Tuesday, January 25, 2011

How low can you go??

Hypoglycemia. Low. A diabetic's worst nightmare, no? The one thing parents of kiddos with diabetes fear most. At camp, its the one HUGE thing we attempt to avoid for the 6 days we have the rugrats. A new diabetic has heard horror stories, everyone (wrongfully) thinks this is why Julia Roberts (I KNOW...I mentioned her AGAIN) dies in Steel Magnolias...wrong. A good friend of mine will let a hypo event rob him of several hours of his life...he is overly dramatic about them (thank you, hormones) and then over treats (hello hyper!), and will bitch, moan and complain about the fear of dropping low again....until it happens....again. Makes me want to choke him. Why all the drama? Why all the fear? How many diabetics do you know, personally, that have kicked the bucket from a low? Now, its not unheard of, and those that have passed in this manner, its absolutely heartbreaking...but honestly, its not something I let ruin my day.....

That is, until this past Thursday. Had an appointment with my orthopedic surgeon...lunch, earlier that day, was a bistro and glass of wine for my BFF's b-day (SHOUT OUT TO THE NESTOR!! COLLLLLAAAAAA), and the partial loss of my voice due to viral laryngitis. Typical day, right? Well, as Dr G is getting my x-rays, I start to feel the quickening pulse and sweaty, light headed feeling that precipitates my lows. So, as a responsible diabetic, I grabbed the glucose tabs out of my purse (These are my FAVE, they taste like sweettarts, and are 1 gram of CHO each ), popped a few...and after a few minutes, the feelings began to dissipate. So, Dr G goes over my xrays, and as we are in the exam room, I began to feel like I was in a tunnel...started to see stars...and the next thing I knew...I awoke in his arms....super romantic, right??? NOT. I was low enough that I couldn't tell the nurse Dr. C's #...low enough that I couldn't speak at all...so I did the next best thing, I started crying!! Thankfully, I was OK, and in the same hospital professional building as the hubs, so he got down there...and proceeded to laugh at me. Yeah. A-hole. I believe the combo of being sick, the alcohol, my use of off label Metformin and not wearing my CGM all contributed to my dramatic lowness.

Its said that an average diabetic, diagnosed in childhood, will drop low between 5,000-15,000 times...in a lifetimes. Dude. Technically, a low is not considered a low until less than 70 mg/dL (3.8 mmol/L, eh?), and some freakkin docs don't consider it low until less than 60...jerkoffs. Something I always aim to explain to my patients is that symptoms can occur, not because of the number, but because of the fall. So lets say you drop from 140 down to 85, in less than an hour..that's at a rate greater than 1 mg/dL per minute...which is quick! Even just that plunge can trigger the symptoms of an actual low sugar. This is where continuous monitoring comes in handy. Having rate of change, predictive and low/high alarms is the only way some diabetics can function. I have been wearing my sensor since Thursday...and I have to tell you, it may be a pain in the ass, but the amount of data made available to me is mind blowing. The thought of bedside screens, displaying this data from another room, or a vehicle that won't start because it senses your sugar is too low, this is the wave of the future, guys!!! Diabetes has come so far, and its amazing to be a part of it all, but yet, we have so far to go. So lets just keep on keepin on, diabetic friends.

Love, Kelley

PS. To all of you Divabetics out there, please remember to always be prepared for a potential hypo. Make sure your Glucoagon Rx is current, that you have at least 15 grams of FAST acting (Not peanuts or Cheerios...you know who you are), this can be 4-6 oz of juice (I love toddler juice boxes for this reason!!), glucose tabs, Smarties, cake icing (Not the can, the tube...duh), and even a follow up snack can be a good idea...Thank you, Sam's & Costco, for your overly large boxes of granola bars!

Saturday, January 15, 2011

Bluuuueeeeee Bayouuuuuuuuu

So when I Googled "diabetes and depression", an interesting thing occurred. First, EVERYTHING was centered around type TWO 'betes, and secondly, several articles stated that diabetes increases your risk of developing depression, and that depression increases your risk for developing diabetes. Hmmmmph. That's...well...depressing!!

For some reason, depression has always been viewed as a taboo subject. Whyyyyyy? It's so common! Over 14 million peeps are clinically depressed in the US. You would think we would all want to commiserate!!

I think my demons were especially difficult to deal with as a teenager, when the dark thoughts crept in. My A1cs were in the double digits...I was drinking...and doing things to my body that were just not healthy. So, not only did I feel like crap physically, mentally I wasn't fit either. Thus began my parent's tug-o-war battle with my life. Endos, psychologists, pediatricians, psychiatrists...I had given up and didn't give a shit. Well I did..as long as it had to do with classic rock, Vodka, the Internet, my friends and older boys. I was a mess!!!!

I eventually got my act (somewhat) together, and made it to college, where I chose my path to become a nurse. Good thing...because I think I'm quite good at it ;-) I still fight with those same demons that haunted me as a 16 year old, though...and have had some pretty effing heavy confrontations with severe post partum depression. Yay for my world class psychiatrist and top dollar pills! Bottom line...as a diabetic, you should be in tune with your body...this includes your head. Diabetes SUCKS...and being faced with a life plagued by a chronic disease can be quite the sugar pill to swallow. Talk to your family...friends..Endo..ob/gyn...teller in the bank drive through...just know, YOU ARE NOT ALONE!!!! There is therapy with a counselor, support groups, girl's night out and medications...utilize one, or all, of them. Without the help of my friends and doctor, I would be up a creek right now. My kids deserve the best me I have to offer, and I didn't want to leave my bedroom. I love them, I love myself, and I'm learning to kind of like my diabetes (which I neglected during themost severe period of my PPD....experienced highest A1c in over 10 years...eeeeeeek!!!).

I want y'all to also realize that the body is a very complicated mess. High or low sugars during the day can cause feelings of fatigue, depression and anxiety....wacky sugars overnight can keep you up, depriving you of sleep, which ain't good for your head....stress revs up your body's stress hormones, which in turn raises sugars and makes you feel hungry (bull shit!!!!!!!!). So very much about you is tied to..well..everything else!!! That pesky gland, the thyroid, can also cause feelings of depression or anxiety...so make sure your doc checks it out at least once a year (a Hashimoto girl, here!!! I tell my parents they genetically screwed me). Low vitamin D levels have also been shown to aggravate depression, so make sure you ate getting your 10 minutes, naked, in the sun daily....or you can take a supplement. I personally take 2,000 IUs per day, and a 50,000 chewable (Replesta..ask your pharmacist) every 2 weeks. Chit chat with your doc about your own dose suited for your needs.

That's all I got! Was feeling a little blue this week, and didn't receive much relief...thought writing about it might be a little cathartic...and also give some others hope, and let them know they aren't alone out there!!!