TALKing Hypos.

This week (September 29th - October 5th) is Hypo Awareness Week. "The aim of Hypo Awareness Week is to raise awareness of hypoglycaemia in the inpatient setting to help hospital staff recognise and treat symptoms and refer patients to the appropriate care teams."

NovoNordisk: Official partner of Hypo Awareness Week 2014.

This year's theme is "TALK hypos" (Think, Ask, Learn and Keep track of [hypos]), encouraging people with diabetes to discuss hypos with their health care teams and vice versa.

My hypos come in various forms but, more often than not, I look like I've got it together, despite how debilitating a low blood sugar feels. There's a video by Kerri Sparling of Six Until Me, in which she video-blogs whilst low. 

"I look and I sort of sound like I've got my shit together, but I don't. I felt so shakey and, actually, after I turned off the camera, I was talking to myself this was stupid, why did you do that? And then I kind of sat on the floor at my house and waited ten minutes for my blood sugar to come up and it was really weird, because it felt so debilitating, but it didn't look really debilitating. It looked...I could have fooled somebody into thinking I was fine."

 

For me, this is why we need to talk hypos: just because we may look fine in that moment, it doesn't mean we are. That, and it's also important to acknowledge that hypo symptoms aren't universal (check out the question Diabetes UK tweeted this morning). So this week, I'll be joining in the discussion, both online and with my (new) GP.

 

For further information about Hypo Awareness Week, click here to be taken to the Diabetes UK website. Also, you can watch the latest videos by Type 1 Uncut, discussing hypos and hypo hangovers.

 

Is It Tuesday, Yet?

Today, I had one of those mornings. You know, one of those ones where I have all of these plans and none of them actually happen.

I planned on going for a run. 

I set my alarm for 7am to set a temporary basal rate on my pump, with the intention of going out for my run around 9am. 

So far, so good.

Another of my alarms went off at 8am. I pre-bolused for breakfast, and had every intention of getting up.

Image taken from Google Images.

You can see where this is going, can't you?

I rolled back over and fell asleep. 

Never, ever good!

A blood sugar of 2.9mmol stirred me from my sleep at 9.30am. Shaky and sweaty (and cursing myself), I made my way downstairs to the fridge and grabbed the cranberry juice, counting the sips, and I sunk to the floor, waiting for my blood sugar to come back up. 

It's one of those occasions where I like to call for a do-over. Except I can't, so instead I'm eagerly awaiting Tuesday so I can try again. 

Dreaming Of Lows.

Hypos come in all shapes and sizes. There are those that I don't feel, and I lose faith in my instincts; those that trigger than internal voice in my head; those that I anticipate, but don't quite catch in time; and, sometimes, they leave me gasping for breath.

Images from Google, merged by me.

But never have I dreamt that I was low, and then woken up low. Very weird!

Happy Monday!       

Frustrated.

Yesterday was a bad day - my blood sugar kept on bottoming-out and I felt like I was constantly eating to keep my blood sugar up. I reduced my bolus insulin, I took less basal at 9.30pm (when I take my levemir), yet I still wasn't getting much above 5mmol.

I floated my way through the day, making small talk here and there with my housemates, trying to concentrate on my revision and job hunting, but very much failing. Instead, I admitted defeat, had dinner with some friends who were in town for the weekend, and, as lovely as it was, was glad when bed time rolled round and I could (hopefully) get some sleep and try again the following day.

It's the following day. 

And things are much smoother-sailing today. 

Gasping.

Image taken from Google Images.

For me, low blood sugars come in a variety of forms. 

There are the ones where (somehow) I'm still functioning.

There are the ones where I can't concentrate.

There are the ones where my ability to form words is inhibited. 

There are the ones where I'm shaky and unstable, causing me to stop whatever I'm doing and sit down.

There are the ones that result me in crying. 

And there are the ones that sometimes (just sometimes) leave me gasping for breath. 

Like last night at 1.30am when a low blood sugar checked in at 1.8mmol.

That one definitely left me gasping for breath.  

Glucoaster.

You know you're in for an interesting night's sleep when you start with...

Positive ketones and a blood sugar of 18.6 and then at 3am you end up with...

 

An empty tube of glucose tabs having consumed the five remaining after a blood sugar of 2.6! 

