I write this first post this during an odd hour of the night in preparation of World Diabete Day, as I am still trying to adjust my sleeping patterns back to normal after getting back from my adventurous, two week honeymoon in Thailand, with my amazing new wife. We were married on October 20, 2012 or 10/20/12, that date just seemed to look good to my wife, “looks good to me too”.
Yes, I nibbled on a few cake pops, and they were Amaze-balls, I think the dancing helped my sugars remain in-check, along with added INSULIN, of course (moderation is key)!
Next, our luxurious backpacking trip through Thailand for two weeks looked like this:
As mentioned in my “About Me” page, my experience on the island of Koh Phi Phi spurred me to finally take on the task of starting this blog. I have thought about it many times over the last few years, but then end up drifting and not taking control. Deterrents usually include, who really wants to read MY blog? It will probably be boring anyways, yadda yaddaa ya, everyone is a blogger these days, so lame, blah blah, look at this cheesy thumbnail that I grabbed online, oh and did I tell you about the latest fashion trends…you see where I would usually end up, nowhere. Except not this time!
After my NEAR DEATH EXPERIENCE, ok, so I didn’t see the light or anything, but it could have been tragic if things happened just slightly different. On Nov 2nd, the hotel wake up call at 6am got me going, checked my blood sugar of 89 mg/ml, usually target about 100 mg/ml. Plan for the day: 40 minute boat ferry to the island’s main port and grab a longtail boat to Maya Bay on Phi Phi Ley, where they filmed the movie, “The Beach”. Plan got canceled real quick!
As I tiredly finished dosing and injecting 10 units of long acting INSULIN from my Lantus Pen, which stays in the body 24hrs and helps stabilize blood sugar levels. I sat back down on the bed, likely coaxing my wife out of bed with, “We are going to miss the ferry”. I Looked at the night stand and my stomach sank with confusion and fear. Holy Shit! Did I just take 10 units of my fast acting INSULIN pen? That INSULIN could drop my bood sugar 100 mg/ml per 1 unit of INSULIN in minutes. As I stared at both of my pens sitting next to each other on the night stand, one grey, one blue, same size, same device - I just thought to myself...WHAT DID I JUST DO!?
ME: “I’ve never in my whole life taken 10 units of fast acting INSULIN in one dose, call the front desk to see if there is a hospital near by!” Think. Be rationale. What do I need to do? MATH, 10 units of insulin equates to a need of roughly 150-180 grams of super fast carbohydrates. For those nutritionally inept, quick frame of reference, Bottle of Gatorade = Can of Coke = ~30 grams of sugar. First inhalation of sugar was 2 GU (sports gel) Packs, 28 grams of carbs each. I re-test my blood sugar, 77 mg/ml, shit, it is already dropping and I have nothing in my stomach!
WIFE: “Do you have that emergency pen thingee with you? Your Glucagon pen? The one I am suppose to give you if you pass out?” My stomach sinks again, “No". After three attempts my wife finally gets someone that speaks adequate English at the front desk, “There isn’t a hospital on the Island, just a clinic and that is still a 40min boat ride away. The only REAL hospital is in Phuket, which is close to 2 hours in a speed boat!” Oh No...
ME: Down 2 more GU Packs and a Gatorade in the fridge, while Michelle runs to the hotel restaurant and gets two glasses of OJ and carafe of honey. I down that. Re-check sugar 127 mg/ml. Good, at least it is going up, for a minute anyway. “I feel like I’m going to vomit”. Then 5 mins later, re-check, 107! Shit! It is dropping again. “Go get more OJ and maple syrup!” At this point, I am so nauseous I’ve started taking Nuasene tablets. If I vomit, my body wont be able to absorb the sugar I just ate and my blood sugar could continue to drop.
What if I go TOO LOW? I would go unconscious and there wouldn’t be enough time to get me to where I need to be, a hospital, and I will die. You can’t be force fed when you are unconscious and I don’t have a Glucagon injection (kinda like the equivalent of an Eppy Pen for diabetics). The side of the island we are on doesn't even have an ATM, they aren’t going to have a Glucagon pen.
