Because a couple of people have asked me about hypoglycemia (low blood sugar), and I realise that while I do explain, I might not do so particularly clearly…and, to be honest, it’s not so common a thing, despite everyone having it to some extent!
The TL;DR of this is – LISTEN TO THE PERSON. THEY WILL USUALLY TELL YOU WHAT THEY NEED.
Having got that out of the way, let me do some more explaining. I’ve got mild hypoglycemia, and have had since I was a child. Basically, I don’t cope too well with not eating for extended periods of time – by which I mean about 3 hours. However, I’m lucky: because it’s mild and not related to diabetes, it’s very much an invisible illness, and one that mostly doesn’t affect me. (Hah. Ok. I manage it so that it doesn’t affect me, mostly.) I don’t need to do the blood pricks or carry insulin/glucose, and it’s not immediately life-threatening – which for many people with the condition, is can be. For me, it just means that I seem to go through glucose a lot faster than most people – and have a worse reaction if I get low blood sugar.
So I’m writing this for a couple of reasons:
- a PSA for anyone who a) knows me, or b) may know someone with the condition; this is the sort of thing you need to watch out for.
- to say that this is one of the small, invisible illnesses that does exist – it doesn’t affect my life too badly (or at least is something I manage) and I don’t need any accommodations beyond “sometimes I need to eat in meetings”, but it’s something that is there.
- and to say: this is me. This is my brain, my body, my life; I’ve had a couple of people asking simply in the spirit of “really? Can you tell me more about it?” so…explanation!
And now a brief diversion via storytime for the fourth reason that I’m writing this…
Basically, one day last week, I messed up. There’s various factors that affect my sugar levels and how they work with my body, including how well I’ve slept and what I’ve been eating (which is why you’ll sometimes find me talking about having a “shaky” day). I hadn’t been doing anything that I knew would trigger issues, and I woke up fine and trundled myself on my walk to work. I realised when I got in that I was a bit tired, but it was the point that I put my bag down and had to try three times to open it that I got a bit suspicious. I can’t always judge how well/badly I’m doing, so it is always a little bit of a guessing game to see where I am on the when-I-need-food scale, and that morning I was struggling a lot sooner than I normally would do…
And that was when I went via a friend’s desk on my way to make tea and porridge, as they know me, and know how to cope – and I had a sneaking suspicion that I might need someone there to watch my back.
The point I nearly dropped the kettle the first time was a bit of a giveaway that I’d been right to be suspicious; the second time got the kettle taken off me before I tipped hot water everywhere, and the point I got tunnel vision was the point I sat myself down on the floor! I think I startled a few caffeine-deprived coworkers, but my friend just handed my tea down to me and spent the next fifteen minutes cheerfully disclaiming any responsibility to said startled coworkers and checking my porridge hadn’t exploded, while I cracked up laughing and got as much of my tea into me as I could. Because I’d caught it in time, I had enough energy to get back to my desk and get breakfast in me (which my friend kindly delivered, mostly to save the carpet from spilled porridge) and by lunchtime I was back to normal. Not unusual in my general experience, but the first time I’ve been that bad at work – and in front of other people *winces* which was…well. Not fun, for them and for me – sorry to anyone I scared!
But! I will bet quite a bit of chocolate that the above incident was the first time everyone (except said friend) in that kitchen had realised there was anything different about the way my body processes glucose and the way I deal with it. Invisible illnesses are invisible – until they’re visible!
So this is your PSA on dealing with hypoglycemia, or at least my case. In anyone with a more severe condition, these timeframes will be a lot shorter, and they’ll have specific things they need to do – but in all cases, more glucose is never a bad thing.
What does it look like?
The first things people tend to notice (to do with my hypoglycemia, anyway) are;
- I’m the snack queen – I’ll usually have a cereal bar, packet of biscuits or banana on me, and my desk drawer always has a selection of noms;
- I’ll occasionally hold my hand out flat and stare at it intently for a few seconds, usually after someone’s asked me “how are you doing?”;
- I usually give time periods before I next need a meal, which can range from “eh, I’m fine” to “you’ve got half an hour and then I WILL NEED FOOD.”
- I’ll occasionally interrupt things with, “Sorry, I need to eat” and cheerfully continue with whatever it was with the addition of a cereal bar. It seems to flummox some people. (Sorry!)
“When did you last eat?”
The root of hypoglycemia is something everyone gets if they don’t eat enough: low blood sugar. A lot of the initial symptoms might be recognisable – know anyone that gets hangry, tired or irritable if they skip a meal? I get hungry and then tired, but I’ll also get shaky, which is what I look for in my hand. That’s my first sign that it’s not just hunger – as obviously I do get the same reactions as everyone, and therefore “hungry” could simply be my stomach demanding a second breakfast or that spare donut 😀
This is basically the “Kate, you’re a bit grumpy/tired/pale, when did you last eat?” stage, and the solution is a decent meal – for me, preferably something hot and with carbs. However, it’s not always quite that simple: my anxiety means that I often find it hard to go to restaurants or buy food, and if I’m not doing great, I’ll actively avoid eating because it’s stressful…which then, of course, makes me worse. (Yes, I know. That’s why it’s anxiety: it’s not rational.) Various friends know what to look for with this, as it’s quite hard to explain – but as a quick solution if I don’t want to eat, get yourself food and share it with me. It’s one of the shortcuts for my anxiety brain, and will at least get enough energy into me that I’ll hopefully get myself sorted shortly afterwards!
