"Is The Patient Unconscious?"

356463_9547“911. What’s your emergency?”

“28 year old Type 1 diabetic with a blood glucose of 33 mg/dl after three juice boxes. It’s been over forty minutes and it’s not coming up.”

“Is the patient unconscious?”

“I am the patient.”

Silence greeted me at the other end of the line, then the emergency operator croaked out:

“Wow. All right. Paramedics are on their way. Can you unlock the front door?”

In 1998, I made the first and only 911 call (so far and knock on wood) about my diabetes. Dinner was vegetarian chili and a beer, and before the pump came into my life, it was the ol’ fast and slow acting insulin show. What was injected in was going to be acting for a long time.

I didn’t count on my food not acting at digesting well – or in this case, at all.

While I was living with someone, he worked nights in the ER at a hospital across town. I was alone. A few hours after I finished my meal, I felt overwhelmingly sleepy, so I got up to check my blood sugar before snuggling down into bed.

32 mg/dl.

Before I see a number like that on my meter, I’m not panicking. It’s that fuzzy thought of: “I’m probably a little low,” that turns into: “Oh. Oh. Oh. No.” I’m fine before and then I’m not. All rational thought flies out the window. It’s go time.

The first juice box went down easy. I remember intently studying the carb count on the side of the box, willing that 24g of pure apple to kick into gear. I knew I would need to ingest more than 24g, but it would get me out of the weeds.

I watched the clock. Tick. Tick. Tick. Precisely fifteen minutes later, I checked again.

35 mg/dl.

My inner monologue was a little salty and blue. The second juice box was choked down. Did you know that you can make a game of pulling a juice box straw in and out of the hole, trying not to pull it out of the box? I lost the game a lot, but it was something to focus on as I sat on the floor of the bedroom, blatantly ignoring the rising adrenaline and cortisol levels.

Low blood sugars suck. I’m one of those people who can still function (and I use function loosely, but I can still verbally communicate and stay upright) in a severe hypoglycemic state. I’ve never passed out from a low. In later years, I’ve had severe hypos when I needed assistance and ones in which my muscles contracted involuntarily, squeezing to get that extra glucose out to help save me. (That is NOT a pleasant experience.) But I had someone around to help me.

I was alone. And after the second fifteen minute mark, the meter was reluctant to show me where I was at.

33 mg/dl.

I picked up the phone and called my boyfriend at work.

“I’m low.”

He knew that I wasn’t calling to chat. He worked in an ER and I never called him there.

“How low?”

I explained, rambling a bit about how I was tired of juice boxes, and that I’m still not coming up.

“Here’s the deal, Christel. We can hang up and you can call 911 or we can hang up and I can call 911. Which do you want?”

We hung up. I placed the call and confused the operator with my 33 mg/dl and I’m still conscious and it’s me and not someone else. Paramedics showed up less than 5 minutes later and tramped into my living room with cases of equipment to find me watching late night TV, taking minuscule sips from my fourth juice box.

They offered IV dextrose and a trip in their shiny ambulance to the local ER. I asked them to wait with me for 15 minutes more and retest. We talked about what happened and then laughed at the informercial blaring from the corner.

55 mg/dl.

They stayed another 15 minutes and I admitted that there was no way I could put anything else in my stomach, so if my blood sugar went south or stayed that low, my veins were their playground.

73 mg/dl.

I felt like I won the lottery.

My boyfriend had called a coworker who was in our complex and had just gone off shift to come be with me for a while. She arrived, flirted with one of the paramedics, and hung out while I slowly drifted upwards to 104 mg/dl. We both slept in the living room.

I was diagnosed with severe delayed gastric emptying two weeks later. (I had other incidents after that, none as serious, where I would eat and go low after a high carb meal with a very slow response to treating glucose.) My stress levels were off the chart and the combination of my body rebelling from the stress and my diabetes manifested in this lovely lack of digestion. I was sent home with anti-emetics and some gastric motility drugs, wondering how I was going to live with this.

Happy to say that my stomach decided to work again after a while (and after the stress went away). But that 911 call is my reminder that no matter what, when you need help, pick up that phone as soon as possible.

Why do I tell you this story? Because I almost didn’t pick up the phone.

And no one would have been there to make that call for me.

 

 

0 comments
  1. I still get the willies when I remember the time I went unconscious because I got so caught up at work I “forgot” to eat. I was working from home, and I lived alone. I woke up on the floor, 3 hours after I’d last communicated with someone through instant messaging. 3 hours unconscious, alone in my house with just my dog (who was very confused as to why I was laying on the floor with her, I’m sure.) My guess at my blood sugar then must have been in the 20s, because after I crawled through the house on my elbows and knees to the kitchen (I literally could not stand up to walk) downed what felt like a gallon of juice and waited about 20 minutes. By the time I could pull myself up off the floor and check my blood sugar, it was 37. To this day, I thank the powers that be that my liver somehow kicked in when I was unconscious (i’m assuming this is what happened) and gave me some bit of sugar to bring me to consciousness. Another moment when CGM in the Cloud would have been amazingly helpful to warn someone – a family member, a friend – that I was dangerously low, and they could have checked on me. No guarantees that if that happened again, I would be so lucky.

