low blood sugar, hypoglycemia

That Low Blood Sugar

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It started just like any other day. Well not quite. I still hadn’t experienced a low low blood sugar even though I’d been taking Insulin for almost two years. To be honest I was terrified of the unknown. I’d hear the horror stories. People fainting, not being able to talk, brains not functioning. If you’ve ever had a low blood sugar you know exactly what I’m talking about.

But here’s the thing; having never experienced a hypoglycemic event I actually had no idea what people were talking about. I mean I could imagine it being awful, but I had never actually felt it for myself. So my fears weren’t based in fact. But that didn’t mean I didn’t have them.

And then it happened!

So randomly and for no reason. It wasn’t about over injecting, it wasn’t about exercising too much. I just started to feel really anxious and shaky and itchy all over. I assumed I was having an overdue panic attack. Except I was just standing over the sink, lost in quite a pleasant thought so what the F…ck. What was there to freak out about? I went over to my husband and mentioned I was feeling a rush of panic. He suggested we go outside and talk it through.

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I didn’t think to check my blood glucose levels, forgot my glucometer, didn’t bring a juice box with me. NADA

For the next 15 minutes or so while my sweet husband talked me through my ‘anxiety’ nothing budged.

Luckily I decided to check my levels. Casually, well not that casually because I was shaking from the inside out, I pricked my finger. The number that stared back at me was nothing like I’d ever seen before.

2.7 mmol!

Seriously? 2.7?

The strange thing was even though mentally I knew that was way too low and I was itchy and shaky and wanting to eliminate everything from my body with a good trip to the loo, I wasn’t frightened. I felt frustrated and curious instead.

Even though I’m sure it was only a matter of seconds, the walk from the living room to the kitchen to get some juice, felt like a lifetime.

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Photo by Pâmela Lima on Unsplash

It was only while I was waiting for my levels to come back to normal that I started to feel the terror. Why didn’t I check my blood sugar sooner? Why did I think it was something else? Why didn’t I do the most obvious thing? Where was my rational mind?

Umm… yep, that’s a low blood sugar event. You don’t think properly.

After my blood sugar came back to normal and in the subsequent years, I’ve had so much gratitude for that first scary low blood sugar. It helped me to face my fear and to lessen my anxiety about my levels in general. I was able to watch my blood sugar rebound and to see that I was okay. I learned subsequently to test how many grams of glucose I need to bring my blood sugar back to a safe range.

As someone who lives with LADA ( Latent Autoimmune Diabetes in Adults) and still producing a tiny amount of insulin I can get away with ½ a glucose tab, sometimes even a ¼  when I am just below where I’d like to be. I love the idea of sugar surfing keeping my levels in range with a little bit of sugar and a little bit of insulin.

I’ve also become more vigilant about checking blood glucose levels regularly especially when I feel slightly off. I.e. itchy around my tummy or vague in my thinking. And I’ve learned to let go of expecting perfection with my blood sugar management.

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So if I’m about to teach a yoga class and my blood sugar is at 4.3 I don’t hesitate to treat it. I’d rather not be checking my levels in the middle of demonstrating down dog.

Another super cool tool I use for soothing anxiety and settling the nervous system during and after a low blood sugar event is mudra. If you’ve been reading my blog for a while you’ll know how passionate I am about mudra for diabetes. A user-friendly tool which is literally at our fingertips.

In a recent interview with Lesley O’Brien from Ayurbotanicals, I go through mudras which help engender fearlessness, increase circulation and give pause for self-reflection.

Join me in the practice below

with great respect…

Rachel

P.s I’ve tried these gummies below and they work effectively to bring up my levels fast 🙂

Hypo Hot Mess

You’d think I’d be used to being on the razor’s edge but I’m not.  Like a mother who forgets the pain of childbirth, I keep forgetting what a fine line it is to live with diabetes. Maybe it’s because my memory is selective, or that I still find myself going into denial. More likely it’s because I’m burnt out from all the nitty gritty stuff I have to do to stay alive.

Hypos are the worst. Every time a low comes on I think, “Sh…t  I’m going low. What time is it? Can I wait 15 minutes and then eat lunch. Nope? Ok, just take ½ a tab. That’s probably not enough. Wait 15 min. Sh…t still going low take another ½… No, strike that, take 1 tab. Wait 15 more minutes (by now I actually feel low… sensation of ants crawling all over my body, mind like a wobbly wet piece of jelly). Ok, just take another tab and be done with it. (check my blood sugar 10 times in 15 minutes). Crap my fingers hurt.

After it comes back up I cry a lot. Later I think about adjusting my basal but worry that if I do I’ll go high. Eventually, I adjust my basal, wait to see what happens and tell myself, “Next time I’m going to take ¼ tab. Next time I’ll trust my body and my intuition. Next time I’ll take less insulin.”

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My last big hypo happened right before I was supposed to teach a yoga workshop on mudras ( yogic hand gestures). I was sitting in front of 15 experienced yoga teachers while furiously checking my blood sugar. The trend arrow on my mySugr app wasn’t looking good.

