I May Never Eat Another Apple Again

Which is a shame, because apples are my favorite fruit. So much so, that my retirement plan for decades has included an apple orchard. Did I mention I work at my favorite fruit company? Associate that favorite with the fruit part, please. Apples have been a part of my life since I was 9 (wow, almost as long as Antartica, go life!).

Buckle up, Future Kitt, we're going for a ride. You're going to want to remember this one.

This past May, I started having dizzy spells. I call them "dizzy spells," but they are more like a dizzy, drunk, exhausted, oh-gosh-I-need-to-sleep hit-by-a-tired-stick narcoleptic feeling. The urge to sleep when these spells occur is HUGE. I had some level of transient narcolepsy back in 2015, but that went away early 2016. That narcolepsy actually could have been location based, as I was working in an older building located near previous silicon chip manufacturing locations. These current dizzy / exhausted / need-to-sleep spells were not location based. They are different, more intense, and independent of location.

The sensation was similar to the feeling when you stay awake for 20 hours and you are exhausted tired. Your eyes do a rapid jiggle back and forth and every fiber in your being says SLEEEEEP. If I could when these spells happened, I would go sleep. I would lie down, instaneously fall asleep, and wake up 60 minutes later. That 60 minutes was unusual, because my naps are 90 minutes long. Sixty, and these dizzy / hit with a tired stick spells, were WEIRRRRRRRD.

Unsurprisingly, I did what any modern person does when seeking medical advice: I asked Dr. Google. Lots of things the dizzy-tired spells could be, but the timing of the dizzy spells could give me insights. They happened about thirty minutes after eating, almost, but not quite, consistently. Dizzy after eating narrowed down what could be triggering the spells, and I wanted to know so that I could adjust what I was doing (eat more protein? walk after food? jumping jacks after food? more caffeine? less caffeine? less sugar? something!). The dizzy spells were sudden onset, one day I didn't have them, the next day I had them every day. That also guided my thoughts towards lifestyle changes, but I couldn't remember what I had changed in May.

A mystery! Except, maybe not. Through all this, I was thinking of my family history, what my parents and brothers and grandparents had experienced. Was my age catching up with me? Did I have something old or something new? This had to be something simple, right?

If you hear hoofbeats, don't think zebras, think horses. The simplest, most common explanation is likely correct.

Except, when you grow up on a zebra farm, zebras ARE what you think of first. Your experiences don't match the common experience, and I figured my years of eating sugar had caught up to me.

Dizzy spells and feeling drunk 30 minutes after eating? How many times growing up did I watch Chris go weird or confused when his blood sugar was out of whack? Uncountable times. My brain narrowed in on diabetes quickly.

Diabetes isn't this big, scary thing in my family, it just is. We have taken a long time to get here. It sucks, but it is a well-known, well-defined problem. If I had this auto-immune disease ("I don't have Crohns!"), I had an expert to help me through it. If I had an insulin resistance, I have habits and a need to always be moving that would help keep my blood sugar in check. I would be okay.

But first, I had to figure out if I actually had diabetes.

I talked with Chris about the different continuous glucose monitors he used. He has tried them all. We talked about the pros and cons of the different ones on market. We talked about insurance, and prescriptions, and the words to say to get insurance to pay for the CGM. We talked about the pain of sensor insertion and removal for the top of the line sensors. We talked about which finger prick monitors were the best. I didn't do much beyond signing up for the Stelo over-the-counter "glucose biosensor," an over-the-counter, no prescription required continuous gluclose monitor the FDA had recently approved.

Time passed. The dizzy spells continued.

At some point in the last month, someone asked on a community Slack workspace I'm in, about what people do to measure their blood glucose. Several people had CGM, with a prescription. Some were Canadian and Just Had Them. One woman explicitly recommended a finger prick glucose monitor that was easy to use, and saved readings to one's phone. I bought one and had it delivered to Portland, having it arrive the Wednesday before XOXO began. During a dizzy spell in that evening, I figured out how to take a reading with my new glucose meter, and HFWTGDFBBQ it was 258. Was this accurate? Did I mess up? Did this sensor need calibrating? No Idea! I just knew this was high.

Let us say right now, the moment I am writing this, and for the record, in the moment I saw that reading, I felt that this was the third time that the XOXO community saved my life. Without exaggeration for effect.

I pinged Chris again.

We talked about what is high, and what is low blood sugar. Over the next couple days, when I didn't understand a reading, I asked him what to do about it. He gave me advice on controlling my glucose spikes, what to do when my blood sugar was 41 and when it was 258, and how I could adjust my food and movement. Chris became my counselor as I navigated the possibility of joining him in living with diabetes.

The dizzy spells continued.

The Stelo was also released this festival week. I jumped on the first day order train, and paid the $89 / month for the monthly subscription of two sensors, each lasting 15 days. I wasn't going to receive them for a week, but I was excited about them.

Fast forward to this past Sunday, when I was at Dena and Grue's at a large family birthday gathering. ("Who is that woman?" "That's Kitt, we adopted her as the fifth member of our family." #squee!). I didn't want to insert my first Stelo sensor by myself, as the placement was on the back of my arm and I was uncertain about the whole thing. Dena's sister-in-law, however, had no such qualms. She said, "oh, yeah, I can do that, we need alcohol wipes." I handed her one I had brought with me. She proceeded to pull the sensor and insertion device out of the box, and, thunk, 5 seconds later, it was on my arm. The adhesive patch went on, and 30 minutes later, I had my glucose readings in the Stelo app.

