Wednesday, December 17, 2014

A near miss

People living with Type 1 diabetes take their lives into their own hands on a daily basis.  We are armed with a very powerful tool in managing our disease, and a small misstep can have disastrous consequences.  I hear and read a lot about how dangerous insulin can be and how small mistakes can lead to big problems but I never really understood it.  I knew that it was definitely possible to take too much insulin and end up in a really scary situation.  And I know that low blood sugars are also very dangerous.  I've blood sugars register as low as 32 on my meter and felt low symptoms (unfortunately I usually don't feel those symptoms until I'm into the 40's), but I have never felt as though my life was in danger.  And then yesterday I made a very stupid mistake.  I missed my Lantus dose on Monday night and kept forgetting in Tuesday morning as well.  I dropped my daughter off at day care and came back home to get ready for work.  I was getting ready and remembered again that I still had not taken my Lantus dose so I went to the kitchen to take it.  I keep my Lantus pen next to the coffee maker and usually my Humalog stays in my case that I take with me.  I was pre-occupied and grabbed the only pen that was sitting there, dialed up my usual 26 unit dose and injected it.  It wasn't until realized that I didn't hear the usual clicking sound my Lantus pen makes when you depress the plunger that I had made a mistake.  Yep, I had taken 26 units of Humalog.  I stood there for a minute while the potential implications of what I had just done began to sink in.  Then I realized that I needed to do something about it before things got really bad.  I was home alone, supposed to be at work before too long but no one would take much notice or call if I wasn't there right on time, and no one was expecting me anywhere in particular during that day.  No one would be at my house for about 6 more hours.  I texted the Pretty Lady in My Life to let her know what was going.  She freaked out a little, but at least someone knew that if I didn't respond they needed to send help.  Then I checked my blood sugar.  I was already high because I forgot to bolus for breakfast so I at least wouldn't have to cover the entire 26 units, only about 18.  With some quick math I figured out that I needed to take in about 216 carbs, as fast acting carbs as I could get.  I scoured the house, found orange juice in the fridge and poured what was left into a glass.  The I looked all over the place to see what was available.  I considered glucose tabs but thats a lot of glucose tabs and the thought of chewing and swallowing 50 plus tabs made me feel sick.  I settled on Fruit Loops and measured out what I figured to be the amount that I would need to cover the remainder of the insulin.  I chugged my orange juice and checked my blood sugar, 42, and started eating my cereal, sans milk.  I checked in with my wife and checked my blood sugar every 15 minutes or so to let her know I was still alive.  I saw my numbers start to climb back into a safe range.  50, then 56, then 74, and eventually back up to 108 about an hour later.  I ended up at 67 around 3:30 before my bloodwork for next weeks endo appointment, so I made sure to keep eating and periodically checking my blood sugar the rest of the day.

In the end everything turned out OK, but the whole experience scared the shit out of me and has reminded me just how easy it is to make small mistakes that can have huge repercussions.  And very dangerous ones at that.  As people living with diabetes so much of our care is left in our own hands.  I'm fortunate to have had good doctors in my short time with diabetes.  I received good direction and on how to use insulin properly and through my own research and the help of others know how dangerous insulin can be.  But I know through my interactions with other PWD that not everyone is as fortunate.  I found out yesterday that even with good training and the knowledge of what to do and what not to do, it's easy to make mistakes.  And with a drug like insulin mistakes can be costly.  That is why we need a cure.  Because insulin is a stop gap measure that keeps us alive, but there are too many doctors out there who just throw a vial of insulin at a patient and send them on there way.  There are too many PWD who don't know what insulin on board is, what their insulin to carb ratio should be, or how dangerous it is to be off on your dosage.  We need a cure because the thing that we need to keep us alive can too easily be the thing that kills us.

No comments:

Post a Comment