I Passed Out

December 24, 2012. Christmas Eve day.

I felt blessed to get in a couple hours of basketball, even on a holiday.  We played hard. I had a lot of fun and wore myself out quickly. Blood sugars were pretty normal for most of the session, with a slight spike as I was finishing.

We got cleaned up and headed out to lunch — a normal routine I have with a few buddies at the gym. Before leaving I tested my blood sugar again and was surprised by a very high reading. So high that it didn’t fit the pattern, but I didn’t think twice about it.  I took a correction bolus and my lunch bolus, wanting to give my insulin a head start on my meal. Especially since I was so high.

About forty minutes later I had my food in front of me and started eating.  I got halfway through my sandwich (a grilled cheese, of course) and a wave of nausea hit me hard. I got up and headed to the bathroom, convinced I was going to lose my lunch.

I felt off as I walked to the bathroom. By the time I got to the front hallway I lost all logic and couldn’t read the signs to figure out which bathroom was which.  Stumbling through the hall and bouncing off of the walls, I pushed through the front door of the restaurant and reached for an outside wall.

That’s all I remember.

I woke to the sound of approaching sirens and my friends calling my name. I was sitting against the outside wall. There was a glass of orange juice. I drank it and asked for another. Coming back now. Help was on the way.

I was embarrassed and confused but knew it was low blood sugar. I was back enough to test myself; 69 mg/dl.

View from inside an ambulance

Ever seen an ambulance from the inside?

A fire truck and a police car pulled in, sirens blaring.  They asked about my blood sugar reading and gave me a tube of glucose gel.  The ambulance pulled up and I was able to get up and climb aboard.

They tested me a couple more times and I was coming back up.  I was fully back now and able to answer all of the questions (name, (new) address, doctor, etc).

I had another glass of juice and some glucose tabs while I sat with them.

A bit later my friends drove me home and I tried to understand what happened.  Was that high reading inaccurate? Possible, I guess. I also think my insulin was accelerated by the recent exercise and started working much faster than normal. Maybe it was a combination of both? Who knows.

What really rattles me is that I didn’t have any warning. By the time the nausea hit me, it was already too late. This low ran me over before I had a chance to see it coming. The CGM had no chance either, and it’s usually a little bit wonky right after exercise anyway.

Until this event, I’ve had no trouble with hypoglycemia unawareness. Time (and frequent testing) will tell if it’s something I need to watch out for.  Heck, we all need to watch out for it, right?

This is the first time I’ve needed help with a low while awake since Jr. high school (1987?).

I thought I was doing everything right. Only the benefit of hindsight shows what I did wrong. I should have double-checked that high reading, and I should have waited on my insulin. The speed and ferocity the price of my mistake exacted on me is terrifying.

After a week of sitting on this experience, I’m feeling a bit better.  But I’d by lying if I said I wasn’t psychologically shaken by this event. I’m a mess, mentally, and my wife won’t let me out of her sight if she can help it.

I need to share that this can happen. Diabetes is dangerous. If this can happen to me it can happen to any of us. If you think you’re exempt from the dangers of low blood sugars, if you think you’re so on top of everything that it will never happen, I have news for you…

Please be careful out there. The tiger is always on the prowl, sometimes just because he’s in the mood for a snack.

Can you have a pet tiger? Sure. So long as you feed it well, groom it, and never turn your back on it, you can co-exist with a tiger in your living room. But if you neglect the tiger, starve it, turn your back on it, the tiger will pounce on you and tear you to shreds. Diabetes is the tiger. Feed it right. Take care of it right. And the two of you will live just fine together.” — Wil Dubois, Taming the Tiger