[jnnydss]

Dear Friends,

I have a close friend that has Type 1 Diabetes. She had a terrible reaction Saturday morning and I called 911. She has an insulin pump.

I am assuming her insulin was too low? She had breakfast...but the night before she had several (six) glasses of Chardonnay. Prior to the seizure,she was walking, almost passed out, then became belligerent and violent for about 30 minutes. It really upset me to see her like this. I was so scared, she would not let me put a straw of Coke in her mouth, juice or anything. I now know sugar packets or honey are a good choice.

Anyway, after the episode, (she didn't go to hospital) do diabetics remember anything that happened? What do they remember? How do they feel? There was a very weird vibe between me and my good friend after that happened. I did spill juice all over her shirt and she acted mad about that. i was only terrified that I would lose her.

Another question, what would have happened had I not got a tiny straw full of coke down her throat? Can you come out of the seizure without help?

She has told me before to do something with her pump if that ever happened, and I was so not prepared. I am so confused, and my friend doesn't want to discuss it with me. Maybe embarrassed?

After the seizure, my girlfriend acted like it was no big deal..but it was a big deal. We were very worried.

Please help, I need more insight on my friend so I can understand how she feels.

Thanks,
J

[xMenace]

We can be very defensive about these episodes. Talk to her after it blows over in a relaxed environment. For now act like it never happenned. But do talk to her about it later and tell her how it made you feel.

The brain of course gets all buggered up. It's not working right. Whatever is said or done is due to the condition, not the person. We also tend to be very defensive during thee things. We'll all say we're fine. Don't ask, don't argue, just give short commands like "eat this" or "drink this." Be firm but not forceful.

Our bodies are very very good at saving us. google "Liver dump" The problem is it takes time, and during that time we can do much damage to ourselves and others. You did the right thing by calling for help when your efforts weren't working.

Don't be too upset. I've been 911'd nine times. Many here have been too.

[jshuffle]

I would ask her to keep insta-glucose in the house, especially after having drinks. Drinks tend to make BG drop due to its effect on the liver's glucose production.

You shouldn't force liquids down somebody who is not conscious' throat because they will not be able to swallow. Calling 911 is your best option.

It is dangerous to mess with the pump, because the insulin inside of it will make BG drop lower. The biggest cause of short term problems with diabetics is low BG. Your friend should be able to take care of any high BG situations before they will lose the ability to respond.

We diabetics can be very hard headed at times, because we feel that we can treat ourselves. If you sit her down though and explain your concern, along with asking her to review any procedures in case of a low or serious high BG levels, I'm sure she will understand.

[Subby]

Hey, you've gotten some good replies so far, heres a couple of thoughts.

Originally Posted by jnnydss

Dear Friends,

I have a close friend that has Type 1 Diabetes. She had a terrible reaction Saturday morning and I called 911. She has an insulin pump.

I am assuming her insulin was too low? She had breakfast...but the night before she had several (six) glasses of Chardonnay. Prior to the seizure,she was walking, almost passed out, then became belligerent and violent for about 30 minutes. It really upset me to see her like this. I was so scared, she would not let me put a straw of Coke in her mouth, juice or anything. I now know sugar packets or honey are a good choice.

It's not like we can make a judgement that this was definitely the problem, but there is a particular reason those drinks may have caused this. It was mentioned but I'll expand: in the course of the day, energy is released from the liver to help us meet out energy needs - talking, walking, thinking, even just breathing, it all takes energy. Alcohol can have the effect of suppressing or dampening this release, for quite some hours afterwards. In the case of a non diabetic: ok, the body doesn't release insulin, the balance is generally kept. In the case of a diabetic on insulin, the insulin being released to deal with these "basal" energy requirements, becomes too much. Hence, as an overdose of insulin, it can create big lows!

The reason I've gone into more detail is it helps you to have knowledge of this, and in fact your friend may not be quite aware that it's simple mechanics going on here. They may have been told 'diabetics shouldn't drink" (and may indeed get it again) or something like that, and it gets rolled into general purpose cr4ppy advice to be rebelled against of ignored. It's much more useful to be aware of the actual issues.

It doesn't mean diabetics shouldn't drink, it does mean they should be aware of this, find out how it works for their body, and be prepared to change their insulin delivery accordingly, before it's a problem.

Anyway, after the episode, (she didn't go to hospital) do diabetics remember anything that happened? What do they remember? How do they feel? There was a very weird vibe between me and my good friend after that happened. I did spill juice all over her shirt and she acted mad about that. i was only terrified that I would lose her.

All I can say is that it takes some time to get over the brain-shock of a bad hypo. Both physically and getting your head sorted out again. Chances are they will not feel themselves until a good sleep or a day or so has passed. I would not read into "the vibe" except that your friend had a big knock to their system and will take some time to act themselves again. At the same time, it might stay as an unpleasant sore point that she just doesn't want to talk about. I can understand that.

