Wednesday, September 7, 2011

How Low Can You Go?

Around ‘99/2000, word got out around Chicagoland that Six Flag Great America was about to open a new roller coaster. The Raging Bull was going to change the way that thrill seekers experienced roller coaster with its “hyper-twister” steel construction and steep drops of over 200 vertical feet. It is an awesome coaster.

Interestingly enough, if you take a look at the profile of that roller coaster (the 2D image that simply shows elevation change) and you compare it to the graph of blood sugars from a person with diabetes, they will look shockingly similar. The difference is that when you view the roller coaster’s profile, the higher the peaks and the lower the valleys, the better. The thrill from rolling over an edge and dropping a few hundred feet in seconds is amazing, especially if you are an adrenaline junkie. With the diabetes, that’s not the case. Those rapid changes just make you feel like crap.

I took to diabetes relatively quickly after my diagnosis. In the hospital, it took the nurses and the diabetes team a little time to get me calmed down and over the terror of being diagnosed with something that is incurable, but once they did, I almost started having fun with it. I had been given some insulin, so I was beginning to feel better and I even thought it was kind of cool to poke my finger and make myself bleed…even though I still didn’t really know why I was poking myself or what to do with the number I saw after I put my blood drop on that weird, little, electronic strip. I even got a sense of rebellion out of the situation. I could now have a cut on my finger and not have people running over to put a band-aid on it. In fact, my parents and the whole medical staff seemed to get excited when my finger started to bleed. To top it off, I discovered that my blood made that little machine swirl around and give me a seemingly random number. I felt like I was playing a video game. It was kind of cool.

I learned tons of information during those few days in the hospital, much of which I probably still wouldn’t know if I hadn’t been diagnosed with this disease. By the time I was discharged, I found out what insulin was, what it did for me, how to give myself a shot, what that number was that I saw after poking my finger and even what the consequences were of taking too much insulin.

In the middle of my second night in the hospital I awoke with a really strange and uncomfortable feeling. I was experiencing my first low blood sugar and it was one of the most peculiar feelings I had ever felt. I woke up sweaty, cold, and shaking and was really confused. I had absolutely no idea what was going on. The weirdest part was that my confusion was drastically different than simply not understanding something. It was deeper than that. After years of experiencing hypoglycemia, I still haven’t found a situation that feels the same.

The feeling of being low is kind of like the uncomfortable "butterflies" you get when an awkward silence works its way into an important conversation, mixed with total confusion about what is going on around you and being totally incapable of making a decision. With many lows I am very aware of what is going on in my surroundings, but for some reason I can’t seem to react to any of it. My brain seems to input any relevant information, but it can’t seem to output any form of action, therefore I just stand there blankly. In addition to the the uncertainty and confusion, I almost always get a numbness/tingling sensation on the roof of my mouth and on the palms of my hands. All things considered, those symptoms  allow for some very interesting situations...

In the years since diagnosis, I have yet to replicate the feeling of hypoglycemia in any other situation, thus making it difficult to describe the feeling to someone who doesn’t have diabetes. I have just begun to tell people that if I am acting stranger than normal, chances are I need to eat something. I think that is easier than trying to explain how I feel in that situation. It is probably difficult to comprehend that I can be low and have a book open, and read one page 15 times and still not understand any of it. The simple idea of “acting odd means I need sugar” has saved my life countless times already and it probably will many times in the future.

When I am by myself, it is nearly impossible to convince myself to get the necessary sugar. Often times I will check myself, see that I am low, and realize that I need to eat. That is where my thought process plateaus. In my head I will think about what I want to eat, walk to the fridge, open it and realize that making the three-course meal I envisioned isn't practical. Then I will close the fridge, sit back down and start considering my options again. The best part is that there is generally a package of glucose tabs right next to me, but those never sound good when I'm low. The process of deciding on a food, realizing my choice doesn't make sense and starting over continues until someone comes in and forces me to eat the glucose tabs next to me, or I start feeling so miserable that I shakily force food into my mouth. Either way, that whole time I am the exact opposite of productive. Hopefully I didn't go low in the middle of doing something important because if that is the case, I will have a lot of make up work to do later. Such is life I suppose.

In a perfect world, there would be no highs and no lows, but since that isn’t the case, I think the next best thing is to be prepared to deal with whatever comes up. To me, that means taking a proactive approach to talking with people I am in contact with regularly, (roommates, friends, professors, etc) and explaining the basics of diabetes, so if I do find myself in an emergency situation, I can be much more confident that it will all work out. I have heard too many stories of deaths due to type 1 diabetes and I have often wondered, “what if the people around them knew more about diabetes?” and “how can this be prevented in the future?”

Intense diabetes circumstances don’t happen that frequently, but they are always unexpected when they do. If we knew our blood sugars were about to drop dangerously low, it would be easy to prevent, but that’s not the case. I like the idea that I am totally in control, and in my experience, I have found that educating those around me is the easiest way to always maintain that control. We can hope that eventually there will be no more stories of people dying in their sleep because of ridiculously low blood sugars.


  1. Great explanation of the feeling. I've stood in bewildered silence before the fridge, opening and closing the door, more times than I can count. I've also got an impressive array of scars around my eye ridges as a result of not getting down the stairs from my room in time to go through the fridge ritual and instead end up face planting at the bottom of the steps. As a cyclist, I assume it may be something like bonking, but I don't think I'm capable of bonking without first going low (or "turtle" as my friends like to call it), so I dunno. Anywho, great post. Thanks.

  2. Interesting. Each of us has a different set of "low" reactions. It's possible that mine are different in part because as someone with Type 2 diabetes (and not requiring insulin), they're not as low, and the drops are never that steep. The last time I felt the sort of symptoms you're describing was the last time I fainted (something I've done maybe twice in my life).