Daughter just had a very scary severe low

My daughter Clara (12) just had a severe low and I thought we might lose her. 27 minutes out of range from her Dex receiver and smart watch while they charged and she dropped from 104 to below the range of the Dex and meter.
The only way we knew something was wrong was because she complained of a headache and was crying on the couch.
I found the Glucagon and kept our close. She was screaming and crying. She was combative and wouldn’t take juice or tabs. I remembered that we have gel stored away to keep at the school and found that. She kept fighting against us putting it in her mouth and then spitting out whatever we could get in. Every time she would get quiet,I thought she’d gone unconscious and we’d need the Glucagon but I’d jostle her arms and she responded.
I finally had to tell her that if she kept fighting she’d need a big needle and have to go to the hospital. The hospital is a threat that I only resort to in the worst situations because she hates it so much. It was awful to have to make her even more upset by saying that, but I was afraid we might lose her if she didn’t get sugar since Dex was still showing “low” straight down.
She still kept spitting out the gel but at least let me put it on her gums. As soon as the Dex showed straight across (although still saying “low”) I passed the gel off to my husband and went to another room to cry. I needed to get away from the situation for awhile.
She hasn’t had a low like that since she was 4 or 5 years old. I keep thinking about what would have happened if she had this low while rafting the river this morning?" She had Gu with her, but nobody would have known what to do. It’s likely that we would have lost her. We were topping up the charge on her receiver and watch as we loaded the car to go camping this afternoon. We were literally leaving in 5 minutes. I’m glad this didn’t happen in the car in the mountains where we don’t have gel.
Her little brother (10) just said he needs us to talk about what to do if this happens and we aren’t around. I hate that he has to worry about this, but I’m glad that he wants to be prepared.
I’ll be keeping gel in the pantry from now on just in case. It’s been 7-8 years since she’s had a severe low, but it needs to be easy to find. I think he’s old enough to learn how to use Glucagon as well, so we may teach him about that. At least he’s seen is do what needs to happen with the gel. I told him that at if he can do it he should put gel on her gums. If not, call 911 and get an adult neighbor.
I don’t think I’ve ever been so scared in my life. I hate diabetes and it’s so unfair that my sweet girl has to deal with it!

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That sounds very, very scary, but it also sounds like you all handled it with amazing clarity. It may not have felt like it at the time, and it might be too soon to feel that way now, but to an outsider, you identified the problem and fought your way through it without hesitation. You didn’t lose her, and the way your husband and you worked as a team, I don’t think you were going to let that happen.

It’s a terrifying situation, and I can’t even begin to imagine having to watch a child go through it instead of myself, but it really sounds like you handled a crisis situation with command. For your 10 year old son to, almost immediately after the fact, want to learn how to participate is evidence to me that you all were calmer than you may have felt. I don’t think 10 year olds, in general, respond to panic and chaos with volunteering to help in case there’s ever another round.

I’m glad you got away for your cry. I’ve done the same in a number of situations. Sometimes it takes that release to gather yourself and return to life in progress. Down the road, definitely not today and probably not tomorrow, it might be a good teachable moment as it was so close in proximity to her rafting adventure. This is not to induce fear but to encourage awareness. It’s a valid question to ask what if. It’s also a valid question to ask how it may have turned into such an event today. I’d give your mind and family a little break though and maybe revisit it once it’s not so fresh.

Great job today, mom. :two_hearts:

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Oh, I am so sorry this happened and so grateful for a good outcome! :+1:t3:

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It might help to have something she really likes. Low BG can definitely cause irritability. I get feisty sometimes, but I never turn down chocolate milk.

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It is unfair. No argument here at all. I was just doing low avoidance (nothing severe like you just experienced) for the last hour trying to remain calm so my kiddos wouldn’t note this in their little memories (which are quite large) as another T1D event that dots our lives. While I was in limbo trying to figure out if what I was doing was enough or if I was going to have to get even more aggressive, or call a friend to come over, I noted that my hands were shaking as I had my tester and glucagon kit out just in case. Everything resolved in an hour, but this is the sort of thing that makes signing them up for extra-curriculars difficult. Every night is roulette. One move doesn’t fix everything. I jump one way, it’s not enough insulin. I jump another way, it’s way too much insulin.

