After the pariocentisis and the subclavical catheter procedures I was released and went home. I mostly laid on the couch the rest of the day, the cutting off of my second hospital ID wristband in a few days being the major activity.
I was feeling low sugar so tried drinking some freshly squeezed grape juice, hoping the first antibiotic (that had been changed two days before) had passed through my system enough by now so I could tolerate fruit juice. It was delicious, as not eating for 5 days can really sharpen your sense of taste.
I waited an hour and it stayed down so I got adventurous. When you haven’t eaten for a while, whether by conscious choice as a fast or involuntarily, how you break the fast is important – eating too much too fast or the wrong things can make you sick. As I have routinely over the course of my life done some extended fasting I know this.
When you don’t eat for a while, the fire of digestion goes out and it needs to be reignited. My first solid food in 5 days was a small banana, easily digestible, and some bioactive organic yoghurt which has a lot of beneficial bacteria that would jump start the intestinal fauna needed for good digestion. I had some little freshly ground flaxseed put in it as well which has a high quality fiber to help clean out the system.
I waited another hour and saw that I was able to eat that. I then switched to some dahl, a bean soup. Dahl is a very digestible bean that breaks down when it is cooked into liquid, the beans themselves losing their shape. This particular dahl soup was courtesy of Krishna Bhava, who had dropped it by to help out my wife. As well as the dahl beans, it had pieces of beets and carrots in it. A little fresh lemon juice and another dab of yoghurt really popped the flavor.
It was so good the cells in my body were practically crying in ecstasy and I was able to eat 8 oz (250 ml) of it.
The weird thing though was that 2 hours later I started to manifest symptoms of low sugar, low level of glucose in the blood stream. I ate another batch which normally would have meant I was in the good range for blood glucose level for hours but in 2 hours again I was going low sugar. So I ate some more.
This pattern repeated until 11:30 at night, when in addition to the soup I ate two pieces of whole wheat toast, something I might have usually waited until the second day of breaking a fast, but I was concerned about going low sugar when asleep and wanted to pump up my blood glucose. Normally after that meal with no insulin taken I would have been quite high, well above the normal range, the next morning.
It having been an exhausting day, even my insomnia couldn’t keep me awake and I fell to sleep. Suddenly I was awake again, it was 1:30 in the morning and I was having clinical symptoms of low sugar. At this point I knew something was seriously wrong. I knew if I went to sleep again, I would end up in a diabetic coma. I don’t know how long you can linger in that state before dying but I was not interested in finding out. I knew I was not going to be able to keep waking up to eat every 2 hours.
I had to wake my poor beleaguered wife and ask her to take me into the Emergency Room. I drank 16 oz (450 ml) of orange juice and ate a handful of cashews. Protein releases slower than juice and when you go low sugar it is recommended to eat some protein as well as the quick sugar source.
When I got to the ER, they tested my glucose and it was already down to 54, normal range 70-120. They asked if I had anymore fruit juice and I did, having refilled the juice container and brought it with me. They said drink that and I did, as well as eating some more cashews.
Ten minutes after drinking that they tested and I was at 72. They waited an hour and tested again an already it was down to 60.
They stuck an IV and hung a bag of 10% dextrose solution and started feeding my veins. They also pushed 2 huge syringes totaling 100 grams (3.5 oz) of some really viscous, thick, liquid that the nurse said was pure sugar into the IV. They tested an hour after that and I was already down into the normal range.
What they said the issue was a pharmaceutical I had been taking for years called Glipizide, even before I had had to start taking insulin. In type two diabetes you still produce some natural insulin and the Glipizide enhances its utilization.
I had been monitoring my blood sugar when I wasn’t eating and had stopped taking the Glipizide a few days before when my sugar had gotten to the normal range but as the kidneys had failed, what ever was still in there hadn’t been eliminated, had probably even built up into a higher than normal dose.
The same thing went for the insulin in my blood, it hadn’t been eliminated and thus the hyperactive loss of glucose and the subsequent low sugars.
They ordered dialysis and I was taken to an in hospital dialysis unit. Just a few days before I had started to think conceptually about dialysis but thought it was months away. In February I had been told dialysis in 2-12 months and we were 7 months into that but I was in a lot of denial and thought I still had months. I had made an appointment to get the peritoneal catheter in (which as it turned out I couldn’t have used anyway) so I would be ready for when dialysis was needed but that was more with a thought to draining the ascites and not because I thought dialysis was imminent.
The nephrologist had ordered the subclavical catheter because she said I didn’t have the time to wait the 6 weeks for the shunt to be surgically implanted in my arm and heal before it was ready to use. So I had that ready to go. But emotionally I was a long way from thinking about actually doing dialysis.
Yet here I was, on a gurney and going through the countdown to my first dialysis treatment. Bit of a shock but at this point I was just along for the ride and being swept by events. Dialysis here I come.