Symlin Scare

I hate that title, because it implies that I dislike Symlin.  That’s not true.  I like it a lot.  Most of the time.  The few times I don’t like it are memorable.  Take this experience from about a month ago.

One of Symlin’s main jobs is to slow digestion.  This helps the post-meal blood sugar spikes, which is one of the main reasons I use it.  But because digestion is slowed, I have to also slow my insulin.  I usually use a pump feature to spread the bolus out over 60-90 minutes.

Shortly after eating I just happened to glance at my CGM.  My heart jumped.  I was below 100 mg/dl and dropping fast.  Two down arrows.  Finger stick confirmed my fear, I was in the low 80’s. I’m too low and dropping fast.   I did that quick mental review of the last half-hour or so, trying to figure out what was going on, then it hit me.

Picture of a train going over a bridge that's outI took all of my insulin.  With Symlin on board.  (this is not the first time this has happened to any of us…)

In a panic, I ran through scenarios in my head.  What would happen?  What could happen? I really messed up this time.  I’m not going to make it.

Grabbing the 50-count bottle of glucose tabs and the emergency glucagon kit, I prepare to have “the talk” with my wife.  Chomping on glucose tabs, unsure of how much she “gets” about what Symlin does, I tell her what happened and that I’m not sure what’s going to happen.

Right then I start sweating like crazy.  Drips and drops all over my face, head, arms.  I’m watching her try to contain her panic while she’s watching me explain the worst case scenario to her.

I’m chewing glucose tabs mixed with kool-aid mixed with more sugar, all the while watching my blood sugar drop and talking my wife through jabbing the glucagon harpoon into my leg if I fall over.  My CGM is saying “LOW”, my blood sugar is around 40 mg/dl and we’re not even 20 minutes into this thing.  I could pass out at any moment, and I’m scared, and my wife is scared.

It’s a crazy thing knowing you could black out and fall over at any second.  We moved to the couch so that I wouldn’t hurt myself if I did (isn’t that a creepy thought?).

I’m talking to her about what to expect after a glucagon injection, but in reality I have no fucking clue – I’ve never been conscious to witness what happens, or know how long it might take for me to “come around”.  What does she do while I’m laying there?  How do I appease the doubt she would be experiencing while waiting?

Scary shit my friends.

It took about 45 minutes for things to turn around, and I never went so low as to start acting funny or lose consciousness, but I had to fight hard.   I felt pretty bad, both physically and emotionally.  I took Symlin and had a full dinner.  The last thing I wanted to do was eat or drink anything.  No, that was the second to last thing I wanted to do.

The last was falling over unconscious.

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Scott K. Johnson

Patient voice, speaker, writer, advocate. Living life with diabetes and telling my story. Patient Success Manager, USA for mySugr (All opinions expressed are my own and do not necessarily represent the position of my employer).

Diagnosed in April of 1980, I recognize the incredible mental struggle of living with diabetes. Read more…