I say that to commiserate. And to acknowledge that even in my much milder low event, it still felt very overwhelming. The not knowing and the gray area is a lot to manage…especially when it sneaks up on us.

But this also makes us durable, compassionate, excellent problem-solvers, and all-around bad-asses. Truly, it does.

It’s not fair. It can be scary. But you will all persevere because that is what we do. I’m glad you shared what happened and I hope you feel that you get the support that is most helpful to you from us FUDders.

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I’m so sorry that your daughter, you, and your family experienced that. Severe lows are terrifying. My parents could have written your post on a number of occasions.

I think it’s a great idea to teach your son, and maybe even your daughter’s friends, how to respond in a low. My parents taught my brothers and friends how to rub glucose gel into my cheek and for anything more severe than that it was call 911 or find an adult. When I was 15 or so I had a severe low one day at lunch when no teachers were around. To this day, I’m forever grateful to my friend for recognizing the symptoms and knowing what to do. She refused to leave me for the entire lunch hour even after I was with school staff and had recovered.

I also agree with others that this is a good learning experience for your daughter. In high school my parents wanted me to carry a fanny pack around with emergency supplies in it. I refused. I said I could go to my locker if I was low. It wasn’t until I had that severe low episode where I couldn’t make it to my locker in time that I decided I should carry supplies. Ever since then, glucose tablets or glucose gel are on my person at all times. Not nearby, but in my pocket or a Spibelt. I also carry an emergency kit in my backpack that has glucose gel and other emergency supplies so that others can easily find them. For me, lows can hit fast and can go from mild to severe in seconds, even with a CGM.

I hope that you, your daughter, and your family recover quickly from this experience, and see it as a victory and a learning experience rather than a defeat.

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True, but she usually likes this stuff (ew) and she likes the juice, but wouldn’t drink it. She’s been almost this low once before and did the same.

Yes, she always has tabs and/or juice in her purse or in her pocket.

This was completely new for her. She almost always feels her lows long before it’s much to worry about. We were completely blindsided by this one.

I’m glad your daughter is OK now. What you experienced is every diabetic’s biggest fear and every parents worst nightmare.

Thank goodness for the parents that care for their D children.

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Good job! Scary though.

My wife and kids don’t have diabetes, but I’ve given them a few memorable low BG scares, none involving going to the hospital, fortunately. However, in one or two of these episodes, I was out of my mind, and they pulled me back from the brink…I don’t often think how much I need loved ones to be there for me. Your story has reminded me, thanks for sharing.

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I couple of things to mention about glucagon.

  1. You can give a small amount and it will do a great job of bumping her up a little bit without making her skyrocket. Maybe about 10 units or so. It’s very fast. Don’t give the whole thing, or else you will be looking at BG’s in the 200’s or 300’s. Just 10 units will probably be in the ballpark of only about 30-50 points for her.

  2. You can keep the unused portion for at least for a few days. I have used mixed glucagon 5 days later and it still worked. It won’t last forever, but you can get a few days out of it.

  3. Also, you don’t need to use the giant harpoon that comes with the glucagon kit. You can mix the solvent in the powder vial, and then use a 8mm 31 gauge insulin syringe to inject it. If you compare a small insulin syringe with the needle that comes with the glucagon, you will see that it would really be much more comfortable. When I mini-dose glucagon, I just use an insulin syringe it works fine. Don’t use the harpoon.

  4. Last point - I know a lot of people are somewhat intimidated about the idea of using glucagon. I was surprised to see in the poll a while back how few have actually used it. But do you know who uses glucagon? Every single non-diabetic in the world. It is the forgotten half of the pancreas - the alpha cells. It is a perfectly natural thing. Using glucagon is just like using insulin, it is just replacing functionality that the non-diabetic pancreas performs. It’s the exact same thing. Don’t be afraid to use it in small quantities for situations like this. Don’t inject the whole thing, just use a small amount, and you will love what it can do for you. Trust me on this!

