An Unusual Precaution

When you fist get diagnosed with Diabetes the doctors give you a brief education on the disease. I had mine while wasting time locked in a hospital for the weekend. The nurse would wheel in a TV with a VCR hooked up to it (this was in 1996) and play some outdated video very similar to the types you would see in drivers ed in high school.

They would show you the basics and try to scare the crap out of you by telling you about all of the complications that can happen if you don't take good care of yourself (think, red asphalt for diabetes). They show you how to shoot up, sorry, to inject insulin and how to test the amount of sugar in your blood.

But the education is brief and shallow. They don't mention the social implications of a disease that involves such a social passtime, eating. They don't mention the fear of not waking up that comes when your go to sleep the night after your blood sugars have dropped so low you had to call 911 on yourself because you knew it was very likely you would pass out in the next few minutes with no one in the house to help. And they don't mention a million other things that you learn along the way.

After fourteen years with the disease, I thought I had pretty much experienced all of the cautionary tales and knew how to keep myself safe. Last week, however, I found there was a new lesson to learn. I have been dealing with a new, temporary, chronic disease, Mulitnodular Toxic Goiter, which in essence speeds up all of the processes in your body. It is like being on speed 24 hours a day.

It sounds like a great condition to have because you could get so much done and have massive amounts of energy. The problem is that your body actually needs rest. It needs sleep and down-time and relaxation. My body no longer gets this.

I thrash around at night and never get any deep sleep. I am forever in that light phase of sleep where you dream, the most useless level of sleep. And so I am tired. I am tired every day at every moment.

I have started playing around with ways to get some sleep. I have tried a nice drink before bed, but with my hyperexcited state it doesn't do a thing. I have tried meditation before bed, staying up extra late, and turning down the lights 30 minutes before bed. I have recently even tried Tylenol PM. The tylenol my doctor has recommended to reduce the swelling in my thyroid and the P.M. sounded good to me so I took 2, the recommended dose.

And, oh what a sleep I had. After about nine months of not really sleeping it was welcomed as much as a sweet summer rain. The problem came when my blood sugars dropped in the middle of the night.

Plummeting blood sugars in the middle of the night are not a rare occurrence for me, although they can be a scary one. It is a bit disconcerting to be awakened, shaking and sweaty, and somewhat disoriented. I feel my way into the kitchen through the darkened house, trying not to bump into too many walls so as not to wake my sleeping family. I stumble to the fridge and pull out the milk, make my way to the cupboard to get the chocolate milk mix and hopefully remember a cup before I pour a gallon of milk on the counter.

I have done this enough times that it is pretty much on auto-pilot. But this night was different. With those sleeping pills on board, I was barely able to function. I felt low, but the thought that I needed to do something about it didn't occur. I simply felt low and knew that was bad.

After about 30 minutes of laying in bed like this, I thought I should do something about it, but the only thing I could think was to stand up. Once I was up, I was lost. Bathroom? No. TV? No. Kitchen? Maybe, let's go see.

Once in the kitchen the overwhelming need to eat started. So I looked around and could not figure out where to find food. I just stood there staring at a closed cupboard, a sink, the skylight, fridge door, 3 inch square white tile with grey blue grout that had at one point in time been white, but, after years of use had been tinged with the food and spilled drinks.

Maybe I should buy something to clean that, I'm sure someone has come up with a new caustic cleaner that will turn the gout back to white, but will poison all of the food we will put on the counter for years to come until we each have 4 arms and 6 legs and can walk on the walls.

Maybe I should just use some Simple Green, but I can't find it at Costco anymore, or anywhere for that matter. Maybe they went out of business, but when I am up at my parent splace I still see their factory building standing with their name still on it. Oh crap, food. Try the cupboard door. Almonds, spaghetti noodles, chocolate milk mix. Hmmmm. Fridge, Left over pizza, ketchup, pickles, milk. We're getting somewhere now. Milk plus chocolate milk mix makes something, I just know it. Cup. Spoon. Pour milk. Spoon up mix.

I watch my hand try to scoop up the mix which it does just fine. The problem comes when my shaking hand tries to transfer the mix from the canister to the cup of milk. Half of it ends up on the counter.

So I go for another 5 scoops just to make sure I get enough in the cup.

Mix. Drink.

Ignore the incredible mess I have just made on the counter, one for which I know I will be mercilessly teased by my husband, Tony, in the morning, but all I can think of now is BED. I stumble back and pass out. When the morning comes, I am refreshed from the first good night of sleep in months, but I know it will be quite some time before I risk that again. The chances of a diabetic dying in her sleep are always there.

We try to reduce our odds by being in good control in the day and by training ourselves to be sensitive to the body sensations of being low so we can wake ourselves up. I have even become aware of the types of dreams I usually have when I am low (typically food based) and have trained myself to wake up.

But taking sleeping pills, although effective for sleep, really increase our odds of not catching a low and reaping the consequences. The body cannot live on too little sugar in the blood. It will simply stop living.

For me, I choose to be tired. Life is much better than sleep. The old saying, "I'll sleep when I'm dead" has new meaning for me lately, one in whihc I do not want to learn firsthand.

My Greatest Diabetic Tool

(Disclaimer: Gu is a sponsor of the Sea Peptide Salties and has provided their product to the team, but I would not use it to save my life unless I knew it was the best way for me to do it.)

One of the greatest finds in my diabetic life was really not a diabetic product at all.

One of the main problems with having diabetes is needing to keep the amount of sugar in your blood within a very narrow window. There are a hundred factors you have to balance and calculate.