Michelle got back with 2 more OJ's and a carafe of Mrs. Buttersworth, plugged my nose and down the hatch! I gagged a bit and washed my mouth out with water. I had consumed close to 200 grams of carbs in the last hour. That combined with fear, was exhausting. I continually checked my blood sugar as I climbed out of what could have been a life threatening situation. Now the 'WHAT IF' scenarios immediately flooded my mind and haven’t stopped since.
Below is the picture of the insulin overdose aftermath.
Those are all frightening scenarios to think about. In my wife’s Google search, there weren’t many self-remedies and the few who had experienced this scenario went straight to the hospital for their overdose. I had never really thought about this before because my Lantus INSULIN use to be in a vile and syringe. Regardless, it was a huge eye opener! PWD, always separate your INSULIN Pens! I have completely separated my pens and put one in its own case...clearly labled.
ALSO, when traveling, always bring a Glucagon emergency injection. I have never used it before, but I will be carrying it with me on all future trips.
Below are a few of our Thailand pics through the lens of Instagram...
11/14/2012 02:56:25 pm
Wow Bram! That scares me...and am so thankful that you are okay. I took a class on the glucogen pen and I too feel it is important to have for emergencies. You have taken a step and can use your knowledge and experience to help a lot of people. I love you!
Sophie diagnosed type 1 for 1 yr
1/14/2013 12:37:48 am
Poor u! I've mixed up my lantus & humolog pens 3 times now... Wven after wrapping them in different colour tape :-0
1/14/2013 01:01:28 pm
Hi Sophie - yeah, I have gotten other comments from people that have done the same thing. I guess it happens a lot more than I thought. Most people say that once you do it once, you never do it again! You should really try and come up with a routine that can help you better be conscience of when you are injecting. I have moved my Lantus into the fridge in a toothpaste holder that is labeled. That way I have to literally read it and open it before I give myself an injection. Dont keep in the same location. If you ever have any questions, I know it can be really hard in the beginning, dont hesitate to reach out! All the best!
11/15/2012 01:20:18 am
Calm heads prevail. That is so scary. Good thing you kept your wits about you and didn't panic. Your deep understanding of how your body uses insulin and reacts to sugars was another key, I'm sure. Thanks for sharing that story. Terri had relayed it to me last night - it was fairly close to your version;-) so glad you are ok! We haven't had you long enough to lose you!
11/15/2012 05:35:03 am
You did great Bram! Scary though, and easy to do! One time my insulin pump bolused 7 units of insulin without me programing it, luckily it beeped b/c I was getting low on insulin and I saw that 7 units had just been delivered. I was at the hospital working so I went to the cafeteria and downed a GIANT cinnamon roll and a GIANT orange juice...nauseating but it did the trick.
11/15/2012 09:58:26 am
I don't know whether I was riveted to your story because I have a vested interest (we love you!) or if you're just a great writer, but either way I'm glad you've started this blog to share your experiences and knowledge. This is certain to make other people think twice when they travel (and don't forget to take along the "thingee")!
11/15/2012 11:26:58 am
That was quite an adventure to say the least. We are so glad you're ok and Michelle was able to help out and think on her feet. I can just picture you downing ALL that sugar. I could see this happening so easily with the mixing up of Lantus and insulin. There are so many things like this that can happen so easily with diabetes. One wrong move or simple mistake can be life threatening. One time Kaleb passed out and we literally poured Coke down his throat.... It's neat that you are blogging. I keep trying to get my son to do the same. Maybe you will inspire him! Thanks!
11/17/2012 05:31:12 am
Hi Paula - Yes there are all kinds of unexpected things that can happen. Maybe I could get Kaleb to make a guest post some time :)
11/15/2012 03:04:34 pm
I wish all my patients were as knowledgeable about dm as you! Great inspiration for other people as well! Can totally see that happening, I guess that is why at work they require us to have all insulin checked by 2 rn's because it is so easy to make mistakes which is scary!
11/17/2012 10:47:10 am
Kind of funny, as I was reading this, I felt really proud of Michelle for her bravery in the face of something so terrifying. You two make a terrific team, and I'm really glad you joined our family.
