Perhaps you saw the picture that I posted yesterday of Arden making a play during her weekend long softball tournament? It was accompanied by a caption that read, "Tournament champions! Five games in two days, not one low BG. OmniPod & DexCom perfect together. #diabetes #softball #undefeated".
I probably could have written a blog post about the experience but I was still plenty exhausted from the weekend - so I went with a simple photo to not only celebrate, but to let you all know that it can be done. Long hot days, travel, little sleep and a lot of exertion can be managed with a few diabetes tools and a little extra focus.
Do you know what a CGM and insulin pump can't help you with? They are not designed to remind a person that they put their wallet into the glove compartment of their wife's car - if they did, yesterday would have gone much better.
This is the story of a blood glucose reading of 25, that happened in a restaurant - it was an old school low, no working CGM and enough rookie mistakes to fill sharps container. Ready?
As previously mentioned, Arden had a softball tournament that lasted all weekend and required us to stay in a hotel on both Friday and Saturday night. In the fine tradition of baseball/softball lunacy, we scampered from the field Sunday afternoon moments after Arden received her championship trophy, to make the ninety minute drive home... so our son Cole could pitch in a 4:30 pm game (Five innings, no runs btw). Anyway, during that drive I put my wallet into the glove compartment of my wife's car and never removed it. This was no big deal, until I found myself in the parking lot of a restaurant the next day - with no money.
I guess that I felt pretty silly having driven ten minutes to the restaurant with my kids and one of Arden's friends in the car only to find that I didn't have any money. I couldn't believe that I forgot my wallet. Then I recalled that it wasn't just abandoned at home, but was in Kelly's car. I thought for a second, asked my son if he had some cash that I could borrow and we drove home to get it from his room.
Ten minutes to the restaurant, a few minutes sitting in the parking lot figuring out what to do, ten minutes home, a few minutes to gather the cash and ten minutes back - then we got our seats, read the menu and ordered.
Lots of confusion, lots of running around - lots of opportunity to forget that I pre-bolused Arden for the meal, when we initially left to go out to eat, you know - almost an hour ago!
My brain snapped back into diabetes mode when Arden said, "Dad, I feel dizzy". I asked her to test. It took a few moments then suddenly the math came to me, Ten minutes + five + ten + five + ten + ten x I bloused for a meal / the CGM is still calibrating = JUST DRINK A JUICE!
I stayed calm not only because we were in a restaurant but because one of Arden's friends and teammates was sitting in the booth right next to her. I prioritized; stop seizure, try not to panic, juice, test, stay focused. Arden's BG was 50 when we tested but I could tell, even without her CGM that she was dropping fast. Not because I knew how long it had been since we bloused, not because a could see it in her face - I could tell because of what she said when I asked her to keep drinking.
Arden took a few sips and then put her head on the table. In my opinion, one of the most frightening and nauseating side-effects of low blood sugar is the inability to care about your own life. "Arden keep drinking, I really need you to keep drinking". She didn't move, I knew she heard me but she could make herself care. Arden understands what will happen if she doesn't drink the juice and she couldn't, because her blood didn't contain enough glucose, make herself care about her own life.
I instructed my son to stand up and then I picked up Arden and moved her to my side of the booth. "Cole, go get apple juice from the waitress, walk right up to her - be fast". I got Arden to finish the juice that we carried and tested again, her BG was now twenty-five. With no CGM arrows to rely on, I just wanted her to keep drinking. Cole returned with the apple juice (Arden doesn't like apple juice) and I had to beg her to drink it - I whispered in her ear, "Arden, please drink this, I think you're about to have a seizure", she responded without hesitation, "I don't care".
Before I knew about diabetes, if you would have told me that a reduction in the amount of sugar in a person's blood would make them cease to care about preserving their own life, I would not have believed you. Continuing to exist is perhaps our most basic and natural instinct, it has kept humans alive and thriving for untold millennia and yet, too much insulin can make you lay down and die without a fight - even when the fight is something as simple as drinking a juice.
I kept talking until she would drink, soon the waitress brought bread and other foods, Arden began to eat and a few minutes later her BG was above fifty. She took a few more minutes to pull herself together and then asked to go back to her original seat, with her friend.
My heart wanted to race but I stopped it from doing so, my eyes wanted to cry but I did not let them. I couldn't breath and I couldn't stop thinking about all of the avenues that I should be considering. Where is more sugar if I need it, when do I let others know how close we are to a real medical emergency, "don't you dare panic", and how the hell did you leave your wallet in Kelly's car? A swirl of thoughts and emotions but they were no longer needed, it was over as fast as it had begun. Now all I had to do was try to put my thoughts all back where they belong. Then the waitress put Arden's meal in front of her and I had to, and this almost seems unthinkable, had to count the carbs that I used to stop the low because I was going to have to bolus again for the meal. Only brave blousing can stop a rebound high. Time to be brave.
I must have looked terrible by this time because my son asked me if I was alright. I only responded, "It sucks being an adult sometimes" - and then we ate lunch.
From Friday night until Monday at noon, I made hundreds of decisions about Arden's diabetes. Some how I was able to manage her through five softball games, swimming, at times - less than healthy food choices, exposure to the hot sun and then I left my wallet in my wife's car - a simple mistake made on Sunday night that took us up to the brink of Arden having a seizure on Monday afternoon. Had Arden not felt dizzy, I don't know what would have happened.
UPDATE: I probably should have included in the original writing that Arden's BG, at the time of the pre-bolus, was 230. It was a restaurant that we frequent, knew what she was going to order and how many carbs it contained.