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Tuesday, October 16, 2012

"I Take Full Responsibility Mom" ~ Joe Maher

I have written on the BUDDIES to humor, to help, and to let other Type 1 families know "same-same".  Our daily grind goes unnoticed by most.  Our "dangers" of activity and food and the lot seem silly to those living the "normal-normal" and not the "new-normal" that we endure.  Today.  Today we had a bit of a scare.

Right now I am writing because I believe today taught me some valuable lessons;  things that I would want to share.  Right now I am grateful that I was with Joe during the following events and that he was not out in the community alone for the one to two hour chunks of time that we have built up to comfortably and confidently as a Type 1 family trying to navigate our way through diabetes management, growing up, and independence-muscle-flexing.



Today...

As I picked-up Bridget from school....

Joe to Bridget:  "I had a diabetes crisis today." ("Diabetes Crisis" - his phrase, not mine... nice drama Joe)

Bridget:  "Oh..." then she somehow proceeded to "blah...blah...blah-ing" her way into changing the subject to boy-girl-middle-school-drama. 

Little did Bridget realize the truth that Joe spoke.  He did.  He experienced a diabetes crisis.  He received approximately 50 units of insulin around noon today (why this is bad).  To put this into perspective, Joe's body and his carb consumption usually utilize around 15 to 20 units of insulin daily.
He received 2 to 3 days worth of insulin in one bolus.  The pump did not malfunction.  Let's just say that Joe had the cartridge out of the pump...the cartridge remained connected to Joe.  Joe received the contents of the cartridge subcutaneously in one fell swoop.

Joe thought that removing the cartridge from his pump was an "easy way" to disconnect from his pump (long, long story).  He did not realize the danger that he placed himself in by doing so.  He is mad at himself. He takes full responsibility.  Yes, he is nine...but, he gets it...he "got" it...the gravity of the mistake. He missed the rest of his day at school.  He missed Math Olympiad.  He missed hockey practice.  He did not bemoan any of it because he knew he was fortunate to be conscious and to be able to free-base carbs like nobodies beeswax.

Luckily, we have been able to manage the resulting low trending blood sugars at home.  Luckily, Joe has a healthy appetite. 

It is now 8pm, 8 hours later, Joe has consumed a few hundred grams of carbs for "free"..both long and short acting.  Joe was disconnected from his pump for the first couple of hours after the 50 unit bolus...his basal rate is currently halved.  His blood sugar has not seen triple digits since the incident.

I am waiting for the lows to subside and the subsequent highs to ensue.

I have a feeling it is going to be a long, sleepless night.

A day-in-the-life of a huge mistake and lessons learned:
  1. Teach your kid to never, ever, never, ever, never take the cartridge out of the pump while connected to it.
  2. Never, ever, never, ever, never, ever underestimate the power of ginormous amounts of insulin.  Seriously...it is 8 hours later...I have not bolused for 1 gram of the hundreds that Joe has consumed in the last 8 hours.
  3. We are fortunate.  I am so very thankful that Joe is OK.

35 comments:

Scott K. Johnson said...

Holy scare!! So glad Joe is Ok.

Lesley said...

Thank goodness Joe is ok! Great job handling a scary situation. I have to say that I wasn't aware that removing the cartridge could trigger a bolus of the amount in the cartridge. Why would that happen?

Kelly said...

O MY HEAVENS! HOLY SHIT REYNA! How did you know? Thank goodness for the Carb GODS! Thank you for sharing this, gave me a swift kick in the ass to talk about these potential accidents with Maddison. (hugs)

Reyna said...

Lesley...The pump lost it's prime. Joe knows he has to "disconnect" to "prime"...somehow during all the "confusion" I think he rewound and then "loaded" the piston in the pump (meaning the piston was all the way up in the chamber)and he proceeded to jam the cartridge back in the pump...which caused him to "bolus" himself with the 50 units contained by the cartridge/reservoir. I hope that makes sense. Pumps are safe...I did not do a good job in educating Joe. Human error here for sure.