Tired for my 9am seminar would be an understatement!

Yay for coffee! 

Low.

Image taken from Google Images.

I could hear my alarm going off somewhere in the distance, trying to pull me from my sleep. 

I shut the alarm off and rolled back over. 

Cue my second alarm (I know what I'm like when it comes to 3am blood sugar checks!)

I fumbled trying to switch it off, and closed my eyes once more. 

Now, I often require two alarms for those 3am wake-ups, but after the second I'm usually okay to quickly check my blood sugar, treat/correct/leave, and go back to bed.

I willed my eyes open and reached for my meter and test strips. That's when I realised that my hands were shaking and my pyjama top felt damp. 

I was low. Like, really low, given I'd ignored my two alarms. 

My meter confirmed this - 1.9mmol.

I reached for the carton of juice on the bedside table and quickly started drinking. 

As soon as that was finished, I reached for my glucose tablets and willed my mouth to chew down a couple of them. 

And then I waited. I grabbed my phone as a distraction - checked Facebook, emails, anything to keep my eyes open as I waited for my blood sugar to come back up.

35 minutes after my first alarm went off, I was at 4.5. Back to my slumber I returned.  

Spinning.

Other than seeing my family, my absolute favourite part of coming back to Mum and Dad's for the holidays is seeing E.Hales and Doodle. We text pretty much everyday, and we skype when we can, but nothing compares to a catch-up over coffee (or tea in my case) with her and the sound of Doodle's voice saying "Auntie Vicki", often followed by a run-and-hug. 

Yesterday, we iced gingerbread men. 

Today, we did spinning.

First note to self: don't engage in any activity with the kid that I don't want to be doing for the rest of the afternoon!

I picked Doodle up once and spun him round.

"Again, Auntie Vicki! Please!"

So I did. You try and say "no" to his smile. And "Auntie Vicki" - I can't say "no" when he "Auntie-s" me!

"Again......again......again!"

And hello blood sugar of 2.8mmol when I got back to Mum and Dad's!

Second note to self: reduce insulin when spinning is the kid's game of choice!

Lather, Rinse...Hypo?!

I don't know how long I was staring at the shampoo bottle for before my brain caught up and realised that staring at something like a shampoo bottle for that long wasn't normal! 

"Vicki...come back down to planet earth!" Cue that voice again. 

I blinked slowly and remembered where I was. I also pondered what was so damn interesting about the shampoo bottle that caught my attention for so long! 

"Vicki! Shampoo bottle: not important right now!"

I touched my hair and realised I still hadn't washed the shampoo out. At that point, I felt my hands begin to shake and I realised that washing the shampoo out wasn't an option; the hypo needed to be dealt with first. I turned the shower off and grabbed my towel. Towel wrapped around me, I slowly stepped out of the shower not wanting to slip on the floor and navigated my way back to my bedroom. 

Courtesy of the kid brother, I have a 1.16kg bag of skittles stashed away that he bought me for my birthday. I grabbed them from the top of my wardrobe and started chewing. I found my meter, fumbled with the test strips a little, but managed to do a test: 2.9mmol/l. 

You'd have thought I'd have been panicking a little bit. Maybe eating more than I needed to just to get my blood sugar up quickly. Well, you'd be wrong. I was thinking "it'd be so embarrassing if someone found me like this [towel wrapped round me, shampoo not washed out of hair, sat on my bedroom floor with a giant bag of skittles in front of me]" I mean, it would have been very embarrassing, but not really what was important at the time! 

I ate about 15 skittles (that's usually the number I need to eat to come out of a hypo) and waited another 5 minutes before checking my blood again to make sure I was in the clear.

I was. I could finally wash the shampoo out of my hair. 

Stubborn Sugars.

I'm a little paranoid when it comes to my blood sugar reading before bed. I like to be on an 8 [point] something. Anything below that, and I do snack before bed. Like last night. 7.2mmol/l. So I had a glucose tablet to "top up", if you will, cleaned my teeth and then checked my blood again. 

I should really know by now to never clean my teeth until I'm certain my blood sugar is stable for sleep.

5.6mmol/l.

Two more glucose tablets. With the taste of mint toothpase. Not nice.

4.2mmol/l.

Now I'm effed off. I wanted to go to sleep.

