Superpowers and Kryptonite

I tend to not remember a ton from the time when I was diagnosed, but I clearly remember one conversation with a doctor that I had when I was 12 and probably type 1 diabetic for only a couple weeks.  I remember the doctor telling me that I would get to know my body so well, better than most people without diabetes, and know roughly my blood sugar just by the way I feel. It was such a foreign concept to me at the time. At that age, I wasn’t paying attention to my body for the most part, maybe the way it looked since I was at the beginning of puberty, but not how I was feeling. I was skeptical, but I found the concept intriguing. “It’s kind of like I have a superpower!” I thought. “I’ll be able to feel my blood sugar. You ordinary humans can’t do that!”

The doctor was absolutely right. As with many health conditions, you become hyper attuned and aware of changes within your body. Sure, I can feel a low blood sugar, but more specifically I can often feel the difference between a 90, 70, and a 50. Between 120 and 220 and even 320. I can feel the low coming sometimes even before it’s reflected in the number on my meter. With my CGM, these feelings are often confirmed by the device, but the discrepancies between how I feel and what the CGM says are often in agreement with how my body feels.

DC Comics, The Adventures of Superman

I’ve been without my CGM, Gigi, for close to a month now. It wasn’t a purposeful decision, but when my transmitter battery died, it’s been taking longer than expected to get a new one sent. So I’ve gone back to using my superpower more, for better or worse. But during these past few weeks, I’ve learned that my power is not perfect and indestructible. Rather, my superpower has a kryptonite. These dangerous forces weaken my power, they confuse me, and they ultimately make me unable to accurately predict what my blood sugars are. Perhaps T1Ds have different forms of kryptonite, different interfering forces, but below are the 5 that I have had to battle against:

1. Adrenaline. I remember before my big interviews or doing something crazy like going bungy jumping or even before a first date, constantly testing my blood sugar because the adrenaline rush that I felt mimicked the feelings of a low. I’m shaking, my heart is racing, am I excited or am I low?!

2. Anxiety. Similar to the rush of adrenaline, my feelings of anxiety often get mistaken for a low. Context is obviously important, but in the middle of the night when I can’t sleep and feel shaky and unsettled, there are times when it’s been nerves rather than a low.

3. Alcohol. I was warned about this one even years before I could legally drink. “Alcohol is dangerous,” my doctors would says, “You can’t always feel your lows when you drink.” While this hasn’t been too much of an issue for me, I do notice that I don’t feel my lows until they are much lower, so in the 50s as opposed to catching them in the 70s.

4. Other medications. I hate using my asthma inhaler even when I need it. After using it, I always get this shaky feeling and my heart races. But usually the desire to breathe normally wins out over potentially feeling low.

5. Nitrous oxide (laughing gas). When I got my wisdom teeth pulled out, my dentist turned on the gas and in less than a minute, I was telling him to turn it off. The feeling reminded me so much of being low that instead of the serene feeling that others get, it made me feel anxious, uneasy, and just uncomfortable.

Unfortunately, a few of my kryptonites are unavoidable and thus my superpowers are always in jeopardy. But part of being so vigilant and aware is also knowing when these weakening forces may be at work, and then taking extra precautions. This may mean more finger tests or checking my CGM more often. But in the end, I may not have the world to protect with my power, but I will do what it takes to protect the one life that is mine for the saving.

 

Apple Snob

Today I realized that I am an apple snob. Not an Apple snob, although honestly I might be that too, but the kind of apple that you find in the grocery store. I’ve known for some time that I am very particular when it comes to apples, but today it was confirmed. If it’s not a Honeycrisp apple, then pretty much forget about it.

I had just finished my workout and was experiencing another low blood sugar, 49 (ughhh!). One of the symptoms of a low can be hunger. However, I wasn’t experiencing normal hunger, it was this insatiable appetite that made me want to go into the kitchen and just binge on crackers or chips or whatever else I could find. I had already treated the low with my fruit snacks, but the hunger remained, like a bottomless pit in my stomach. When this kind of hunger from a low strikes, the best solution is an apple. Apples are healthy, filling, and satisfy that urge to just crunch on something. Luckily, I had one apple in the fridge with my name on it.

I took a bite. Woah, this is NOT a Honeycrisp. It was missing that perfect combination of sweetness, firmness and tartness. This apple was definitely not crisp and was not living up to the high apple expectations that a true Honeycrisp apple had set.

So how do I know that I am an apple snob? Because I couldn’t even get myself to finish the apple! Let me remind you that my motivation for eating the apple in the first place was not for taste or enjoyment, it was to satisfy the symptoms of my low blood sugar, but yet I still was refusing this perfectly average apple.

While I am quite aware that it is past Honeycrisp Apple season, I either need to track them down or find a suitable replacement because whatever imposter was in my fridge today is just not cutting it.