I freaked out! I’d driven all that way, spent weeks preparing had gathered an awesome group of yogis, only to have the whole thing crumble because of my broken pancreas and stupid carb to insulin miscalculation. I kept telling myself, “Push through you’re stronger than this maybe it won’t keep plummeting. Start teaching you’ll be fine.” But no matter how strong I thought I was, I couldn’t fight reality. My body wasn’t going to kick in and save the day. I had to share through my vulnerability. It was either that or bale.

Stepping up meant sharing with the group that I was in the middle of a hypo, that I’d taken some glucose tabs and had to wait 15 minutes before I could teach. I felt awkward, my brain wasn’t clear enough to communicate, but the smiling and compassionate faces of the group gave me heart.

“Living yoga is about being with what is,” I continued, “and sometimes ‘what is’ sucks.”

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Luckily within a few minutes, I could feel the glucose bringing my brain back online. The class flew by and was loads of fun, but later I felt drained, weak and really emotional.

Before my diagnosis, I would get tired after teaching, but it was a good tired. The kind where you knew you had worked hard enough to deserve a rest. Hypo fatigue is something else. 24 hours later I still find it hard to focus, my nervous system is overly sensitive and I’m prone to panic attacks. In a way, it’s akin to burning oneself accidentally. At contact, it burns sharp and hot, but that’s not the problem. It’s the lingering throbbing pain that’s tough to withstand. Plus Hypos aren’t always just a one-off thing. When a Hypo, builds on another Hypo it takes days to recover. It’s a challenge not to lose heart or worry that I’ll never get on top of things.

As I mention continuously in my blog posts I really have to take my hat off to yoga. The physical practices of posture and breathing definitely help. Lately, I have been using the deeper practices like mudra (gesture) and mantra (sound) too. Holding my hands in certain positions really calms my emotions and repeating a mantra like OM is soothing for all the systems in the body. In fact, so soothing that chanting lowers my blood sugar.

In honor of being a Hypo Hot Mess, this weeks offering is a simple 5 element mudra sequence. As you go through each mudra feel harmony coming into the body, relax and breathe. You can do this anywhere anytime, focusing on one element for your practice or including all five.

With great respect…

Rachel

 

When Gratitude Steps In

About two weeks ago I had my worst low ever. We were on the road driving. Luckily I wasn’t at the wheel but being somewhere between Jugiong and Gundagai (yes those are names of Aussie towns) it was still scary.

As it was happening I kept racking my brain trying to figure out the why. I hadn’t over injected for lunch or had I? Did I take an extra unit of basal insulin in the rush to leave that morning? I’d already had a near low the day before. Was I just that little bit more sensitive to Insulin from our sunset walk the evening before?

Whatever the reason, the one and a half tabs I popped weren’t working fast enough.

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I had to play the waiting game. We stopped at a fancy pub and I made an obligatory visit to the loo. Every time I go low I might as well have a tiger chasing me. The feeling is exactly the same. While in the lavatory I kept a close eye on my levels but sadly the numbers weren’t looking good. I couldn’t make my trusty mySugr app lie. The numbers surrounded in color-coded circles kept going lower. Orange had been replaced by red.

I popped another tab while my body began to shake. Everything looked blurry, I felt blurry and at the same time, my thoughts were like sharp bubbles that I could catch and get lost in. I made my way back to my husband who was waiting for me at a lone picnic table and told him I was still low. He held me and we waited. I kept testing and finally ten minutes later it came up a few points. We got back in the car. Disaster averted.

The rest of the day I felt fragile like I’d been poked with a stick. The days that followed were filled with unmanageable high readings. And I was scared to take insulin. I took it but I was still scared. I went to sleep at a higher level just to be on the safe side. And when I woke up higher I didn’t correct. Instead, I waited for it to gradually coast down by midday. Every time I tried to gather the courage to be a bit more accurate with my dosing I couldn’t do it.

And it dawned on me. This is what burnout looks and feels like.

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It’s taken me two weeks to find my confidence again. Gratitude has been the first step. In the depth of the low, I remember thinking quite clearly how grateful I was that I could still think clearly enough to test my blood sugar, that I had glucose tabs on hand, that my partner would come find me if I hadn’t come out. I felt grateful for my breath which I began to watch rising and falling in my chest. As the next two weeks unfolded, I was even more grateful for my daily yoga practice.

The ability to step on the mat and feel peace, calmness, stillness. The reminder that the experiencer, the seer, the one having the highs and lows is unaffected. As much as I want to believe I am my body, I cannot be my body. My body is something I have. As much as I think I am my thoughts about my disease. My thoughts are something I have. As much as I want to think that I am the disease, diabetes is something I have.

The depth of gratitude cannot be underestimated. I know it is a way of being that works in any situation, any crisis. I believe it is an essential yoga practice.

