Toenail Totem
Friday, January 30, 2015 at 7:00AM “George we are going to help you up, do you think you can stand?”
“yeah, I think so.” I looked at this strangers face and noticed there were 4 other people in my room. Radios kept coming on which made me believe these must be paramedics.
“Okay, we are just going to walk you outside okay?”
“okay.” Nothing hurts. I can walk okay? Did I have a stroke? Did I have a heart attack? Is this a dream? This has to be a dream.
“Watch your step down and can you sit on the gurney?”
“yeah.” The red lights flickered all around my front door and at that moment I saw my children standing beyond the doorway looking out at me. They looked scared, tired, worried, helpless. This has to be a dream.
“Just swing your legs up and slide to the middle”
“Where is my wife?” As soon as I said it I heard her familiar voice.
“I’m here, I’m right here.”
“What happened?” As soon as I said it I could not wait for an answer. I couldn’t hold anything back. My sobbing drowned out what she said.
When I was in the back of the ambulance I heard my wife talking to the driver so I knew she was upfront. The paramedic in the back started asking me my name, my birthday, and how long I had diabetes.
For fear of a stroke or to prove to myself I was awake I spouted off every single fact I could pull out of my head. “George Scott Simmons. Born on March 23rd 1973 in Hollywood California. It was Friday. I have had type 1 diabetes for 23 years. I was diagnosed on October 2nd 1990. It was a Monday.”
They must have thought I was crazy.
“So why are your toenails blue?”
This was when I was sure I was awake. Like a totem from the movie Inception, those blue toenails were nothing I would ever dream up so I knew for sure this was real life.
“My nieces were painting their toenails over the weekend and I thought, what the heck. Go for it!”
That was when the paramedic started to tell me that I had a really bad low blood sugar that I could not come back from. That was when I noticed I had an IV in my arm and 3 Band-Aid’s on different fingers.
When we got to the hospital my wife started to explain the entire situation piece by piece to the doctor. It turns out she knew I was having a lot because I threw all of the covers off of myself and started to moan. She woke up and saw my sweating profusely. She came to my side of the bed, grabbed my machine, and had me sit up. She put a strip in my Verio meter and grabbed my hand to prick my finger. When she did blood streamed down my hand on a river of sweat.
She grabbed a hand towel and dried my hand and arm off. She squeezed the same finger and as soon as a drop of blood appeared it found a new river of sweat to travel down. She has never seen me sweat so bad and neither have I.
Finally she was able to check my bg. It was 37.
She grabbed a Level glucose gel and tore it open. She put it in my mouth and started to squeeze the gel into my mouth. She said I bit the end in my mouth and wouldn’t let any gel in. Not in a argumentative way but rather like I had no idea what I was doing.
She flicked my mouth and I opened up. She squeezed the whole thing in and when to get my daughter up to help. I swallowed the gel and lied back down.
My wife got my daughter up and asked her to make some waffles for me to eat. It was 4 in the morning and we usually add some waffles for some more carbs to last me through the morning. She popped in a couple of Eggo’s and my wife came back to check on me.
I was still sweating and out of it. She opened up another Level and squirted it into my mouth. She said I did not swallow it. I just left it in my mouth so she had to keep telling me to swallow it. Finally I did and just then my daughter came in with the waffles.
My wife put a piece of waffle on a fork and stuffed it into my mouth. She said I just sat there with the waffle in my mouth. Not chewing or reacting at all. Like I forgot what to do.
She grabbed another Level, took the waffle out, and squirted it in. Apparently I started leaning forward as if I was going to fall over. My wife got scared and told my daughter to wake my son up to help.
A ramekin full of regular syrup and about 8oz of regular soda were brought in by my son and daughter. My daughter put a straw in the soda to make it easier to drink. My wife said I looked at the straw, took it out of the glass, and stuck it on my finger to try and get blood out for another bg test. She said I kept squeezing my finger to try and get blood out even though she kept reassuring me she already got the drop she needed.
I drank the soda and swallowed down the syrup.
Still I was completely out of it. I could not talk and my family could tell I was not “there.” My wife grabbed the Glucagon shot and instantly was overwhelmed by the instructions. My son stood right in front of my wife’s face and said, “we need to call 911 mom.”
When the ambulance got there they came into my room, put an IV in my arm and checked my blood sugar.
The machine read 34. This was 40 minutes after this all started.
My son remembers them putting a bag of fluid in me via the IV and when it was done they started to stand me up. This marked the very beginning of my memory.
That is what scares me most. I remember nothing before when I started this post. Not a glimpse or flash of the story I heard my wife tell the ER doctor. None of it.
I kept waiting for a fog to lift like a night of too much alcohol. As soon as you hear the story flashes of memories start to trickle in. But this was and is so different.
I have nothing.
