I get my first cup of coffee and sit on the sun deck with the birds singing. I feel as if I have not slept a wink, and my head aches. I could go back to bed and sleep all day, but work awaits. It’s a beautiful, sunny day, but my body feels heavy, and stuck to the chair. It hurts to lift my arms. My blood sugar was 381 this morning. Again. I think about having to face the day at the office. Driving down the interstate, the lines are blurry.
I know that if the DMV got wind of it, I might not be driving as high as my A1C had been. When I get to the office, I walk in with a dark fog feeling surrounding me, and take some deep breaths at my desk. As I begin to review the end of the month reports, the numbers get fuzzy, and I can’t concentrate on them. My 36 ounce water bottle with only a few sips left beads sweat on the desk, and it’s across the building to get to the bathroom. Sometimes it’s a race to get there in time. My body is taught and swollen, like the Blueberry Girl from Willy Wonka’s Chocolate Factory. My blood sugar is a blue river of sticky blueberry filling as I roll down the hall toward the bathroom. I feel that if I had a needle, I could pop myself.
That would surely be a mess. My skin is so dry and flaky that no amount of lotion will hydrate it. No amount of water can quench my thirst, and my mouth feels like the Sahara Desert. With one hand on the water cooler, and the other hand on the bathroom door, I guzzled down what I could until the feeling hit that I wasn’t going to be able to wait any longer. I was out of regular insulin, and I had taken my long acting insulin. I was not so patiently waiting for it to kick in. This morning was not starting out so well. I’d have to tackle the reports in my current brain fog. I did have a doctor’s appointment tomorrow. I was expecting “the talk.”
My mind led me down memories of the weekend, and the family get-together. The food was so delicious, and all of my favorite family recipes were spread across the tables outside at Aunt Ruth’s. There was no way I wasn’t going to indulge in that. Yes, I should have exercised after we ate. I had cheesecake and brownies. It was too much for my weak will power. I could have found my sister to ride bikes with me. But the great big beast that was my high blood sugar felt so heavy. I could imagine me trying to pedal the two-seater with that 300 pound weight tagging along. It couldn’t be done, so I took a nap instead. Sometimes, your fatigue takes over your need to manage. That’s when the diabetes wins. It’s a struggle to get back on track, and one Sunday slip-up can set you back for a month. The guilt sets in, and the hopelessness.
I rummaged through my bag for my ketosticks. Opened the bottle, and voila!! 1 strip left. No problem to return to the bath room! My co-worker said I had a “fruity” smell, and asked what was my perfume. No more hints needed, and a positive. Of course! DKA, oh joy! I had been a little short of breath, and my heart was racing. I quickly called my supervisor, and told her my situation. She agreed a trip to the doctor was needed. I gathered my things, and prepared for my third episode in a year. I had to get myself in better control. An A1C of 9.7 just wasn’t good. I would try to do better, but for now I was an uncontrolled nightmare. Not every high episode was this bad, thankfully. In the hospital, I was poked and prodded, hooked up to IV insulin and fluids. I didn’t get much sleep there either. The stress of everyone coming in and out of my room all night made me want to get myself in better control so I didn’t have to return. Next time, I would not let my high blood sugar get so out of control. I was going to check about getting help for my insulin though the program the diabetes educator told me about.
As my blood sugars returned to normal in the hospital, I felt anything but normal. I was at about 140 according to the nurse on duty, but for some reason, I felt as if I was having a low blood sugar. My brow had started to sweat. I felt a little irritated, and my hand was shaking. The nurse didn’t particularly like the way I was reacting, so she checked my blood sugar again, asked me about my usual blood sugars and what they run, and then proceeded to tell me that I was just used to high blood sugars. She said I may feel like this for several months while I’m “re-normalizing.” Great, I thought. What an incentive to get my blood sugars lower. I can feel wiped out high, or wiped out low! Now my negativity was taking over – time to regroup! I asked to speak to the social worker. I had to get something set up for my insulin. I couldn’t afford it, and I had no insurance. She said that she would arrange for me to speak with her and get some help with my insulin on discharge.
Blood sugars coming down, and discharge being planned, I braced for the reality of the medical bills that would hit. The social worker came in, and helped me with some applications. I had an appointment at a rural medical clinic that could provide my insulin and supplies. I would be qualified for financial assistance from the hospital, and that was a relief. Still, I felt so fatigued! I was like a butterfly that couldn’t get off the ground. My wings felt battered and old. I hoped this feeling would pass soon.
I met with the nutritionist, who went over counting carbohydrates with me. I knew how, I assured her. It was just a matter of doing it. Consistency had been my problem, and getting off track at holidays and special events. I found it difficult to keep up the steady, even pace that I needed to self-manage my diabetes. I found some of the nutritionist’s suggestions helpful, and we planned my exercise and activity calendar. We went over my blood sugar target ranges, and talked about how I was going to keep it there, and keep my energy up. I was to call the doctor if I had more than 2 blood sugars that were over 240 mg/dl. I was not to wait until I got into ketoacidosis before I did anything. She gave me a fresh bottle of ketosticks to carry home with me. I drove myself home.