If you want to know more about gratitude and how it shapes my life with diabetes I recently sat down with my good friend Lauren Tober the creator of A Daily Dose of Bliss and A Grateful Life Podcast to share about Yoga, Diabetes and why I practice in my P.J’s.  Listen to the podcast and if you’d like to join us on a Daily Dose of Bliss registrations are open now.

Podcast on Gratitude with Rachel Zinman

with great respect…

rachel

 

That Mysterious low

It finally happened! I’d heard about it, read about it, feared it, even dreaded it. But one can’t stave off the inevitable. At some point, if you live with diabetes and take insulin you’re going to have a mysterious low. Today it was my turn.

It would have made sense if I’d had lower levels when I woke up or hadn’t thought I’d seen the number 8 mmol just 20 minutes before. I’m not someone who ever crashes fast. In fact most of the time I’m a big flat line. Being a LADA ( Someone who lives with Latent Autoimmune Diabetes in Adults) I still produce some insulin and use a low carb diet with moderate protein and fats to keep things balanced. I take a small dose of long acting insulin and time my walks and yoga practice around the time my insulin begins to wear off. Usually, if I am heading towards a low, I feel hungry. So I’ll grab a high protein, hi fat snack to keep things in check. Plus I check my blood sugar all the time. I mean, I use test strips like Candy!

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So what the heck happened?

I have no idea! I noticed my hands were shaking when I sat down at my computer around 6.45 am. I checked my blood sugar levels, had my morning injection, (which had burst a small capillary, but I’d made sure there was no bubble or bruising under the skin) and decided that I should eat something to get grounded. I chose a small avocado which had a bit of a bitter taste, didn’t think much of it until I started feeling like I was itchy under my skin.  I never feel like that… usually, if I’m itchy it’s on my skin and I can see hives or something… but this was like a slow skin crawl… and I was shaking… I cooked an egg to have with the avocado and sat down to eat it and offhandedly remarked to my husband that I was shaking while I was eating which was weird. I didn’t think to check my blood sugar. Instead, I went to the bathroom ( probably too much information here but anyway…) and had a panic attack. Heart racing out of my chest, feeling even weirder I called out to my husband… “I’m feeling weird and now I’m having a panic attack.!”

My husband says, “Let’s go outside and sit in the sun.” So we sit down and he asks me what I’m worried about? I say, “I don’t feel worried it feels physical”…then I lift up my shirt to examine my imaginary hives…the skin keep crawling and I keep feeling weird. But the panic has subsided…we sit in the sun for about 10 minutes and then I think about checking my blood sugar.

My husband is standing right there when we get the results 4.1 mmol…I panic. My husband says, “Check again.” I pull out my other meter, it says 3.8 mmol…I panic more… my husband says, “Check one more time just to be sure.” I check again on my first meter…3.9 mmol.

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I RUN TO THE FRIDGE

My husband is trailing behind saying, “Stay calm don’t panic.”

I don’t listen, I open the fridge find my juice popper ( we have our juice in small bags here in Australia) The straw is missing! URGH!!! I get the scissors and cut the bag open and drink a big gulp. My husband says, “Okay stop there, it will be enough.” I’m like, ” NO! I can drink the whole thing.” I guzzle down the entire 200 gms of juice in about 1 minute. Then I lean against the counter, wild eyed.

I’m thinking to myself… and how long do I have to wait for my blood sugar level to come up?

I carry another juice bag and my meter back to the living room and sit on the couch… trying to figure out what happened. I was sure that the last time I’d checked my level was right before I ate. So I went through the log on my meter. I was shocked! I checked at 6.45 am… and then checked at 8.07 which was when I saw the low.

I’d started having breakfast at 7.30 am… so couldn’t have checked just before I ate. Had I imagined the whole thing?

I’ve heard people say that when you’re low you don’t think like you normally do. But I had no idea what that meant. I remember feeling completely aware of everything that was going on. So it seemed super weird that I didn’t do the one thing I was supposed to do…

CHECK MY BLOOD SUGAR!

And my husband used to me reacting to foods or having panic attacks in the loo didn’t think to ask me to check either.

Once my levels had returned to normal… (well not quite I did overshoot with the 200 gms of juice and am now running at about 9 mmol)  I’ve had a chance to reflect on what worked for me during the mystery low.

  1. I didn’t freak about the skin crawling sensation. I stayed calm and tried to figure out what it was
  2. When I started having the panic attack the first thing I did was calm down and breathe deeply, Then I called my husband
  3. I went outside into nature and put my bare feet on the earth
  4. When I finally did check my blood sugar level, I checked a few times just to make sure it wasn’t a mistake on the meter
  5. I knew exactly where to go to get what I needed, took the remedy and managed not to eat everything in site
  6.  I waited calmly for my levels to return to normal, watched my breath and trusted my body
  7. I decided to do a yoga practice to support my adrenals and to bring more circulation and blood to my brain to help stabilize my levels after the low
  8. I drank quite a bit of water knowing that I would go a bit higher than I liked from the juice to flush excess sugar out of my system
  9.  Lastly, I hugged my husband and counted my blessings for all of the above!