difficult to understand that insulin administration is not a 100% user controlled input/output arrangement.
I’ve been T1 for 48 yrs this year, and well controlled with no complications. I’ve had my share of “scary” hypos, including driving off a UK motorway about 10 yrs ago, but luckily no damage to car or myself.
So what was the fix .. proper carb counting & bolus based on ratios … easy peasy .. 🙂
Since doing that in 2012, my Hba1c dropped from 7.5% to 6.3% .. and hypos are totally elimated .. win .. win.
Jon, thank you for your comments. It is exciting to hear of your wonderful A1C improvement. I am a few years behind you with type 1; I was diagnosed in 1974, almost 43 years ago. I have also found a modern pump, and better carb counting have made a nice difference. Still, I have to say that not all of my serious lows have been eliminated, but yes they are greatly reduced.
Oh, the low brain. Its an unfiltered bastard that does and says whatever it wants.
I don’t apologise though, because if people care about me they know its just low brain and not to be upset. If I have to apologise it probably means we’re not good friends. After all, why should I feel guilty about something that was out of my control? Anyone who loves me wouldnt want me to feel that way, when feeling low is bad enough.
I apologize because I can get pretty angry. Sheryl, says it is ok but I cannot let it go because I think it is appropriate. I mean throwing the pantry items across the room is sort of difficult to not feel bad about.
May I reblog this Rick?
Kati, please feel free. I enjoy having my items reblogged.
My thing is getting annoyed when my mum or husband ask if I’m low – them knowing it before I do! It’s illogical because someone knowing before you do is helpful. I liked the story of you opening and eating a packet of Frosties. I’d love to have that as a hypo anecdote.
Oh Emma, if only that was the only story of my lows. LOL thank you for the very kind comment.
Hi Rick: Apologies for being so late to comment. Although I don’t have diabetes (of which Type 2 is prevalent in both sides of my family), I am prone to blood sugar swings. When I was younger, my brother and I used to call them the cranky shakies, because we would get really irritable and feel like we were getting the shakes. I have a great deal of compassion for people with low blood sugar because it’s such a horrible feeling. As an adult I’ve worked hard to make sure my glucose levels are healthy, but it hasn’t been easy. Not sure how you manage with having RA as well. Hope you’re doing well and that I get to see you soon!
Thank you Carla,
\i think those of us with diabetes and who insulin have several little helps. Fruit juice (I like apple), glucose tablets (CVS has a chocolate fudge marshmallow) and a new favorite, something called Elovate powder. Of course, the best way to not need these is to keep our blood sugar at the appropriate level by not using too much insulin. Sometimes I even accomplish that some days.