I have now been taking desipramine for 2 months, and ten days. I have lost 6 lbs. I realize that is not a lot over that much time, but it has happened without any special effort on my part whatsoever. I have been eating what I want, when I want, and getting the moderate exercise that anyone who owns a particularly energetic dog who must be walked several miles a day will get; that is in addition to the fact that I happen to live quite near a lot of places, so I can walk or bike, rather than drive to do most errands. The only place I drive to that is actually in walking distance is the twice-a-month big trip to the grocery store, and that’s just because I bring home too much stuff to carry. I wish I had one of those carts I could wheel behind me. Both for the exercise, and because what I’d save in gas would be helpful. But this twice monthly trip is when I buy my son’s Sprite Zero, our milk, and RO water for my softwater aquarium, and some other heavy things.
Now, seeing that weight loss wasn’t the goal, what has it done for my sleep? that’s a little better too. I’m not seeing as many 2ams as I used to. I’m finding it a lot harder to go to bed at my previously strictly enforced bedtime of 9pm; now I’m settling in closer to 11pm, then waking up around 3:30 or 4.
This means that I’m not just occasionally sleeping 4 & ½ to 5 hrs. a night, interspersed with 3 hr. nights, and 0 hour nights. This is a great improvement over 5 hour nights being occasional. More importantly, I’m no longer sleeping in fits and starts. I’m sleeping a solid block of 4.5 – 5 hrs. – remarkable!
I have a new concern, though: when I wake up, my blood sugar is often very low—below 70, quite frequently, and never above 86.
Now, 86 isn’t bad. A lot of people who don’t carry any diagnosis have a waking blood sugar of 86. But this is my high. I have an average morning blood sugar of something more like 70. And again, 70, in and of itself wouldn’t be especially concerning if that were my low, but as an average, it’s not great. One in every three mornings or so, it’s below 70, and once or twice a week, it’s below 60.
Those below 60 mornings are killers. I wake up foggy and shaky, and it takes a minute to remember where I am, what’s going on, and what I need to do. Sometimes even who I am. Once in a while, I “wake up” to the sound of my own voice reciting facts about myself: “I live in [city]; I was born in New York; I’m 53 years old; I have a 14-yr-old-son named J. I work in a preschool; I was in the National Guard; I graduated from Indiana University….”
I have no idea how long I have been doing that. I can assume only that I woke up, but did not really regain consciousness, and my brain is trying to keep me oriented to self (which is one of the few decent things its ever done), or possibly even trying to rouse me by reminding me that I have a consciousness to regain in the first place. It’s a strange experience, to say the least.
There was one night when I had gone to bed early, around 7pm, and then awakened, stared into the darkness, and couldn’t remember what to do about it. I sat up in bed for what seemed like 10 minutes, though it probably wasn’t, until I remembered that I could turn on the light. I looked at the big schoolhouse clock across the room. I read 9:41, and I thought “My god! I slept 14 hours?” Then I realized it wouldn’t still be dark after 9am, and I must have slept just about 2 & ½ hours. That’s when I became aware of how cold my hands were, and the fact that I was trembling. My blood sugar was 35.
I keep bottles of shelf-stable, high protein milk next to my bed for such times, because one of the best things for me when my blood sugar drops really low is something with a lot of protein, and some fat, but not necessarily a lot of sugar—and definitely no processed or otherwise added sugar. Even fruit is not a great idea.
Of those mornings when my blood sugar is below 60, maybe one time in four, it’s even below 50; that’s about three times a month, if you are taking notes. But below 40, is rare and it’s scary.
I now suspect that sudden drops may be responsible for at least some of the middle-of-the-night awakenings—not the fits and starts, but the ones that happen when I’ve been sleeping well, then wake up after 4 or 5 hours. I realize it’s probably a good thing that I wake up when it’s 52. But when it’s 82, that’s not dangerous. I wonder if it may have dropped suddenly and sharply from something like 125, and it’s not the number, but the difference that awakens me. Normally I the dizzy shakes don’t start until my sugar gets below about 70, but I can get them when it’s 82, if it has dropped suddenly. If I ate a meal with more carbohydrate than usual, and my blood sugar rose to 130, but than dropped in less than a minute to 82, I’ll react just as I do when it’s gotten too low.
For this reason, I test when symptoms show up only if they have persisted for several minutes. People think I’m playing with fire by doing that, but honestly, I know what works. Sometimes the symptoms are there only briefly, and those I suspect are the ones I can attribute to a sharp drop.
I haven’t talked to my doctor about this, though. I have been to see him so many times recently, in the middle of a pandemic, for other-than-COVID concerns, when he surely has more immediate things to concern himself with, that I’m worried I already have the snowflake sticker on my file. And I have an appointment on February 11 at the sleep clinic to be assigned a “watch.” I’ll mention it to them.
I wish I could find some way on my own to stabilize my blood sugar and prevent overnight drops. I think I’d sleep better, I really do. I don’t think that’s the only problem—my blood sugar certainly is not responsible for my lying in bed awake an entire night, or for my waking every 45 minutes. It is a factor in a lot of middle night wake-ups after several hours of otherwise uninterrupted sleep; I’m sure of that.
Ironically, the more I weigh, the easier my blood sugar is to control—maybe that’s not really ironic, but it is unfortunate that I have two competing conditions that keep each other in check, so that it seems I have to live with one or the other. Before I had a baby, which is to say, in my 20s & early 30s, I weighed 130lbs., and had terrible problems with blood sugar control. I gained a lot of weight when I was pregnant, which it took me a long time to lose, and I weighed almost 190lbs. for a few years in my late 30s and early 40s. I had pretty good control over my blood sugar then. Now, at 155lbs., it’s not as bad as it was at 130, but worse than it was at 190. I have no idea why, but I’m guessing it has something to do with whatever makes overweight people develop type II diabetes.
Maybe I’m somehow protected against type II diabetes by my remarkable ability to over-produce insulin, but I doubt that this suggests I should try to gain weight. Blood sugar notwithstanding, I’m sure I’m healthier at 155 than I was at 190. I don’t have back pain anymore, that’s for sure. But I don’t know what’s left for me to do. I don’t eat refined sugar at all; I don’t drink; I’m careful about how much fruit I eat at once, and that I don’t eat it on an empty stomach; I’m careful with carbs—all my grains are whole grains, and I always eat them with protein. I can’t cut them out entirely, because I’m a vegetarian—sometimes beans and rice, or tofu, are my protein for a meal.
Maybe on the 11th of February, I’ll get some answers, or at least some suggestions.
The Little Hours 