On Waking In a Mexican Restaurant

It might have been the cold meds I had stopped using that day, stored up in my system still fighting the good, and bad, fight. It may have been the coupl’a beers I’d had during the day in Knoxville while record hunting with a friend. It may have been that my "spot" was resistent to insulin and something gave way rushing insulin to my system very quickly. It might have been that my CGM is untrustworthy. In truth, it was probably just another weird occurance in a diabetic body.

I had a good day. I was feeling better than I had in a week or so after moving past a cold. We visited a couple of breweries in Knoxville in between searching for vinyl albums at 2 of our stand-by stores. I watched my CGM (continuous glucose monitoring) system on my phone all day as I took insulin with meals and otherwise trying to get my blood sugar below 200 at any point. I was never able to get it there till I got home. I calibrated the CGM at around 110, if I remember correctly, and we headed to a local Mexican place to eat.

And we ate. As soon as the chips hit the table, I took my bolus for my meal (blood sugar was near 100…this is a theme) and we had a good meal. I didn’t notice anything was awry till I reached for the check. I looked at my wife and said simply "I don’t feel right. I feel nauseous." She said to sit still and then I go blank.

What I can clearly say about passing out from a blood sugar occurance is that you really do not remember any of the excitement, anxiousness and worry that it causes. When you pass out, you’re out. No dreams. No thoughts. Floating in complete darkness. And then there is the loss of time…if felt like a second. It was more like 3-5 minutes. It was weird.

When I woke, I was still in the booth at the Mexican place. My wife was petting my face and drool was running down my cheek. It seems odd, but the drool was pretty important and I had to get that cleaned up. She urged me to tell her I was ok. I did. My brain woke and I wasn’t sure what had happened. My CGM read 105. My body read 35.

Here is a strange little tidbit about my CGM solution, and any that I have read about. Most of them do not give you an immediate right then reading. They use data smoothing to show trends. I was not trending low, according to the CGM, at least not at that point.

The EMTs got there. They asked me questions. Date of birth. They didn’t ask who the president was, which used to be the go to "hey you passed out" question. Guess times have made that a rough one to get responses to. I digress. My blood sugar was 83 according to their monitor, so I already saw a trend my CGM didn’t.

Long story short, I had a seizure and then passed out. I didn’t remember any of that, but my body went rigid and then I drooped. My body felt all of it after the fact. By the time we got to the ER, my blood sugar was 55 and my CGM had caught up. We verified with their monitor. It took them 15-20 minutes to get me some OK (emergency maybe???) and I righted that ship. By the time I left, clean bill of health in hand, 4 hours later, my blood sugar was around 250, I was tired and I just wanted to be home.

Every low blood sugar symptom I always had rushed to me. Headache, tiredness, cold sweats, etc. I could not, however, figure out how my blood sugar had dropped that quickly that my CGM, and my own sense of self, hadn’t caught it.

It’s been 2 weeks, today, since that happened and I have done, with my wife who researches everything under the sun of consequence, research and spoken with my doc. Sometimes a diabetics body will release insulin, especially after cold meds and a bad entry point for their pump, are acting insulin resistent. My heart checked out. I have no history of seizures with which to take to a neurologist for further deliberation. So in order, this is what happened…

My body got about 25 units of insulin about 35 to 45 minutes before this occurred. It had some stored due to resistence from cold meds and the bad entry point. My body took that in before the food metabolized (Mexican food metabolizes slower for me and usually gives me a high reading about 2 hours later, as opposed to right after). My sugar dropped quickly. My brain had a lack of glucose and reboot through a seizure. No data smoothing was going to catch this. Then something amazing happened. I learned from my doc that even in diabetics, if the brain senses a lack of glucose and shuts down (like mine did) when it comes back it tells the body to rush glucose into the system so that the problem doesn’t happen again. So to answer the EMT and the ER doc…that’s how I had an 83 reading after passing out.

It took a week after the seizure to feel like myself. I am scared of everything that I ate and drank that day. My body felt like I had been hit by a truck. I spent most of Thanksgiving day on the couch resting and most of that weekend doing the same. My head was foggy and I had a persistent headache for 10 days. To those who deal with a seizure disorder I have an amazing amount of respect for you. How you live day to day with that force wrecking your body without warning is amazing to me. Once was all I can handle!

Diabetes is hard. It is a silent and merciless force that overwhelms the body and ravages the confidence of its victim. From day to day I see failure in everything I eat, do and record with a prick of my finger. There is no cure. No solution. No quick fix. One day it will not kill me, but it will weaken me so that something else does. It could take my legs, sight, and my heart. On this day it took the confidence built from 32 years of being a diabetic with no serious side effects that I was "doing just fine". I am not sure there is anything that can give me that back.