And most of the time, you’re really just estimating. There is no number for how hard you pushed on your last swim or the quality of sleep last night. No stress number or hormone level number.

The numbers we do have are not much better either. My blood glucose meter is allowed to be off by at least 20%. TWENTY PERCENT!

So let’s do some math. Your meter says 400. And with a few expletive flying out of your math, you start to calculate. 400 equals 6 units of insulin to drive that sugar out of your blood and into the muscle. And so you coast back to your window of 80-120. But what if really you were 320, 20% lower than your meter said.

So now you are sailing 80 points lower than you expected. Let’s see…80-80 =0. That 20% puts you at zero sugar in your blood. Absolutely none. And I’m sure you can figure out what zero sugar would do to a person. Just like zero gas in your car, you aren’t going anywhere for a long time, or really ever again.

With estimating being so unsure, you need to have a Plan B. Plan B usually consists of some easy to eat, easy to carry, easy to digest sugar source. When I was first diagnosed, I followed my doctors recommendation of carrying Life Savers around (fitting name). Problem is when you are low and somewhat confused, it is really hard to eat a whole pack of Life Savers in under 30 seconds, especially the mint ones.

I moved onto Skittles, but those are really good. They didn’t last long even when I wasn’t low. The 'I’ll have just one…' syndrome. Chocolate milk and Gatorade are my go to sugars on land when I’m mopping the floors and I mop a little too hard (yes, even serious mopping will drive your blood sugars too low).

The conventional wisdom is that Diabetics shouldn’t do anything where they could get hurt if the get low or if they can’t get to a sugar source quickly. That presents quite a problem when I surf, snorkel or swim in the ocean. Sometimes I can be a quarter mile out to sea while exercising vigorously.

I tried candy in a Ziploc, which lasted about 4 seconds. Salty Skittles are just not good. I tried to stash sugars buried in the sand, but they were too far away. I even toyed with the idea of having some waterproof container glassed into my board so I could stash sugars in there. Maybe a little too much work for that one.

My quest was over when I discovered Gu energy gel. For those of you who are not endurance athletes, Gu energy gels are a honey-like gel that contains quick acting carbohydrates and electrolytes. And these things are amazing.

They are the perfect dose (odd that I refer to food as doses, one of the side effects of having Diabetes, I guess.) There is no chewing involved so it takes about three seconds to get one down.

They are designed for athletes so they get from the pack, to your stomach and into your blood stream quickly through some chemical transaction that I memorized in college but have since forgotten in favor of every word of the new Hannah Montana Album (not my music choice, I have a six year old daughter).

They come in these compact cases that fit perfectly into the leg of my wetsuit so I have them ready to go. And I can’t tell you how amazing these things taste after being in the salt water. After the saltiness of the water they taste like vanilla frosting straight form the can. Vanilla is my favorite, followed by the Strawberry Banana.

I had one Strawberry Gel from another company that tasted like a warm, somewhat turned Strawberry Jelly that you kid forgot out on the counter in the warm sun all day while you were at school. And the worst part is you usually squeeze at least half of the pack into your mouth all at once, so you have this mouth full of jelly that you really can’t get yourself to swallow, but you can’t find a way to get it all out of your mouth (I’ve been told spitting isn’t ladylike and anyways how do you get that much gel out in one spit) and you really don’t want to waste the calories on a good, long run.

So you turn your mind off and tell your mouth to swallow. And then comes the real quandary; do you want those extra calories enough to knowingly take another hit, or risk not being able to go as hard as you wanted because you didn’t bring enough fuel. Let’s just say that is the last time I go out searching for one of the new brands just to see if they’re any better. Short answer, No.

One of the great thingsGu has allowed me to do is set into motion plans to sail single-handed in the Florida Keys next summer. Solo sailing is one of the big No-No’s in the diabetic world. It’s up there with flying solo and scuba diving. You get low, you crash.

Or if you’re under water you can’t really stop to test your blood sugars and get sugar (well unless you don’t mind an underwater Gu, which, personally, I think sounds pretty good and doable.) Since I can stash these tiny perfect sugars everywhere, I don’t have to worry about setting a self steering mechanism and going below to get some sugar.

What happens if I have to do that in some bad weather when I can’t go from the tiller? When Johnny alerts me that I’m going low, (Johnny is my Continuous Glucose Monitor who checks my sugars every 5 minutes and reports them to me) I now grab the Power Gel in my shorts and down it. Crisis averted

Brown is Much Easier Than White

Last night I found myself in an unfamiliar kitchen shoveling down brown sugar in front of a somewhat concerned and scared lady.

It was the first night of a Bible study a friend invited me to where I knew nobody. Johnny, my CGM, alerts me that I'm low, so I go to my truck parked outside to find I have once again forgotten to replace my emergency stash of sugars.

I had to ask the hostess if she had any sugar. She is staying at her parents house. Dad is "some other type of diabetic," as she put it, and being a good boy he has annihilated all traces of sugar in the house so he won't be tempted.

We're scouring every nook and cranny for some source of sugar. Everything was diet or sugar free. Maybe he forgot to replace his emergency stash too.

I spot a small crystal bowl on the counter next to the coffee pot and have to ask if it is in fact my savior. Luckily it was brown sugar (much easier to eat than white, in case you have ever wondered.)

Without even asking I am scrambling through drawers to find a spoon and start to dig in as her face starts to look a little concerned for my sanity. She asked if I was in any danger. She was real sweet and knew enough to know it could be bad.

Nope, I told her, just a minor low. Minor except for the fact that I just ate sugar. Haven't done that since I was eight.