Nifty! What do I do with this?

The dizzy spells continued.

Because the Stelo devices are "biosensors" they do not send real time information to the Apple Health app. If they did, they would be CGMs, and would require more stringent FDA approval. Neat way around the letter of the law to get to helping people. In this case, I approve. I can see my glucose levels in the app, and they were fascinating and extremely informative.

Fast forward a couple days, and I have some data available to me. I absolutely love this data. I can see how my blood sugar goes down when I'm sleeping (interesting!), and I can see how it goes up after I have my usual breakfast of oatmeal, almonds, blueberries, wheatgerm, ground flax seed, nutritional yeast, turmeric, ginger, cinnamon, cocoa, chia seeds, and nut milk. I can see how taking three capsules of fiber as I start to make my breakfast blunts the glucose spike that eating my breakfast oatmeal brings. I can see how exercise pulls up my blood glucose, even if I haven't eaten recently. I can see how walking after eating will drop my blood sugar. All the things that various health providers say to do: don't eat sugars or straight carbs; eat fiber; eat vegetables first, then proteins, then carbs or sweets, always in that order, to slow down the absorption of the sugar. I was getting a handle on this. Doing great!

I had managed to keep my blood sugar in the 70mg/dL to 140mg/dL range for a good part of my days, with a couple going up to 160 as I was experimenting, but thought I was doing a pretty good job of dealing with my blood sugars.

After the first couple meals, however, I was still having the dizzy spells and they were not correlated to the glucose spikes. I would have higher blood sugar and not have a dizzy spell. I would have blood glucose of 82mg/dL and be ready to pass out in the middle of the day, with the same happening at 138mg/dL. The dizzy spells were not correlated to food intake, not even delayed intake, nor blood sugar levels, nor fiber, nor carbs, nor vegetables, nor cinnamon, nor turmeric.

MUCH relief. I am not diabetic.

But what the fuck were these dizzy spells from? They were sudden onset and terribly puzzling. Were they the result of a switch to a vegan diet 4 months before and I was going to need to go off the diet that was working well for other health benefits? What? The? Fuck?

And then I realized, I was taking some pretty powerful medicine to see how it would make me feel, could it help me recover from that hamstring injury from like 17 years ago? I had started taking it in May, adjusting the dose for a bit until I managed a level that helped physically and didn't trigger sleep apnea and dreams of drowning or being smothered by Jonathan. I enjoyed taking that medicine, I liked the effects I had noticed, but maybe, just maybe it was causing this dizziness?

I went off of it.

In two days, the dizzy spells and sudden onset I-NEED-TO-SLEEP-NOW narcolepsy-like exhaustion fits just stopped.

Hot damn! They were gone! Yay yay yay!

So, dizzy spells gone? Check!

Not diabetic? Check!

Glucose in check? Check!

I mean, a blip here, an issue there, I was figuring this stuff out. Fiber before, walk after, don't eat sugar (oh, sugar, I shall miss you, but fuck off). Check!

So, fast foward to yesterday, when mid-afternoon I was hungry. I hadn't had much for lunch. I knew that I was heading over to hang with Grue and Dena shortly, and that we were all planning on having dinner together. I didn't want to eat my usual lunch this late, because it would totally ruin dinner for me. I looked in my refrigerator and pull out an apple. I cut it in half, put the other half in the fridge, wandered over to my desk, and ate the apple as I skimmed a Slack workspace for a bit. Some interesting art and games coming from Portland, and I love celebrating others' achievements. I finished my apple and shifted back over to my work computer, working for a bit.

After about half an hour of working, I pulled out my phone and looked at my glucose level. I have no idea what prompted me to look at my phone, maybe some alert, but holy fucking hell what the Hod-damned fuck just happened?

Half of a large honeycrisp and my blood glucose goes from 90mg/dL to 220mg/dL? And I didn't f--king notice? Again with the What. The. Fuck?

Needless to say, I quickly rose and went for a walk to drop that glucose. I hustled without running to pull it down. I managed to pull it down as fast as it went up, that blood glucose drop is a real thing.

I felt like I started fishtailing my blood glucose. Which of course sent me back to the memories of fishtailing cars, so much fun.

All of these puzzlements were predicated on the accuracy of the Stelo glucose biosensor. I am assuming they are correct because they correlate well to my fingerprick glucose monitor. That "below 70" matched the 66mg/dL the fingerprick test showed, so yeah.

Fuck.

At this point, I don't know when I'll eat apples again. I mean, I'm all of five days into even knowing what my blood glucose was doing. I DO know that I don't want those 220mg/dL spikes (or even a gradual increase to that level, let's be real). Which is a shame. I love apples.

Update 9/9: Mentioned this whole thing to Kris who asked, "What happens when you eat apples with peanut butter? You used to do that." Which is true, that is my favorite apple consumption combination. I'll run that experiment soon, along with fiber 20 minutes before the apple to see if I can eat apples again.