Oh, and here's a gosh-darn (((hug))) because WE care about your danger of complications, even if you don't right this minute.
Sheesh.
if you had tested a couple of times "en route" to last night, perhaps you'd be able to achieve a better tactical solution
I just have to say I love how you talk about this stuff. As well as insulin and such "deploying." :)
When I was a kid (11+) I played a lot of war games, with little cardboard pieces and maps with hexagonal grids on them. D perhaps kept me out of the army but the terms can make sense. It's a war composed of a lot of little battles?
I would think there'd be different brain chemistries frying away for "psych"(?) panic attacks vs. hypo panic attacks? I don't know that much about Ativan but the wikipedia article makes it sound a bit like Valium which isn't exactly what I'd think would be good for hypos?
I appreciate the concern but you really don't have the right to say there is no way I can guess my blood sugar. I've been managing it for years like that with some testing here and there. Yeah I screw up sometimes but so do the meters. The fact is my A1'c average over the last decade is probably in the low 6's. My last few were in the high fives. I get a lot of lows regularly and though I can't confirm the highs if I had to bet I'd say my glucose levels over 200 are probably no more then 10 to 15%. If I were in horrible control there is no way my A1C's would be in that range. Not trying to brag but tell me another diabetic you are aware of that doesn't test much that can get their A1C in the 5's. I know the high sugars are damaging and I do try to avoid them at all costs but its more about not feeling well then dwelling on what may happen to me from them. I am not poised in any way shape or form to cope with serious complications from this I would absolutely take an overdose of insulin if my life became of that.The way I see it no point in hanging around deteriorating and waiting to pass away.
Interesting topic, I never knew that there was a link between Diabetes and panic attacks.
I suffered from panic attacks quite a lot, before I had diabetes. I didn't go to school for a year, because I had panic attacks every day. Only after 9 months of cognitive behavioural therapy did I go to school again. When I got 'D' a few years later, I wasn't to terrified since it couldn't possibly be worse ;-)
I thought an anti-anxiety med, Ativan, would help. It didn't:) My husband's dose is very low. Ativan is prescribed for panic attacks.
There's no difference between a hypo induced panic attack & a "regular" panic attack.
Oddly enough, the counter-regulatory hormone involved is the same: epinephrine also known as adrenalin. We dump it out when we go hypo and we also dump it out during a panic attack -- or when being attacked by mutant ninja bears. The only difference is that we also dump out glucagon when we go hypo. Bodies are weird, huh?
The good news on hypos (vs. full-blown panic disorder) is that as Gerri pointed out, once you're back into normal glucose, most people stop dumping adrenaline. The small percentage of diabetics who have panic/anxiety issues probably (I'm making a semi-educated guess here) dump out more adrenaline during a hypo and metabolize it less well, resulting in greater fight-or-flight symptoms which also last longer.
I have a Chinese friend who, if he drinks so much as an ounce of liquor, will turn bright scarlet in the face, start to sweat profusely, become slurring, falling-down drunk and stay that way for several hours. He's kind of my go-to mental picture of what happens when people are genetically impaired in their ability to process/metabolize a substance that is (relatively) benign in other folks.
His reaction to alcohol is an exaggerated example of my reaction to an adrenalin dump. A "normal" person might feel anxious or uncomfortable for a while. I start feeling like someone is kicking me in my diaphragm, start fighting for air, am bent hanging onto something, feel terrified way out of proportion to the stimulus, feel a harrowing sense of impending doom, imminent death, unreality -- I start the self-talk ("It's OK, I'm OK, it's just a panic attack, breathe, breathe...") and eventually get to the other side, but I might have sore muscles and feel super tired for 24 hours afterwards.
It's good to read others' experiences and thoughts about panic attacks and hypos. One thing I notice is that, while there are some features common to both, I interpret them very differently, so far.
I find it hard to talk myself out of panic. I think that's part of the PTSD: I start thinking that I deserve to feel hopeless, that I really am out of control, that I've somehow earned what I'm going through, right then. Depression mounts sky-high, my judgment about myself and my life becomes absolutely warped and I feel full of shame.
But if my BG is too low, I don't tie the way it feels to anything in my immediate environment. I start to feel shaky and uncertain, mildly confused. My meter is on my desk, or otherwise nearby, so I haven't had any problem about checking my BG. When I see the too-low number, I know what to do and it's easy for me to do it. I also know that I'll feel much better within 10-15 minutes. Even if I'm still too low, then, I don't feel as unwell as I did and I know I can correct, again. Usually I'll double up on whatever I ate or drank the first time and that takes care of things. I may end up going a bit too high, but I wait about two hours before I do anything about that and then I step down slowly to my safest range, maybe taking about half the insulin I may need and waiting another hour before I take any more.
The important thing is that for whatever reason, I don't tend to blame myself for having or being in the midst of a low. I find that remarkable for a perfectionist! I'm able to see the hypo as a mistake, something that happens to all of us from time to time, something I'll be able to learn from later, when I'm feeling well again. But with a panic attack, my thoughts become very dark, critical and full of blame. I'm sure that everyone's experience of these things is different. I'm glad we're having this discussion--I hadn't thought about these things in any organized way until now.
