Hypoglycaemia: drunk is more fun than this.

One of the films that I have a sort of love-hate relationship with is the Bill Murray-starring black comedy Groundhog Day. I will not go into what that film is about, except to say that on the first occasion when Murray‘s character gets an awfully heightened sense of deja vu, he is asked by his producer if he is drunk. His response is, and I quote, “Drunk’s more fun than this”.

There are other ways in which hypoglycaemia can be described to those who have never experienced it, but quoting the film properly works the best. Although the mechanics differ, both essentially have the same result. Loss of motor control, especially fine motor control, is usually the first stage. Loss of gross motor follows with lower blood sugar, and the eventual result is loss of so much control that even standing still is a major challenge.

Another area in which hypoglycaemia and drunkenness converge is the effects that both can have on mood. Although being drunk can make a person feel elated or even manic, the withdrawal symptoms include such a severe downturn in mood that it can feel akin to grief. That is what I have been experiencing recently when my blood glucose has fallen far enough for it to become noticeable. It feels like having a baby, my baby, die in my arms. It is one of the most horrid feelings that I cannot possibly imagine wishing upon another Human being unless their name is Jenny McCarthy (et cetera). Also converging with drunkenness is the fact that hypoglycaemia can make one feel snappy and irritable in progression with severity, too. A man with a blood glucose level of 4.0 mmol/l will snap at people and make them wonder what the hell his problem is. A man with a blood glucose level of 0.7 mmol/l will find every breath that he himself takes to be an intolerable nuisance.

Hypoglycaemia on its own has to be rather extreme in order to be fatal. Usually, before death, the affected patient will enter the state known as a coma. Comas are bad enough, but being in them without anyone to know where you are or what is happening to you… well, I believe I am circling around a point here. The thing is, there are more horrible things than dying where severe hypoglycaemia is concerned. The loss of ability to move one’s legs in a coordinated fashion, or at all, is bad enough. The loss of ability to even sit still without any sensations of pain is worse. As is the loss of ability to sit still, period. Ever feel so compelled to move in random ways that you cannot even remain in the seat you have set yourself down in? That is the kind of hidden-seizure effect that can visit a person whose blood sugar is low enough to make emergency personnel move rapidly.

The question of irritability, however, is something that brings me toward what I would like to say to those emergency personnel. One might feel irritable because their blood glucose is low enough to impair neurological function, but that does not necessarily mean you are not irritating under normal circumstances anyway. First of all, when a person who is having a serious loss of coordination and abstract reasoning refuses to eat something that you are offering them, it might be because they know they will find it so irritating that they will likely just throw it back up, anyway. Yelling at them to “eat the paste” will only piss them off. The paste in question is so disgusting both in terms of feel and taste that it may well make them think of things that come out of the wrong ends of male animals.

(If you are an ambulance officer or similar emergency medical staffer, please do not get me wrong. I love the work that you do. Picking up after an ugly, useless sack like myself after I have managed to get myself into a pickle where I have forgotten how to get back up again is never an easy task, and that you have the stomach to even give it a go speaks highly of you in general. This commentary here is more intended as a comment about aspects of certain things that a small, limited number of you have done on prior occasions that really need to be rethought. I have done a lot of rethinking concerning my strategy on insulin intake, so I would ask you to please do the same about treatment strategies that I am outlining here. If we can both do these things, we help make the world a better place for both us and those who might end up dealing with us. Thank you.)

This, of course, is similar to the complaint about honey. Honey is one of the most disgusting things ever to occur in nature. When I was young, and I mean really young, the mere sight of it was enough to make me start vomiting. Vomiting, however, is pretty mild compared to what could have happened. You see, contrary to what seems to be a popular myth, nature is not automatically benign. Some of the deadliest poisons known to exist are all-natural, and the consequences of unchecked glucose consumption on the part of an individual suffering from diabetes cannot be overstated. It should come as no surprise to anyone who has the slightest acquaintance with science, therefore, that there are people in the world who are allergic to honey. The chances of this being the case increase when a person is also allergic to bee stings, apparently.

