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Pamplona
7:30 p.m., outskirts of Pamplona: I'm sitting in the Bar Arga (named
for the river Arga which runs around the north side of Pamplona) eating
a tapa (canapé) of cangrejo con mahonesa (crabmeat
with mayonnaise). This particular trip I haven't been eating tapas,
because for the past four years, I have not eaten bread. But when I
tested my blood just a moment ago, it was 74 mg/dl. Normal folk have
a blood level of 88-98 and mine indicated that I was approaching a state
hypoglycemia and that was a state I didn't want to be in.
To avoid going "hypo" I ate the tapa. It was a tough
decision, but someone had to make it. Seriously, folks, hypoglycemia
is the big fear of diabetics. It causes a very unpleasant feeling and
if left unchecked, could result in serious problems including diabetic
coma and virtual death. (Does anybody remembers Sonny Von Bulow??) The
diabetic "gone hypo" appears confused: he is weak and may
stagger. Thus, a lot of people assume he is drunk. But let me assure
you, he is not. He is staggering along a dangerous path and needs help.
He needs a quick dose of sugar-fast! One of the best ways is to give
him a glass of orange juice. The high natural sugar will raise his blood
sugar quickly.
What causes hypoglycemia? Well, one cause is that the diabetic takes
more insulin than he needs for the intake of carbohydrates in his food.
(This can occur also with non-insulin diabetics who take glybideride
or other medicines. Another reason may be an increase of physical activity,
which burns off more carbohydrates than normal, resulting in an excess
of insulin. This is the problem that a hiker such as I, or an athlete,
has to be concerned about. Another may be illness. (Remember just a
couple of days ago in Madrid?) Illness may cause changes in metabolism.
I remember the first time I "went hypo." It was years ago
but it seems like yesterday. It was my birthday and several of us were
going to celebrate with a special meal. But first, we went to see a
local play. It was longer than we expected. By the time we got out I
was "bouncing off the walls." I asked my friend to pull into
the first mini-mart he saw and I ran in to buy a candy bar. After a
few minutes, my friend came in to look for me. I was standing, staring
at the candy stand unable to make a decision. Which one should I buy?
If he hadn't rescued me, I would have stood there until someone called
the police.
Another time, I was asleep and began trashing around in bed. My partner
awoke to see sweat pouring off of my face. She aroused me — afraid
of what was happening. We tested my blood and it was 20 mg/dl —
a dangerous state indeed! She wanted to call the EMT's but I insisted,
NO! Instead I had several glasses of orange juice and we kept testing
and testing until my blood was up to over 100. Was I right or just foolish?
I think the cause of the event was that I miscalculated my dose since
at that time I had just changed my insulin regimen.
The second such event occurred a year or so later. I was alone and my
cat woke me up. Since I was sweating profusely, I knew what was wrong.
I started searching the kitchen for some carbohydrates. Crackers —
none in the house! Orange juice? None! (We had gotten rid of all carbohydrates.)
I knew that there had to be some sugar somewhere. I finally found the
stash put away for guests' coffee. (It's a good thing that it wasn't
hidden too well!) After a couple of spoonfuls of pure sugar (yuk!) I
laid down and waited for the sugar to kick in. The cat stayed by my
side.
This state of hypoglycemia is the reason most diabetics don't want to
take insulin or try to control their disease. They don't like the feeling
of being hypoglycemic or they are afraid. Not to control the sugar is
a Hobson's choice that could result in blindness, amputation, or even
kidney and/or heart failure. Well, what is the answer? It is testing-frequent
testing. Personally, I test at each meal and before bedtime. During
special times like above or when I'm sick, I test every couple of hours.
Two hours after a person eats, his blood sugar is at a high point. Three
hours after eating, it is back to baseline. Thus this is the method
that I am using. And since I am alone, I want to err on the high side.
It is 8:25 and my blood is 89 mg/dl. Normal, but it should be higher
after eating a couple of slices of bread. Did I miss a dose? I went
back to look at my food log. I must have over calculated the amount
needed with the menestra verdes (green vegetable mix) and pastel de
San Marcos (whipped cream torte). I feel chagrined. I need to find a
carbohydrate guide for Spanish cuisine. Well, I guess I should keep
testing every couple of hours until I stabilize.
Actually, I've had a lovely day. Most of it was spent in the Museum
of Navarre (this province). It was quite interesting. But I feel that
I wanted to tell the above story because it's more relevant to my purpose
of the "walk." More about the museum later — perhaps.
¡Mañana me yoy a Roncesvalles! Tomorrow I go to
Roncesvalles.
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