Colleen said...

Oh Sh**.
Poor Joe!
Hugs...

Joanne said...

Holy crap... How scary! Glad he is okay. It literally made me sick to my stomach just thinking about it.

Kelly said...

So super glad that he is okay! I am sure it was a scary day for all of you. Thinking of you all this night as you put this day behind you. xoxo

WendyP said...

Thanks for sharing! Read the post with Josh. He was mainly concerned that Joe was gonna get fat after eating all those carbs! LOL. Then I panicked him by filling his cannula right after we read it. He yelled,"No, that's connected to me!! Mom, that's what we just talked about!" Poor guy. Then we had to have the talk all over again! I think he gets it ow. I hope! Geez!

laura said...

Wow. This made me want to hurl. We had a similar situation with independence flexing where the pump was attached, not rewound and a reservior was inserted. It wasn't 50 units but a girl went to 26 before it was caught. So scary! Joe truly is amazing! I hope you can breathe easy soon.

Sara said...

SCARY! SCARY!

I am glad that Joe is okay. Thank you for writing about this. Maybe it will help other families talk about this with their kids (or us adults too) and it will prevent it from happening to someone else.

Stephanie said...

OMG. OH EM GEE. Wow, Reyna. I am so glad that Joe is okay! That is a whollup of insulin. ((Hugs))

NeurosurgeryNP said...
This comment has been removed by a blog administrator.
NeurosurgeryNP said...

So glad he's OK and it was discovered. I too, forget the importance of disconnecting before removing the reservoir from my pump during site changes and this has opened my eyes to this fact. Thanks for sharing this story.

NeurosurgeryNP said...

Glad he's OK. I too, sometimes forget about the importance in disconnecting myself before removing the reservoir from my pump. This has opened my eyes to that fact. So glad he's alright and it was discovered.

Sarah said...

YIKES! I am so glad he figured out something went wrong and let you know, I can't imagine what we would do in that situation as Isaac tends to be combative lately when dropping quickly, I guess glucagon mini doses, but still YIKES. I am so glad he is okay. Definitely one of those moments where we are both thankful for insulin and ANGRY/SCARED about it. Take care, no more scary crap hopefully - seems you should get a smooth night of sleep and a few days of easy carbing after that, right?!

Jonah said...

Wow. That sounds really scary. I am imagining getting 2.5x the upper end of insulin I normally take, and being out (without access to a kitchen full of food) in the middle of the day... that sounds traumatically scary.

And imagining being the parent of a child who made that mistake... and to still be able to put in the perspective of this happened because my child is learning to be independent, which he continues to need to be allowed to do- that takes guts. Even if it is the only thing you can imagine doing it still takes guts.

Reading "I did not do a good job of educating Joe" (in the comments) makes me think of my boss (in a weaving studio). Everytime I make a mistake that's based off of not quite understanding what I'm doing, she blames herself for not teaching me correctly. But if she wasn't the great teacher she is, I wouldn't be motivated to try to figure it out in the first place. And if she blamed me all the time, I probably wouldn't like her as a boss as much as I do.
Joe is on track to become somebody who really knows the ins and outs of managing his diabetes, and that's a credit to you.

FeltFinland said...

Bloody hell - 50 units, that's a shed load of insulin! Glad you were able to feed him out of trouble!

Scully said...

holy mother of F...
you are in a world of non hurt thanks to Joe's immense appetite.

I think he learned his lesson. Don't fuck with technology. Although these pumps have huge safety features on them to prevent shit like that from happening we surely can't prevent human error.

I'm so glad you guys were able to take care of it on your own.

Sandy said...

OMG Im scared just reading this. Im so glad he was ok and was able to eat so much. That was my biggest worry when my hubby went back on the pump. It was a first time expierence for me, not him, and I kept saying, what if all that insulin goes in you at once!!! whew. Glad our little Joe is okay!

sky0138 said...

holy shit! my heart is pounding reading this, my friend :O( I am so glad you were there and I am so glad he is ok. big gigantic hugs to you both.

