LifeAfterDx--Diabetes Uncensored

A internet journal from one of the first T1 Diabetics to use continuous glucose monitoring. Copyright 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014, 2015, 2016

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Location: New Mexico, United States

Hi! I’m William “Lee” Dubois (called either Wil or Lee, depending what part of the internet you’re on). I’m a diabetes columnist and the author of four books about diabetes that have collectively won 16 national and international book awards. (Hey, if you can’t brag about yourself on your own blog, where can you??) I have the great good fortune to pen the edgy Dear Abby-style advice column every Saturday at Diabetes Mine; write the Diabetes Simplified column for dLife; and am one of the ShareCare diabetes experts. My work also appears in Diabetic Living and Diabetes Self-Management magazines. In addition to writing, I’ve spent the last half-dozen years running the diabetes education program for a rural non-profit clinic in the mountains of New Mexico. Don’t worry, I’ll get some rest after the cure. LifeAfterDx is my personal home base, where I get to say what and how I feel about diabetes and… you know… life, free from the red pens of editors (all of whom I adore, of course!).

Sunday, March 07, 2010

Living off the land

Time presses down on my soul like a living thing. Each passing second brings me closer to disaster. Fear knots my stomach. Fear and guilt. I’m too old to really care what happens to me at this point, but I’m worried about Rio.

I glace at my waist. Again. The Dex now shows me at 70 mg/dl and dropping. One arrow down. CGM being what it is, that means I’m already lower. I don’t want to take the time for a fingerstick to confirm. I know I’m almost out of time. I look above at the deep blue New Mexico sky, and the rough scramble up the talus slope above us. 500 feet to go. To get to the top. To get out of the canyon. To get where, hopefully, Rio can see our home, several miles off.

In the back pocket of my blue jeans are two bottles of glucose fluid. Empty. Both empty. Apparently 30 grams was not enough.

I don’t want to scare Rio, but if this ends the way it looks like it’s going to end, he needs to know what to do. He needs to leave me where I fall. He needs to stay calm. He needs to get himself home safely. And if possible, he needs to remember his route so he can find me again to bring help. Not that I’m holding out much hope for that. But please, God, just let my little boy get home safely.

Rio, I don’t want to scare you, but we need to talk about the worst case scenario, I start, grabbing his small hand to help in over a large boulder in our path…



It all started last week, when winter abated for the first time in months. It was Wednesday. And it was beautiful. The sun shone brightly, there was no wind. It was just warm enough without being too warm. In short, it was the perfect spring day.

Now normally, Wednesdays are the day I work for the University. Thanks to the telemedicine platform, I get to spend my hump day working from home. I think my family tends not to regard this as real work, because I keep finding notes saying things like “on your Wednesday, can you do a couple of quick loads of laundry?”

Growl.

This is real work. I get paid for it. I’m expected to be productive. It just happens I don’t have to commute on this one given day. But luckily for me, less was expected of me this last Wednesday than normal, as we are on hiatus for a couple of weeks between training cohorts. That meant that I’d be done by 1:30 in the afternoon, just in time to drive in to town and pick Rio up from school. Which I did.

Now, I had not too long ago accused Rio of being a mushroom. He doesn’t really like to go outside, which is a shame as we live on 20 acres of the most interesting land you can imagine. We’ve got a large sandstone butte that towers over the center of the property, several arroyos, fields of petrified wood, a place where we often find Paleo-Indian lithic chips, and a wide range of interesting desert plants and critters.

But Rio generally prefers the living room couch, with the TV set to the Disney Channel, with the drapes closed so he can’t even see the outside.

Clearly, I have failed as a parent.

But it was such a nice day I pitched the idea of a walk on the land. Much to my surprise, he was up for it. He told me, “My spirit of adventure went south for the Winter, but I think it’s back now.”

When Rio was tiny he was quite the little mountain goat, brave and sure-footed. Somewhere along the line he became physically timid (especially for a boy) and a bit of a klutz. Maybe some sort of growth spurt made him lose his sense of balance and equilibrium.

When we got home we grabbed the cell phone and a couple of bottles of glucose fluid and headed out. First we visited the Fire Circle, where we like to toast marshmallows and watch the Perseid Meteor Showers in the summer. Then we cruised through the Chipping Ground, looking for new artifacts the weather might have unearthed, then we went to Mars. Mars is an outcropping of vivid red soil that looks exactly like what you’d expect to find on the red planet. The real Mars is a big subject in our family as Rio’s “Tio Tim” (Uncle Tim) built the cameras on the masts of the Mars rovers, as well as the cameras on one of the orbiters. Very cool.

On top of our Mars, my niece and nephew erected a huge petrified wood log, that by the nature of the knots, looks remarkably like a face on an Easter Island statue. They call it “the Tiki God.”

At this point Rio would normally be ready to head home. “I think I want to go a little higher,” he told me. So we did. And then still higher. And then higher again.

