PLS HLP NON-DIABETIC SPOUSE

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Question:

– Hide quoted text — Show quoted text – A person who finds via repeated tests of values 70-180, that they have less than 19/20 repetitions in the range +/- 5% should reread the instuctions for using their machines, they are almost *definitely* doing something wrong. Statistic Correction 19 out of 20 within +/- 10% (2 SD). And let me add my comments, as a statistically compulsive person who uses the One Touch II, and is an excellent ’statistical guinea pig’ as a consequence of extremely consistent fasting readings. Have taken approximately 140 readings this calendar year, with an absolute low of 92, and an absolute high of 129. The mean value of all readings is 113.1, and the standard deviation is 7.1. If all this spread were due to meter errors, it would be less than 7 percent.

Wow, I’d be really happy if *my* fasting BGs had a SD of 40 points! (But this is of course mostly in my BG, not in my meters.) I think we agree, a 5% SD value probably includes a lot of bad technique and/or maintenance. For my test procedure (meter vs. meter variance at the exact same time) my experience, n=aprox 30 double-tests over the last 6 months, has been about 3% SD.

Response:

A person who finds via repeated tests of values 70-180, that they have less than 19/20 repetitions in the range +/- 5% should reread the instuctions for using their machines, they are almost *definitely* doing something wrong.

Statistic Correction 19 out of 20 within +/- 10% (2 SD).

Response:

And let me add my comments, as a statistically compulsive person who uses the One Touch II, and is an excellent ’statistical guinea pig’ as a consequence of extremely consistent fasting readings. Have taken approximately 140 readings this calendar year, with an absolute low of 92, and an absolute high of 129. The mean value of all readings is 113.1, and the standard deviation is 7.1. If all this spread were due to meter errors, it would be less than 7 percent. In fact, much of the spread is probably due to the fact that I have had ‘better’ months on average and ‘worser’ months on average. Conclusion: If you take decent care of the meters and the strips, and your testing technique is good, you really are unlikely to have an error exceeding 10 percent occurring. Trust the meter, but of course be aware of the 12 percent bias between the types which measure whole blood (like the O.T. II), and those which emulate plasma readings via 12 percent bias. — "If I am not for me, then who will be for me? If I am for myself alone, what am I? And if not now, when?"

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I previously said: (C) Insulin Shock victim is operating machinery (read DRIVING THE CAR). This cannot happen to me, I drive only with 90+ test results (immediately before starting) One thing you should know is that you may have to adjust that. Most meters can be off by as much as 20% so that 90 could = 72,

Comment (since your point concerns accuracy): As per the ‘accuracy’ thread a few weeks ago, even with amateur (but careful amateur) technique most meters have a SD of less than 5% in this range. The odds of a test being off by *more than 4 SD* is *vanishingly small*. This 20% figure is only apropriate for (1) lawyers who want to make sure that their firms don’t suffer lawsuits for accuracy; and (2) lazy users who don’t maintain their strips, equipment and technique. LESS than 72 is hypo by definition.

Although there are of course, degrees of seriousness. Now that’s also based on WHOLE BLOOD Your program is good. Just make sure your meter is too.

Agreed. I bench them against each other and against their test solutions at least 1x per week. A person who finds via repeated tests of values 70-180, that they have less than 19/20 repetitions in the range +/- 5% should reread the instuctions for using their machines, they are almost *definitely* doing something wrong.

Response:

Been there, done that. A few suggestions: Have some glucose tablets on hand. They’re a lot easier to feed to a reluctant person than juice. (I don’t know of any way to get either into a person who’s being totally recalcitrant, but if they’ll back off for even a short time, you’ll get a tablet in during the window of opportunity when you can’t get enough juice down.) But on at least one occasion, I talked my wife into some juice when I couldn’t get her to take a glucose tablet. So keep both handy, as well as any other sources of quick carbohydrate that you might have success with. My wife has been easier to manage in these situations after she had some talks with herself. She firmly resolved to cooperate, and it’s helped noticeably. Keep glucagon on hand for the times you can’t get any sugar down. Roy Lewallen

