It’s the day after the gig and things have gone well. My bloods were stable through the afternoon and evening and I was able to get on with the work without having to worry too much about my levels.

Performing when you’re not in the right place with your bloods can be pretty difficult. If your blood glucose is low you enter a state of hypoglycemia. Your brain is starting to feel the effects of not enough fuel to keep it going. You get shakey, disorientated and it can be hard to maintain a train of thought. Oh, and you sweat. A lot of folks are pretty used to the image of the sweat-soaked muso hanging off a mic stand but when you’re rocking that look playing folk music to a bar full of travellers on the Picton to Wellington ferry at 8 am people start to worry. The guy on stage is starting to worry too. Can I finish the set? How long have I got before the lights go out and I drop? I dunno…what was I thinking? This starts to go on in your head while you’re supposed to be remembering lyrics and chords. Sweat dripping from your elbows. Shit, I need a lolly.

My standard unit for dealing with a low is 4 snakes. 6 if I’m in a hurry but that may mean that the pendulum swings the other way and I end up a little high. Hyperglycemia is not much fun to play on either. Your breath gets hot and sweet, my throat gets dry and my voice suffers. I also get mean. I always thought of myself as a shoot from the hip, call it as I see it kinda guy. If folks are annoying me I’ll tell ’em. I cut my teeth playing in metal bands in my younger days. It was the nineties and stage diving was the norm. Gigs could be pretty physical and I thrived on it. The audience could reach out and grab you. Sometimes mic stands and guitars got used in self-defense, sometimes the self-defense argument hung a little thin. In my forties, I’ve managed to tone down the physical element but I’m still partial to talking to the audience a bunch and I’m not afraid to use the mic and the stage to shut folks down when I think they’re being disrespectful. As a diabetic, this requires a little extra care. When I’m hyperglycemic I’m edgy and quick to anger. Shutting someone down in a way that is witty and clever is fun but getting angry is just bad form and no one wants to look back on their set and think that they inadvertently bullied someone. Ok GG Allen wanted to but he lived his whole life like he was Hyperglycemic.

The wireless blood glucose monitor is a godsend for these moments. “Hang on a minute I want to tear this guy apart and I’m not sure he deserves it”. I’ll test, onstage if I have to. It’s not worth getting a punch for being high and the thing that follows mean sucks more. My hands curl up. That’s a gig ender. It’s also bloody painful. I have to find the corner of a table or an amp and pry my hand opens in the hope that I’ll be able to limp my way to the end of the song. No fun. I’m yet to have a real explanation for whats going on. There is a history of arthritis in my family. Like adult-onset diabetes it is autoimmune related but there is not much clarity to be had beyond that. I am in no doubt however that my symptoms are far worse when my BG is high.

The far more important issue with being high is Ketoacidosis. A diabetic who’s blood sugars have been high for a while can easily find themselves in pretty hot water. One of the side effects of high blood sugars is the presence of Ketones in the blood. These come about as the body starts to breakdown fat and muscle for fuel when the absence of insulin prevents the utilisation of the glucose in the blood. Ketones are toxic, and their presence can result in a heart attack, coma and death.

When I presented to the ED ten years ago I had lost 5kgs of body mass in ten days. I was 69 kg to start with. My girlfriend at the time was watching me shrink before her eyes. I came out of the shower one morning and she burst into tears. I remember the cramping muscles in my legs rippling like there were fingers beneath my skin. I looked like I was dying. I would have been if I hadn’t got to hospital in time to be stabilised with simultaneous drips of insulin, glucose, and saline. A friend of mine let his bloods get away on him during a music festival. He lost his monitor, took a bunch of drugs and thought he’d be able to keep track. He suffered a heart attack but was revived and hospitalised. He was in his mid-twenties.