In the end we scaled the butte in our “front yard.” He, who had not been climbing for years was the sure-footed little mountain goat again. And I was the nervous wreck as he stood at the very edge, calmly looking down over the 100 foot-drop.

Rather than return the easy and established way, Rio choose the wriggle down a steep chute of sandstone and we then worked our way down the rough and tumble talus slope, a process that has more in common with skiing than hiking, as the loose dirt and rocks slid under our feet and half-out-of-control we slid, stumbled, jumped, and careened downwards to the flat land below.

Rio announced we should walk every weekend, now that the weather was nice. I agreed. Then Rio complained that we only have 20 acres, where as Whiney the Pooh has 100.

True.

So when Saturday came around I was a wreck. My sugar had been stuck in the 300s all night, and I slept very poorly. Hiking was the last thing on earth I wanted to do. I just wanted to sit on the couch with the drapes closed and the TV set to the Discovery Channel.

But a promise is a promise. Rio’s mother got out our matching Foxfire safari shirts and held open the door for us. I filled a canteen, grabbed two bottles of glucose fluid, and a small digital camera to record the expedition for Rio’s album. I briefly considered taking the cell phone, but Rio had stated his desire to visit the “back arroyo” which runs down the back side of our property. It is the lowest elevation point on our land and cell phones don’t work back there. So I left the phone behind. That proved to be a mistake.

As it was planned to be a short walk, and not too far from home, I didn’t take any other supplies beyond the one quart of water and the two bottles of glucose fluid.

The day was lovely, and as we worked our way down to the back arroyo I began to feel better and better, and slow constant movement of my legs gently dropping my elevated blood sugar. Once we dropped into the arroyo itself, Rio decided he wanted to work his way upstream instead of our original plan. As I was feeling better with every step I agreed.

We ducked under the barb-wire and onto the “neighbors” land. “Are we trespassing?” asked Rio.

Technically, yes. I told him. But there are no signs telling us to keep out, and so long as we don’t take anything or damage the land in anyway, I don’t think anyone will mind.

Now depending on where you live, 20 acres may or may not sound like a lot of land to own. When I bought it back in 1987 it set me back all of ten-thousand bucks, less than a nice car in those days. It is a semi-barren, rugged landscape. Cheap, as it wasn’t regarded as good for much by the locals. I love it.

My nearest neighbor has only three acres, but the place to the south of me is 100,000 acres. So my neighborhood is a patch work of small land holders, giant ranches, and government land.

And so we walked, and walked, and walked. We stopped to inspect rocks, both tiny and gigantic.


Years ago I had followed the arroyo to its source high on the mesa, but I had not been this way since diabetes joined the family. I had a destination in mind, and some cool things I wanted Rio to see, but time had compressed the distances in my mind. It was farther away than I had remembered.

When my sugar dropped below 200 I reduced my basal rate on the pump to 50%. When it dropped below 170 I knocked it back another quarter. And when I gently sailed into the 150s I suspended all insulin delivery.

As we worked our way up the arroyo, now a proper canyon, my sugar stayed pegged at 150. I felt great. Rio was having a good time. We just kept going, and going, and going, and…

We had now gone farther upstream than any member of the family other than myself. Rio was quite proud that he had explored further than his mother. I was proud and excited because I had looked forward to hiking up here with him since he was born.

Then he spotted a rock formation part way up the slope above the arroyo that he wanted to inspect. It was a tough climb. The slope was steep. The rocks lose. It was slow hard going and it triggered the hypo.

I got the fall rate alarm first. I was still safely high, but drank the first glucose bottle to head off trouble early.

It might as well have been water. It had no effect.

At all.

So there we were, a third of the way up the slope, one bottle of glucose left. A serious hypo developing. No other supplies. Miles from home. I slammed the second bottle, now crossing below 90, and made a poor decision: to get the hell out of the canyon and on to the top lands.

In hindsight, which is always 20-20, and at a normal blood sugar (remember when your blood sugar drops, so does your IQ), I confess this was a very poor choice. If I had to do it over again I would not have gone up, for several reasons. We should have dropped back into the bottom on the canyon. First off, it would have been less effort, physically, than climbing up. And secondly, it would have been an easy matter for Rio to retrace his steps to get home again. He would have merely needed to follow the arroyo back down until he was on his own land. Thirdly, there would have been no ambiguity about where to find me (or my body).

But that is normal-blood sugar hindsight. At the time, my befuddled brain made the bad choice of trying to get up and out so Rio could see his home. I had forgotten that while you can see the house from on top of the ridge line, you still had to come down some pretty steep slopes and navigate a number of small cliffs to do it….



Rio regards me calmly with his mother’s deep-brown eyes, “I don’t know if I can get home by myself.”

Of course you can, I tell him. You’re a good little climber. Just go slowly. Take your time. Focus on traveling safely and don’t think about me.

