Wednesday, 28 September 2016

A Hypo That Hurt

Today I'm sharing my experience of a hypo (hypoglycemic attack) from a few months ago that has stuck in my head. 

For those with a fully functioning pancreas a hypo is caused on a very basic level by either having too much insulin on board, not enough food or a combination of them both. Hypo symptoms vary from person to person and a good summary can be seen at Diabetes UK here.

As someone who's lived with diabetes for a while there are a few hypos that stick in the brain. And those that do tend to be the big ones. The ones that require the help of other people mostly. Thankfully for me this isn't a frequent occurrence but one that's unsettling none the less. A few 'highlights' over the years include; being collapsed in bed while visiting my sister in Germany instead of meeting up for a lunchtime squash session, collapsing in my hallway when my (other) sister was visiting the house with me scrambling around on the floor trying to get some sweets, and my personal favourite which is laying on the landing after my toddler son's bathtime and while Mrs Tangerine is coming to the rescue and getting some food he decides to draw on my face with a pen.

You'll notice from the descriptions above the really big ones normally come with massive co-ordination issues and the need for assistance from others. But the descriptions are also very factual and fail to give a sense of how it feels to be there. And I know my words here are entirely one sided and fail massively to capture the emotions of those around me trying to bring me back into the world of the conscious. 

The one this summer was the first really bad one for a while and maybe that's part of the reason why it has hit me so hard. 

First up the mechanics of it. As with all good stories it started with an impromptu visit to the pub in the afternoon. I'd had very little to eat that day and, as I've found recently, the lager I was drinking sent my blood glucose (BG) levels climbing higher. As it climbed higher and higher, in my drink fuelled brain, I decided to correct this and correct again by giving myself more and more insulin. Sat here now typing the outcome was inevitable and I got what I deserved. But the people around me didn't deserve what they got. For most of them this was the first time they'd seen me dangerously low and I know it surprised them too.

After a few hours we decided to return to a friend's house to continue the party. As time passed I started to feel more and more drunk even though I'd stopped drinking. The decision to stop was mainly down to the BG nightmare I was having and even tipsy Dave knew more alcohol wouldn't help the situation.

To add to the fun my BG testing kit was at home and the battery on my Freestyle Libre had died. This meant I was flying solo although by this stage my judgement was getting more and more messed up.

At this point my memories go fuzzy but I do remember very clearly sat on the sofa with my wife knelt before me force feeding me chocolate Minstrels. This is where it gets nasty and I did well to avoid getting hit very hard. In my hypo-head my BG levels were perfectly normal and eating food without taking any insulin was dangerous. With all seriousness and no thinking I shouted at the person who loves me unconditionally and doing their best to make me well "By making me eat these you are killing me!" Even now it's hard to think about without feeling massive regret and guilt. How that must have felt for her I can only guess. Her actions at the time were the polar opposite to killing me and she didn't deserve this abuse from me.

After a few minutes I agreed to prove to her that I was fine and would test my blood glucose levels. I mentioned above that my co-ordination levels often disappear but this time I was able to walk/stagger perfectly well. As we live on the same street we marched together back home. Both of us convinced we would be proven correct but obviously this was only going to be correct for one of us. I say we both marched but the reality was that Laura guided me home hoping I would finally accept the reality.

The BG meter was quickly found, blood extracted and applied to the strip. The five seconds wait for the BG meter to deliver its judgement is normally a quick process but on this occasion the penny dropped in my head and reality hit before the timer had finished and I knew the number about to appear would be a low one, it felt like time stood still. A bit like the scene in The Matrix but with fewer bullets. It was a low number. 2.0 mmol/L (36mg/dl). I've had numbers this low before without any drama but for some unknown reason this was hitting me hard. Whether the consumed Minstrels had already had an effect and I had been even lower I'm not sure.

The meter was a definite lightbulb moment and my own self-preservation and awareness kicked in. I started to consume some quick acting carbs and at the same point attempted to apologise for the abuse I had unloaded in the previous 30 minutes. I knew I'd messed up big style here and no amount of saying sorry could remove what I'd said. Added to this were a handful of close friends who had been left in a state of wondering what had just happened, how and why. They all know about my diabetes but this was the first time I'd shared with them the hard parts that Laura has experienced occasionally before.

Massive credit to Laura as she is fantastic and says she understands it wasn't the real me saying those things but I know that being on the receiving end of the abuse isn’t easy and must hurt. A lot. Especially when she’s trying her best to keep me safe. And also credit to my friends who saw this and didn't judge me but were amazed when I returned to the house virtually back to normal and able to have civil conversations about the episode.

The classic question to a person with diabetes is what does a hypo feel like? Well to everyone it will feel slightly different and for me each hypo can hit me in different ways. In this instance although BG levels quickly returned to normal the impact of it has been long-lasting. The guilt of putting those who are closest to me through that is significant and I'm very keen to do the best I can to prevent this happening again. This has involved cutting down on the drinking and also not correcting any alcohol related highs while still in the pub. If I am high then waiting until we leave is an acceptable risk for me to prevent the much bigger danger of being dangerously low.