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(C) Insulin Shock victim is operating machinery (read DRIVING THE CAR). This cannot happen to me, I drive only with 90+ test results (immediately before starting) and 2-hour MAX test periods during drives. If he is argumentative and behind the wheel, IT IS AN IMMEDIATE EMERGENCY. You should practice this situation to be sure that he will immediately pull over when you suggest. One thing you should know is that you may have to adjust that. Most meters can be off by as much as 20% so that 90 could = 72, That’s cool, But anything LESS than 72 is hypo by defination. Now that’s also based on WHOLE BLOOD If you should happen to get one of these new "Lab Calabrated" meters that are set to PLASMA levels (15% higher) then you have to adjust the reading down by 12.5%, Now your 62 mg/dl would be within spec for a reading of 90. Not good at all. However. Your program is good. Just make sure your meter is too <G. `[1;33;44m "Nothing adds excitement like something that is none of your business" Once you pull the pin, Mr. Gernade is no longer your friend. `[1;33;42mNet-Tamer V 1.06X – Registered

Response:

– Hide quoted text — Show quoted text – Kasak) writes: Is it just me? Am I just paranoid, or when my 17-yr diabetic insulin- dependent husband gets really low, is it or is it not a medical emergency, or ALMOST one? HELP! He gets PISSED at me when I say he’s low… He’s not himself; help me! The answer to the question as to whether he’s at risk when his bg is quite low is "yes". The level of risk is quite individualised, and that’s an issue no-one can accurately address online. I’d offer that what’s really at issue is the relationship. A couple that’s been together for 17 years could reasonably be expected to have worked out their differences. That he gets p.o.ed when you offer your concerns indicates that either those issues never have been satisfactorily addressed or some new process is going on that deserves attention.

I think that it is very probable that the relationship is not the issue at all. Many people are not themselves when their blood sugar gets low. To imply that behavior under low blood sugar indicates the presence of hidden or suppressed attitudes is a *big* leap in speculation. Cut the hypoglycemic person a little slack – he isn’t himself in this state and it is unfair to draw conclusions based on his behavior at that time. As a person who has been married nearly as long (16 years) as cited above, I think the statement that all issues should have been worked out is unfounded. Indeed, it is this very kind of expectation that is likely to cause real problems in a relationship. Relationships are dynamic and each is unique. Just because a couple should happen to find an issue to address after 17 years says little about their quality of their relationship in the prior years. To say that one can’t accurately address the physical risk online, and then offer such an speculative psychological assessment seems odd to me. I would be inclined to say that there is always real physical risk when dealing with hypoglycemia, and as far as any meaning to the belligerent behavior, this is very much individualized and nobody can offer an accurate assessment online! You might consider enlisting the assistance of his primary care physician. Go to that physician yourself and express your concerns – which are legitimate – and you need not inform your husband of these enquiries until later. This will help you address the immediate concern – whether your husband is adequately dealing with his diabetes. Then you can work on the relationship issue. Good luck.

If there even is a relationship issue – again, a highly speculative conclusion, imho. — Steve Kirchoefer Naval Research Laboratory Washington, DC 20375-5347

Response:

Is it just me? Am I just paranoid, or when my 17-yr diabetic insulin- dependent husband gets really low, is it or is it not a medical emergency, or ALMOST one? HELP! He gets PISSED at me when I say he’s low… He’s not himself; help me!

Yes, it is a medical emergency… If it is not taken care of early. Getting upset and very emotional is very common when someone goes low. My father denies up and down that he is not low and refuses to eat anything. My mom sometimes gets him to do a blood test if he is low. She uses the "O-Yea, then prove you are not low" dare. He usually will do it just to get her off his back. When he cannot figure out how to do the test, cannot get enough blood from a finger or the test reads low he gives in. — Rusty Nail (Russell R. Nell) Norland Corporation W6340 Hackbarth Road, Fort Atkinson, WI 53538-8999

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Its even more fun with a 9 year old. When my daughter goes low and we want her to eat, if she does not like the choice of food she gets REAL STUBBORN. The comment "I dont like these" is real common, even if it is one of her favorite foods!! — Rusty Nail (Russell R. Nell) Norland Corporation W6340 Hackbarth Road, Fort Atkinson, WI 53538-8999

Response:

My wife is the same way when she her BG gets low – she insists she’s fine, and will fight every effort to get her to drink some juice. This usually happens at night, when weirdness from her hypo (tossing in bed irrationally, moaning out loud, fidgeting with the blankets or pillow) wake me up – I’ve gotten very sensitive to her night activity to try and catch it early. She’ll often actually fight me when trying to get her to drink juice, and will curl into a fetal position, and pull the sheets over her mouth so I can’t try to force anything. It’s like dealing with an ugly drunk who won’t admit he’s drunk. When she’s finally taken something and gets better, she often can’t even remember being difficult. I’ve had limited success with different tacts – always first I pray, because nothing else is consistent! Sometimes I can cajole her into drinking some juice, trying to convince her how "yummy" it will be (she gets like a child); other times I’ve faked being very upset with her, and pretended to cry so she would drink some juice out of shame; more often than not, I’ve had to wait until she’s gotten unresponsive, and then just held juice to her lips until enough goes in to get a favorable response (very dangerous). I plan on getting Glucagon for the extreme cases, but when she’s not that far gone, it’s a crap shoot, and she does not cooperate. The best thing is to get better control in the first place. My wife was having these incidents three to four times a month, and I was starting to go nuts. We went out of state to visit some friends in July, and she had an incident which was so bad that nothing worked, and she started into convolutions – a visit from the EMS and the rest of the night in the emergency room, plus three days of violent nausea were the result. Since then, she’s changed her regimen so she takes less insulin at night, and early in the evening; her doctor also put her on Precose, and reduced her insulin from three times a day to two. She has not had a serious hypo incident since (by that I mean since then, any hypo she has had was mild enough for her to recognize herself and cooperate right away). The bottom line is to find a way to avoid the situation in the first place. It may not be easy to find what will work for your husband, but you have to work at it. — DBH – Hide quoted text — Show quoted text – Is it just me? Am I just paranoid, or when my 17-yr diabetic insulin- dependent husband gets really low, is it or is it not a medical emergency, or ALMOST one? HELP! He gets PISSED at me when I say he’s low… He’s not himself; help me!

Response:

This is very common. I used to argue a lot! (A long time ago, I once found 4 policemen holding me down so the ER doc could handle me!) THIS NO LONGER HAPPENS TO ME. I still argue some, but not as much as I used to. After a few seconds (maybe as long as 10-20 seconds but usually less) I grasp that: This is a situation that I have *been in before* (because we have practiced), and to eat or drink something is the next step. And testing is *afterwardsr* And that was the end of my problem! My advice is: The two of you should PRACTICE this argument a couple of times, ending in the correct behavior. (Not an excessive amount of OJ for practice, of course). Until I practiced, just a few times, I had never experienced what I was doing *inside a situation where I could change my behavior*. Now I argue very little, because I know by rote memory and *practice* that I am supposed to drink some OJ or down some candy. Try this! It solved my problem. And please, post your results. Now, my next paragraph refers to something else which you should *practice*: If your husband has the energy to be PISSED and ANGRY, I would guess (based on my experience only) that he might be in the 30-60 range, which *for me* is not an emergency. I can perform a test with no problems even at the bottom of this range). I do not consider it an emergency unless: (A) Insulin Shock victim is behaving very tired/quiet (which I have experience a few times), or is completely unresponsive/passed out, which has never happened to me; (B) Insulin Shock victim has stomach retching which prevents him from keeping the OJ down, this happened to me once and I came out OK, but it took an extra 2 hours longer than I would have liked (My 2 MD friends and I should have done an IV that day, but we didn’t realize that I was going to keep heaving for so long). or (C) Insulin Shock victim is operating machinery (read DRIVING THE CAR). This cannot happen to me, I drive only with 90+ test results (immediately before starting) and 2-hour MAX test periods during drives. If he is argumentative and behind the wheel, IT IS AN IMMEDIATE EMERGENCY. You should practice this situation to be sure that he will immediately pull over when you suggest. I have fightened myself with this problem TWICE before practicing and implementing my 90+ driving rule. I hope this doesn’t sound complicated (it isn’t- I’m just a disorganized and wordy writer). I *know* that both of you will appreciate solving this problem together. I think that solving problems together is one of the most unique and enjoyable things which married people do. Have fun, relax, and *practice* a few times. Feel free to Email if you would like to discuss my experiences further. I see by his age, your husband is a lot newer to this than I am

Response:

Kasak) writes: Is it just me? Am I just paranoid, or when my 17-yr diabetic insulin- dependent husband gets really low, is it or is it not a medical emergency, or ALMOST one? HELP! He gets PISSED at me when I say he’s low… He’s not himself; help me!

