Monday 30 January 2012

Friday the 13th

I am not a superstitious person. I own two black cats, have walked under countless ladders, I don't wink/wave or clap at magpies and seeing only one doesn't move me in the slightest. I often walk under scaffolding and I never throw salt over my shoulder, that is just plain messy. Dates in the calendar - particularly superstitious ones - mean nothing to me

But on Friday 13th January, I had an extremely unlucky day. After attending the funeral of my grandmother (you could argue that was worse for her than me but nevertheless, it was tough) I found myself having driven for 5 hours and in need of some quick fix food in the evening.

I tested my BGs en route to the shops to buy myself a Pizza and was a comfortable 8.8 mmol (that's pretty good - 4-10mmol is acceptable). I picked out my pizza and knowing how much pizza normally makes my stroppy little condition fly off the handle, injected what I would need for the Pizza nice and early, to give the insulin a chance to work before I bombarded my system with garlic bread and pizza dough.

This was all a good plan and in normal circumstances would probably have been the right way to go. However, after bolusing (delivering insulin through the pump) the amount I needed, I started to complain of how very tired I was from all the driving and asked Jamie, my husband, to take over for me.

It wasn't long before I was sat tucking into my pizza but also being very aware that the overwhelming feelings of tiredness I had been experiencing were actually a nasty hypo which had snuck up behind me without much warning. There was no shaking, nervousness, sweating, nothing. Not until this point, anyway. As my cognitive function began to slow down, leaving me with the last image I had looked at, no matter where I looked, the feelings of panic began to set in. But this wasn't like my usual panic. I usually just worry about where my glucose treatment is, but know that I can cope with it. I downed a huge glass OJ and hoped I would recover quickly.

But this time was different.

I began to convulse (something which I thought was impossible while still awake) and within moments was screaming because my mind could no longer understand what was happening around me. Jamie at this point had managed to lead me to the kitchen to wash my hands for a blood test, but that was the last time I would make any sense. Hearing the TV in the background, my mind had begun to convince me that people were in the flat. I knew for sure they were behind Jamie but he wouldn't turn around. WHY DIDN'T HE TURN AROUND?? I was screaming at him and panicking so much that he stood no hope of getting the Glucagon into me. I could barely see for shaky vision at this point, and the next thing I knew, Jamie was stood above me with the ambulance people on the phone, them asking if I was being violent (what with all the shouting and screaming).

The last thing I remembered was being collapsed on the kitchen floor, screaming and crying because there were people touching me and I couldn't see them (these were the convulsions, only my brain didn't have enough glucose in it to understand that).

As quickly as I slipped into that hypo, I was out again. Two ambulance men arrived within minutes - 3 to be exact, according to Jamie. At this point I was able to talk again, had stopped screaming and the large glass of OJ was taking full effect. As quick as that it was over. It took a while for my glucose levels to return to normal, but even after 2 glasses of orange juice I was still only 2.7mmol (anything below 3 is a serious hypo).

I can only imagine that the 8.8 I had seen only an hour before was on the way down at a drastic rate and that by the time I had taken my insulin for the Pizza I was fueling an already nasty hypo.

I have always been lucky in that hypos come and go for me with never a great deal of excitement. I haven't needed assistance for the last 10 years and expect it will be another 10 before it happens again. But it goes to show that even those diabetics who walk a reasonably stable glucose path can be struck by the odd stealthy hypo.

It also goes to show why even people with 'good' control would benefit from CGM. At the rate that one hit me, I would never have seen it coming even if I hadn't been tired, even if I hadn't eaten the Pizza.

It also goes to show that not everyone gets hypo symptoms all the time. Mine normally hit me like a freight train. This one didn't. This one went all ninja on me!

Wednesday 11 January 2012

An islet of Langerhans named Jeff

Explaining diabetes is never straightforward. Most people are lucky enough not to have to know what insulin, adrenaline, islets of langerhans or beta cells are, or what they all have to do with one another. But despite not needing to know, most people do show a general interest and I love to be the one to tell them. Any opportunity to put the record straight is a bonus, as far as I am concerned.

So when I was recently out having some coffee at a Krispy Kreme with my brother and neice, the arrival of the food at the table led to the inevitable retrieval of the pump from my pocket and my brother Ben, always keen to show her knew things, pointed out my insulin pump. Intrigued as most children are about new things she piped up, "What's that?".

Now normally anyone who looks that interested in my insulin pump is fair game as far as I am concerned. The problem is, I have never explained diabetes to a 4 and a half year old and explaining an insulin pump often baffles even those who understand diabetes and know the basics of the condition. So how do you manage it with someone who doesn't yet understand what insulin is, let alone the role it plays in the body.

As I thought about what to say and started stumbling over my words and starting over again and again, it dawned on me that perhaps she thought I didn't actually know what diabetes is! Clearly going down the route of "Once upon a time there was an islet of Langerhans named Jeff" wasn't going to go in the right direction and neither would in depth discussions about the pathophysiology of diabetes and lack of ability of the pancreas to produce and secrete insulin into the bloodstream, allowing for the transportation of glucose to the muscles for energy, was also going to confuse the hell out of her.

I looked at my brother in desperation. "How do I explain this?"

"With the truth" he encouraged me.

As I journeyed with her through some of the very basics about how 'when I eat food I can become ill unless I take a medicine called insulin', and explaining that 'my robot' (as Ben described it) helps me to stay well and have energy because it gives me my medicine, it was clear that I was losing her the further into the conversation we got, even if she tried her best to look as though it made sense.

But at least at the age of 4, she has heard the words diabetes for the first time. Hopefully in ten years time, she will be correcting her school friends when they spout 'facts' they have picked up in our media. Hopefully she will be the first generation of diabetic-free people who know what the hell it is all about.

So what is the message of this story and how do you tell a 4 year old about diabetes?

I still have no idea; I just love the idea that we did it in a Krispy Kreme.