But diabetes had other plans. 

I reached for my apple juice carton and drank half. And then I had to be patient and wait for my blood sugar to come back up. So I played that Minion Rush game on my phone - totally addicted - and waited for my blood sugar to come back up. 

Godson, Doodle, in his baby days.

Twenty minutes later, and my blood sugar was 8.5mmol/l. I went and cleaned my teeth again, and finally collapsed in bed around 1am, letting sleep take over. Kind of like this (---->), giving diabetes the finger too!


 

Symptoms.

Image taken from Google Images.

My low blood sugar symptoms are really crappy. I'm shakey, I sweat, I can't see straight, forming words becomes the most difficult thing in the world and sometimes I cry for no apparent reason.

I told you: crappy.

But, as much I hate the symptoms, I'd rather have them than be without them. These symptoms make me aware of the fact that I need to check my blood sugar, and it scares the hell out of me when I check my blood sugar and see a low reading without these symptoms. 

Like this morning. 3.5mmol/l and no symptoms. 

Not one.

I checked my blood again: 3.4mmol/l.

And then I'm going through my symptoms. And drinking a juice carton at the same time!

I looked at my hands to see if they're shaking - no.

I felt my forehead to check for sweat - no.

I could see perfectly fine.

I started ranting about how I had no symptoms - forming words: check!

And I wasn't crying.

I get so angry when this happens and I lose faith in my instincts. 

It sucks.   

Hypo Hangover.

It was 2am when I started hearing voices again. But being the stubborn person I am, I rolled over and tried to ignore them. My blood sugar was 9.8mmol/l before bed at midnight and I didn't take a correction dose. I shouldn't have been low.

"You need to check your blood sugar, kid" that internal voice tells me.

I, of course, still chose to ignore it. Logic told me that I shouldn't be hypo, so therefore I'm wasn't!

"Gibbs! Blood sugar! Check! Now!"

But I still wasn't having any of it. Logic was telling me otherwise.

"Blood. Sugar. Check."

I don't know how much time passed, but I arose from my slumber, shaking, sweaty and disorientated. 

I reached for my meter and tried to check, but shaky hands made it impossible. So I just treated with glucose tablets (ones I bought from Walmart that come in pots of 50 - it's the little things in life...)

My eyes were heavy, probably due to both sheer tiredness after spending the day at Universal Studios and the hypo itself. 

After the shakiness had lessened, I reached for my meter again to check my blood.

2.8mmol/l.

"Woah, I must have been low!"

I carried on treating the hypo with glucose tablets and I ate a granola bar too. I changed my pyjama top, re-checked my blood (8.2mmol/l), and once again allowed sleep to take over my body.

Damn that internal voice always being right! Very glad to not be leaving the villa today!

Cotton Candy Low.

Cotton Candy or Candy Floss to us Brits: It's a new way to treat a low and it made a nice change from the chalky glucose tabs and apple juice cartons I usually chug when in this state! Damn not anticipating my swim this morning!

Hypo...With A View...

Madrid.

Hypos are never any fun. Despite that somewhat, cool, calm, collected exterior I somehow manage to maintain, on the inside, I'm panicking: worrying about getting my blood sugar back up, thinking what if it doesn't come back up? I feel a bit unsteady on my feet, dizziness tends to ensue, and all in all it's just not a fun experience, which sometimes ends in tears. 

Yesterday, whilst in Madrid meeting up with friends from my university back home, this happened. And it was a stubborn one that took an apple juice carton, a cereal bar and then another juice carton (which literally tasted like sugar dissolved in water) to bring my levels back up...and even then they were only up to a 5.6mmol/l. And did I mention that I was in a cable car whilst this was happening?! 

I was angry and frustrated and close to those tears I mentioned above (well-hidden by my sunglasses) and then I saw Madrid. And it was awesome. The river, the palace, the skyscrapers. It was incredible! And the anger I felt towards my diabetes disappeared, as I was reminded that, although it's not something I can ignore, it doesn't dominate everything; suddenly, the cable car ride wasn't about the fact that I was hypo and struggling to get my levels back up, but instead the breathtaking view of the city where I've spent the last four and a half months.

Diabetes, you've had your moments since you entered my life, but year abroad's all mine!

Hearing Voices.

Bedside snacks.