“In school they told us how the Native Americans used smoke signals,” says Rio. “Maybe I could rub a stick against a rock and start a fire so Momma would see the smoke. That way I wouldn’t have to leave you.”

Well, that’s good thinking, but I really doubt your mother would see the smoke and if she did, she probably wouldn’t realize it was from us. And besides, it’s a hell of a lot harder to start a fire that way than it sounds.

“We’re studying living off the land,” Rio says.

Then I have an idea. Living off the land… Using the natural resources around you to survive. Where can I find sugar near the crest of a barren mesa top? Too early in the year for cactus fruit…

I need to find a Pinion tree. Juniper, Juniper, Juniper. All Juniper trees around us. Never a damn Pinion when you need one. Then, I spy a Pinion about 50 feet away. Come on Rio, I have an idea.

It is an old, gnarled tree, just what I was hoping for. I break away some dead branches at the tree’s base to get in close to the trunk. And there it is: a snow white taffy, oozing down the bark.

Sap.

I take my razor knife and scoop out quarter-sized piece and stick it in my mouth. It’s sweet, but “gamey” in flavor. Like Spearmint gone bad.

“Can I have some?” asks Rio. “I’m awfully hungry.” I cut him a piece too.

Tree sap has sugar. It varies from type of tree to type of tree; and even from tree to tree in a grove. I don’t know if this is going to work, but I have nothing to lose but my life.

Come on, we’re almost to the top.

The tree sap is sticky. It coats the roof of my mouth. It sticks to my teeth. I watch the Dex like a hawk. There is no change. We are at the crest of the hill, below us twisting canyons and buttes spread out to the horizon. I can see our house, much farther away than I had expected. A new stab of fear and self-doubt rips through me. We need to get as close to home as we can.

I’m keeping the banter light, pointing out this and that to Rio. We stop for a drink of water.


Then it happens. The Dex’s arrow is pointing to the right, not down. My blood sugar has stopped dropping. It’s damn low, but stable for the moment.

We keep walking. We come to a felled forest, frozen in time. Tree trunks, turned to solid rock lie like giant sticks across the ground.

Then we cross a field of cactus. Miniature prickly pear, with long thorns out of proportion to their pads. We stop to get a rock out of Rio’s shoe.

Then a miracle: the Dex’s arrow is angled up. Like a spear, the upwards arrow slays the dragon of fear. My blood sugar is rising. It's going to be OK. Good news, Rio, the Dex is showing a rise.

“Does that mean I won’t have to go home by myself?”



And Rio didn’t need to go home by himself, the tree sap got us both there, along with a solemn pact to always carry a pack with six glucose bottles, some candy, more water, the glucagon kit, and the cell phone. I’m grateful that nature gave me the resources to get home safely, but if I never have to chew on Pinion sap again it will be OK with me. I’m still trying to clean the damn stuff off of my teeth.

We’re also going to focus on exploring every nook and cranny of our own truncated 100 acre wood, where the dominating butte in the center stands like a lighthouse to guide you home no matter where you are.

And the head waters of the arroyo? Will we go back there again?

Yeah, of course we will. But will be better prepared, even though there is always tree sap when push comes to shove.

And we’ll also take a magnifying glass with us in the future. Just in case Rio needs to light a signal fire.

6 Comments:

Blogger Jonah said...

If you just sat and waited, with no insulin delivery, would you expect your blood sugar to eventually rise? Did you go high after you got home?
Glad Rio didn't get to see anything worse than anxiety, glad you are ok.

4:32 PM  
Blogger Crystal said...

Wow, Wil. What an adventure.
Glad all is well and you will be going back.

4:40 PM  
Blogger Michael Hoskins said...

Wow, Wil. Incredible, suspenseful writing. Glad it all worked out, and impressed by how you "lived off the land" like MacGyver would! Good to see you'll be going back, too.

7:53 AM  
Blogger Scott K. Johnson said...

That is such a scary thing. Perhaps one of the most scary things ever - to think that you might just fall over, and, just like that, your precious little child is alone in the wilderness.

I shudder every time I think about it.

I am so glad that you made it back in one piece, and without having to send Rio off to dispatch the rescue squad.

As usual, your writing was incredible. Anyone ever tell you that you should become an author?

4:03 PM  
Anonymous "D" as in "D" said...

What an incredibly horrible feeling. I am amazed (overused word, I know) at your ability to have it together enough to know what you needed to do to survive.

On another note, lately I find that when I treat a low, I immediately go high. I don't understand the liver's ability to kick out some sugar when it needs to and so, apparently, overtreat. Is it possible to understand this?

Just another diabetes quandry for me.

Loved reading this on-the-edge-of-my-seat story. Glad beyond measure there was a happy ending.

11:18 AM  
Blogger Bernard said...

Wil, that was a scary adventure and I know exactly how that kind of low blood sugar and dropping catches you off guard. Blame diabetes. I'm glad you thought about living off the land and got home safely. Thanks for another wonderful read.

6:19 PM  

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