Short: 3 AM

by Penny Freeman

1am:  Unable to concentrate, I close my book, turn out my lamp, and settle in for sleep.  Dallas turns down the volume on the BBC documentary he is watching on Channel 8.2, the marvels of metal.  Doesn't bother me, as his lamp does not.  I'm used to it, and I'd rather have him here, in bed, than snoring in his office chair, sitting up in front of his computer.

2:20am:  Dallas starts making grunts and other inarticulate noises at the TV.  Groggy and put out, I huff, roll over, and pull a pillow over my head.  I spare him the tongue lashing as I'm too asleep to bother.  It's just a soft murmur now and again.  He should get the hint.  He doesn't.  The intermittent babbling continues as I fade in and out of consciousness.  I think, if you're going to talk to the TV, at least take it in the other room.  PBS has moved on to the wonders of plastics.

2:40am:  The babbling has increased, but now his soft voice is sweetly holding a conversation in nonsensical words.  Wondering if he's a lunatic, I wake up enough to decide he's actually asleep.  The TV and glasses need to go off and the CPAP on so he can settle down into restful slumber.  Getting up and walking around the bed don't quite wake me up, but his glassy-eyed stare does.

Pale and clammy, Dallas is flat on the bed, staring up at me and babbling.  Drenched through, he looks like he stepped into the shower in his pajamas, then came to bed.  His feet are cool—too cool—as are his hands and face.  But, it's not the worst I've seen him.  The worst I've seen him, he was as cold as death.  I had to check his breathing to make sure he wasn't.  That time, I couldn't wake him up with shaking and slapping.  I mean, really slapping his face, like you see in movies.  That time, two of my sons were there when my panic set it.  It was his second ride to the ER in an ambulance.

"You're in trouble, aren't you?"  I say softly.  It's not a question, more like me trying to calm myself with the sound of my own voice.

Dallas blinks at me. "Trouble bubble." His babbling takes on the vowels, he adds his own consonants, but no real words are there. Neither is he. I'm used to it. I've seen him worse.

"We're checking your sugar," I say as the lancet jabs into his finger. He never likes to have his glucose checked when he's like this. His eyes appear four years old—brave but confused and betrayed. Why would I hurt him on purpose?

His finger jerks back, but I hold onto it and squeeze. The test strip poking out of the monitor sucks up the tiny droplet of blood—not like the old days when the jab had to be deep and the blood a generous smear. That's a mercy.

5.  4.  3.  2.  1.  Beep.  39.  Bad, but I've seen it worse.  39 is babbling incoherence and copious sweat.  39 used to be sitting him up and pouring sugar down his gullet.  Orange juice, mango juice, maybe a can of fruit if he's awake enough.  Like a baby, I make him eat until he comes back to me.  I hate 39.  I hate 20 worse.  Fortunately, there's a new rule:  anything above 40 is food; anything below is the needle.

Tonight, it's the plastic red box in the medicine chest, about the size and shape of a remote control, if not as wide.  I open it, then break the seal on the little vial inside.  It holds a fine white powder—glucogon.  The needle on the accompanying syringe is a wicked-looking thing, but tonight it's my best friend.

2:45am:  I jab the needle in the vial, then squirt the pure water that comes in the syringe into it.  A few shakes, and the glucogon has dissolved.  I fill the syringe with air, then squirt that into the vial.  There is now positive air pressure inside the upside-down vial, so when I release the plunger, the glucogon solution fills the syringe effortlessly.  You learn things.

Now the hard part.  I don't have trouble giving Dallas insulin injections, but this is different.  Those needles are fine and short.  They're made not to permeate the fat layer beneath the skin.  He scarcely feels them any longer.  The needle on this syringe is a wicked little beastie, made to go clear to the muscle.  It has to get working fast.  Think of it as an Epi-pen for diabetics.

No alcohol.  No swab.  I don't even need skin contact.  I just jab the thing into his leg, straight through his sodden pajamas.  A quick jab is less painful than a slow insertion, but he flinches anyway and tries to pull away.  I speak softly, like I would to a four-year-old.  We have to do this so he can feel better.  I speak softly and (the gentle part) push the glucogon solution into his muscle.  And mark the clock.

Now all I can do is wait.  I remember to pull his insulin pump out of his shirt pocket and put it on PAUSE.  The TV blares on, Dallas continues to babble.  Tic toc.  Finally, he quiets, his breathing starts to slow, and he closes his eyes.  I fret that maybe his blood glucose has fallen too low, like the time I couldn't awaken him, but force myself not to panic.  It's just real, restful sleep.  Tic toc.

3am:  15 minutes of the natural hormone glucogon forcing his liver to spill stored glucose into his blood stream.  Time to make sure its working.   I put the test strip into the meter.  The beeping causes him to open his eyes.  I smile and cock the finger-jabber.  He doesn't even wince when the spring hurls the lancet into his finger.  "What happened?"

"39."  That's all the explanation he needs.  We've seen worse.  I smile and squeeze a drop of blood from his finger, and the tip of the test strip drinks it up.  5.  4.  3.  2.  1.  99.  Perfect is a hundred.

"What can I get you?  Peaches?"  His blood glucose is still too low to get through the night without some food.

He snarfs the peaches like he hasn't eaten in a week.  That's the thing about having low blood glucose.  Your instincts kick in and you have to shovel it in as fast as you can.  Your body forgets manners in favor of survival.

"I'm sorry," he apologizes.  "I messed up on the insulin.  . . . Not on purpose."  I hate it when he apologizes—or states the obvious.  I smile and remind him to start his insulin pump going again.  Beep.  Beep.  Beep.

I pull out some clean pajamas and consider the sheets.  Hypoglycemia has a distinctive smell.  "You're soaked," I point out.

"I noticed."

"How about a change?"

He grimaces at me.  "I can barely move."

Personally, I can't see how he can sleep like that, but then, I've never had a blood glucose of 39.  Every muscle aches and burns, as I understand it.  I guess a little sweat never killed anyone.

The PBS has moved on to the marvels of ceramic.  Dallas fumbles around in the bedclothes until he finds the remote controls to kill the beast.  The glasses come off.  The CPAP mask goes on.  I kiss him and turn out the lights.  The rest can wait until morning.  It always has in the past.

—A Chaotic Mind


Weaver said...

Scary! My hubby has to use the CPAP but not the insulin.

Gloria Gay said...

This was hard to read, Penny.As your mother, I could feel your fear, your love and your pain, your courage and expertise. I wish I'd kept a journal those hard months when your dad was dying.

Unknown said...

Mom, I wish you had as well.

tomiannie said...

That was very powerfully written.

Lucy Stern said...

Glad Dallas is doing better, so glad he has you to take care of him... Getting old is never easy... Hang in there Penny...

ginger said...

What a gift you have for writing, and kindness.

ginger said...

What a gift you have for writing, and kindness.

carrieap said...

You are amazing Penny! Love you! Love your writing. Love you Frister!

Marsha Ward said...

I'll just echo what others have said. It's powerful writing, Penny, and you're a wonder with these medical emergencies. Keep it up, sister!