Out of nowhere, time can slip away from us when a high or low blood sugar comes at us unexpectedly.
This happened to me the other day, hitting me like a sucker punch in the gut and stealing a couple hours of my afternoon.
Thanks to that Low, those hours are time I’ll never get back.
Still, I’m so very grateful that I was able to eventually catch this hypo and treat it myself, and it didn’t happen overnight when my radar for sensing lows seems to go quiet. We have to be grateful for the small blessings, you know?
Besides the considerable risks, what I hate most about these “hypo excursions” is the sense that precious hours of my life have been robbed from me, gone down some unforeseen rabbit hole.
In this case, a cause isn’t tough to pinpoint. I’m assuming it was the fact that I recently began an insulin pump vacation, to take a break through the start of the year, and have gone back to multiple daily injections. While no stranger to the pump hiatus (I’ve been on two in the past three years), it’s always a change that takes my body time to get used to.
My pump use dates back to my final year of college in 2001, and before that I was on two or three injections a day since the time I was diagnosed at age five. But I’m not one who follows the FDA’s guidance of rotating my infusion sets as often as one should, so my skin tends to get worn out and I often look like a bruised and battered pin cushion. There’s some significant scar tissue.
So I’ve gotten used to taking the intermittent pump hiatus and “being free” from that contraption for a bit. Don’t get me wrong: I love pumping, think it’s all kinds of groovy and plan to happily return to that flexibility of dosing. But my body needs time to heal, and the pump vacation mixes things up and allows me to change my routine that doesn’t often get the chance for a refresher.
I’d been mulling over this most recent break for a number of months, and finally decided to begin the day after Thanksgiving. But on Day 6 the bottom fell out of my seamless transition and my D-Management caused me to nearly fall of the cliff (not Congress’ “fiscal cliff” of course, but the BG Cliff that we PWDs know all too well…)
Diabetes can take you over the cliff in a couple of ways.
With Highs, it takes the form of us feeling that we’re stuck in molasses. Tired. Can’t get motivated. Just feel under the weather and as if tucking our heads back under the pillow would make it all go away.
With Lows, so often we just find ourselves quickly gorging on fast-acting carbs and then waiting… waiting for higher BGs to arrive, waiting for safety, waiting before getting behind the wheel or carrying on our workday or studies or whatever life activity has been so rudely disrupted by these unwelcome symptoms.
In that Low I mentioned late last week, I lost several hours of work time thanks to a hypo that hit without warning. That day, I’d forgotten to take my basal dose of 
Lantus first thing in the morning, so I had to catch up by taking the shot three hours later than usual. As a result, the typical kick I get right after lunch was delayed by a few hours, causing that late afternoon Low.
It seems clear to me now, although it wasn’t then.
Not wearing my Dexcom continuous glucose monitor (CGM) thanks to my current scar tissue hiatus, there was no early warning this time.
I remember the blurry vision, the cold shivers, my inability to concentrate. But instead of mentally connecting the dots and treating that hypo immediately, I managed to convince myself I was just tired and needed to take a nap.
And that’s when I disappeared. Missed a phone conference… Didn’t respond to emails or texts from Amy.
Being that I work from home and the only one at my “office”" with me during thee day is my dog, this could’ve turned out badly… Thankfully, it didn’t. I managed to wake up, realize what was happening, and pull myself out of it enough to treat.
About two hours had passed by the time I came out from under this Low and inhaled some of the glucose gel that was on hand. My sensibilities flooded back, and I realized how much valuable time had been lost.
Sometimes, these Lows happen and you can’t prevent them. Sometimes you don’t know why, while sometimes you do. Either way, they aren’t welcome and are scary as hell.
I hate using excuses about diabetes when it comes to work or any part of my life, but when these incidents come up, I’m so incredibly thankful for understanding people who “get it” or at least don’t give me grief.
And when you feel like you’re losing precious hours of your own life due to frustrating factors beyond your control, it’s invaluable having that kind of support.
Mike, Scary! We’re all glad you managed to wake up and treat. And I’m glad I’m not the only one who forgets to take basal insulin, although the results aren’t as serious as they are in type 1.
Re the “lost time.” Many people lose time from self-inflicted problems like drinking themselves into a stupor. Your lost time wasn’t your fault. You didn’t choose to have diabetes.
I wonder if one can train a dog to wake you when you’re low. Some do without training.