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What was her actual sugars? When my sons receiver indicates he’s going low or is low I never trust it and always check to be sure. Did you do actual finger sticks?

Sorry you guys went through this. These lows are always an unpleasant experience.

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I thought about doing this but didn’t know how much to give AND although I know that I can use an insulin syringe, I just kept picturing the “harpoon” and how upset she was and didn’t want to try. I was a bit panicky.

I will remember your advice if we are in this situation again.

Thank you!

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We did do finger sticks, but she had glucose gel all over her by then. We gave glucose first because it was apparent that it was an emergency. My husband cleaned her finger as much as possible, but she was really making everything difficult. The first reading we got was 47. That was after we got some sugar in her. The Dex was still showing straight down and her symptoms and behavior indicated much lower. The lowest we’ve ever measured was 35 and she was in a similar state, so she was probably close to that.

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I’m sorry you experienced such a stressful event, and I’m so glad she’s ok!

My experience is that Dex is pretty unreliable at the very low ranges (or really extreme ranges on either end), including both its values and its arrows. And I say that as someone who finds Dex waaaaaay more reliable than most—my G5 is usually very accurate for me with minimal calibrations (after the first couple with a new sensor, I often let it go days without any, and it’s fine, within 10 or so from my meter). But once it gets close to its thresholds on either the low or high side, it loses accuracy quickly and tends to exaggerate values relative to the meter, tends to model continued dropping (or rising) even when that’s no longer happening, and is slow to pick up on recovery. Now it’s entirely possible Dex is always that slow to model change due to the interstitial fluid thing, and the difference is that that’s a time I’m way more anxiously awaiting it. But either way, if you’re getting LOW with arrows down and you’ve administered glucose, in my experience there’s a very good chance the glucose is indeed working and the Dex hasn’t been able to pick that up yet. I would probably still err on the side of giving more if I were you too, because worst case you get the double arrows back up and need to correct a little, but better safe (and a little high) than sorry. But just know that your Dex may very well be misleading you and increasing anxiety in those moments.

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Really glad your daughter is ok! It is good to know that you were able to handle the tough situation. Once you recover from the shock and awe of the event, would love to hear about your thoughts on the cause. Was it just a miscalculated dose or something else?

Just like pilots, actual sitreps helps everyone.

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Hi @sahmcolorado, so sorry you guys went through this.
It seems like you did a great job in the moment despite how scary it was.

We’ve had a bunch of time where Samson just reads LOW on his receiver but usually he is not that low (usually he’s mid-50s then – so not great but not awful.) Your daughter very well might have been low, but probably recovered much faster than Dex registered – which is also what we invariably find. Still, the symptoms of the low can linger for 15 or 20 minutes after the BG number has recovered and the immediate danger has passed.

Just want to second what @Eric says about miniglucagon. We were at camp and they basically told us that even in an emergency you never really need to use the full glucagon. The typical advice is about 1 unit per age, and if it’s not a seizure it can be delivered in a regular syringe and should do the trick in 10 minutes. We tried using minigluc at camp for a low at night and it worked about 5 to 10 minutes faster than the juice would have.

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Yes, I understand. Her symptoms and behavior indicated that she was dangerously low even without the Dex. She doesn’t act that way when she’s in the 40’s. We were giving glucose, but it was a tiny bit on the end of my finger rubbed on her gums and she spit out a good portion of it. I know exactly what you mean about the delay on the Dex and knowing that the glucose is working, but in this case it was hard to take comfort in knowing glucose was in board because she was getting so little, you know?

Mini-dose of Glucagon would have been the best thing, I think.

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Yeah, we really don’t know what caused it. It was so unusual. She’s never complained of a headache and nausea with a low before and she’s never dropped so quickly. I’ll have a look at the bolus history on her pump today. She is trying a new site location on her leg, but I don’t think that is relevant.

It took an hour to get her up to 63 and then another hour to get her to a normal range even with her pump disconnected, so it seems like she had a ton of insulin on board. But then again, it was slow going to get glucose in her at first.

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Then, of course, she was really high last night, so we got even less sleep than usual. Zzzzzzzzz