| CherylAnne,
Hello. I am a "diabetic husband" speaking. I totally understand the frustrations and difficulties you face dealing with Bill--I WAS pretty much that kind of guy for quite a while, and it does put a lot of stress on the individuals, not to mention the relationship. From the point of view of the diabetic, let me attempt to explain something, which does not in any way excuse his behavior, but may help you to understand it. We're scared of high readings. We're scared sh!tless of them--they represent the bogeyman of complications, unseen, wrecking our internal organs. If high readings are our enemy, it must follow that low readings are our friend. Faulty logic, we realize, but nonetheless, the more time we spend low, the faultier our logic becomes and the less we can feel our lows, until this sort of twilight edgy state of consciousness becomes accepted as nearly normal. It makes us edgy, nervous, paranoid, stubborn and, unfortunately, enormously resistant to seeing how "off" we are and trying to change it. It makes us resistant to suggestions that we need to change anything. And it's a vicious cycle--Afraid of highs, we drive our sugars progressively lower and lower. the lower we get, the less we "feel" low--in other words, when we live at 90 and seldon venture lower than 75, 65 feels pretty bad. But if we live at 70 and often venture down to 55, we barely notice 50. It's a VERY small range, when you think of it-- between 75 being just below fine, and 55 being just above whacky--only 20 points. There's no clinical difference between the 20 points separating 85 and 105, but a HUGE difference between 55 and 75. The more time we spend in the 70's and lower, the less we feel it affects us, and the less we feel it at all.
Bill has no doubt dulled his sense of alarm and danger by spending way too much time in this "too-low" neighborhood. There IS one fairly certain way out of this--it requires a lot of dedication and hard work. He needs to scrupulously avoid a reading below 80 for two weeks. If he can manage that (and he can--IF a coalition of friends, family, doctor, employer, whoever can be enlisted to support you puts the screws to him) than he will recover his own internal sense that these low readings are bad for him. It's a form of intervention that took me from a twilight of nearly 10 lost years of my life into a fully functioning person. I remember doing the same stupid things--being outside working in the yard, or shoveling snow, lost track of time and eating, went too low to know or care, figuring, "Whatever...", then wondering why, when my wife finally pulled me in to eat when I was way too low to stop and figure it out myself, why someone hadn't taken better care of me sooner... And her being really mad at me for letting myself get like that, and me being mad at her for letting me get like that... and around and around.
It's HIS fault, and it's NOT his fault--at this point his thinking processes are likely slightly impaired on an on-going basis, and if he spends a lot of time low, he likely has never sufficient glucose in his system to built up his counter-regulatory store of glycogen in his liver to allow him to fight off lows himself. He requires a time-out, as we say in Special Education, both for his mind and his body. He needs to repair his thought process and his liver response to hypoglycemia. He needs to back off his dangerously tight degree of control. with many low blood sugar episodes, he's courting permanent brain damage, which will scar his memory, judgement, reaction time and mental acuity. I've been diabetic for 38 years, and I lost the entire 1990's to the fog of hypoglycemia. I dragged myself back through fear, guilt over the hurt I'd inflicted on my wife and children, a couple of near-misses in the car and one wake-up fender-bender, two 911 calls at work and several more at home, and a desire to stop being a ticking time bomb. I wanted control, not just over the diabetes, but over myself. It takes incredible patience, determination, strength and willpower to do it. Read him the riot act. Call his doctor and insist that the doctor read him the riot act as well. He may think he's protecting himself from a tomorrow of being blind, in dialysis, in a wheelchair, but he's subjecting you to a today of anger, frustration, danger, hurt, emotional torment and confusion. Print out my letter and sit with him as he reads it. Look into his eyes and ask him, "What are we going to do about this problem?"
He MUST test his blood sugars 5-8 times a day, especially as he attempts to get off the roller coaster and normalize his readings. Self-regulating insulin doses IS a fairly standard practice, but he is obviously not doing it successfully. Perhaps he needs his ratios recalculated, or his basal dosage adjusted. Maybe he's not counting carbs accurately enough. There are a lot of things which would lead to his difficulties, and all of them are correctable--this is NOT a side effect he has to tolerate.
Good luck. Michael, type 1 since 1965  |