Yes, you can, Gretchen and I am doing it! I have a CGM but I am also training a scent-imprinted dog. Roman just pawed me tonight and went to fetch my meter and the bringsel (another way to signal a low). My Dexcom said 95 but the meter (and Roman) said 60. Eventually the Dex caught up.
Mike, I like to put my Dexcom sensor on my butt and my pump (Omnipod) on arm, breast, or calf. How about trying new sites?
I went back to read this post of yours since I totally understand and feel frustrurated (and not know what to do about) these high and low twilight zones we can get in.
The last time I had a low, I thought about what you mention above – that I had just lost precious hours of my life! I have had that thought before – in fact, I’ve had that same thought every time I’ve had a low bad enough that it took me awhile to recognize it, and do something about it, and then wait to be sure what I had done was adequate. When I’m not having lows, I tend to forget about this aspect of hypoglycemia. So, in the past 40 years since my diagnosis, I wonder just how many hours of my life have been wasted due to hypoglycemia. Fortunately, the answer is that I’ve lost fewer hours to this side effect of insulin than I would have lost had insulin not yet been discovered. In fact, I would have lost forty years! Oh – and I religiously rotate my infusion sites (which I do every 48 hours) and my sensors – yet I still develop scar tissue that forces me to go on pump vacations!
Reading that your dog was there made me think of training him/her as a service dog. Dogs have been shown to be more effective than CGMs at sensing lows. There’s a place here in Seattle that will train your family dog, so long as they have a good disposition. I’m sure similar services can be found in other cities. I’m a T1 that’s just starting using insulin and I am considering having one of my pups trained.
This was just posted in the Wall Street Journal. Shana is a DOC friend of mine who is an excellent resource if you want to train your own diabetes alert dog. You are also welcome to email me
http://online.wsj.com/article/SB10001424127887324001104578163423121970336.html?mod=ITP_personaljournal_1#articleTabs=article
As I’m reading this, I’m actually killing time after a low until my blood sugar is in a safe range for me to drive again. It is frustrating! But, I really appreciated June S.’s perspective. A few minutes or hours lost is better than a whole life-time. And I guess it forces me to slow down from the hectic pace of life.
I’ve been having a rash of lows lately. Three in the 60 range on Monday alone. Hang in there brother!
MIke – I’m glad to read you pulled yourself out of that hypo. It ended well and I would consider the time lost as “tuition” if you make then make some concrete change to minimize the chances of it happening again. Perhaps finding an alternate site for your Dex, like the back of your arm, might help. I enjoy reading your columns!
Mike, interesting post. I too have had lost blocks of time attributed to BG excursions. I especially dislike the continued feeling of being low even after I have corrected and have the BG back in range. As I type this, I am having that exact set of symptoms, with trouble concentrating and taking a “break” from what I really should be doing right now because my brain is feeling …. wonky.
Do you take pump vacations for other reasons?
Dr’s didn’t test me for hypoglycaemic as a child, they still don’t recognise it as a condition in it’s own right here, only as an insulin injection side affect. Two of my kids have t1 diabetes and now we know that I was having hypos as a child (and occasionally as an adult) not unexplained seizures.
I used to regularly “loose time”. One of my most vivid memories was of sitting in a German class, the lesson had just started. The teacher asked the class a questions. Then she called my name twice and asked me for the answer. I gave it. The whole class roared with laughter and then the bell signalling the end of class rang. I had lost a whole 1 1/2 hours. I was still sitting and had my eyes open, but was effectively unconscious.
For people without diabetes, the closest way that many can relate to this concept is being really drunk and the next day not being able to remember parts of time from the evening before. It’s sort of the same concept.
This is oh so true- I was on multiple injections for years and went on a pump 3 montns ago,and I must say the lows are more infrequent and easier to deal with-but when I think about the seemingly countless hours not only that I lost,but also the hours lost by your family, loved ones,friends,co-workers,and sometimes complete strangers that can be involved in these circumstances can lead to a vicious cycle of other big time wasters;guilt and self pity(the devil’s babysitter)-anyway,good luck and God Bless,you really struck a sensitive nerve with this provacative post
thanks,Dean
Well Mike,
I know the feeling. You see, I woke up hypoglycemic this morning. Not a fun way to start the day! A dream in which a friend from a few year’s past told me that I needed to do something. I don’t remember what that something was. Check my blood sugar maybe ? Anyway, I woke up and did get a low blood sugar reading and corrected it. So I guess I ought to count this a success.
I have never had a CGM. But if I did have one, I’d probably forget to wear it to bed the night after strenuous physical exercise, and end up with nocturnal hypoglycemia.
Adam