My blood sugars were 150 mg/dl 2 hours after my lunch, and I had clear vision. This was something that I hadn’t experienced in months. I was determined to get in touch with a support group that the social worker told me about, and join a walking group in town. I was going to make the lifestyle changes that I needed to make this time, and get my A1C down to less than 7. I had diabetes education appointments set up at the health department, and they were seeing me without insurance, and were able to slide my income eligibility to 0 percent. I was getting all the resources I would need lined up, and it was all to make sure I didn’t have another setback like this last one, and of course to avoid all of those nasty complications. Still, the day to day fatigue that you experience when you are not self-managing, is simply not worth it in my book.
I kept a daily blood sugar, food and activity log. It helped me to see that with my new efforts, my blood sugars were for the most part staying within the target range that my doctor had set. I noticed a big difference now that a month had gone by, and I didn’t feel so bad anymore with my blood sugar staying around a 150 mg/dl. I was now “re-normalized,” and I was able to get out and get some more activity in. I would get my sister to walk with me after meals. At work, we would meet and walk around the square for 30 minutes.
After supper, we would take a 15 minute stroll through the neighborhood. All of this helped to keep me in my target range. I got the best advice, and I used it. I eat more, not less. I am just eating the right kind of foods now, and I know what I really should do if I get another high blood sugar. I will not wait, and I will let my doctor know right away. I understand that sickness or stress can run up my blood sugar too. I have to do a balancing act daily, but I feel better about my overall management. My last A1C was 7.2, so I’m getting there! I had to look for the right advice, and so should you! Don’t believe those who tell you to just take a Tylenol and suck it up. I might knock the next person out who tells me to eat less when my blood sugar is high. Then there is always your grandma, and no, grandma! It’s not shingles! Everything is not shingles grandma!
The 3 Poly’s
The cardinal signs of high blood sugar are what are referred to as the 3 poly’s:
- Polyuria (excessive urination)
- Polydipsia (excessive thirst)
- Polyphagia (excessive hunger)
What causes high blood sugar?
- lack of physical activity
- increased carbohydrate intake without additional medication/insulin
- having a severe illness such as the flu, or going through a time of stress such as a death or divorce
- forgetting to take your diabetes medications
- using improper injection techniques or insulin that is expired
What’s going on inside
Inside your body, it’s an acute situation and you can’t use the energy from the food you eat. It floats in sugar molecules in your blood stream, and becomes rather sticky. That is why it can stick to the sides of your arteries and cause heart problems, or to the inside of your veins and cause circulation problems. It’s like a syrup running through your system of veins and arteries. Meanwhile, your poor body cells are starving to death. The cells in your brain, hands, feet, heart, and all over are not getting the blood sugar which is the energy that they need to live. So close, yet so far away! The blood sugar is floating nearby in the circulatory system, but there is either no insulin there or the insulin is not working like it should.
Symptoms you’re feeling on the outside
You’re constantly drinking water and running to the bathroom. You know your blood sugar is high, and you shouldn’t eat, but you’re starving. Your mouth is dry, your skin is dry, and your body feels bloated and full. There you go with the fatigue, and the foggy-brained feeling. You want to drag back to bed, but life won’t let you. You get a hot feeling, and sometimes a headache. You get nausea, sometimes vomiting, and weight loss. When you get ketones in your urine, you may have the “fruity” breath, shortness of breath, and a feeling of your heart racing away with you. This signifies that your body may be going into Ketoacidosis. That’s why it’s important to contact your doctor if you have 2 or more blood sugars over 240 mg/dl.
When blood sugars are 150-200 mg/dl, you may feel one way. Then when they get much over 200 mg/dl, you may begin to feel other symptoms. Some people don’t feel much before they hit about 250 mg/dl. Others still are unable to tell until they reach ketoacidosis or hyperosmolar syndrome. Then you are at risk for dehydration and coma, or even death. Knowing your own symptoms is what is important, and checking your blood sugars often if you’ve been having high blood sugars. Again, don’t wait too long to call your doctor and drink plenty of non-caloric fluids such as water.
Long term symptoms are complications
If you start having circulatory problems anywhere in your body, it’s likely due to chronic syrupy blood from high blood sugars. The loss of feeling from neuropathy may give you pain, and you may end up on medication such as Lyrica or gabapentin. Kidney symptoms can slowly turn into a need for dialysis, and loss of circulation to eyes can lead to blindness over time. Syrupy blood leads to sores that won’t heal, and eventually amputation of limps. So get control now, before your short term symptoms from high blood sugar turn into long term complications. You’ll be glad that you took the time to live healthy with diabetes, and have a good quality of life.