Interesting. most people on this forum keep suggesting I go on some kind of medication to correct my feelings but being I know for a fact the symptoms are strictly there when my glucose goes a little to low or a slight bit high I've wondered what the chances of medication are in helping me? The fact is their is a chemical imbalance when glucose is to high or low and your brain should really only function correctly with the ideal amount of glucose in your blood. In other words would a pill be able to camouflage the fact that I don't have the ideal level of glucose in my blood? I still have a serious hard time in accepting I feel like high sugar if I am anything over 95 which is about my cutoff. My lows and symptoms from them though not the same as everyone's nor at the same level are normal to me but there is no reason I should have any discomfort or symptom really up to 125 glucose level but I do.
Gary,
Since you're going to a new endo, consider asking him/her about adrenal testing for cortisol levels. Other symptoms of adrenal fatigue you can research, but the inability to cope is a red flag. Constant stress causes adrenal burn out; insufficient cortisol levels causes more problems dealing with stress. If you're interested, happy to tell you the type of test needed because serum cortisol isn't enough to diagnose.
People are concerned since you're always very distressed. They've also suggested counseling innumerable times to help you better cope, whatever the cause.
The feelings you report seem to be more extreme than what many other people report so people are thinking perhaps there's something else, besides the BG at work. Of course, none of us are doctors (or maybe there's a few...Zoe has some expertise...) and none of us have reviewed your medical records and you don't track your numbers/ food/ insulin so we can't try to offer solutions based on that so we go with what we can.
Although I am perhaps dull in suggesting testing? I think that's a good place to start. From that, you have a log, maybe you'd see that cereal and the randomness of NPH aren't the best combo you could choose despite your apparently excellent A1C results.
Thanks, Ann. Learning a bit about your thought processes helps me, too.
When I was in my twenties, I often had panic attacks "for no reason" that I could fathom. They'd just happen out of the blue.
Now it seems that every time I have one (99% of the time?) there is a cognitive trigger, usually moderate to strong stress combined with really negative self-talk, usually involving something psych doctors call "catastrophizing". This is the kind of cognitive distortion where, for example, a lump under your skin becomes "I'm going to die a hideously painful death from cancer just like my poor brother" or a harsh word from a moody co-worker turns into "I'm going to get fired and I'll never get another job and I'll be homeless and freeze to death under a bridge". The rational mind knows better than to go down these rabbit holes, but because of the adrenalin dump it's really hard to stop the negative feedback loop once it gets triggered.
And yet, sometimes you are high and you don't feel it.
All I know is almost every time my sugar has shown post 95 on the meter usually 2hrs or more post injection and food something is not right physically and mentally. If I am in target range what I ate should really not make a difference. The symptoms aren't always the same but none the less I have trouble coping. I need to have more of a window to feel well like most seem to have. Last night I was up around 300 and my temperature seemed way off. My body felt extremely warm with a slight feeling of radiation type of crap. I can accept the fact that I feel horrible at 300 but not 105, 115, 125....etc,, Other times I get a buzzy feeling, sometimes my body feels like it wants to explode and so forth. The lows are generally more mental distress with very little physical symptoms.
Rarely ever. I woke up high again this morning and new before I tested I was high. Sure enough 210.Dam Liver!
What test should I request?
Gary, do you know the difference between "anecdotal evidence" and "statistical evidence"?
http://en.wikipedia.org/wiki/Anecdotal_evidence
There is no way that anyone with a science background (doctor, researcher, etc.) can help you based on your "gut" or your ***undocumented*** anecdotes.
If you were able to show a log, you could discuss with some certainty, "OK, I wrote down my symptoms, and charted them against blood glucose tests. I note from my log that when I had Symptom X, 64% of the time my blood glucose was 110 to 149 and 84% of the time, my blood glucose was 150 or above. I never experienced Symptom X when my blood glucose was below 90."
You might also realize that, "Hey, when I had Symptom Y, my blood glucose was just random: 84, 63, 107, 79, 245, 92, 185 ... there is no correlation between Symptom Y and my blood glucose. Huh."
Without proper documentation and logging, you're just telling the doctor stories with no foundation for problem solving.
You want a diurnal saliva test that measures cortisol levels four times during the day. Cortisol levels fluctuate & how much they fluctuate & at what times is telling. The pattern of cortisol highs/low determines proper functioning. Serum cortisol is just a one-time reading & not enough. For example, people with high cortisol at bedtime have trouble going to sleep or staying asleep. Those with low cortisol in the morning don't want to get out of bed. Not expensive to pay for yourself & you don't need an Rx, if your doctor isn't receptive.
Not rare to have dysfunctional adrenals, but infrequently tested. We're told that feeling unnerved, anxious, panicked, stressed to the max & exhausted is in our heads when it's an endocrine imbalance.
In addition to handling stress, cortisol also is involved with carb, protein & fat metabolism, BG levels & reducing inflammation.
Believe it or not many times shoot for hypo's. First off and number one when I overshoot my chances of being high are slim to none. Second I like being able to eat junk and not feeling like ■■■■ and this is one of the only safe ways of doing it. Don't get me wrong hypos screw with me mentally pretty bad and if I had the choice I'd never want to experience one again but it see it as the lesser of two evils. My biggest problem is going to sleep at night with low sugar. In the last two years I've had some real close calls. Negative is my middle name. My folks didn't help with that but I fear much of what you said. I live in a house that is paid for and still fear being in the streets like some drug addict. You feel like your loosing control of your thoughts and when I crises kicks in you just want to crawl into bed and not wake up and face it.