The answer to the question as to whether he’s at risk when his bg is quite low is "yes". The level of risk is quite individualised, and that’s an issue no-one can accurately address online. I’d offer that what’s really at issue is the relationship. A couple that’s been together for 17 years could reasonably be expected to have worked out their differences. That he gets p.o.ed when you offer your concerns indicates that either those issues never have been satisfactorily addressed or some new process is going on that deserves attention. You might consider enlisting the assistance of his primary care physician. Go to that physician yourself and express your concerns – which are legitimate – and you need not inform your husband of these enquiries until later. This will help you address the immediate concern – whether your husband is adequately dealing with his diabetes. Then you can work on the relationship issue. Good luck. Bill Mayers, RT, RN

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Carole, I agree mostly with what Bill Meyers said in his post, but I’d like to add that, if your husband is well enough when low to get peeved, he is well enough to eat, therefore it doesn’t seem like it’s time for 911 quite yet. Make his test rather than fighting about it. Sam – Hide quoted text — Show quoted text – Is it just me? Am I just paranoid, or when my 17-yr diabetic insulin- dependent husband gets really low, is it or is it not a medical emergency, or ALMOST one? HELP! He gets PISSED at me when I say he’s low… He’s not himself; help me!

Response:

Dear Carole, Having been a diabetic since I was 2, and having a wonderfully supportive husband who has been through the ringer more than once, about all I can say is that your hubby’s reaction is normal. Remember that when he’s low he’s truly NOT himself, and altho’ that doesn’t make it ok for him to be unreasonable with you, it does explain what’s going on. Maybe you could gently ask him to prove to you that he’s not low by doing a sugar? If that wouldn’t set him off altogether, it might be the nudge he needs. After a while he may come to realize that you are able to recognize his lows better than he can. Otherwise, I’ve heard of spouses "spiking" a drink with sugar, or handing the wayward diabetic a regular coke. May or may not work. As for it being a medical emergency, my body typically pulls itself out of a low (when I reach the emegency level, but I can still be walking, talking and basically functional with extremely low sugars) by having my liver release glucagon naturally. This is a pretty crummy means of "controlling" diabetes, and doesn’t happen to everyone, but hopefully it will for your husband. If he’s really, really bad but is still conscious, you might consider calling 911 just to prove to him that he is low and does need some help. That’s a pretty drastic measure, and only you know if your husband will appreciate it and recognize it as an act of love or not, but it might help. Hope this has helped, but I kind of doubt it. Have you tried talking to him after an episode to explain what happened and how it made you feel? There’s a slight possibility he’ll remember that discussion during his next low. Good luck! Pamela Cox www.geocities.com/Heartland/1028

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On 16 Sep 1996 YFLA97A said: Is it just me? Am I just paranoid, or when my 17-yr diabetic insulin- dependent husband gets really low, is it or is it not a medical emergency, or ALMOST one? HELP! He gets PISSED at me when I say he’s low… He’s not himself; help me! I’d go with almost. (If he’s low, and he don’t eat, it will become an emeregency, And if he shoud DRIVE, then I get involved, I’m the freindly neighborhood POLICE dispatcher). I do have a suggestion however. Work out something less threatning. One diabetic I’ve corosponded with keeps a few bags of M&M’s (not the best choice but far from the worst) in the ‘fridge. When he starts getting somewhat "bitchy" his wife will get his meter, and one of the small (Trick or Treat size) bags of M&M’s and leave them on the table. This is his clue to TEST. If he’s low, he then eats the M&M’s If not… Well sometimes there are other reasons for being upset.. But when he spies the M-M&M’s (Meter + M&M’s) she’s not there to holler at, And the meter don’t mind being hollered at, SO. He tests. I’m told it works well. Wish I was that lucky. `[1;33;44m "Nothing adds excitement like something that is none of your business" If ours is a man made world, why can’t we remake it? `[1;34;41mNet-Tamer V 1.04 – Registered

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– Hide quoted text — Show quoted text -om!usenet Newsgroups: misc.health.diabetes Organization: Prodigy Services Company 1-800-PRODIGY Lines: 5 Distribution: world NNTP-Posting-Host: innugap2-int.news.prodigy.com X-Newsreader: Version 1.2 Is it just me? Am I just paranoid, or when my 17-yr diabetic insulin- dependent husband gets really low, is it or is it not a medical emergency, or ALMOST one? HELP! He gets PISSED at me when I say he’s low… He’s not himself; help me!

