Lo! Lo! Lo!

The first time I experienced low blood sugar, I thought I was dying.

I was an eleven-year-old child still in the hospital being “stabilized” after my initial diagnosis of Type 1 diabetes when I felt the “rush.” The rush that takes breath away as is often felt as a free fall.

Imagine the face of a sheer cliff, and though the “fingertips” of the brain scramble frantically in search of a hold, there seems to be no niche to catch onto, nothing but air. Space and air. Internally, there seems to be some dramatic drop in the barometric pressure of each cell in the body. The diabetic is falling or sinking and the insides become weak, the mind distracted. On that particular day, I was struck by the inaction of those around me in the hospital room, the other patient and visitors. Did they not notice I was dying? I did start to cry then, though at least, I finally managed to find and push the nurse’s button.

Normal blood sugar levels are said to range between 70-120. Of course, a diabetic’s blood sugars can soar way, way over a 120. Numbers like 200, 300, higher still, are not out of the question. The word “coma” is used to describe passing out due to a high blood sugar. (The public at large still confuses a diabetic coma with the physical state resulting from low blood sugar or insulin shock.) However, I think more diabetics die of low, rather than high, blood sugars. Hand-held glucometers were not available in the world of my childhood, but the lowest blood sugar most today’s blood testers will measure is 30. Thirty and then today’s machine starts to flash: LO, LO, LO. Too much insulin; the diabetic is overdosing! O.D.!

A diabetic then needs to get his or her sugar level up immediately. Or what? Most diabetics don’t stop to think much about what’s happening, or perhaps can’t think well as the sudden “rush” or “drop” is accompanied by a ravaging hunger and sweat pouring over the skin. If glucose tablets or fruit juice is not administered, what can follow all too quickly is a loss of consciousness, later convulsions and even death. Glucose tablets can be purchased at any drugstore. The tablets dissolves immediately in the mouth, and therefore, sugar bypasses digestion, immediately hitting the blood stream. However, any sugar can do the trick, though orange juice is recognized as the fastest home remedy, or a glucagon shot if the diabetic has passed out. (Glucagon emergency kits are available for home use for the diabetic today; they were not in my childhood or young adulthood. The kit is roughly a prepared shot of “sugar” that acts immediately to stave off or bring one out of shock.)

My favorite sugar is chocolate or cookies, though these take some time to digest and enter the blood stream. However, after the diabetic has “crashed,” eating will not cease until the sufferer feels “safe.” Hence, the person then has an immediate climb in blood sugars, perhaps gradually resulting in very high blood sugar. A good thing about an insulin pump is then, without sticking one’s self, the diabetic can also compensate for the intake of way too many calories.

I have no real memory of my first reported low blood sugar outside of a medical setting, but to this day, I feel a twinge of embarrassment if I remember the tale I’ve been told. Evidently, I’d been playing at home on the front porch swing when I turned violently on a young girlfriend. I was told neighbors actually had to help drag me from underneath the swing then as I’d screamed quite clearly that I WAS NOT going back to that hospital again! I was also told I became quite violent in the emergency room, slapping at nurses and knocking a urine specimen across the shiny hospital floor. The story of my behavior mortified me, and I was sure that in our small town, the story of my “fit” was spreading like wildfire. Childhood friends have since shared with me a couple of lows that turned into convulsions and/or a frightening event of some sort. Frightening to them; fortunately, I have no memory of some of these times. Still, though not always, I usually came out of them without hospitalization. Just a little bit of sugar.

Not to worry, I have suffered nothing this serious since very young adulthood. Also, like most diabetics, I still always carry candy with me. I can panic if I forget, though I’ve certainly learned to remain cool and “bide my time” as perhaps nothing bad will happen. This “carrying of sugar process” actually often proved somewhat difficult when I was younger, however. Remember, candy and gum were not encouraged in school, which is where I was most of the time. Yes, I’m afraid I learned early on to carry a large purse, even when not the fashion, so that it could hold candy besides all of my insulin paraphernalia. Glucose tablets were not widely available in the olden days. No, the candy suggested to the diabetics was, of all things, lemon drops. (Many diabetics love an excuse for chocolate, but chocolate can melt in your pocket or your purse!) Not that I didn’t like lemon drops, but they did not come individually wrapped in those days; rather the tart, but sugared lozenges came in large crackly bags that called to much attention to me as I tried to sneak some out during the quiet of say, study hall.

Life Savers also became a popular “cure” for low blood sugar since they were easier to carry, but those pieces of candy seemed so tiny. Someone “falling fast” into low blood sugar could chew and swallow a whole pack in maybe seconds, and still wonder desperately whether even that amount would do any good. I’d like to meet the diabetic who could easily and calmly wait the medically suggested twenty minutes to find out before downing yet another cookie or brownie, or yet another lemon drop or half-pack of Life Savers.

Even in today’s world, there are many who rush to “blame the victim” of a disease. The result was that as an adolescent diabetic, I was so embarrassed when I had to search my purse for that bit of sugar! Remember the crackling bag? Also, it is not uncommon for the public at large to think that diabetes is caused by eating too much sugar. Why, I’d caused my own disease by eating too much sugar, hadn’t I? Or maybe I had. Not to mention, everyone in town, as far as I was concerned, thought I wasn’t supposed to ever eat sugar. Not wanting them to make a big deal about policing my sugar, I’d try to stave off low blood sugar panics until I could manage to be alone. However, there I’d be, smack dab in the middle of a group of people as the telltale weakness and heat crept over me during a quiet church service or a study hall where others were not even allowed to chew gum! I just so did not want to feel different or be blamed, or even envied as I struggled with crackling candy wrappers. No, better to just sit quietly and concentrate on not sweating or fainting. I must look and act like everyone else—“normal.”