Emily B said...

HOLY SHIT!! Thank God Joe's ok.

Lora said...

So glad you were there with him. I am kind of saddened that they have to know the enormity of this situation... Justin had a reaction the other day that just made me think of how responsible they are REQUIRED to be because of this damn disease.

Marla S. said...

ho.ly shit. glad it all worked out ok.

Amanda said...

Yikes! I'd have been a mess, glad you were with him and he can eat a lot!

Denise aka Mom of Bean said...

Holy eff-ing Hell!!
My mouth is gaping open and my head is shaking back and forth.
So, So, SO glad things were OK...can only imagine how insane those eight plus hours were!!
Diabetes is a serious as shit disease and IT SUCKS when things go 'wrong' and it takes forever (it seems) to get things back to 'normal.'
HUGS!!!

shannon said...

holy shitballs, reyna. i'm so glad he caught it and you were able to deal with it together. 'diabetes crisis', damn.

ourhealthydiabeticlife said...

Thanks for sharing this! I have two kids with pumps and I never would have thought of this potential problem. This is the scary shit about diabetes you only learn when it happens!

I had my ten-year old read your post and made sure she understood exactly what happened and how easy it would be to make the mistake. Glad your son was A-OK.

Misty said...

So thankful that Joe is ok! Thanks for sharing your story. It took my breath away just reading this post....

Anonymous said...

You have one smart, alert boy there and thank God for that! I'm not sure all kids would notice and Joe noticed right away. So you did train him pretty well. He pays attention. We get so used to our kids using the pump that we can forget pumps can malfunction. Or there can be human error. So scarey. We have the Minimed pump and I alerted our teen if she ever has to prime, change a battery, do ANYTHING with the pump, to disconnect. I ran in and reminded her again after reading your post. Re the Animas pump... if the black cap becomes loose, human response might be to just tighten it, and I can see children making that mistake...many adults have. Tightening the black cap while you are connected can likewise deliver the remainder of the cartridge into the body. I hope you can sleep tonight after such a scare. "Diabetes crisis" is an understatement. But Joe gets it, he really gets it and you are very lucky that he does. Thanks for sharing this; it is a wake-up call.

Nikki of Our Diabetic Warrior said...

Praise God Joe's ok!!!!!!!!!!!!!!!! HUGS

Christi, Dmom said...

I am soooo thankful that your sweet boy is fine now! My son is the same age as your Joe and it made my breath stop, I really think that my lungs stopped function for the entire post, plus. You do such a great job educating Joe. He (AND his Momma) are only human though. It is so unfair that our mistakes can be so potentially fatal. I will be sure to share this with our school Nurse as well as my family and Evan (my son). God bless you Reyna. Bless you for living this life, bless you for fighting so fiercely for your children, bless you for sharing (especially the stuff you are afraid/embarassed/sad/ashamed of!). You make our world a better, safer, saner, crazier (in a good way!) place. Thank you and God bless you and your family.

katy said...

Holy shit! Maybe it the answer to this will be in the comments---but was it the act of taking the cartridge out that made all of its contest swoop into his body? What's the physics of that?

My person fiddled with his cartridge cap the other day, possibly to make the song play, possibly to go to the nurse to get out of music class. Or it could have been an accident. But seriously--if he had gone the next step and pulled the thing out---it would have all fallen into him? So scary.

I am grateful for this warning.

katy said...

I found the answer to my question in the comments. I got all jittery and in a rush to say something before reading them. OK.

Kristin said...

My skin just crawled. So very glad he's ok!
And - makes me angry that pump aren't better designed to avoid that kind of user error. Should really be easier to make them foolproof (have to admit, that's one thing I appreciate about Omnipod's set/pod changes, though we've had other issues).
Hope the word "crisis" doesn't crop up anytime soon!

Amy L said...

Yes, I am SOOO behind. So thankful Joe is okay. You are both amazing. You should have heard me talking outloud to myself reading this. Wow. Just Wow. Sooo, soooo thankful.