50 Shades of Low Blood Sugar

It’s hard to accurately describe what it’s like to have low blood sugar (hypoglycemia) without really experiencing it for yourself, but I can say that the feeling sucks. Low blood sugar happens when there is not enough glucose (sugar) in the body to be used as fuel for cells. Most people, whether you are diabetic or not, probably have experienced a mild form when you’ve gone a really long time without eating. Maybe you get a little grumpy or light headed. Now take that feeling and multiply it by 100. While some symptoms are more common than others, people with diabetes experience their lows differently, you just learn to recognize your symptoms. I’ve compiled a list of common and possible symptoms, starting with the ones I’ve experienced personally.

1. Shaky– my hands literally shake when my blood sugar drops
2. Light headed– kind of a dizzy, out-of-it feeling
3. Hungry!– It’s your body’s evolutionary response to tell you to eat and get more carbs. The lower the blood sugar, the hungrier I feel, even if I just ate a huge meal. More than I’d like, I find myself raiding the refrigerator and eating until I start to feel better and that awful low feeling disappears. This is one of the worst symptoms for anyone on a diet or trying to watch what they eat! And this over-treating can lead to high blood sugar and a seemingly endless roller coaster of ups and downs.
4. Lethargic– Sometimes it feels like my limbs have become really heavy and all I want to do is lay down.
5. Trouble thinking/concentrating–  It becomes really hard to put together coherent thoughts when my blood sugar is low, which was incredibly inconvenient if I was taking an exam or writing a paper in school.
6. Irritable/short temperedThis symptom I personally never noticed, but I’ve been told that I can occasionally get “mean” when my blood sugar drops.
7. Pounding heart/racing pulse– This symptom can be deceiving, often when I’m nervous or anxious I confuse the feeling with having low blood sugar.
8. Suddenly feeling very warm/hotI’d imagine its kind of like having a hot flash? Nice when it’s cold out, but not so great any other time.
9. Numbness in mouth and tongue– This symptom freaked me out! It happened for the first time recently and I had no idea that it was a common symptom.
10. Confusion

11. Dizziness
12. Headaches
13. Pale skin
14. Sweating
15. Trembling
16. Weakness
17. Anxiety
18. Poor coordination
19. Nightmares or bad dreams– that’s interesting, I actually didn’t know that one (thanks WebMD)
20. Skin becomes cold and clammy
21. Drowsiness
22. Sleep disturbances
23. Blurred vision
24. Slurred speech
25. Depressed mood
26. Restlessness
27. Personality changes
28. Tingling in hands or feet
29. Frequent sighing
30. Nausea or vomiting– for me, this is a symptom of high blood sugar, not low, but apparently it happens to people

So these next few I’ve personally never experienced (and hope to never!), but it is what happens if a person’s blood sugar drops dangerously low:

31. Passing out/unconsciousness
32. Seizures
33. Coma

Not quite 50 symptoms, but there are definitely a lot.

While I try to avoid having low blood sugar, I have accepted it as part of being diabetic. And while I don’t think I can ever get used to the horrible feeling, I’ve learned to tolerate it. However, having an episode of low blood sugar might be the most disruptive part of having diabetes. Sure it takes time to test your blood sugar or give insulin, but we’re talking less than a couple minutes for those tasks. Most episodes of low blood sugar last about 15 minutes before I start to feel normal again. That’s 15 minutes of not being able to think straight or concentrate, 15 minutes where your body feels shaky, weak, and light headed, 15 minutes of wanting to just sit or lie still. Most of the time I don’t or can’t completely stop what I’m doing at the time. I eat my fruit snacks and carry on with my life, but it’s not always an easy thing to do. And while I enjoy the taste of my fruit snacks, there’s nothing worse than exercising and working hard to burn off those calories to then have to turn around and eat sugar because my blood sugar had dropped.

Sometimes I will go days, maybe even a week without experiencing a low, but there have been other times where I will drop low 3 or more times in a single day. The scariest part is, you never really know when or where you will be when it drops low and it can become very dangerous very quickly, so you must always be prepared. That’s why I carry packets of fruit snacks with me everywhere. The best thing is to learn to recognize your symptoms so that you can react and treat it early before it gets too low. That’s one of the reasons I really like my continuous glucose monitor, it tells me when I’m dropping low sometimes even before I feel it. 

I’m sitting here trying to think of what kind of silver lining there might be from having to deal with low blood sugars. I could say that it has taught me to always be prepared and to expect the unexpected. But maybe, it’s more that sometimes things in life just suck! There’s no better way to put it. Having low blood sugar is awful, but it’s part of having diabetes and just something you have to learn to live with and deal with. I think everyone has something in their life that they wish they didn’t have to deal with, something that might be disruptive, uncomfortable, or unpleasant. Maybe you’re lucky and can find a way to deal with it so that it disappears, but for the rest of us that are stuck with our “low blood sugars”, it’s recognizing that sometimes even though life has handed you lemons, you can still have a great life.

(Images from DiabetesHealth- http://www.diabeteshealth.com/cartoons/)