It's 3am. I'm still tossing and turning unable to sleep, and there's that little voice in my head telling me to check my blood sugar. Now, I knew I wasn't hypo: I wasn't shaking, I wasn't sweating. But that voice was still there telling me to check. When it comes to blood sugar levels over night, I am very paranoid. I like to go to bed between a 7 and 8mmol/l, knowing that, usually, on such levels I will wake on a 5 - 6mmol/l. So when I get this voice in my head telling me to check my sugars at night, I listen to it!

4.2mmol/l was the result. Cue carton of apple juice. I waited 15 minutes, tested again: 3.4mmol/l. Whattt?! Ok, cue some Skittles, and test again: 4.1mmol/l. Going in the right direction, but still not happy with this level. So I then have three chocolate digestive biscuits and wait up for half an hour before checking my blood once again. Finally, after an hour of stubborn sugar levels not wanting to budge from the 4s, I get a reading of 7.1mmol/l. As soon as I got that reading, I crashed out.

It's times like this that I am so grateful that I have good hypo awareness, particularly at night. I mean, I hate hypos no matter when they strike, but I'm especially paranoid about going hypo at night and just not waking up. Last night, my brain would not let me sleep for anything. I went to bed at around midnight, obviously checking my levels before sleeping, and they were at a lovely 7.5mmol/l, so I spent three hours trying to get to sleep before giving into the voice and checking my blood sugar levels again. Clearly, it's a good thing I did. Not gonna lie, that voice has come in handy on a number of occassions!  

Dear Diabetes...

El Acueducto, Segovia.

Just over three years ago now, you came and turned my world upside-down. 

At the time of diagnosis, I knew very little about you - whatever I learnt in GCSE Science just about covered my knowledge on you. Back then, I probably wouldn't have been able to even tell you where my pancreas is located. And you know what? I still can't - it's somewhere between my head and my toes.

But what I have gone and done is learnt how to live with you.

Yes, you make my fingertips rough and sometimes sore; that just means I get to invest in lovely-smelling hand creams.

Yes, you can cause scars, scabs and pin-prick marks on my thighs, stomach and arms; I never liked wearing shorts anyway, and I was never that comfortable with my midriff exposed either.

Yes, you can keep me up at 1am (my laptop is English time, but living in Spain puts me an hour ahead), like you are now, drinking tea and eating chocolate digestives, even when I'm not hungry, to get out of a hypo; chocolate digestives aren't a food I tend to turn down at the best of times!

Yes, you can make leaving the house a mission, what with all the extra kit I need on me - blood testing kit, insulin, needles, hypo treatments; that means I get to spend money on pretty make-up bags to put all that stuff in and I've never had an issue with carrying a big bag.

Yes, you can cause me to have mini-meltdowns with your constant highs and lows and general reminders that you're there; you've helped shape who I am today, so I get that you might want some recognition for that.

But what I won't let you do (or at least try not let you do) is change my attitude towards you; since you became a part of my life, so much good has happened and new friendships have been formed, and they've all been worth every blood test, injection, hypo and hyper (well...maybe not every, but a significant proportion of them are worth it anyway!) 

So thank you.

Livin' La Vida Hypo.

Segovia.

It's been a week now; a week of constant hypos. The first few days were okay: it was the perfect excuse to indulge in ice cream whilst sitting out in the sun, have the occasional glass of sangría instead of playing it safe with wine. A week, however, and I'm frustrated. There is only so much reducing of my Novorapid that I can do. Because at this rate, the next step is not taking any, and I really don't want to be going back down that route! I think I'd actually prefer to eat a little more with my meals. The thought of not taking any insulin and getting back into that habit scares me seeing as I've just managed to sort the diabetes-side of my life out!

Luckily for me, I don't really suffer with my hypos: I get a bit shaky, but, generally, I can still function. It's the night hypos that really get me - they're a whole different ball game. But nonetheless they are draining; they make me feel so, so tired, and no amount of sleep seems to help, and right now, I cannot afford to feel like this. I have classes, exams, coursework deadlines and then finals coming up, and I'm still trying to fit in some travelling as well! I've just got back from Segovia, which was absolutely beautiful, but having to deal with hypos constantly did take away from my day a bit!