Another question, what would have happened had I not got a tiny straw full of coke down her throat? Can you come out of the seizure without help?

Usually one will, the liver (there's the liver again) will release energy in response to a low. But if really suppressed by a lot of alcohol... I don't know how the chances change and tip towards unconsciousness before liver release.

She has told me before to do something with her pump if that ever happened, and I was so not prepared. I am so confused, and my friend doesn't want to discuss it with me. Maybe embarrassed?

First I'd give it a few days if you haven't yet. Then I would say something like "I don't want to mother you, I don't want to tell you what to do, but I was just really scared for you when that happened the other day - I couldn't help it. I didn't know when I should call 911, or what I should do. You said you'd tell me what to do with your pump... do you think we could go over that, just for those emergency situations? I would feel so much more at ease and stop worrying, then." Make it about you, not her. Keep it calm. Make it positive and removing involvement/encouraging independence, rather than getting "more involved". If your friendship is reasonable, she should see the sense of that.

After the seizure, my girlfriend acted like it was no big deal..but it was a big deal. We were very worried.

Please help, I need more insight on my friend so I can understand how she feels.

Thanks,
J

Look, apart from the vulnerability this sort of scenario goes on, and that's an especially large problem for anyone with any trust issues, chances are there could be some denial going on. In that your friend can take a ticket and join the club, type 1 can be a very tricky condition to come to terms with as part and parcel of your every day and sometimes every hour. I'd say many people get along really well with it but there are usually going to be some sore points and times along the way.

As suggested, I can only echo treading softly, but do gently and positively insist that you are more clear on what to do, next time - just for your own sake, if nothing else.

[lorilei]

my guess is that her directions at one point were along the lines of..."turn my pump off if i exhibit symptoms of a low"...but a little chat about what to do for any future incidents is imperative...and "when in doubt...911 out" is a good way to go...

you are a good friend, and hopefully she will get over it...but maybe approach it along the lines of..i would like to find out how you want me to do in xyz situation..when is a good time????

[GeishaGirl]

I feel ya. My mom was a type 1 with a grand mal seizure disorder (so she would seize EVERY TIME she went too low -- or if she forgot her meds) and my best friend also has a seizure disorder.

Yes, there is embarrassment, definately. Things we say and do that are funny in a few years are horrifying right after they happen. My tiny little 5'2" mother knocked out an ER doc while in a deep reaction -- it was YEARS before we could laugh about that. Sometimes (like what happened this time) NOTHING is funny -- but it does need to be discussed.

Wait a few days, let her get her head together, and bring it up as others have said. Also, if you're really nervous, buy a small package of glucose gel. (If I'm wrong, someone tell me, but my endo told me this!). If she passes out again, schmear some gel inside her mouth, along the gums -- NOWHERE NEAR THE THROAT. The sugar should be absorbed well enough that way.

And yes, short commands do work. Sometimes threats, but it depends on the mood of the diabetic. When I was in elementary school, I used to get my mother to drink juice by threatening to call my father. Then she'd cry and beg me not to tell him. Yes, this is why I'm so terrified of these lows and panic when I have one :P

[jnnydss]

Wow, you all have been so much help. I totally understand her feeling off about the episode. I also know that it was not her, it was the disease. This is the second one she has had with me, and I wonder how many she has.

One question I have is, does she remember the episode? I was forceful...major no no, but I was so worried. I did not realize she would snap out of it after the liver process kicked in.

Yea, i deal with Scleroderma and lung disease...I understand illness very well, and I know the value of a good friend when you have to deal with stuff daily.

Thanks everyone!
J

[kgm0612]

My younger brother (43) has these episodes several times a year. He goes so low that he gets MEAN & VIOLENT towards his wife and anyone else that's in the room. He is so confused at this point that my SIL calls 911. They show up at the house, in most cases they have to hold him down so they can take his BS reading, administer something to get his BS up, and when he's back to "normal"...........doesn't remember one **** thing that happened!

Karen

[It Ain't Over]

My best guess is that she remembers some of what happened and is deeply embaressed by it. Too much to drink and going low, all of which we are likely to take on a lot of blame for if and when it happens.
It can take a lot of work to get someone to learn to cooperate with you when they are low. Like has been written here, we get terribly defensive about it.

[xMenace]

Originally Posted by It Ain't Over

My best guess is that she remembers some of what happened and is deeply embaressed by it. Too much to drink and going low, all of which we are likely to take on a lot of blame for if and when it happens.
It can take a lot of work to get someone to learn to cooperate with you when they are low. Like has been written here, we get terribly defensive about it.

And yes we do get embarrased and defensive afterwards too.

The best help might be to get this person on DiabetesForums. It is much easier to open up to others with similar experiences. Much can be done to minimize the frequencey and intensity of these episodes.

