Wednesday, 28 September 2016

A Hypo That Hurt

Today I'm sharing my experience of a hypo (hypoglycemic attack) from a few months ago that has stuck in my head. 

For those with a fully functioning pancreas a hypo is caused on a very basic level by either having too much insulin on board, not enough food or a combination of them both. Hypo symptoms vary from person to person and a good summary can be seen at Diabetes UK here.

As someone who's lived with diabetes for a while there are a few hypos that stick in the brain. And those that do tend to be the big ones. The ones that require the help of other people mostly. Thankfully for me this isn't a frequent occurrence but one that's unsettling none the less. A few 'highlights' over the years include; being collapsed in bed while visiting my sister in Germany instead of meeting up for a lunchtime squash session, collapsing in my hallway when my (other) sister was visiting the house with me scrambling around on the floor trying to get some sweets, and my personal favourite which is laying on the landing after my toddler son's bathtime and while Mrs Tangerine is coming to the rescue and getting some food he decides to draw on my face with a pen.

You'll notice from the descriptions above the really big ones normally come with massive co-ordination issues and the need for assistance from others. But the descriptions are also very factual and fail to give a sense of how it feels to be there. And I know my words here are entirely one sided and fail massively to capture the emotions of those around me trying to bring me back into the world of the conscious. 

The one this summer was the first really bad one for a while and maybe that's part of the reason why it has hit me so hard. 

First up the mechanics of it. As with all good stories it started with an impromptu visit to the pub in the afternoon. I'd had very little to eat that day and, as I've found recently, the lager I was drinking sent my blood glucose (BG) levels climbing higher. As it climbed higher and higher, in my drink fuelled brain, I decided to correct this and correct again by giving myself more and more insulin. Sat here now typing the outcome was inevitable and I got what I deserved. But the people around me didn't deserve what they got. For most of them this was the first time they'd seen me dangerously low and I know it surprised them too.

After a few hours we decided to return to a friend's house to continue the party. As time passed I started to feel more and more drunk even though I'd stopped drinking. The decision to stop was mainly down to the BG nightmare I was having and even tipsy Dave knew more alcohol wouldn't help the situation.

To add to the fun my BG testing kit was at home and the battery on my Freestyle Libre had died. This meant I was flying solo although by this stage my judgement was getting more and more messed up.

At this point my memories go fuzzy but I do remember very clearly sat on the sofa with my wife knelt before me force feeding me chocolate Minstrels. This is where it gets nasty and I did well to avoid getting hit very hard. In my hypo-head my BG levels were perfectly normal and eating food without taking any insulin was dangerous. With all seriousness and no thinking I shouted at the person who loves me unconditionally and doing their best to make me well "By making me eat these you are killing me!" Even now it's hard to think about without feeling massive regret and guilt. How that must have felt for her I can only guess. Her actions at the time were the polar opposite to killing me and she didn't deserve this abuse from me.

After a few minutes I agreed to prove to her that I was fine and would test my blood glucose levels. I mentioned above that my co-ordination levels often disappear but this time I was able to walk/stagger perfectly well. As we live on the same street we marched together back home. Both of us convinced we would be proven correct but obviously this was only going to be correct for one of us. I say we both marched but the reality was that Laura guided me home hoping I would finally accept the reality.

The BG meter was quickly found, blood extracted and applied to the strip. The five seconds wait for the BG meter to deliver its judgement is normally a quick process but on this occasion the penny dropped in my head and reality hit before the timer had finished and I knew the number about to appear would be a low one, it felt like time stood still. A bit like the scene in The Matrix but with fewer bullets. It was a low number. 2.0 mmol/L (36mg/dl). I've had numbers this low before without any drama but for some unknown reason this was hitting me hard. Whether the consumed Minstrels had already had an effect and I had been even lower I'm not sure.

The meter was a definite lightbulb moment and my own self-preservation and awareness kicked in. I started to consume some quick acting carbs and at the same point attempted to apologise for the abuse I had unloaded in the previous 30 minutes. I knew I'd messed up big style here and no amount of saying sorry could remove what I'd said. Added to this were a handful of close friends who had been left in a state of wondering what had just happened, how and why. They all know about my diabetes but this was the first time I'd shared with them the hard parts that Laura has experienced occasionally before.

Massive credit to Laura as she is fantastic and says she understands it wasn't the real me saying those things but I know that being on the receiving end of the abuse isn’t easy and must hurt. A lot. Especially when she’s trying her best to keep me safe. And also credit to my friends who saw this and didn't judge me but were amazed when I returned to the house virtually back to normal and able to have civil conversations about the episode.

The classic question to a person with diabetes is what does a hypo feel like? Well to everyone it will feel slightly different and for me each hypo can hit me in different ways. In this instance although BG levels quickly returned to normal the impact of it has been long-lasting. The guilt of putting those who are closest to me through that is significant and I'm very keen to do the best I can to prevent this happening again. This has involved cutting down on the drinking and also not correcting any alcohol related highs while still in the pub. If I am high then waiting until we leave is an acceptable risk for me to prevent the much bigger danger of being dangerously low.

There are other factors to bring into the equation too. As part of UK driving licensing rules people with type 1 diabetes need to get their licence renewed every three years. And one of the questions asked is if you have had two instances of a hypo requiring the assistance from another person in the last 12 months. For me it's over 12 months until I need to renew but if I did then this would count towards my two strikes total. As a side issue this would be harsh as I wouldn't have been driving that night as I'd drunk too much alcohol anyway. I guess saying that I only have disabling hypos when drunk wouldn't make me exempt from the analysis?

This post for me is a massive conflict as I hate to say that diabetes holds me back in any way. And as shown in the last one about a day on a bike this is definitely the case. The impact of this hypo wasn't in the short-term, it's been the ongoing worry, analysis and regret of it and the feeling that others will judge me because of what they saw and did on that night.

Thank you for reading and please do let me know about what hypos feel like to you.