Wow - that's a scary story indeed! When I used Lantus (after moving on from the vial-and-syringe) I had this big, heavy clunky pen with an LCD display and a battery. No way it could be confused with my regular fast-acting pen! But so many things can go wrong when you use that type -- even if you DON'T use it and think you are, as you so eloquently pointed it out.
11/29/2012 03:46:05 am
Thanks Scott! Yes, all the kwick-pens look the same these days regardless of the insulin in them. Yeah they are different colors, but feel exactly the same. Certainly was an eye opener.
11/30/2012 10:58:09 am
That's a scary story! I can see you're using the pre-loaded pens. Is that more affordable for you? I have the penfills, here in Canada, they actually give different pens for each, so that they cannot be mixed up (instead of just color coding them).
12/1/2012 09:19:56 am
Hi Kassi - thanks for the comments. I have never seen those pens before, but they look pretty cool. I think the only mix up would be when I try and write with it:) They look like normal pens! I will certainly look into those.
3/22/2013 03:44:03 am
Wow ! Thanks ! I will label my Pens Now.. I keep forgetting which one to use.. New to Pens...
6/6/2013 07:55:21 pm
let's support for this world diabetes day with the power of insulin. I am sure Things now will always be the best.
7/24/2013 05:16:35 pm
I would like to thank you for your nicely written post, its informative and your writing style encouraged me to read it till end
7/27/2013 02:04:53 pm
Thanks @onlineprnews, I will continue to write posts, but I must admit it has been less than I would like, but hopefully be writing more soon. Glad this was encouraging! thanks!
7/5/2013 07:11:45 pm
It is very important to carry Glucagon emergency injection with you when traveling...you never know what can be the situation!!.Hope you will not neglect next time :)
7/27/2013 02:03:04 pm
Hi at Cameronores - yes, I will for sure be packing my glucogon kit next time we travel, but I have yet to use one, so am still unsure how my body would react. Either way, I know it is literally a life saver, so not even an options next time, thanks for visiting my site!
9/24/2013 09:59:58 pm
WOW, I am so glad you are ok! So scary! We always have our glucagon injection with us! We also have not had to use to for emergencies but it's always good to have!
2/10/2014 11:42:57 am
Just happened across your site. Watching the Olympics and the back story of the USA cross-country skier who is T-1. Anyway, they mentioned how insulin is a banned substance and he got a therapeutic exemption to use it. I wasn't familiar with why athletes would use insulin for performance enhancing but when searching it came across your site. My sons a T-1 for about 7 years now and he's 18. He never let it stopped him from athletics or doing what he wants in life. Hard at times though, always got to be a boys out and always be prepared. Keep posting!
6/1/2014 10:10:57 pm
Poor guy! If you weren't on your honeymoon, diabetes style, 10 units of insulin would cover about 100 grams which is a lot, but doable. I don't know how you managed to keep all that down, but glad you did. We use Solostar insulin pens now for Lantus and Apidra. Very easy to confuse as one is a blue and one is black. They should make one of them a bright red or orange. Same with the vials. There are covers you can put on the insulin but I just keep one in a different place. Look carefully each and every time you inject! I got a pretty insulin pen case from Sugar Medical which hold the Solostar Apidra pen (and it can hold glucometer, strips and Lancet as well (made very well). And a black pen case called the Day Mate. All Apidra pens that are out are in the cases. The Lantus pen, I keep in a plastic baggie in a drawer. So fast acting in case, long acting not in case. Lantus vial in butter compartment, Apidra vial in second shelf compartment on side of fridge. Separate and color code.
10/9/2014 12:50:03 pm
I hope you understand a bit french, it's easier for me! Je viens de faire la même gaffe ce soir! J'étais sous le choc, mais vraiment contente de m'en être rendue compte aussitôt après avoir terminé mon injection. J'ai commencé à manger les glucides nécessaires malgré mon manque d'appétit. J'ai aussitôt pensé à toi Bram et à ce post. Je suis diabétique depuis 9 mois maintenant, je suis étudiante et en pleine période d'examen, donc épuisée. Mes glycémies jouent au yoyo avec tout ce stress et je le vis difficilement! Disons que cet erreur ce soir n'était pas nécessaire!!
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