Be aware that the liver may not always kick in to save them. Alcohol consumption interferes with its ability. Also large overdoses are problematic. It can likely cover most overdoses, even large intentional ones, but there are limits.

[Delphinus]

Originally Posted by jnnydss

I am assuming her insulin was too low?

Here is a tip. A diabetic will never need someone to inject their insulin.

There are no instances I can think of anyway, save for the person not being conscious. IE: in a coma in a hospital, or in some other situation where the person would need someone else to manage their insulin needs until they were able themselves, etc. You will, however, probably have to administer sugar to a diabetic friend now and again.

If your friend is ever acting weird, it is almost always a case of too much insulin, or something else creating a lack of glucose in the blood.

Never give insulin to a diabetic. It will always make the situation worse. IMO anyway.

[genie86333]

Yes, as Delphinus said, it's not her INSULIN that was too low, it was more likely that her BLOOD SUGAR was too low (meaning too much insulin!) so DO NOT give her insulin.

The safest thing to do is to assume it's sugar (soda, juice) she needs - if she's concious & able to eat/drink & she will cooperate to take it, that's great! If not, or if the sugar doesn't help, 911 is the way to go.

Even emergency medical personnel are taught to give glucose first...then test. The reasoning is that the glucose can save the person's life if they're too low & if they're way too high already, making their sugar a tiny bit higher isn't going to make a huge deal in the long run.

Also, don't depend on the liver dump if she's been drinking. Drinking gives the liver too much to do so it may not have time to do a liver dump. It *may* happen, but it may not.

[Delphinus]

Originally Posted by genie86333

Yes, as Delphinus said, it's not her INSULIN that was too low, it was more likely that her BLOOD SUGAR was too low (meaning too much insulin!) so DO NOT give her insulin.

The safest thing to do is to assume it's sugar (soda, juice) she needs - if she's concious & able to eat/drink & she will cooperate to take it, that's great! If not, or if the sugar doesn't help, 911 is the way to go.

Even emergency medical personnel are taught to give glucose first...then test. The reasoning is that the glucose can save the person's life if they're too low & if they're way too high already, making their sugar a tiny bit higher isn't going to make a huge deal in the long run.

Also, don't depend on the liver dump if she's been drinking. Drinking gives the liver too much to do so it may not have time to do a liver dump. It *may* happen, but it may not.

Exactly.

Even if someone is "high" on sugar, when in doubt, you give the person sugar anyway.

The worst someone will be with too much sugar is cranky, in MOST cases anyway. The proper procedure is administer glucose/sugar. Test. Treat.

As mentioned, you will probably NEVER have to give a diabetic insulin in his or her lifetime. Insulin is exactly what creates these lows and dangerous situations.

Nobody ever really worries or panics when "having a high". There is also no urgency to address one either. Just practical and long term health reasons.

If someone says or experiences the opposite of a "high", that is when it gets scary and urgent, and you have only a matter of minutes in most cases, whether you are a diabetic or non-diabetic.

You can take your good ol time dealing with a high if you like. H eck, take the whole day if you feel so inclined, just don't be around anyone who hates it when you are irritable.

[jimhuck]

I have had MANY seizures in my life, and I want to let you know two things:

• Your friend is most likely very embarassed, and probably can't remember a thing about what happened, which is even more embrassing. She also probably thinks there is nothing anyone can tell her that will make things better. Even though she probably needs it, she doesn't want advice.

• Seizures are incredibly serious. Most diabetics survive them, but there exists a very real chance of stroke and death. If your friend has a seizure more than once in a year's time, you really need to convince her to see a doctor who can teach her how to reduce her insulin levels. I'm not giving medical advice, but I'm saying that I haven't had a seizure or any significant insulin reaction since I learned how to drastically reduce my insulin levels. Richard Bernstein writes extensively about the fact that small insulin dosages result in small mistakes. BIG insulin doses result in catastrophic mistakes.

Again, I don't mean to try to sound like a "medical expert," but seizures/severe reactions are serious and can be eliminated. It doesn't have to be a "part of diabetes." Your friend may not be open to advice right now, but keep an eye on her. If this is a recurring problem, talk to some family members about intervening.

Sorry if this message is a little bit strong. It's a subject near and dear to me.

[HollyB]

Just wanted to add, you did the right thing calling 911. As others have mentioned, can't BANK on the liver bringing someone out of a seizure, especially after drinking, and once they are not conscious enough to eat or drink safely, then IV glucose or (or a glucagon injection, but that's another story) by the paramedics is the best option.

IMO there's not much useful you could have done with her pump -- you could disconnect it during a low but it's only dribbling out a tiny amount of insulin at a time and the effect of turning it off takes time -- too much time -- to accumulate. Better to concentrate on getting sugar into the system asap.

If you were my son's friend, I'd be very grateful to you right now.