The Chai Table - 2015


Everything Was In Slow Motion - Living with Type One Diabetes

By Neel Jadeja

I don't have to tell you that you're never prepared for any day living with Type One diabetes. When I was diagnosed at age of thirty-five, I had no idea what to expect. I was told about the symptoms, I read the pamphlets, but even I knew that nothing would be predictable. It's been five years since I was diagnosed and even though insurance and technology has made living with this mental and physical crutch slightly easier, nothing ever prepares me for the daily physical challenge. If you are vigilant about your diet and your insulin maintenance, therefore keeping your numbers between those lines, the symptoms of hyperglycemia and hypoglycemia, won't wreak havoc in your life. But, if you're like me and have those complicated days caused by overnight lows, random spikes or any unknown factor, your body goes on a rollercoaster ride. Your entire day becomes clusters of literal physical highs and lows that leave you drained, tired and exhausted, and you might have not even gotten out of bed.

I'll never forget the first time I felt my blood sugar totally plummet. I had been diagnosed for only about 6 weeks and had just gotten home from a 28 day rehab facility for alcoholism. That was an experience unto itself. When I was diagnosed my A1C was 15.7, so my sugar level was never really low. I really don't think my sugar was ever in the 100's since my diagnosis. As far as maintenance, I did everything I was supposed to. I would check my sugar and then take a shot of insulin that corresponded to this chart I was given, the higher the glucose level, the more insulin I took.

I had another chart for how much insulin to inject depending on the amount of carbs I was going to eat for any meal. I would test again two hours after I ate and take a compensation shot for however high my glucose level was, which was always. That afternoon, I was home alone and making my lunch. Lunch was a big production back then, consisting of all four food groups. Healthy stuff. I would do all the carb counting from the packages and books. I would do all that math with ratios and I would prepare my shot. On this day, as I'm about to check my sugar for a grilled chicken sandwich, I suddenly felt hot. That was the very first sensation, and usually always is. My body temperature got really warm. I was standing at the kitchen counter in a t-shirt and shorts, and all of a sudden it felt like I was generating internal heat. I could feel myself slowly starting to sweat and I was starting to freak out. I started feeling heavy too, physically heavy. My bones, the inside marrow of my bones, felt like each one of them weighed 500 lbs. from my skull to my toes.

I went and sat down on the couch and sweat was running down my temples. Within 60 seconds, my t-shirt was soaked and I couldn't think straight. Everything was in slow motion. Even my brain was going slow. The fact that I was alone is probably the only thing that put me into motion. I was only able to move because of primal fear and instinct. I very slowly figured out that this oversized pile of invisible jello that had fallen on top of my body, must have something to do with my new Type One diabetes. I was mad. And low. But I was scared more than anything.

I got up and went to my glucose meter, which never left my side and my sugar level was 70. I couldn't tell you what 70 felt like today, but back then it was brutal. I had never seen a number that low. I just sat there on the couch trying to stand up, and it probably took me a few minutes to figure out how to do that. Honestly, I felt drunk, but without the fun of being drunk, which I knew all too well. It took a long time for me to get up, and when I did, I just roamed around aimlessly, with tears streaming down my face. I thought I was going to die. I knew what to do, but I just couldn't do it. I knew I was supposed to bring my sugar level up with snacks, or 15g of carbs, but how the hell was I supposed to do that?

I felt like sludge and my pure inability to move at any speed was astounding. I went and leaned up against the kitchen wall, only because it could support my weight. I felt so heavy and weak I thought I could fall straight down. I remember I ended up standing right above the air conditioning vent on the kitchen floor and how good the cool air felt on my skin. My pug Slash had been circling around me this whole time because he knew something was up, and I was actually mad at him because I feared I would fall over him. Then I hear my phone ring and it was the loudest thing I've ever heard. As I nearly tripped over Slash, I got my phone off the counter and it was Mom, thank God.

