Sputterpub's Blog

Del knew something was up the minute Annie walked through her door. There’d been foreshadowing in their phone conversation, and there was also thirty-two years of experience.

“I need your bathroom!” Annie declared as she darted toward the toilet. Her face shined with perspiration.

Del remained in her chair at the small table. She and Annie went back almost fifty years. They’d been college roommates and had naturally allocated the academic work to make the most of their individual talents and thus free up maximum time for light drugs and games of Scrabble. Del was the scientist and Annie did sociology. So when Annie was diagnosed with Type I Diabetes in their mid-thirties, it fell to Del to read up and learn about the condition.

Annie’s blood sugars were labile (“brittle” was another term); they sometimes rocketed up or down in spite of intensive insulin therapy and multiple daily finger pricks. So Del knew the urinary urgency was a sign Annie was high and the sweating face indicated low. She waited for her friend to emerge from the bathroom.

“What’s up with you?”

“I don’t know; my GCM keeps sounding off that I’m high.”

“You don’t look high.”

“Yeah, but…” Annie reached into her leather hobo bag and fished out the small black box. “It’s reading 205 right now.”

Weird, thought Del. She acts low but gets high alarms? When they’d spoken earlier, Annie told Del she’d just had the highest reading she’d ever seen. “How much?” Del asked. “Over 600.” “Jeez! Was that from a finger prick?” “No. My GCM.” “Still…I’d love to see you, but you shouldn’t be going anywhere.” “No, no” Annie insisted. “I corrected it. And I just tested. I’m fine. Really. I feel great. I’m good to go.”

Annie plunked down in Del’s big upholstered armchair. “Wow,” she said. “I do feel low.”

It was hard for Del to disregard Annie’s Continuous Glucose Monitor, but she did. “Where are your glucose tabs?”

Annie didn’t answer. She was groping deep in her bag. The look she gave Del was almost vacant.

“How do you feel?” Del asked.

It took Annie a moment to pull her focus away from Del’s eyes. “Weird,” she replied, and from the expression on her face, it didn’t look like a good sort of weird. I’ve never felt like this before, was what passed through Annie’s mind, followed by but here’s Del’s face – her beautiful face – okay…

Shit, she’s really low, Del thought. She knew more than anyone else how much Annie hated the arrival of the handsome EMTs, the haul to the hospital, the hassle of getting herself out of there. Del crouched at Annie’s feet and started searching for glucose herself.

Annie is known for being a bit scattered. She compounds her weak organizational skills by carrying an expensive, beautiful, pocketless leather sack. It was always a challenge to find items in Annie’s bag, and it was often a case of not finding what should be in there. I can’t believe it, Del thought as she upended the bag and dumped its contents on her rug. But she could believe what she didn’t find: her friend had managed to leave home without glucose.

Shit, she thought. Okay: what do I have here? At which point Del would have laughed if Annie didn’t look so out of it. Del had given up sugar a year earlier. She had forsaken most flour products and all packaged snack foods shortly after that. She had to find something that would raise her friend’s blood sugar in a hurry, in her low-carb kitchen.

“How do you feel?” she asked Annie again.

“Weird.” Annie aimed her big blue eyes at Del’s face and reached her right hand toward her, but Del rose, spun and strode to her pantry. Nothing. Her eyes landed on the basket of orange cherry tomatoes next to the sink. They’re sweet as candy, she thought, and she brought them to Annie.

She had to put the first one and then the second into her friend’s mouth, but Annie bit and chewed and murmured, “Hmmm. These are good.”

“Keep eating.” Del had to insert a few more, but Annie started robotically ingesting the little orbs. “Hmmm,” she said again.

Del dashed back to the sink area. She picked up the ripest nectarine among three, and took a paring knife to it. One taste told her it was too tart for her purpose. She returned to Annie and the tomatoes. She couldn’t tell if they were doing anything.

Del had never seen Annie as low and still conscious. I’m sorry, honey, she thought. “Annie, I think it’s time to call the ambulance.” She was reaching for the phone on the shelf behind the chair when Annie looked at her and slurred “Am-bu-lance?”

Probably that should have encouraged Del to complete the call. Afterwards she thought so. But at the moment all she could think of was how distressed Annie would be if she had to deal with the hospital. And Annie wasn’t convulsing or unconscious. Del searched her small kitchen one more time.

And she found the dregs of a four-pound bag of sugar, rolled up and pushed into the very back of her refrigerator. It had undoubtedly moved in with her years ago, and then lived in the fridge because other storage space was limited and tiny California ants were regular visitants to her place.

She poured the contents of the bag into a one-cup measure. There were three or four teaspoons. She took cup and spoon to Annie’s chair, crouched down, and fed her friend a heaping teaspoon of granulated sugar.

Annie’s mouth cooperated. Then her lips pursed as her saliva turned the sucrose to a paste she could process. Her expression was one of mouthful surprise.

Del got another rounded spoon-load into Annie’s mouth and watched the salivating/swallowing process again. She filled the spoon one more time, but Annie then aimed her face upward and sat back against the chair. Her eyes had a shine of alertness to them.

Ah, thought Del. And There’s Del’s face, thought Annie.

“How are you honey?”

“Weird. What just happened? Wow.”

“You went really low. I’ve never seen you this low and conscious.”

Annie was enough recovered to stick herself and insert a blood sample into her meter. They both knew she’d already risen a bit, so when they saw 62 they figured she’d been flirting with the low 30s. And her GCM was still acting like she was high.

She’s back but not for long, Del thought. No way will, what? ten grams of sucrose? get her where she needs to be.

“Annie? Are you okay here for five minutes?” She made Annie look her in the face to answer. “Yes.”

Del isn’t a runner but she pretty much jogged to her corner market then. Faced with a wall of candy, she made fast grabs: the share-size bag of M&M’s Peanut, a like-sized bag of M&M’s Almond, and a roll of Starburst (original flavors). She raced back to find Annie exactly as she’d left her.

Annie went for the M&M’s Almond, but Del made her eat some Starburst too. Del was concerned that the chocolate in the M&M’s would slow down absorption; she knew Starburst were like straight sugar.

After another ten minutes most of the M&M’s Almond were gone, a third of the Starburst were no more, and Annie had a decent level of glucose in her blood.

An hour after that Annie’s glucose was a little high (the cherry tomatoes had finally kicked in, but the time it took was a vivid demonstration of how fiber will slow the absorption of carbohydrate). Her elevated blood sugar wasn’t ideal, but it was comfortable; she felt well enough for them to go to a neighborhood bistro for some shared simple food, and she was able to drive home after that meal.

They discussed the event afterward of course. Del told Annie not to apologize, and yes of course Del had been nervous, but there was no way Annie was dying on Del’s watch. Annie tried to describe to Del the experience of being conscious but unable to retain any short-term memories, of feeling freaked out but calming down every time she saw Del’s face near her.

They agreed that Annie shouldn’t have left home after a 600 reading. In fact, they set the bar at 400; Annie promised that if she ever sees more than that on her meter, she’ll hunker down and treat it as the medical crisis it is. Del can come to her.

They placed the unopened M&M’s Peanut in Del’s freezer, as future emergency sugar.

And they found out that Annie’s CGM should be replaced every six to twelve months. The unit she carried with her that day was a completely unreliable piece of shit that deserved the disregard they gave it.