Monday, September 26, 2011

EMTs in My Bedroom

This is the hardest blog post I've ever had to write. It's hard because it forces me to admit that I am vulnerable. I hate doing that. Seriously hate it. I "have" to write this post because I need to be 100% transparent and because I want to use it to educate others and to encourage others that "vulnerable" does not mean "weak." They are two very different concepts.

Let me clearly state I have Type 1 diabetes, not Type 2. People with Type 2 diabetes typically do not experience this degree of extremes in their blood sugars. I also want to clearly state that I was 100% fine as soon as my blood glucose levels returned to normal.

Last night, for some unknown reason, my blood sugar dropped to dangerously low levels. My husband, Terry, did everything right, but my sugar refused to come up. He was forced to call 911. Before the EMTs arrived, I had a seizure with mild convulsions. For the record, a seizure is caused when the brain receives conflicting signals. Symptoms vary but may include staring into space, appearing awake but being non-responsive, etc. Since the brain's only source of "fuel" is glucose, it is not unusual for diabetics to have seizures - but not convulsions - when they have low glucose levels. A convulsion is a series of involuntary, rapid muscle contractions that are sometimes caused by the abnormal electrical charges occurring in the brain during a seizure. The belief that seizures always cause convulsions is false.

My heart breaks that my husband had to experience this. I can only imagine how frightening it must have been. As I said, he did everything perfectly. I spent today thanking God for him and his wisdom. From what he tells me, I fell asleep (probably due to a low blood sugar) and then awoke but was completely unresponsive. My eyes were open, but I was not acknowledging his presence and would not respond to verbal cues. I was having a seizure.

He fixed a solution of sugar and water and was able to get me to drink from a straw. (He's brilliant, by the way!) He then took a blood sugar. It was 25. I've had sugars of 25 and lower before and been completely coherent. The fact I was still unresponsive with a sugar of 25 indicates my sugar had been much lower and that my brain function was still mildly affected by the seizure. (Which is very temporary and perfectly normal.) He called 911 when I failed to become responsive even after drinking the sugar water.

The EMTs gave me IV glucose and I finally "came to" about 25 minutes later. It took a total of over sixty minutes between the initial seizure and complete coherency. One of the interesting things the EMTs told me was that I appeared to be "ready to fight" when they arrived. The brain is an amazing organ. My survival instincts were fully functioning even when the rest of my cerebral functions were not. Seeing strangers enter my bedroom caused me to react belligerently. On some level I knew I needed their help, but they had to talk me into letting them help me. I apparently changed my mind in the middle of receiving the IV, because I jerked my hand away and succeeded in spraying the carpet with blood.

The EMTs who came were incredible. A man and lady, they were experts but were also very kind and personable. Unfortunately, I failed to ask their names. I owe them a debt of gratitude and need to call to find out who they were.

I want to share what I experienced and what I remember in the hopes it will help others understand what it's like to have a seizure caused by low blood sugars. I remember becoming extremely tired and lying down. The sudden tiredness was a signal my blood sugar was low, but I was not capable of recognizing that at the time. I have no memory of anything until I began having a strange dream where strangers were in my room and a blond woman was speaking very firmly to me. I thought it was a dream, and then wished it were when the realization hit that the woman was an EMT and that my sugar had bottomed out. I became coherent when my sugar reached the mid-30s. The EMT checked my levels and got a 40 after I became coherent and was conversing in a way that made sense. As soon as coherency returned, I began eating fruit to continue the upward rise of my blood sugar. As I said previously, a blood sugar of 40 is low, but is not a level that typically causes incoherency for me. I've had diabetes for over 45 years, so my body has developed an ability to tolerate extremes that most people could not. That fact scares me more than anything else. I hate to imagine how low my sugar was when I first had the seizure. 

After coherency returned, I was embarrassed beyond belief. Was it wrong to feel embarrassed? Of course it was, but that's how I felt. I was mortified to have needed the help and felt horrible to have put my husband through what he went through. Could I have prevented this event? Probably not. I maintain exquisite control of my blood sugars and work hard to maintain control. I probably didn't eat enough yesterday, but there is still nothing that can explain having a sugar low enough to completely destroy my ability to function. Stranger still is that drinking a large amount of glucose failed to raise my blood sugar rapidly enough to restore coherency.

Strangest of all is that my liver had already released the store of glycogen (a natural sugar) that the body typically uses to raise blood glucose levels in emergency situations. My blood sugar should have been in the 400s after that combination of events, yet the highest it got was a very temporary 216. Drinking sugar water, eating fruit, receiving IV glucose and the liver's release of glycogen should have sent my blood sugar through the roof, but did not. My sugar quickly dropped to 95 once the IV glucose wore off This can only mean that my pancreas actually kicked in at some point and did what it was supposed to. I've spent the last 10 years working hard to restore function to my pancreas. The fact my efforts appear to be working is very encouraging, but does mean I must be even more diligent in controlling my blood sugars. I'm ok with that.

The after-effects of an extremely low blood sugar and seizure vary. Mine included a splitting headache and a body temperature of 94 degrees. My body stopped maintaining a normal body temperature in an attempt to provide more glucose to the brain. In effect, I had hypothermia and a reduced core temperature without being exposed to cold. A long, hot bath was the only thing that worked to restore my core temperature to normal.

There you have it. I always want to be 100% transparent when it comes to my health. Sharing this was harder than you know. I hope it helped provide some education and understanding on some level. More than anything, please remember that people with diabetes can't always control what happens with their blood sugar. We try our best, but our bodies sometimes do things that can't be anticipated. Please read my follow-up post, Corn in my Veins, for the unexpected side effects I experienced from the IV solution I was given. Important info for anyone with a corn allergy.

5 comments:

  1. Ohhh. An on again, off again pancreas makes it soooo hard to manage BGL.

    It is a move in the right direction--difficult transition tho it may be--if your pancreas had not been functioning prior. Hopefully, it will fire up right proper and real quick.

    Prayers!

    Deb

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  2. As a Hypoglycemic I know the feeling. It's really hard to understand what's going on once your blood sugar starts tanking, fortunately most of the people around me know what to look for and will suggest that I eat when they see the external signs. One of the most important things is to remember to tell the people you work and live with what to expect. I've had co-workers pick me up off the floor more times than I care to admit.

    The biggest irony -> I've had to learn to be a stress eater. That's one of the things that will cause blood sugar to drop and not recover until you've crashed hard. The other funny cause of irregularity for me is when I eat something that I didn't know had boatloads of sugar in it

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  3. Thanks for sharing Pamela. I bet it was very hard to do. But I appreciate it....it is a good reminder that things can happen and we do need to be prepared, or have those around us prepared. So glad you are fine now!

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  4. Thank you for the courage to write and share this post. It is typical of your blog which makes your blog outstanding. - Randy Clark

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  5. Thanks so much for all your kind comments. It's amazing how God uses situations that appear "negative" to allow us to educate others. Thanks again!

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