Sunday, 12 August 2012

Hypo - The Hunger Games



The Hunger Games - A yearly event for two tributes to fight for survival, but also as a reminder to the country of Panem not to rebel. Surviving, however, takes strategy planning and knowledge of ones limits.

Trying to describe the feeling of hypoglycemia to a person who doesn't have diabetes is quite difficult. No hypo is ever the same... sometimes different symptoms occur, some come on rapidly and others are gradual, some take more time and effort to treat than others, some make a person laugh and others make them cry.
I feel my most considerable frustration by far while having a hypo is the feeling of urgency to treat it and to return to the normal state that I was in before it happened.

These are my hypo symptoms:
  • Flashing white lights around the edges of my eyes
  • Double vision
  • Feeling faint/drunk/weak
  • Pounding heart
  • Feeling hot and sweaty
  • Shortness of breath
  • Tingling mouth arms and hands
  • Confusion
  • Incoherent
  • Aggressive/moody
  • Extreme hunger
Imagine feeling those 11 symptoms all at once within a few minutes, out of nowhere they all hit you at the same time without you expecting it. They could sneak up on you while at work, driving, looking after children, in the gym, in a club, while asleep etc. Imagine if that happened more than once a week... more than once a day even! You eat to make the those symptoms stop, but nothing happens so you eat more. You wait but you start to feel weaker and are quickly reaching the stage where you can't help yourself, and eventually everything starts to look a little bit darker as you slowly start to slip in and out of consciousness. It's a scary thought isn't it?

For years I thought that I was alone in over treating my hypos, but when I started speaking to others I saw that I was far from alone...

“I realize, for the first time, how very lonely I've been in the arena. How comforting the presence of another human being can be.”  - The Hunger Games.

As other people with diabetes will appreciate having a hypo is extremly confusing and abiding by the rules which our health care professional give can sometimes become impossible! My consultants have always told me that 15 grams of carbs will treat my hypos and if it doesn't then to repeat until all is well. I can't help but smile to myself when they tell me this because although it's true they don't understand that instinct takes over. The need to regain control is too strong to stick to the 15 gram rule and a lot of the time my body will overpower my brain and all rational thinking. Add to that the sometimes overwhelming and uncontrollable hunger which makes me feel like I haven't eaten for weeks and I have a recipe for... well... The Hunger Games - the fight to survive.

So yes it is very easy for people to tell us not to over treat a hypo but how easy is it for us to stop? Not easy at all is my answer and I think that a lot of people would agree with me. I know that over treating causes sudden spikes in sugar levels, that I'll need more insulin to cover the extra food which I ate, that it may cause my a1c to increase and that the next time I see my consultant he will point out straight away the days which I didn't take his advice. I know all of this, but at the time none of it matters. It's pushed to the back of my mind until the hypo has left me, and then I can tell myself that it won't happen again and that next time I MUST control that overwhelming urge to binge. Easier said than done, right?

A bad experience

If anyone has been through a particularly bad experience with hypoglycemia which resulted in an ambulance being called, a hospital admission or even just being unable to treat the hypo themselves then they will understand that those memories aren't easily forgotten. They serve as a good reminder that hypos are very dangerous and frightening, whether they last a for few minutes or a few hours. Nobody wants to repeat a bad experience, so if there is a way to treat a hypo quickly and prevent that reoccurrence then it becomes very easy to take the option to over treat.

"You can never tell what you will find in the arena. Say it's a gigantic cake” - The Hunger Games.

What if the "rules" don't work?

As I mentioned our HCPs tell us that 15 grams of carbs will treat a hypo and if not then to repeat this rule until it has. That's fair enough but what if levels are crashing so fast that we don't have time to think about how many carbs we're eating? What if we don't feel that we can wait for 10 minutes to see if our blood sugars have risen? What if we're so confused that we just grab anything and everything that is edible and close enough at the time? Living with diabetes means that we know better than anyone how our body feels and how it reacts to hypos. We know whether or not our sugars are coming back up or if they're plummeting even further and we treat our diabetes accordingly.