  2. Thank yiu for sharing this! It’s a good reminder that you don’t need to be having a seizure to wait.for.someone else to call 911! And so glad you survived that experience 🙂

  3. In the 1940s and many years beyond, there was no meter for testing my BG. My one injection of animal insulin in the morning was the only thing that kept me alive, but my BG did flip flops that could not be measured. So many seizures and unconsciousness at night. My parents, and eventually my wife, dealt with this so very well. No ambulance or paramedics were ever called. Were there any paramedics in the 1940s? I feel so lucky to have survived all those seizures, and to be alive and have good diabetes health today, after 68 years with type 1.

  4. Holy crap and thank you so much for sharing – Such an important lesson in all dimensions!

  5. Wow! Its a great lesson for me to start teaching my 11 year old, who at this point is never alone but will be soon enough. Thanks for sharing…and glad you made the call 🙂

  6. I get that low about once a month. Even while teaching. Sometimes I ignore my alert dog on a steep drop like that because I and focused on getting something done. Never have called 911. But I know exactly the feeling of not being able eat one more thing. My roommate had me suspend my pump and eat Reese’s pieces last night to bring me up. People never believe me when I say I am that low and still upright and talking to them. Glad I am not the only one. I truly thought I was weird since other diabetics I know collapse and call 911 regularly. My lowest known was 26… And yes, I was still coherent. Scares me to think how low I have to be to go unconscious.

  7. Recently had a low of first 38 then 10 minutes after 2 cups of juice it was 35! Freaking out I googled dizzily to read “If your BS is 35, you’re unconscious.” Uh, no. More juice with added sugar while fighting black spots. Not rational enough to call 911. Finally after 20 minutes it registered 60. Scary enough for me to make an emergency kit in fridge and to alert family members to watch me if I yelled out that I was low. Happened after not eating lunch. (Type 2 for 14 years on Byetta and Glimiperide)

    1. Terry, I think that “not rational enough to call 911” hits so many people with diabetes. Once you’re there…. you don’t think you need to call. I’m so glad that you are OK and that you created an emergency kit! Great idea!

  8. Great advice. I have definitely been in the “I don’t think I’m bad off enough to make that call” camp before. Could have been a big mistake.

  9. This freaks the heck outta me because I have this happen any time I eat a large meal. My food just sits there for hours while my BG plummets, so I do everything I can to keep adding more sources of sugar into my system – like sucking on glucose tabs hoping the sugar will get into the capillaries of my mouth because I’m thinking my stomach is pretty much not gonna help things at that moment. I wish there were a way we could do our own mini-glucagon shots or something when stuff like this happens.

  10. Back in my early days of diabetes, around 23 or so years ago, I found myself in the glucose basement while at work. I about freaked out when my meter read 19! I did NOT have a phone to call my doctor, so I walked to find a pay phone!!! I did get a hold of the doc and he talked me through it. Weird feeling, my tongue swelled up and my speech horribly slurred and I could not remember things I did 10 minutes before. I got past that day and, lo and behold, I dropped to 21 the very next day!!! Shortly after that I was put on insulin and had found an endocrinologist. I haven’t been that low ever again. Upper 40’s and 50’s are my very worst these days. Luckily, I wake up when I’m dropping in the middle of the night. I get up and take care of it. Should I take too long, my Shih Tsu comes looking for me and won’t leave my side.

    1. Gail,I also have a dog-a shih poo and I just KNEW that he knows when I am low-he also sits by my head on the back of the couch!! Too bad they can’t call 9-1-1

      1. They can call 911. They make a phone for dog use. One button tied directly to 911 with your info coded. Dogs just learn to push the button. I have a DAD (diabetic alert dog) that alerts to keep me safe. Sometimes the drop is too fast, but he brings me orange juice if I get too low.

  11. I’ve been having severe hypoglycemia for about a year now and that”I’m not bad enough to call anyone “feeling is so prevalent–almost embarrassingly so. I walked in from work the other day with the”I think I might be low” and checked,I was 42. I turned and said to my daughter,I shouldn’t be talking to you at 42. It’s talking longer for glucose tablets to work and so I grabbed the bottle of pancake syrup.That worked–brought me to 82. I also have passed out for 1.5 hours. Even with my CGM it’s too late. I’m glad that you called. You’ve inspired me.

  12. Scary story! I tend to subscribe to the belief that “if you’re with-it enough to be able to call 911, you don’t need to do it” (same thing with glucagon). Then there was the time I got really sick after Thanksgiving dinner and couldn’t keep any food down (but had a ton of insulin on-board). I was surrounded by family, fortunately, and I asked them to take me to the hospital because I was afraid of the inevitability of what would happen. It was the weirdest feeling, almost like preemptively calling an ambulance before getting shot.

    I suppose if you don’t want to have any regrets later, then it’s best to ask for help now. I’m glad you made that choice.

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