Wednesday, 5 November 2014

A hypo in Berlin

For the first time I felt I wasn't prepared enough.
For the first time I felt diabetes was in control.
For the first time... I felt vulnerable.

It was after my wife and I had enjoyed a lovely meal at a restaurant in East Berlin, where the irony of a flashing neon sign above the entrance reading "Capitalism kills love" hadn't been lost on us. We decided to walk home rather than catch a bus as we'd just eaten a superb pudding - it seemed sensible. That was the second mistake.

The first mistake was clearly miscalculating the true carbohydrate content of my meal and the impact walking throughout the day would have on my numbers.

It should have been easy.

The only carbs in the three course meal were some chips and a lemon meringue tart.
I had the carbs and cals app on my phone to assist.
I knew the amount of walking (and climbing) I'd done during the afternoon.
Yet somehow I managed to get it wrong. Seriously wrong.

So, whilst walking "home" through the dimly lit streets of Berlin, I had a feeling. I whipped out my Freestyle Libre scanner and waved it over my right arm. Through my coat and t-shirt it scanned my blood glucose level and displayed it on the screen: 3.2 mmol/L and a slow decline arrow.

bgs are going down
Getting into trouble...

Thoughts started tumbling through my head...

"Ok that's not good, but it's not disastrous."
"It always reads lower than my normal meter."
"But it's going down and my hypo senses are tingling."

We carry on walking and I ask my wife, "How far do you think we are from the hotel?". We both agreed it wasn't much further. We carry on walking.

I scan again: 2.3 mmol/L and an arrow going towards the floor.

Going nowhere!
Bother! I'm feeling hot and despite the Libre always reading lower than my usual meter this is now definitely hypo territory. I open up my "bag of life" and take out a tube of Glucotabs. Popping them in my mouth two at a time my wife asks "Shall we just stop at this bridge until you're feeling better?"

I look around.

There's a small group of young adults standing on the bridge, they're drinking bottles of wine; chatting; laughing; enjoying themselves. A few other solitary figures are walking, heads down, no doubt rushing to their destination hoping to be back in the warmth.

I'm boiling, physically sweating beneath my coat, hypo! All these people make me feel unsafe, yet none of them know about the condition I find myself in. I doubt any of them have even noticed me.

"No, we're nearly at the hotel. I'll be fine, I'm gluco-tabbed up." I hear myself reply.

We stumble on. No. I... stumble... on...
I scan again... LO.
This walking is getting harder!

My wife chirps up again, clearly concerned: "Why don't we just sit here at this table?"

We're near the hotel now, restaurants and bars had appeared on the street we were walking on. I looked at the ever decreasing amount of glucotabs in the tube and the people around me. Lots of people around me. It maybe a brighter and busier street... but all these people... I don't want them around me whilst I'm like this!

"No, the hotel is only a few metres away, let's carry on."

Each step felt harder than the last one but, finally we're outside the hotel.

Whenever we're away we scout out the nearby area for any suitable shops that might sell "approved" hypo treatments. It's an unspoken rule. We both do it, acknowledge it, but never openly say "there's an emergency hypo supply shop". The night before we'd both identified what seemed to be a large-ish late night newsagents with lots of drinks chillers.

My wife decided she would go and find some appropriate carbs whilst I went back to the room.

"What's our room number again?"

I repeat this over and over in my head as I enter the hotel. Four - One - Two - Three - Four - One - Two - Three - Four - One - ...

I wipe my forehead with my hand as I approach the lift. It glistens in the light with its new coating of sweat.

I finally reach our room and enter.

Shrugging off my coat my arms reveal that they too are glistening with sweat.

I scan again.
Still LO.

bgs in Berlin
A packet of crisps! I take them, lie on the bed and devour them.
What else? Poppets! There are poppets in my luggage bag... not anymore, demolished!

... and then? ...then I fall asleep, waking when my wife arrives with "goodies". The newsagent turned out to be selling alcohol! Instead she returned with a muffin from a nearby coffee shop. None of this is exactly fast acting carbs, but I ate that too! ...and then back to sleep.

I wake to her scanning the Freestyle Libre sensor on my arm, clearly worried. Thankfully it was a good number. I was just shattered from the whole experience.

So now I reflect. This is the first hypo were I've felt vulnerable. Why?

I think the answer is two-fold:

  1. Previously all my hypos have either been when I've been on my own, in the company of my wife or at work (when usually no one notices and in any case I'm surrounded by people I know). This time I was in a public space.

  2. Did I carry enough hypo treatment?

    What if I hadn't made it back to the "safety" of my hotel room?

    What if I'd eaten all the glucotabs in my bag of life, stayed on the street and my numbers hadn't come up? It wasn't like there was a shop or bar nearby that could have solved my problem. My wife would need to leave me on the street and go in search of carbs... and then what?
It's a rare event but it's left a lasting impression. Diabetes has made me vulnerable and I've seen first hand how that impacts those closest to me. It's a hard lesson to learn.

What I thought was a good enough safety net might not be... hypo treatments aren't "just in case" items, they are vital items and one tube of glucotabs might not always be enough.