“Everything was in slow motion. Even my brain was in slow motion.” A hypoglycemic episode explained.

I don’t have to tell you that you’re never prepared for any day living with type one diabetes. When I was diagnosed at the ripe age of thirty-freaking-five, I had no idea what to expect. I was told about the symptoms, I read the pamphlets, but even I knew that nothing would be predictable. It’s been five years since I was diagnosed and even though insurance and technology has made living with this mental and physical crutch slightly easier, nothing ever prepares me for the daily physical challenge. If you are vigilante about your diet and your insulin maintenance, therefore keeping your numbers between those lines, the symptoms of hyperglycemia, and my all-time fave, hypoglycemia, won’t wreak havoc in your life. But, if you’re like me and have those complicated days caused by over-night lows, random spikes or any super unknown factor, your body goes on a roller coaster ride. And it sucks. Your entire day becomes clusters of literal physical highs and lows that leave you drained, tired and exhausted, and you might have not even left your bedroom. Or you might have had to go to school or playground and attempt to live the already unpredictable life of a child.

One of the best things, I believe, we can use social media for as a community is to share, other than cure-hunting. Cure-hunting should always be number one. I love being able to go on any one of my bajillion devices and read about or look at pics of all things related to type one diabetes. Health updates, technological advances, cure research developments, management tips or personal stories just to name a few. And I love the personal stories. I love how we share what we go through, especially the honest moments. I used to be really involved in a lot of type one fundraising events and I loved seeing those stories in person. I loved sharing my story with another T1D and enjoyed learning how they lived and thrived. It made me live a better life. I had connections with all those people and those children because, we had the same day to day functionality issues and the drama that comes with it. Functionality issues, yeah, that sounds good. But I can tend to get really caught up in what I see online, especially when I can relate. For any parent or caregiver, watching what we go through can’t be easy. When I see a parent post a picture of a meter reading with a 58 or a dexcom line that looks like a schizophrenic stock market, it really tugs my strings. I see hundreds of comments with advice, what to do’s, or ‘that happened to us’ from parents, but I wanted to tell you, as an adult, what that 58 and that spastic cgm line can feel like. As an adult, I can try to put into coherent words what some of my experiences with hypoglycemia have been like.

I’ll never forget the first time I felt my blood sugar totally plummet. I had been diagnosed for only about 6 weeks and had just gotten home from a 28 day rehab facility for alcoholism. That was an experience unto itself. When I was diagnosed my A1C was 15.7, so my sugar level was never really low. I really don’t think my sugar was ever in the 100’s since the diagnosis. As far as maintenance, I just did everything I was supposed to. I would check my sugar and then take a shot of insulin that corresponded on this chart I was given, the higher the glucose level, the more insulin I took. I had another chart for how much insulin to shoot up depending on the amount of carbs I was going to eat for any meal. I would test again two hours after I ate and take a compensation shot for however high my glucose level was, which was always. That afternoon, I was home alone and making my lunch. Lunch was a big production back then, consisting of all four food groups. Healthy stuff. I would do all the carb counting from the packages and books. I would do all that math with ratios and I would prepare my shot. On this day, just as I’m about to check my sugar for this grilled chicken sandwich, I suddenly feel hot. That was the very first sensation, and usually always is. My body temperature gets really warm. I was standing at the kitchen counter in a t-shirt and shorts, and all of a sudden it felt like I was generating internal heat. I could feel myself slowly starting to sweat and I was starting to freak out. I started feeling heavy too. Physically heavy. My bones, the inside marrow of my bones, felt like each one of them weighed 500 lbs, from my skull to my toes. I went and sat down on the couch and by this time, sweat was running down my temples, and soon I was profusely sweating. I have put my body through a lot, and the hardest I ever remember sweating was onstage under really hot lights or working construction one summer, but that was nothing compared to this. Within 60 seconds, my t-shirt was soaked and I couldn’t think straight. Everything was in slow motion. Even my brain was going slow. The fact that I was alone is probably the only thing that put me into motion. I was only able to move because of primal fear and instinct. I very slowly figured out that this oversized pile of invisible jello that had fallen on top of my body, must have something to do with my new type one diabetes. I was mad. And low. But scared more than anything. I got up and went to my meter, which never left my side my side and my sugar was 70. I couldn’t tell you what 70 felt like today, but back then it was brutal. I had never seen a number that low.  I just sat there on the couch trying to stand up, and it probably took me a few minutes to figure out how to do that. Honestly, I felt drunk, but without the fun of being drunk, which I knew all too well. It took a long time for me to get up, and when I did, I just roamed around aimlessly, with tears streaming down my face. I thought I was going to die. I knew what to do, but I just couldn’t do it. I knew I was supposed to bring my sugar level up with snacks, or 15g of carbs, but how the hell was I supposed to do that? Incidentally, I raise a toast to the T1 that can bring their sugar back up from hypoglycemia with only 15 grams of carbs. You’re a rockstar. But I felt like sludge. And my pure inability to move at any speed was astounding. I went and leaned up against the kitchen wall, only because it could support my weight. I felt so heavy and weak I thought I could fall straight down. I remember I ended up standing right above the air conditioning vent on the kitchen floor and how good the cool air felt on my skin. My pug Slash had been circling around me this whole time because he knew something was up, and I was actually mad at him because I feared I would fall over him. Then I hear my phone ring and it was the loudest thing I’ve ever heard. As I nearly tripped over Slash, I got my phone off the counter and it was Mom, thank God. She called to check on me and I tried to explain what was happening but I knew I didn’t make any sense. I kept saying ‘I’m low’ but kept trying to explain why I might’ve been low. Of course, she knew what to do and told me to hurry up and drink a Coke that she knew was in the fridge. Divine intervention. That Coke didn’t stand a chance. That sugary, carbonated concoction got annihilated. It was so cold, so damn tasty. I sat there dumbstruck that I could consume anything at that speed. What was going on with my body? Of course, my stomach felt awful and could barely handle the carbonation. I was sitting on the floor at this point, Slash by my side, the Coke can rolling away. I was still hot and I was still crying and even more scared. I felt sick and so tired. I felt hunger, but in sharp stomach pains. My head started to hurt from the inside, but then I realized it was hurting the whole time. Right at that moment, I started realizing a whole lot of things. I don’t know how long I was on the floor, but the Coke started working and my levels must’ve started to rise again because I could think clearer. I still couldn’t move any quicker, but I was comprehending what just happened and why it happened and I was angry at myself. I looked around and I realized that this was reality. I was realizing things like sugar could kill me, but it would also save my life. But mostly, I was realizing that this was going to be forever. That this could happen anytime, anywhere. I still really didn’t know why I dropped. The awful part is I was getting ready to inject a large dose of insulin at that moment. It took a long time for the physical effects of that episode to wear off, at least an hour and a half. The physical toll was one thing, but the mental anxiety that set in was, and is something that has never, ever left me. Today, my entire diet, lifestyle and existence seems to concentrate on avoiding hypoglycemic events. I used to be scared of heights, now I’m petrified of lows.