You are not paranoid. It is not just you. Low blood sugar causes personally changes. It starts with slowness, barely detectable, perhaps a poor choice of words–not the wrong word, not an inappropriate word, just one not usually used. It goes through someone not knowing who you are nor where they are. When your spouse is obviously low, putting your arm around him and talking to him for a while rather than first requesting he test may mute resentment and resistance. He may actually not know who you are. Often or ask if you can test him. Offer glucose tablets, gel, sugar water, a soft drink (sugar), sweetened iced or hot tea or coffee–whatever he will go for. Of course glucose is best medically, but whatever he will accept is what will work. Get some sugar or carbs in him one way or another. He will thank you afterwards when he is his own old self again. Some Diabetic conferences have sessions for spouses or significant others with social workers or psychologists. These can help you both. Learn to use a glucagon kit. The prefilled ones are the best because it is one less step if he is unconscious and you are trying not to panic. If he blacks out call the paramedics or EMTs or fire department or whoever handles emergency ambulance services in your area. Note: this is not to be construed as medical nor psychological advice, just my experience with a long term type I brittle insulin dependent diabetic who sometimes remembers her semi-conscious activities.

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Sorry. I posted my response to the bulletin board, but had meant to reply by e-mail instead. I guess, the bottom line is, he should ask his doctor about the importance of low blood sugar and diabetes. AnnaBel

Response:

Uh Oh. Well, I’ll try. I’ll start anywhere and go from there. I have been an insulin dependent diabetic for 22 years now since I was 12. I have lived through adolescence, teens, university, early adulthood and am soon approaching "middle age". Your spouses story sounds very familiar to me, as it seems to match my own. I have had many experiences which I won’t both describing here but which can almost all be attributed to my continued state of denial. In recent years I have finally begun to come to terms with things and can tell you this,… I caused myself much more agony than was ever required. Once you decide to take control of your diabetes and work with it, not against it, you find that it is not that difficult and you actually have peace of mind and a sense of accomplishment. You are in control of your life. My first message is to you, the non-diabetic spouse. Congratulations for being strong enough to want to support your spouse and find answers for him. You are doing all you can by trying to present him with the facts and be supportive. However unless (or until) he decides for himself to take control of things, things won’t change much. And unless he is trying, it unfortunately affects you while you stand by and have to watch and worry, and that is difficult. I’m not sure about when your spouse gets angry about the low blood sugar thing, but I can say that in addition to being a very serious thing, having an insulin reaction is also a very annoying thing. At the time it is happening, not only are your nerves just firing and jumping all over the place (very very difficult to control) but you often get angry because it is a very intrusive experience. One moment you are happy, experiencing an almost perfect blood sugar, doing your thing, and the next moment BANG,.. it is there, it is happening, it is taking control of your mind and body and it cannot be ignored. Even the most well-adapted and well-controlled diabetics resent this intrusion. However, we must give it immediate priority, treat it and wait for it to subside. But after that, life goes on and usually no one much noticed the reaction except for the diabetic himself. Really, in the end treating the reaction was just a minor inconvenience, and after it’s all over, we can rationalize this and the anger goes away. Or so it should. YES! YES! YES! Low blood sugar especially in an insulin dependent diabetic is a medical emergency which cannot be ignored. But it is something that the diabetic himself can both minimize the frequency of and can quickly rectify when it happens by doing: BLOOD GLUCOSE MONITORING and following a regimen, and keeping a roll of candy on his person at all times. Lots of non-diabetic people chomp on candy once in a while, so popping a candy when you feel low shouldn’t be much of a problem. Monitoring your blood sugar can often prevent this from even happening. Monitoring or not, having the candy with you is very important. It has saved me many times. Medic alert id is also important. I’m sure your spouse knows what he is supposed to do. It is up to him to do it. There are many diabetic clinics which offer excellent and very practical tips used by other diabetics. His doctor or specialist can refer him to a clinic. Libraries and book stores are full of literature on the subject (get something current) and so is the Internet. Maybe this bulletin board would appeal to him because there are others with the same problem here yet we are all nameless and faceless. I used to be "scared of" other diabetics myself because facing them usually meant that I had to face my own diabetes and I really didn’t want to. Maybe if I had of had something like this bulletin board, I could have compared a few notes and spared myself a lot of unecessary agony. Good luck to both of you.

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Is it just me? HELP! He gets PISSED at me when I say he’s low… He’s not himself; help me!

No, it’s not just you. I often get PISSED when my wife tells me I’m low. The reason I and many people change when low is that the nerve cells in the brain depend on glucose in the blood to work. When the glucose goes low, the brain doesn’t work as well, and people become "different" when that happens. After about 5 years of being married, I’m getting better. I now eat, or at least test, when she tells me I’m low. You need to set up an understanding that he will test his blood sugar when you think he is low. After a while he’ll get used to the idea that you can judge his blood sugar level much better than him when he’s low. Steve

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