The Big Chill

Ironically, the low-point of my CGM graph makes it look like a big smile *

I am guilty of a scary borderline-serious low this evening.

I say borderline-serious because I was still fully aware of what was happening around me, and because I never reached that confusing haze, also known as Telltale Sign Number One.

I say borderline-serious because my CGM was, at one point, showing a 54 mg/dl with double-down arrows.

I say scary because I felt fine – I had no idea I was so low (and going lower, with a full unit of insulin on-board from an earlier high correction). I would not have known if not for my CGM alert, and even then, I thought it was a false reading until my meter confirmed it.

Then the sweat caused my shirt to stick to my back, and my hand to constantly wipe my oversized (thanks, receding hairline) forehead. Then I really believed it.

Though I’ve been doing a really good job of keeping by blood sugars on the lower-but-normal side in the eight weeks or so leading up to Thanksgiving (I’m targeting a monumental A1c improvement), I’ve pretty much fallen off the wagon since Thanksgiving, so much to the point that I’m feeling lows when they aren’t really low, which has led me to trust my feelings more.

Sometimes, trusting one’s feelings is a good thing. When it comes to hypoglycemia awareness, it is not

I say guilty because, although I knew my BG was dropping, I never thought it would drop so far, so fast. I had been clearing the dusting of snow from the driveway when the first “triple-vibrate alert” came. Without looking, I knew it was a LOW PREDICTED alert. I ignored it until the second and third followed, and then I unzipped my coat, took off one glove, and silenced it. Then I zipped up my coat again and put my glove back on.

This was a new coat. My old wool coat had five buttons down the front, but I could easily reach my hand in the space between the buttons and pull the pump from my belt. That technique was a lifesaver – whether I was driving and buckled in the seatbelt, or keeping busy outside. But that coat was well worn out years ago, and this year, I replaced it with a warmer wool coat — one with an extra-warm liner and a zipper — and no means by which to access my pump without partially disrobing out in the freezing cold. This has (seriously!) been a real challenge for me this winter. And though I’d like to blame my new wool coat for several of my low blood sugars lately, I know that would be improper.

But that’s not the chill I’m talking about.

I say guilty because I continued to clear the snow, and when the next alert came, I likewise silenced it. I have a bad habit of trying to outrace lows- whether it comes while shoveling snow, building the backyard hockey rink, or performing household electrical work. Perhaps it’s because I can’t be bothered, or perhaps it’s because I feel I can be stronger and heroic if I just push through it and get the job done.

(Note to self: Trying to outrun a low doesn’t make me a hero. Just a fool.)

Against obvious better judgment, I heard the mail truck making its rounds through the neighborhood, and decided to stay outside and clear the sidewalk until it arrived at the box. After receiving a stack of junk mail from merchants who just won’t quit (because I ordered something three years ago) and making some small-talk with the letter carrier, I came inside and saw the 54 ↓↓. The meter said 48. It wasn’t too long thereafter that I felt the sticky sweats.

I know why this low happened — it doesn’t take a rocket-scientist to figure it out. I rage-bolused a stubborn high, then I went out to shovel snow (without a BG or IOB check first), then I dismissed the CGM alerts without looking at the numbers which led to them. And then I tried playing with my 3-year-old son to distract him from wanting to jump on the iPad. It was one lapse of judgment after another on my part, and I take full accountability.

Sprinkled throughout this story, I consumed a total of six glucose tablets. I’m not quite sure when, but I know it was of a “just one or two”, “maybe I need a little more”, “maybe some more” pattern. I only know the total because there are four left in my tube of ten. Which reminds me, I’m running low and really need to buy some more hypoglycemia-recovery supplies (my new favorite phrase…even if they are not tax-deductible).

But other than the damp shirt and face, physically I felt fine. Certainly, the physical feeling of 48 mg/dl felt fine. (The mental feeling is a different story).

Obviously (since I’m writing this), I recovered. The recovery sucked. It felt horrible, and I can only describe it as

The Big Chill.

That feeling of a shivering coldness unlike any other. It’s not being outside in the freezing cold (with an unzipped coat and just one glove) that leaves you chilled to the bone.

Rather, it’s a chill that comes from within — a chill from the bone — that no amount of layering of apparel  or laying by the fireplace can quell. A chill that starts at the core, within the body, working its way to the surface. Like a real-person-sick, 105-degree-fever type of chill. Only it indicates that my vital signs have become good again.

Physiologically, I think The Big Chill comes from the sweat.  Just as the body perspires to cool itself off in extreme heat, the perspiration also (but unintentionally) cools the body off during hypoglycemia. Except we don’t want that to happen at that time

That Chill signifies that the blood sugar is back to normal, yet it feels so much worse than the actual low did.  As I watch my BG rapidly climb to 80…135…220, I feel worse than when it was dropping 83…62…45. And there’s absolutely nothing I can do about it, other than try to guess how much insulin to take to compensate for the overcorrection of the low.

Well, maybe I can go and buy a new wool coat.  With buttons.

—

* Also, when the Hell did I run out of insulin?! I didn’t realize my reservoir was empty until I went to snap this photo.