Husband went into seizures on two nights.. help me!

[smokray]

My husband works away from home and comes home once a month. While home, he performs a lot of physical chores that need to be done. He is not as physically active at work during the month. Last month and this month, I awoke in the middle of the night with him jerking and sweating profusely and cold as ice. He is not conscious even though his eyes are open. The first time I called 911 and they wouldn't let me do anything until the ambulance arrived so they took care of him. He was fine after being given glucose and they left. I promised myself I would never be on the phone with 911 again with them telling me to do nothing while waiting for help, that I would give him sugar myself. Well, it happened again this week after a long, hot day of building dog kennels. I awoke with him jerking and unconcious. This time I gave him straight sugar by pouring it in his clenched mouth and did so several times and called my mother who came over with her tester. His finger tips were hard as rocks, by the time we finally got some blood to test he measured 28 on the tester, this was after giving him a lot of sugar. Finally he just suddenly "woke up" and was coherent so we got some Sunny D juice in him and he ate some cookies. He was fine after that. If I don't wake up, will my husband die? Will there be a time when he won't have the seizures to wake me up?  He is testing himself more and making sure his sugar is higher when he goes to bed especially when doing chores now, but I am scared to death that I will let him die if I don't wake up. I'm afraid to sleep. Will he die if I don't wake up?

[JDRF-Team-LRS]

Smokray,
What a terrifying night!

We are volunteers with lots of experience with diabetes, but none of us is a medical professional, so be sure to review what you learn with hubby's endocrinologist.

First, talk to the endo about a presecription for Glucagon.  Glucagon is safer & quicker to use than forcing sugar in an unconscious person.  Glucagon is given by injection and works by causing the liver to dump its stores of glucose into the bloodstream, quicker than it would otherwise.

Those severe lows are dangerous, and the aftermath can last for several days, particularly whether or not glucagon has been used.  The cycle works like this ... in our normal diet, some of the carbos we eat get stored as glycogen in the liver -- for use in "flight or fight" situations such as danger or, in the case of diabetics, when our blood sugar drops too low.  The shot of glucagon causes the liver to dump this sugar "now" into our bloodstream and begin a recovery process.  HOWEVER, once the liver has used its store of glycogen, it takes several meals for it to rebuild its life-saving storage.  During the few days after a severe hypo, endocrinologists & ER doctors will often advice that we target slightly higher blood sugars to AVOID a cluster of lows at that point.  

While we are not necessarily more susceptible to a low soon after a severe low, our liver cannot help us out if we drop too low.  Thus, it is VERY important to avoid any lows while our liver rebuilds.

It is important that a person with diabetes (I assume your hubby is Type 1, given how low he got) learn about Glucagon and always have a Glucagon kit available bedside.  You might ask the endo for an extra kit so that you can practice with one (into an orange) do you'll know the technique when you need it.  My hubby was taught to call 911 and then give me a shot of Glucagon while he awaits their arrival.  

It *is* terrifying to witness a seizure.  The best advice I've heard is to keep the person from hurting himself -- move anything they might hit if they flail around.  AND, get a shot of glucagon into a diabetic as soon as it is safe.  

Please give the endo a call and review some techniques for adjusting insulin & food according to activity.  For Type 1, we have a daily balancing act that requires we understand how activity, insulin & food interact in our bodies. Sometimes we need refreshers on how to balance those things since the balance also changes over time.

I hope this helps you both avoid future severe lows, and to respond to it safely if he does have another one.  He is lucky you were there to get him the help he needed.

[JDRF Team SGG]

I happen to be very sensitive to insulin, and during a period of years after my second child was born, I had many severe lows. I agree with LRS totally about the importance of having a Glucagon kit handy at all times. My husband has had to use it a number of times, and after the glucagon is injected, it takes about 15 minutes, and the person who is semi-conscious or unconscious just sort of wakes up, feeling pretty much OK, but wobbly. It really IS better for me to have my husband inject this than to have to be carted off to the emergency room, where the intravaneous glucose always leaves my sugars way too high. I feel better with the glucagon, and it brings me back to the point where I can do safely eat or drink some carbs. When semi- or unconscious, it is very difficult to swallow, and your husband could choke or inhale some of the juice, which could cause serious injury.