Busy, busy, busy. But with less than two months left now, I need to make the most of my time here. Think it's time to start adjusting my basal insulin and see if that improves things. If I'm having these problems in April, God help me when real summer hits!  

Hola Hypos!

Taking in the sites of Madrid.

The weather in Alcalá/Madrid at the moment has suddenly become amazing! (Hello tan for when I return to the UK!) Yesterday, I took a break from working and went into Madrid just because. When I first arrived in Madrid, I completely fell in love with it, so now, if I'm ever at a loose end, off I go into the capital. I actually went to meet a friend from UEA who I hadn't seen since before the Easter break. We just wandered around without a plan, really. The weather was nice so we just thought we'd take in the sites and soak up the sun at the same time. I got a couple of Starbucks coffees whilst I was there (I told you Starbucks was my favourite), but basically we did nothing with our day other than walking around. It was nice! 

However, this sudden change in weather means I need to be on-guard. As this means hypos are going to start happening and ratios are going to need changing. Just when I thought I got it all figured out! Yesterday, I had three hypos, which I'm pretty certain were due to the sudden increase in temperature. In England, I don't have this problem, as it never actually gets that hot. Here, though, it's going to take a lot of effort and tweaking of doses to stop the hypos from happening. 

I posted in the SDUK facebook group today asking people where I should start: is it the basal that needs changing, or is it my meal time ratios. Unfortunately, I received the answer I didn't want, and that was that, chances are, I'm going to need to adjust both! (N.B. Not a healthcare professional, and neither are (most) of the members of the group!) Things are never simple with diabetes! The forecast for the next week doesn't drop below 20 degrees (yay!) so I'm thinking every couple of days is a good interval to then change any doses if necessary? I'm going to start with reducing meal time ratios, and if I find I am still having hypos, I will then look at reducing my basal too. 

Let's see how this works!

Here Comes The Sun.

Finally, some sun!

Alcalá/Madrid in general has finally seen some sun today! The weather has been beautiful and I took full advantage of this as, not only was the weather good, but it was also "puente" or a bank holiday here, so after teaching this morning I ventured into Madrid for the rest of the day. 

I spent most of my day outside taking in the sun. First thing I did was grab a Starbucks. I was getting withdrawal symptoms it had been so long since I last had one. I then walked from there through El Parque De Buen Retiro (picture) to Puerta De Alcalá, up Calle De Alcalá and then along Gran Vía all the way along to Plaza De Espana where I bought another Starbucks (withdrawals, I tell you!) and sat myself down with my kindle for a couple of hours. It was bliss.

However, as lovely as all this walking around soaking up the sun was, it also meant that I spent a lot of the afternoon bringing my sugar levels back up. Yep...one day of sun and a little bit of heat, and it's already having an affect on my sugar levels. And we're not even near the kind of temperatures that I have been told to expect after Easter break. Brilliant. Think it's time to start stockpiling on fruit juice cartons and sweets! I have a feeling I'll need quite a lot whilst I work out new insulin to carb ratios as the weather gets warmer. On a brighter note (no pun intended), hopefully means I'll return to England in June with an awesome tan. If not, definitely a waste of 5 months!

Beat The Hypo?!

Yum!

Now, if we are all honest with ourselves, I'm sure at one stage or another in our diabetic lives we have found ourselves playing a little game of what I'm now calling "Beat the Hypo". Well, I'd like to think I'm not the only person in the world to have decided to play this game, anyway! Here are the results of when I played yesterday on my way back from teaching:

Hypo 1, Vicki 0.

I made it 3/4 of the way home, and then hypo-ed good and proper! It was horrific! I was in the middle of my local supermarket and I managed to find fruit juice cartons. I was fumbling around for what felt like hours trying to get a carton out of the packet, and started drinking extremley quickly, as well as trying to check my blood to establish just how low I was (2.8mmol/l). At this point, security was approaching me, and in my hypo state, had to try to remember as much vocab as I could in order to explain that I had diabetes and was hypo. 

Turns out I didn't need to, as when he saw me holding my blood testing kit, and then the juice cartons he knew exactly what was happening and actually stayed with me to make sure I didn't keel over! He told me that his Mum had type 2, so knew what a hypo was and that I was having one when he walked over. It's not often you bump into someone that knows exactly what's going on!