So we stayed in the ER until about noon on Sunday after my bg was stable. The nurse asked me why my toenails were painted blue. I told her the paramedics must have done it on the drive over.
My kids had followed the ambulance in my car and they stayed with me all morning. When we all got home we all passed out on the couch. Exhausted and drained we slept until 5pm.
I have never in my 23 years of diabetes had a low like that. I have had bad lows that take forever to come up. I have had some where I couldn’t walk or talk but I remember them. Even though they felt like a dream I remember what happened. But this was crazy.
Have you ever had a low like this? I cannot understand what made it so different. I have seen 34 on a machine before and been totally aware of what was going on.
More than anything I feel so bad for putting my family through all of this. It is not fair.
I pray I will never have another low like that ever again.
Reader Comments (30)
I'm glad I read this post. Our DD has Type 1 but I did not know this type of low was even possible (assuming if you keep feeding glucose, your blood sugar must eventually come up). Not so. I would like to know the reason this occurs. I'm glad your family was there and can understand your wife's frustration with the glucagon instructions. Easier than it looks. Just remember this mantra "Wet to dry. In the thigh." You would have to know to swirl it around to mix it. The needle is intimidating. You can use an insulin needle and just refill the needle until you use up all the glucagon (might take two shots). And sub-Q is fine. You do not have to inject into muscle. There are demos online on Youtube. So everyone get your expired Glucagon shots and practice. After reading this post, I know I will. I'm so sorry you had to go through this. It's not the norm and it probably will never happen again.
George, just stumbled upon your blog from a link on emotionaleatingwithdiabetes.com and I wanted to tell you my diabetic diagnosis experience sounds almost verbatim to my story except I was in DKA with hyperglycemia. Strangely enough though, your recollection of your unconscious experience sounds like what happened to me-- mine, however, took several days/ weeks to develop and I never realized the signs of DKA (urination, excessive thirst, weight loss, blurry vision). It was a slow but steady decline for my mental capacity and function; finally one day, I just sat down in the shower and next thing I know I wake up in the hospital after a 2.5 day coma. I completely agree with your sentiments on the period that you were "out of it"-- literally I have NO memory while I was unconscious even though my mom (who found me in the shower) said, while paramedics were working on me that my eyes were partly open and I was moaning and mumbling to myself. The male nurse who was my admitting caregiver said my core temperature was 76 degrees when I arrived yet I was highly combative once the attempt at intubation began. I have NO memory of anything for a span of 2.5 days. I always hoped people in comas were off somewhere beautiful and peaceful... turns out it feels much more like a light switch. But I must say it didn't dampen my belief in the spiritual realm one bit because I know that just surviving my ordeal without any significant damage I must have had someone(s) watching over and protecting me!
So glad you survived your ordeal-- it's so amazing that a seemingly insignificant thing like sugar can cause so much damage if left unchecked!
I think we all pray we'll never go through that, but as long as we're forced to rely on exogenous insulin that is dosed in a non-physiological manner, that remains an unfortunate possibility. And people who dare ask why a cure for diabetes is equally urgent to cancer or other maladies should experience this and then answer if theirs is any more urgent IMHO.
George, yeah, I know the feeling. My sister have had simila experience before and its wasnt fun at all. The repeated effort get the BG up again is even another trouble on its own.
Thanks for sharing this story again George
Hi George,
I wanted to tell you that yours is the first diabetes blog that I have ever read. Once I started reading yours, I truly felt connected to you. I realize that trying to cope all the time on my own has gotten emotionally overwhelming. I feel like I now have a lifeline to a support system.
I have had a scary low like yours - only once - thank Goodness. It was the day after school got out last year and I was cleaning and packing up my classroom for the summer. I had not stopped to eat a regular meal all day, but nibbled as the day went along. I also had not been testing all day either. Shortly before I left school for the day, I decided (without testing) that I better take a little bit more insulin since I had snacked quite a bit that afternoon. On top of all that, I had had a sinus headache that morning and had taken some Aleve Sinus medicine. It was 97 degrees that day, too. So, on the way home from school, I started feeling a bit funny and was sweating profusely, but it was 97 degrees out and I had the top down on the car. Who wouldn't sweat, right? I made a stop at an office supply store, felt funny there and ate a snack in the parking lot before heading on home. I made one other stop at the pharmacy. Still felt funny and had a granola bar in that parking lot. I proceeded to drive home. I have very little recollection of the drive - just glimpses along the way. I took out the road sign while turning into my neighborhood, and my neighbor's mailbox while turning onto my street. I went straight into the house and got in my bed feeling like I had just escaped from a bad dream. When I woke up, my sugar was 72. I looked in the garage to verify that I really DID do all those things I thought I did to my car. I called my husband at work and told him what happened. I replaced the mailbox, and kept my secret about the street sign. It was the scariest thing that has ever happened to me regarding my T1D.