Diabetes Self-Management Blog

Saturday, July 24, began in the same way as many of my other Saturdays in the summer of 2010. Kathryn (my wife) gets up around six or six thirty to take the dog for her walk. I often wake up about fifteen minutes later, and the first thing I do, because I don’t have a thyroid, is go downstairs and take my Synthroid (levothyroxine sodium) with a large glass of water. Then I check my blood glucose.

After Kathryn returns, after the dog is fed, and after we’re Saturday-morning presentable (lax standards for the weekend), the two of us head downtown to Beezy’s for the most delicious, decadent breakfast we know. Kathryn goes for savory, the breakfast burrito with chorizo, while I treat myself to the sweet Beezy’s weekend special, typically super-tasty French toast. Let me tell you, for most of my life French toast has been stale bread soaked in egg, fried, then soaked in syrup and butter. This Beezy’s ain’t your typical French toast! (I can’t do it justice in this blog, so I’m not even trying.)

Maybe you’re wondering why someone with Type 1, insulin-dependent diabetes — someone who ought be a bit careful about his diet — is eating such sweet deliciousness. Well, because I can. I bolus appropriately. I exercise. I’m healthy (relatively speaking, of course). And I don’t often eat like this. I am not caught up in what I’d call an antiquated mindset of what a person with diabetes can and can’t eat. I live my life. I manage my diabetes quite well. I do all the doctory stuff I need to do. Therefore, if you’re passing judgment on me for French toast, get over it. I know how to handle food.

At least, for the most part.

Read on…

Saturday continued along its normal trajectory. I went home and did yard work. Kathryn and Ellie (our dog) went on their weekly Saturday afternoon visits to the hospital, where Ellie, who’s a registered therapy dog, visits with patients and makes their stay in the hospital a little brighter.

After they returned home, after the evening dog walk, Kathryn and I headed to Ann Arbor’s Chop House for her birthday dinner. Oh, have I failed to mention that this was my wife’s birthday? Well, yes, it was. And as such, we’ve started a tradition of visiting The Chop House, a not-so-cheap establishment, to celebrate. See, dining on one’s birthday at this restaurant is half price. So, really, the birthday girl gets her delicious filet mignon for free.

I ordered steak au poivre. We both had the lobster bisque. We had some bread. And for side dishes, potatoes au gratin and mushrooms. Not an overly carb-tastic dinner, all things considered. To deal with my diabetes, I did what I often do for slow meals: bolus for each course as it arrives rather than try to figure it out beforehand.

At the end of the meal, or rather, halfway through our meal, we were done. Finished. Check please. We even begged off dessert, a rare occurrence during a birthday meal, but thanks in large part to my sharing my French toast for breakfast, we’d had enough sweet to last a week.

The waiter boxed up our food and we headed back home to wind down the evening with a beer and some TV-on-DVD.

While watching an episode of Criminal Minds, I started to feel the symptoms of mild hypoglycemia. At least, I felt most of the symptoms. I recall the nervousness and the jitters. I developed cold, clammy arms and legs. My hands began to tremble some, as they often do during hypoglycemia.

Yet as I sat there watching Mandy Patinkin try to catch a serial killer, I wondered if this had something to do with my thyroid regulation. I’ve unfortunately discovered that sometimes I encounter the symptoms of hypoglycemia when my blood glucose is perfectly fine. Yet since the thyroid cancer, I’ve had to wade into an even more ambiguous sea of hypo- or hyperglycemic symptoms, and I’m even sometimes totally asymptomatic. It’s just that much fun! You know, don’t you, that you can never trust your “feelings” when it comes to diagnosing highs or lows; you ought to always check your blood glucose rather than go on symptoms alone.

And I’d like to pause here to give a big, hearty thank you to my wonderfully flawless endocrine system.

(That’s a joke.)

Me, during my wife’s birthday, late evening, on the couch. I was nearing — or in — that blissful state we Americans often eat ourselves into: a food coma. We’d both overdone — just a bit — the day’s gustatory festivities, and although half of my steak and the potatoes were still in the fridge, I couldn’t eat another bite. Hunger was the last thing my brain was telling me to be aware of.

Which is why I wanted to ignore the symptoms. Lethargy ruled my world, and these mild hypoglycemic symptoms, in my three years of living with diabetes, always accompanied the need to eat the shelf. I mean, really, apart from this instance, I can’t recall a time when I was low or going low in which I didn’t become ravenous and have to work to restrain myself from overeating to satiate the signals coming from my brain.

I got up to check my blood glucose, and it was somewhere near 65 mg/dl. I can’t recall the number any longer, but I was low. Yet to treat the low? I wasn’t thirsty. I wasn’t hungry. I didn’t want anything else to pass my throat. I just wanted to flop back on the couch and continue to groan with discomfort.

I think I got some orange juice or some energy drink and sipped it for the next few hours. I still had insulin on board from the dinner, so I had to be careful because it was still working, still wanting to bring my blood glucose down. Thus I ended my wife’s birthday by observing blood glucose hypervigilance until around midnight.

Where did I go wrong? Did I overbolus? Maybe. But as any of you who have diabetes know, the confluence of any number of things the 24 hours or so prior to a low can play a part in contributing to that low. You can’t always blame the most recent action. Maybe it was the breakfast. Maybe it was my working out too hard at the gym the day before. Maybe I overdid it in the heat in the yard. Maybe. Maybe. Maybe.

Will I abstain from this type of celebration on my birthday in February of 2011 (when we’ll observe with religious fervor the same foody indulgence)? Or Kathyrn’s birthday next year? I don’t think so. It’s simply living — and enjoying — life despite diabetes.

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