She called to check on me and I tried to explain what was happening but I knew I didn't make any sense. I kept saying 'I'm low' but kept trying to explain why I might've been low. Of course, she knew what to do and told me to hurry up and drink a Coke that she knew was in the fridge. I guzzled the whole can. I sat there dumbstruck that I could consume anything at that speed. What was going on with my body? Of course, my stomach felt awful and could barely handle the carbonation. I was sitting on the floor at this point, Slash by my side, the Coke can rolling away. I was still hot and I was still crying and even more scared. I felt sick and so tired. I felt hunger, but in sharp stomach pains. My head started to hurt from the inside, but then I realized it was hurting the whole time. Right at that moment, I started realizing a whole lot of things.

I don't know how long I was on the floor, but the Coke started working and my levels must've started to rise again because I could think clearer. I still couldn't move any quicker, but I comprehended what just happened and why it happened and I was angry at myself. I looked around and I realized that this was reality. I was realizing things like sugar could kill me, but it would also save my life. But mostly, I was realizing that this was going to be forever ant that this could happen anytime, anywhere. I still really didn't know why I dropped. The awful part is I was getting ready to inject a large dose of insulin at that moment. It took a long time for the physical effects of that episode to wear off, at least an hour and a half. The physical toll was one thing, but the mental anxiety that set in was, and is something that has never, ever left me. Today, my entire diet, lifestyle and existence seem to concentrate on avoiding hypoglycemic events. I used to be scared of heights, now I'm petrified of lows.

I mentioned things moving in slow motion, but it's a weird slow motion effect. You kind of feel everything starting to shut down; all your nerves feel it too. There are different tingling sensations I feel almost inside my brain, in the core of my spine, and throughout my extremities. The tingling sensation then almost transforms into this pressure, or pushing down feeling, heaviness. The hair on your head feels like lead.

Imagine if you were a car and you were zipping down the interstate in the normal flow of traffic. All of a sudden, you start to feel the AC going out. You know you shifted to 5th gear, but now you feel the transmission slip to fourth. Then the radio station that was crystal clear is nothing but static, and you just noticed the wipers don't work for the rain that just started to fall. Your car is starting to slow down and people are passing you. You try to make sense of what you see on the dash and there's a bright check engine light on. Beside that you notice the fuel light and battery indicator blinking at you too. Everything is shutting down, you're running out of gas and your battery is going dead. Don't look now, but each of tires has gone flat.

Everything that's essential in that car functioning has slowly left it. That's what it feels like sometimes. Some are not so bad, and some are very excruciating and the feeling doesn't leave. If you have a bad low sugar experience, sometimes you can just count yourself out for the rest of the day. For me, they're usually followed by an extreme bout with hyperglycemia because I overcompensate. I try not to, but sometimes a juice box, or 3 cookies or a powdery tablet just won't do it. Of all the things Type One diabetes has given to me, hypoglycemia is the one I hate the most. It stops me from doing what I want. That's the part that gives me the most limitations. I hate that it happens to other people, especially to kids. I hate how unexpected the episodes come and how indiscriminate they are to timing and location.

I'm pretty good at maintaining my glucose levels, for the most part. Today I wear a Dexcom cgm and an OmniPod insulin pump, and I do not know if I could live without them. I could not be more serious. Some people are obsessed with staring at their phones; I stare at my PDM and my receiver. I spend all day adjusting temp-basals and extending bolus' just to maintain a balance. There is so much micro-managing I do, I feel like I should really be an OmniPod all-star. But I feel like I have no choice. And I do everything in little increments to avoid the extreme fluctuations. I don't eat and take a corresponding insulin amount anymore. I'm very insulin sensitive, so I take a safe amount of insulin, and eat to that amount. While I don't rely on my Dexcom for dosing, I rarely take my eyes off it. The Dexcom has become essential to survival because I can no longer feel normal lows, only the extreme ones. I can drop as low as 60 and not even know it.

I don't know if I'm tolerant to symptoms, but many times I've been in the 50's when that first feeling of warmth comes and that's scary. I also sleep with candy. I've started this phenomenon called 'dawning' where my sugar inexplicably spikes only between 4am and 7am. But I've adjusted my temp basal to try and control that and sometimes it works like a charm, sometimes it doesn't and I still spike, and of course sometimes it works too well and I start the day from the depths of hell. It's all a gamble. Everything's a risk and we always have to be careful. Unfortunately, whenever this car starts to go dead, while there's no AAA I can call, I can have a Coke and smile.