Most diabetics, and many other “victims of illness,” not desirous of pity or the snobbery and horror often accompanying it, try so hard not to need help. Of course, I can finally concede (but only finally) that a whole lot of people may try too hard. Anything, to retain our self-respect as “healthy” human-beings, “cool” teens, or self-assured and proficient professionals.

In my youth, if I suffered an insulin shock during the night (horror of all diabetic horrors), milk was somehow comforting to me, perhaps as a security food. I remember standing weak and wobbly in the bright yellow light of our old refrigerator back home. I’d never turn on the lights. (No need to wake the whole household and cause a commotion!) Most times, though, my birdlike mother would wake and hover at my annoyed teenage elbow. Her nervousness, I’m afraid, made me nervous. Even angry. But more terrifying than waking up and suffering her shock and fear, was the thought of not waking up at all. It was possible to die in one’s sleep, was it not?

Early in college, I once evidently “slept” all the way through the night, the next morning, lunch, and into the late afternoon, before my roommate discovered that I could not seem to wake up at all. I had to be rescued and taken to the health clinic while wearing my ragged bathrobe and no makeup. A boy who was a friend of mine was called in to carry me down the steps of the dorm. After this incident, he grew painfully distant. This more serious degree of low blood sugar has luckily happened only a couple of times in my entire life. Once, a resident fellow for my dorm actually spooned honey into my mouth. It was the only form of sugar on hand since no one thought to go through my purse. If I lost consciousness, the general consensus back then must have been to call an ambulance and frighten everyone to death. I have to say all this type of behavior did was edge thoughts of death into my consciousness more and more.

I remember once waking and turning to shake a boyfriend awake. I tried to speak, but to my horror the sounds that came from my throat were not recognizable as words. I sounded like a braying donkey–me, the scholarship winner and articulate English major, not to mention a new and romantically involved graduate magna cum laude. When my boyfriend finally got me to the hospital and propped me up inside against a wall, while he dashed for a nurse and a wheelchair, I slid slowly down the wall into a sodden heap on the floor. I thanked God I’d remained conscious, though, and hadn’t hauled off and hit my lover or peed on the floor. A really attractive damsel in distress I’d have been then, right? On the rare occasions that I did go into complete insulin shock, I remember feeling embarrassed, ashamed, and humiliated immediately upon waking. None of this experience is good for the growing adolescent, much less an adult.

Unfortunately, I’ve heard since of one diabetic, a teen boy who had an extreme episode of low blood sugar and passed out in shallow water. He drowned. Others swerve off the road to harm themselves or others. (Is the driver acting drunk? Check the medical tag, please!) Diabetes is a serious illness. Diabetics can live a “normal” life, and yet that daily life often conceals the real possibility of sudden death. Still, the vast majority do manage to stay “in control” and save themselves and others. Since I did not suffer any serious episodes after adolescence and the accompanying rampant hormonal imbalance, to this day, I am told I have remarkable powers of concentration. People say I portray “calm” itself. I’d say rather that I see no use in hysteria. Mine or yours. The child I was learned early on, and the adult remembers that hysteria is deadly or silly.

To all sugar police: Never chastise a diabetic for eating too much to overcome a low blood sugar. The medical advice to take glucose tabs or drinking half a Coke and then sitting for twenty minutes will not do it for most. This is because my reaction to that advice is, “You have got to be kidding me!” You want me to sit quietly while I’m disappearing behind my own face? Thank you, but I’ll eat or drink until I feel that blood sugar rise, myself, within my own blood vessels. I don’t want one bite, but the whole candy bar; not one cookie but a dozen and not just one sip of orange juice. I’ll swallow the whole glass.

Remember, a diabetic is grappling for a hold along the sheer rock face of a cliff, or grappling against empty air, struggling to keep conscious, inch by inch. A harrowing experience. Do you really want to judge for me as to when I’m back on firm ground? Am I smiling and nodding as if nothing is wrong, though you could swear I was slipping way away just a moment ago? You bet I will. Again, I rarely have low blood sugars these days, but rather than shame now, I do try to feel grateful, thankful, at least act politely if anyone expresses concern about my health. I still want to assure all, as I always have, that yes, I’m going to live. I’m all right and A-Okay. Please do not worry about me. I’m an old hand, after all.

As a matter of fact, I feel the need to assure people that I consider myself a lucky diabetic because I can actually feel a low blood sugar coming on. In addition, if I am having low blood sugar during the night, I automatically wake up, (unlike the old college days of raging hormones and nights spent staying up too late). I have been informed by fellow patients that those new to diabetes, as well as Type 2s, have a harder time feeling a low coming on; thus, the danger. (In this case of “not feeling,” I’ve been told the glucose sensor’s up-and-down arrows are of particular help. The sensor’s arrows, not to mention its alarms, do tell a diabetic that the blood sugar is rapidly rising or falling.) Again, I always feel that “falling” feeling. Then I pop some sugar immediately and/or eat, and all is fine.

As a “patient,” I ask one more favor. There are a growing number of patients, including children who were perhaps struck by a virus as I was—and thus, here comes yet another juvenile diabetic. Some are very small children—those babies I always worried myself about, the toddlers and the very young. What about those rebellious adolescents like I once was? Should we not ask of medical research as a whole: why do the remedies to chronic diseases always seem to cause such serious side effects, including injury and death? (No wonder people are so anxious for “natural medicines”!) And again, I can see how insulin delivery was the most natural or sensible thing to study early on, but are there not also other methods and areas to study on the way to finding a cure for diabetes? I’m not enough of a scientist to know. Just asking and now willing to listen and learn. It’s hard not being perfect, but come join me in the freedom of letting go of that idea. Let go and breathe easy.