I do understand that unless HCPs themselves have diabetes then they can only do their best, teach us what they know and look out for us as much as they possibly can. However we can also do our best and teach them what we know... We're all healers in this together.

“My mother says healers are born, not made.”  - The Hunger Games.

I woke up this morning fully clothed, surrounded by test strips, dextrose tablets and half a packet of kit-kat's. Last night my sugar levels dropped to 3.1 so as usual I tried the 15 gram rule (three times) and 50 minutes later I had crashed to 1.9 From 9pm - 11pm my sugars danced between 1.9 and 4.1 and I still tried to suppress the urge to eat more than 15 grams of carbs every 10 minutes. This left me in tears, unable to move from the floor, not making any sense at all as I sobbed about random troubles, I was unable to test my own blood sugars, and I was told this morning that I'd turned on my hair straighteners and left them lying on my carpet (the last time I had a severe hypo I managed to turn on 8 gas rings on my oven just before hitting my head and knocking myself unscoucious - luckily I was found quickly!) Eventually I gave in and let my body take over from the consultant's rational and wise voice in my head. I ate as much as I possibly could and didn't think about the consequences of having a rebound high. I felt that sticking to the 15 gram rule would have bigger consequences for me then not giving my body what it was telling me it needed. I don't remember much... but managed to avoid calling 999. My last blood sugar test showed I had dropped again to 2.7 after which I must have fallen asleep; luckily I had eaten enough to wake up this morning.

Exercise - Help or Hindrance

Last nights experience brings me nicely on to the topic of exercise. The only explanation that I can think of for my hypo and the reason I couldn't bring my sugar levels up is because of my workout 3 hours earlier. I made sure that I ate before the hand and tested my blood sugars before going in. I tested as soon as I left and ate when I got home. Admittedly I didn't have a huge meal but I had eaten throughout the day and I'd taken the correct amount of insulin for what I was eating that evening, minus 10% for exercise.

I find that exercise is very much trial and error and I don't know about others but I'm constantly told the reasons for why I should exercise, however I don't know how to manage it with my diabetes. Yes the majority of the time having a workout is fantastic for my blood sugars it gets them to a good level and seems to sustain them throughout the day. But then there are the odd occasions when it all goes to pot and that lovely hours exercise is spoiled by glugging coke or eating chocolate afterwards. Sometimes I feel like I'm going round and round in circles and it shouldn't be like that.

I know that there are courses which give advice on combining diabetes and exercise, however I feel that generic advice doesn't always work and that sticking to a "one size fits all" outlook needs to be expanded to a much more tailor made approach for individuals.

I've also noticed that when exercise and diabetes are used together in the same sentence whether this is online, in articles, in reports, in educational material, by spoken word etc, type one diabetes rarely comes into the equation and type two diabetes is very much a predominant focus. I can't help but feel a little isolated when I see and hear this, and as much as I hate to say it, I feel quite forgotten by the health care world in this instance.

“Destroying things is much easier than making them.” - The Hunger Games.

We need to know how to manage exercise properly to stop this from happening. If I'm constantly eating after exercise to treat a hypo which counteracts my productive workout then saying "what's the point?" may turn into "I'd like to cancel my gym membership please."

However...

I realise that not all hypos are like this and that it certainly isn't all doom and gloom! I joke that having a hypo is a good reason to eat chocolate or biscuits and to have food which is a nice little treat... to treat the low levels! A lot of the time hypos can be caught quickly and treated quickly making our lives that little bit easier. We know our individual signs and symptoms and we know that the majority of the time the 15 gram carb rule does apply. We know that mostly we can control that urge to over treat and that the hypo feeling will pass.

I also know that should these overwhelming feelings arise then there are ways to balance it with extra insulin for the food which I ate, testing blood sugars to catch a rebound high and eating carb free or low carb food if I do feel the need for more.

I am scared and feeling uneasy at the moment, these things take time to get over, but I know that I will get over them eventually. It's not the end of the world if this happens, it's just a little bit more work... one more fight to survive the diabetes games.

“Here's some advice. Stay alive.” - Suzanne Collins, The Hunger Games.


Ninjabetic x 







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