Now, having been a type 1 for 35 years, I know all too well how hard it is to manage type 1 diabetes when our routines are changed. And this is what is happening when he comes home and does strenuous physical work. For me, that 6-8 hours while I am sleeping is the most dangerous time because I am not awake to test every few hours and catch glucose levels that are possibly dropping too low. Maybe the safest thing is for you to help him on the nights after heavy work all day by setting an alarm for about 4 hours after going to bed, waking up and rousing him just enough to do a finger *****. If you do the work for him (he probably is exhausted after a long day of work), he may agree to let you do this middle of the night check, and it would be a real relief to know if his sugars are dropping at night or not. Maybe this plus having Glucagon handy would be the safety net you are seeking. Losing 5 minutes of sleep is better than worrying.

In my case, every time I have had a severe low in the middle of the night, i have either thrashed around or moaned or made some obvious noise or movement so my husband wakes up. I mention this to help you relax somewhat. Since this is not something that happens regularly, your doctor probably is not going to suggest that your husband make any real changes to his insulin regimen based on these two isolated experiences. But both you and your husband should know that the body can experience glucose drops for up to 2 DAYS after strenuous activity. I happen to take Lantus insulin as my basal dose combined with Novalog before meals. Because of my occasional night lows, my doctor has me inject the Lantus in the morning instead of at bedtime (which is what most patients do). There is a slight peak action of Lantus about 4 hours after injection, and for someone who tends to get low at night, this can be avoided by switching the Lantus to the morning. I am not going to go into this in depth here, since this comment may not apply to your husband at all. But if he DOES take Lantus or another 24-hour insulin at night, this might be worth discussing with his doctor.

[mlevy911]

Let me first say that you have a misunderstanding of 911.  911 dispatchers are not trained to render emergency medical service, they are trined to give pre-arrival instructions until EMS can arrive on scene.  You have to remember that as a 911 dispatcher they are not there and can only go by the information they are given.  If they were told that someone was having a heart attack and attempted to do CPR because they were told they person wasn't breathing and in reality they were, it would cause more problems.  Yes, you knew what was happening, but please remember they are only there to offer pre-arrival instructions.  How do I know this, I am a 911 dispatcher and I have been on BOTH ends of the phone in this situation.  My husband for whatever reason has developed siezures and I have had to use  911.  It is different when you are on the other end. There are certain questions that we have to ask per protocol and I was frustrated because they were asking me those questions!
Please also know that I am a medical first responder and my husband is a paramedic.  Putting ANYTHING in someones mouth that is unresponsive is not a smart thing to do.  It can cause them to choke.  When someone is having a seizure, the best thing you can do is just protect them from hurting themselves.  Don't put anything in their mouth.  Roll them on their side to allow any vomit or blood that is in thier mouth to roll out.  Keep them on their side and talk calmly to them until help arrives.
Talk to your Doctor.  Ask hiim what you should do when your husband has a seizure.
Also, have you had a sleep study done on him?  We found that my husband would stop breathing up to 22 times a hour for up to 83 seconds. That could be a cause of nite siezures.
I wish you the best of luck.

[quatlox]

Smokray,

Get your husband a wrist watch that has alarms on it for his snack times.  That is what I did and now that I eat my snacks on time I very rarely have LOWS.  My watch has 3 alarms on it I wish it had more, I set the first alarm at 10 am to eat a morning snack, 2nd alarm at 3 to eat an afternoon snack and then at 6 pm to eat dinner on time.

I can not feel the LOWS,  so it was very important for me to eat my snacks on time before I got in trouble and can not help myself.

It is very important for your husband to test his blood on a regular basis to know where he is and take action as necessary. Tell him to ALWAYS check before he goes to bed.  That 6 - 8 hours of being asleep is very dangerous for us diabetics and when your husband is out of town tell him to eat before he goes to bed.  I will not go to bed unless my blood sugar is at least 160, Yes, I know that is high, but it is better to die 10 years early from diabetes high blood sugars than to DIE TODAY from a LOW BLOOD SUGAR.

Yes, the "DEAD in BED" syndrome is very real for diabetics.  My son had a good friend that died in bed from a low and the death certificate stated "died of Natural Causes", because he was a diabetic and a very young one at that.

My wife thinks the world of that $40 TIMEX alarm watch, as she was much like you, SCARED to death that I would DIE of a LOW that could have been prevented by a simple SNACK.

I NO longer have any 911 stories to tell about low blood sugars that I could not do anything about since I have been testing myself on a regular basis and eating my SNACKS on time.

Bob