There are other factors to bring into the equation too. As part of UK driving licensing rules people with type 1 diabetes need to get their licence renewed every three years. And one of the questions asked is if you have had two instances of a hypo requiring the assistance from another person in the last 12 months. For me it's over 12 months until I need to renew but if I did then this would count towards my two strikes total. As a side issue this would be harsh as I wouldn't have been driving that night as I'd drunk too much alcohol anyway. I guess saying that I only have disabling hypos when drunk wouldn't make me exempt from the analysis?

This post for me is a massive conflict as I hate to say that diabetes holds me back in any way. And as shown in the last one about a day on a bike this is definitely the case. The impact of this hypo wasn't in the short-term, it's been the ongoing worry, analysis and regret of it and the feeling that others will judge me because of what they saw and did on that night.

Thank you for reading and please do let me know about what hypos feel like to you.

13 comments:

  1. Great post Dave and you sum up the experience really well. It's not just the event itself, it's how it changed the way you feel for weeks and months afterwards. It shames me to think of all the years I put my family through this sort of thing all too often. Thankfully I've not had a really nasty one for some years now, but I know the guilt you describe all too well.

    Hope it's a very long time before you get another anything like this - sounds like you are taking all the right steps.

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    1. Thanks Mike. Check, eat/bolus, move on and repeat.

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  2. Hi, have just come across your blog, and I do know what it feels like during and after hypos. I have had plenty of experience, though at the time, I had no idea what was happening to me.
    I do not have diabetes but I have a condition that means if I'm not careful with what I eat, I hyper, then hypo.
    Because of my ignorance, the rollercoaster of fluctuating blood glucose levels between hyper then hypo had my head in what I refer as my hypo hell period.
    During this time, I really didn't know wether I was coming or going, finding myself in places and situations that were totally baffling. I use to fall asleep at times, but it wasn't sleep, I would just conk out and wake an hour or so later. I had so many symptoms because of my highs and lows, such as depression, anxiety, forgetfulness, memory blanks, disorientation, dizzy spells, sweats, hunger, rage, anger, sleep deprivation and wild lucid dreams and lots more!
    Because of my constant hypos, I was finally referred to an endocrinologist, who diagnosed me. My surgery and another endocrinologist didn't have a clue!
    I was lucky to find my endocrinologist, I'm certain there are others struggling with this type of metabolic condition.
    Thanks for sharing.
    The weird non diabetic!

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    1. Thanks for reading and commenting Kitman. Good to hear you've finally got someone who can help you properly as it sounds tough.

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    2. Hi Dave,
      I've been diabetic for 27 years and have had some proper scary hypos in that time, the one that always comes to mind was waking up feeling low came downstairs to check blood it was 1.6 mmol, I remember getting up to find somethin to fix me, when I regained consciousness I was face down upstairs on the bathroom floor!
      I was home alone for this one!
      It hurts when loved ones see a bad hypo, it makes it harder for me to deal with!
      My daughters saw a bad one a couple of weeks ago, seeing them upset and crying because daddy was 'shaking' really made me feel guilty!
      I suppose we've all had episodes like these, our war stories, it's how we learn from them that counts and having them alone to not feel guilty for them, lol!

      Hope you have been as well as you can be since your episode!
      I would like to say "and you don't have anymore" but unfortunately they do happen!
      Thanks for posting this blog it touched a chord!

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    3. Hi Andy,

      Thanks for reading. I'm sure your daughters will understand and don't think any less of you because of it.

      Like you say they do happen we've just got to learn how to prevent them as much as we can and accept our imperfections when they appear.

      Take care.

      Dave

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  3. A Dave I'm so sorry. This sounds utter shite. And I definitely agree with you: it's terribly romantic to say diabetes shouldn't hold you back - but in reality it can, and does, many a time. BUT, you have done what makes the difference - picked up, carried on and keep kicking the arse out of it every single day. Kudos to you, my friend.

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    1. Thanks Anna and the same to you!

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  4. Dave, thanks for sharing this. I'm glad you're alright. The thing that bugs me the most about lows is that they cripple the one thing thing we need to get out of them safely — our brain! Not a fair fight.

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    1. Thanks Scott.

      No, not a fair fight at all. All in all, we do quite well to keep winning.

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  5. Dave, your experience completely mirrors similar episodes I've experienced, not helped by the fact that as a result I've become hypo unaware. Ending up in A&E after having a severe hypo during a bike ride was a wake up call for me. Happily after going onto an insulin pump my control has improved considerably but my longsuffering girlfriend can especially relate to that aggressive unreasoning attitude during the hypo when your brain isn't functioning properly. I've been there too many times but now at least less often.

    Ian

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  6. Thanks for sharing this Dave! Hypos are a huge pain in the backside. We don't seem to talk about the anxiety and all the other emotional stuff around them very much.

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    1. Thanks for the comment Gráinne. Sadly you’re right. I can’t remember ever being asked by a healthcare professional how a hypo made me feel. Maybe because it can’t be plotted on a graph of blood glucose results.

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