If I ignore the hungry I-should-eat – which I can, and frequently do – then I start getting then I get what I affectionately call the “umbles”; mumbles, grumbles, fumbles, bumbles. I’ll drop things. I start getting noticeably tired. I’ll be a bit more clumsy – I’ve referred to “egg days” before, after the day I was handed an egg for baking and it went straight through my fingers…
So if I’m at the I’m at the a-bit-shaky stage, hand me a cereal bar or biscuits, but preferably something not too sugary – so oats, nuts, plain biscuit, that sort of thing. Chocolate isn’t great because it’s too quick a rush, and while it works, if I don’t then get something more substantial in me then I’ll come down off the sugar rush HARD, which hurts. The amount of people that give me chocolate when I’m looking a bit shaky is lovely – I thank them profusely and save it for later. (Definitely not wasting chocolate.)
This is also the stage where if I say to you, “I need to go and eat NOW,” it is not the time to just spend ten minutes faffing or “oh but I just need to-” because I am now on a time limit and You. Are. Not. Helping. If I ever say this and look like I want to murder you, that’s why. (In the nicest possible way, of course.)
“Ok, I’m not doing great: help?”
I can push through the shakiness. I know, I know – but if I do then hey, I get a bit of a second wind! Which depletes my reserves and I shortly end up in exactly the same shaky position just without the second wind option, and I really should, by now, know better. It’s easy to just keep going, but the consequences can be nasty (which I’ll go into in a sec). It also happens if I haven’t eaten for 10+ hours (for example, if I’ve been asleep…) or my body’s having a strange day with how it’s processing things, so it’s not just me making terrible decisions.
This is, to me, the “ok, this isn’t great” sitting-on-the-floor and completely-out-of-energy stage – I’ll be properly ‘umbles’, shaking, likely close to fainting if I move too fast, and I can feel an ache in my muscles. I’ll probably also be fairly pale, having trouble focusing, talking quite slowly, and generally a bit subdued.
I’ll possibly also ask for help if I’m around friends – that’s when you know it’s bad!
The solution: anything sugary straight off, and then a decent meal of some sort to back it up. A good compromise is tea, preferably with two sugars, and make sure I’ve got a damn good grip on the mug because I’m likely to drop it. I say ‘compromise’ there because the hot liquid and sugar hurt my stomach but it’s the best thing mentally, and also usually the simplest thing for someone else to make. Also be aware that it will take me about fifteen minutes to get enough sugar in me to recover and get myself somewhere (in last week’s case, off the floor and back to my desk) and then up to 3 hours to get everything back up and running – the aftermath feels a bit like a flu ache, so I’m likely to be moving slowly and holding on to things for a little while after.
The friend help at this stage is often more to field off enquiries and well-meaning people; I know what I need to do, and I’m usually already doing it. It’s also to carry things – yes, I have dropped full mugs of tea before because they’re too heavy – and generally just make sure I am recovering. I’ll still be completely compos throughout all of this; it doesn’t affect my brain (much), only my body. So just keep talking to me, and I’ll probably be laughing at myself while working through tea!
This is pretty bad… (not likely to happen soon to me, at least)
I can keep going, but I’ve not been that much of – frankly – a damned idiot for 15 years. Apparently I collapse, have a fit, and if I then push past that – which I’ve never done – I’d end up in a) hospital, or b) a coma. Fun.
So, if I (or circumstances) do push far enough that I do collapse: let me pass out. I’ll recover, and then you can do the above – aka. feed me sugar. Paramedics can’t do anything: I appreciate it’s a bit scary to see someone shaking on the floor, but it really is a case of just letting it happen and then dealing with the aftermath. I appreciate that anyone around me would probably call an ambulance anyway because it’s hard to tell what is causing a fit, but if you at least tell them I have hypoglycemia they’ll be able to confirm that’s the cause, rather than anything worse. In the one experience I have had, I’d recovered by the time the paramedics turned up and was able to reassure them I was fine.
General advice for any of these stages: talk to me.
Yes, my brain’s sometimes an idiot but if you ask me when I next need to eat, I’ll tell you! I’m also a lot better at letting people know and planning it in to trips, and letting people know if I am having a problem; it’s something that I can – and will – talk about.
If you’re not sure, then ask me (and feel free to tell me that I’m an idiot, as long as you back that up with actual help).
So that’s your random PSA for mild hypoglycemia in Kate form!