Not that I am allergic to bee stings or honey, but I do happen to have major sensory issues that are not helped any by the presence of syrupy, sweet liquids in my mouth. Putting honey on your fingers and then poking your fingers into my mouth whilst I am in a state of altered consciousness is only going to make me angry at you later. Especially if you start acting like it is a perfectly fine thing to do and something to make light of in any way. Putting any part of anyone’s person into my mouth is, bluntly put, not on. When you are otherwise a complete and utter stranger to me, and have not warned me in advance or explained in some manner that you need to do this thing in order to accomplish this or that medical result, it is a severe violation of personal space. One that I am not inclined to tolerate anymore.

That is why the product known to trademark and patent offices as Coca-Cola, or informally as Coke, and I do not mean the diet variety, is my preferred tool with which to alleviate falls in blood glucose. For one thing, the amount of sugar yielded in Coke is comparable to the volume of liquid the user drinks. That is, if you drink a litre of Coke, you may as well make a litre of pure sugar solution in liquid form and inject it into your veins. This, of course, makes Coke extremely effective in raising the amount of glucose in one’s blood from 2.0 or less mmol/l to above 5.0 mmol/l.

(Oh, and other point here. If hypoglycaemia is so severe that a person cannot drink Coca-Cola under their own power, trying to pour honey or indeed any kind of liquid into their mouth is not going to help matters. In fact, if their brain is so fuel-deprived that they are having trouble even raising their head or speaking, trying to put anything of any kind into their mouth might well kill them by choking. Parents of children who are unfortunate enough to live with diabetes, you can thank me later for this very important advice.) 

Another point where being drunk and being hypoglycaemic converge is that people in a position of authority tend to take a dim view of you trying to drive an automobile in such a state. The effects also have a way of sneaking up on a person. Whilst a person might feel they are fine to make quick judgements and turn their hands or push their feet down at a rapid pace, in the right places, with a blood glucose level of 4.9 mmol/l, knowing whether one’s blood glucose is 4.9 mmol/l or 3.9 mmol/l without a scientific test is a bit of a guessing game, and guessing wrong can have fatal consequences when one is trying to operate complex machinery.

Regardless of all of the above, having diabetes should not necessarily disqualify one from driving. Sure, it is not an ideal situation, but if one is on the ball and approaches the situation correctly, one should be fine. The same cannot be said for being drunk. The number of car accidents that have been caused by drunkenness, especially drivers who think that they are okay to drive even when they have had two “light” (read: piss-weak) beers five minutes ago, is more than anyone cares to imagine.

Of course, the real problem with car accidents is that people are often too careless for their own good. Many an accident is caused by the kind of driver who will quote to all and sundry the number of years that they have been driving without ever being in an accident. Being in an accident and being the cause of an accident are two very different things, and that difference is important in my eyes. Overconfidence has caused more accidents on the road than alcohol, diabetes, epilepsy, and drugs put together. This will always be the case, regardless of how the mechanics of driving change over time.

Not that one needs to be travelling in a car for hypoglycaemia to become a severe, even potentially fatal, problem whilst travelling. Merely walking through a busy road with one’s ability to put one foot in front of the other reliably can have everlasting consequences. Being on a train in such a state is not exactly a good idea, either. Nor is being around a train station. But this just emphasises the importance of keeping a blood glucose test kit on one’s person at all times, and keeping oneself appraised of their blood glucose level at all times. I have such severe callousing in the upper corners of the fingers on my left hand that even getting them to bleed can sometimes pose a bit of a challenge. But I must confess, all of this is really about demonstrating a point.

Irrespective of what you might think, people on the autistic spectrum who are described in the diagnostic criterion as being “high functioning” do not necessarily have easy lives. Far from it, in fact. Between the extreme sickness and pain that I feel when my blood glucose is 15.0 mmol/l or above, and the extreme psychological weight involved in a blood glucose level of 4.9 mmol/l or less, or flat-out terror and pain that results from having a blood glucose level of 2.0 mmol/l or less… well, it is like this. Curebies love to talk about suffering or the like so much, but they never seem to quite grasp that their narrow, self-serving idea of what suffering is might conflict with the ideas that others have about suffering. To me, being so thirsty that it feels as if I have a mouth full of petrol that I have vomited up, having my bones ache so much that physically moving in any fashion hurts, or having to urinate so much that I wonder if my kidneys are about to give up the ghost, is suffering. Seeing the world differently, seeing it in a way that allows me to see people who think they can cover up their ignorance with displays of flesh for what they really are, does not even get a look-in.

And if you cannot understand all of that, then you are not qualified to give me an opinion concerning anything (even such things as the colour of the sky).