I mentioned things moving in slow motion, but it’s a weird slow motion effect. You kind of feel everything starting to shut down, all your nerves feel it too. There’s different tingling sensations I feel almost inside my brain, in the core of my spine, and throughout my extremities. The tingling sensation then almost transforms into this pressure, or pushing down feeling, a heaviness. The hair on your head feels like lead.  Imagine if you were a car and you were zipping down the interstate in the normal flow of traffic. All of a sudden, you start to feel the AC going out. You know you shifted to 5th gear, but now you feel the transmission slip to fourth. Then the radio station that was crystal clear is nothing but static, and you just noticed the wipers don’t work for the rain that just started to fall. Your car is starting to slow down and people are passing you. You try to make sense of what you see on the dash and there’s a bright check engine light on. Beside that you notice the fuel light and battery indicator blinking at you too. Everything is shutting down, you’re running out of gas and your battery is going dead. Don’t look now, but each of your tires just went flat. Everything that’s essential in that car functioning has slowly left it. That’s what it feels like sometimes. Some are not so bad, and some are very excruciating and the feeling doesn’t leave. If you have a bad low sugar experience, sometimes you can just count yourself out for the rest of the day. For me, they’re usually followed by an extreme bout with hyperglycemia because I overcompensate. I try not to, but sometimes a juicebox, or 3 cookies or a powdery tablet just won’t do it. Of all the things type one diabetes has given to me, hypoglycemia is the one I hate the most. It stops me from doing what I want. That’s the part that gives me the most limitations. I hate that it happens to other people, especially to kids. I hate how unexpected the episodes come and how indiscriminate they are to timing and location. Do not tell my endo, but to slap hypo in the face I have only the finest candies, cakes and sodas to alleviate the drop. Hypoglycemia can shove it now, because I celebrate like its Halloween on Willy Wonka’s birthday (Moderation folks, take the delicious candies and sarcasm in moderation).

I’m pretty good at maintaining my glucose levels, for the most part. Today I wear a Dexcom cgm and an OmniPod insulin pump, and I do not know if I could breathe without them. I could not be more serious. Some people are obsessed with staring at their phones, I stare at my PDM and my receiver. I spend all day adjusting temp-basals and extending bolus’ just to maintain a balance. There is so much micro-managing I do, I feel like I should really be an OmniPod all-star. But I feel like I have no choice. And I do everything in little increments to avoid the extreme fluctuations.  I don’t eat and take a corresponding insulin amount anymore. I’m very insulin sensitive, so I take a safe amount of insulin, and eat to that amount. While I don’t rely on my Dexcom for dosing, I watch the trends like a virgin hawk lookin’ for tail. I rarely take my eyes off that. The Dexcom has been become essential to survival because I can no longer feel normal lows, only the extreme ones. I can drop to as low as 60 and not even know it. I don’t know if it’s tolerancy to symptoms, but many times I’ve been in the 50’s when that first feeling of warmth comes. And that’s scary. I also sleep with candy. I’ve started this phenomena called ‘dawning’ where my sugar inexplicably spikes only between 4am and 7am. They call it that because morning wood was already taken. But I’ve adjusted my temp basal to try and control that and sometimes it works like a charm, sometimes it doesn’t and I still spike, and of course sometimes it works too well and I start the day from the depths of hell. It’s all a gamble. Everything’s a risk and we always have to be careful. Unfortunately, whenever this car starts to go dead, while there’s no AAA I can call, I can have a Coke and smile.

5 thoughts on ““Everything was in slow motion. Even my brain was in slow motion.” A hypoglycemic episode explained.”

  1. Hi, Neel. I just read an article about hypos in Diabetes Care, abstract here: http://care.diabetesjournals.org/content/38/8/1583.abstract, which covers recommendations from a study group on minimizing hypoglycemia in diabetes. Your blog gives an excellent description of the autonomic symptoms (palpitations, tremor, sweating) and neuroglycopenic symptoms (weakness, impaired cognition). The unfortunate thing is, lows can beget more lows (as well as make us lose our ability to recognize the symptoms). One bright note: scrupulously avoiding lows for 2 to 3 weeks can help many people revive their recognition factors! I think that we’re going to see more and more attention on reducing and avoiding hypoglycemia. Even when it doesn’t require the help of others to recover, it is way too disruptive in life. Thanks for bringing up the conversation—and the too-low BGs!

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