Choke It Down

A couple of weeks ago, after a hockey game, Joe bought an apple strudel-y muffin from the rink snack bar.  He was going to eat it on our 30 minute trip home.

'My number is 223...60 grams..I'm not going to correct, but will cover the muffin.'

A 5.5 unit bolus was then cranking into his subcutaneous tissue to cover this muffin ... which he hadn't yet tasted.  I chimed in with a 'I sure hope you like it.'

'If I don't, I can either cancel the bolus and drink a juice ... or ... I'll just have to choke it down.'

A day-in-the-life of knowing you may have to 'choke in down'.

A Free Meal

It's one, of many, difficult concepts to explain to those who do not intimately know t1d;  the tasks that accompany the simple act of eating.  Typically, a blood glucose level should be obtained.  The number, if high, should be corrected with insulin.  The number, if low, should be treated with fast acting carbs.  The food that will be consumed should be counted for grams of carbohydrate.  The carbohydrate count should then be covered with insulin.  Eating, the joy of eating, ...at times..can be dampened by the cumbersomeness of the management.

This morning, Joe sat down to a chocolate chip pancake breakfast.

Outta habit, he went to do a check.

"Joe, you just corrected about 30 minutes ago."

His morning BG was in the 230s, which he corrected.  I had pre-bolused for the 120 gram meal of 3 chocolate chip pancakes and a full cup of OJ.

"It's kinda nice not having to do the diabetes stuff ..."

"Is it doing the stuff every time you eat that bugs you? ...  Or, the me reminding you?"

Joe was kinda quiet here.

Me.. "Perhaps, it is both?"  It's hard to conceptualize.  I'm possibly as annoying as living with t1d; maybe more so?

A few more seconds of silence.

A mumble-y "yeah " ... and then a quiet "both" came out of Joe's pancake-stuffed mouth.

Enjoying a meal without doing his day-in-the-life.

Too Many "Special" Things?

A quiet, drawn out plea of "Stay .. with .. me .. mom." came from Joe.

"You want me to read some of our book?"

"Yea"

It was last night.

His blood sugar was a bad 39.  Not that there is a good 39, but the "bad" means he was really feeling the 39.  His eye lids were closed.  His lanky bod was twisted up in the covers, curled tight in my bed.  He was motionless.  At times it was difficult to tell if he was still "with me".    As I read "Catching Fire" aloud to him, I would check in with a ..."Joe, you ok?" every few paragraphs.

Yesterday afternoon he had attended a three hour birthday party.  The party included three hours of swimming with eight of his buddies. The swimming consisted of playing "King Of The Cheese"... basically this can be described as "King Of The Mountain"... but in the pool using an inflatable cheese as "the mountain."  There was freezy pop ingestion in the hot tub where Joe reported if you wanted the freezy pop to be less freezy, you just dipped the bottom tip of it down into the warm hot tub water.  Of course the party included a couple of pieces of ice cream cake and snacks.  His blood sugar was steady throughout the party (80s to 130s).

On the heels of the party, we decided to have dinner out as a family.  You know...stuff a normal family should be able to do.  Pasta Alfredo and a sundae was ordered and consumed by Joe.  Carbs were counted.  Boluses were dispensed, combo and regular.  Within and hour after dinner, Joe's above mentioned 39 was experienced.

Joe's original response to the 39 was regret over eating the pasta for dinner.  I reassured him that it was not his fault.  I explained that I over-bolused for his meal while underestimating his previous activity at the birthday party.

Here is where he got me.  It is here where I felt the sting of the unfairness of this damn disease.

"I guess we just did too many special things today ma." 

Too many special things?  Really!?  He went to a birthday party and then out to dinner.  These are things that all kids should be able to do without a second thought. 

A day-in-the-life of  childhood and Type 1 Diabetes.

Going Well!

I promise I did not "wear" the headlamp as I dropped off Joe to his friend's house for the sleepover last evening.  However, for your viewing pleasure I did ....

I thought the "head lamp" was a thoughtful token for night-check-ease.  Salami and pickles were brought for Joe's snacking pleasure to veer him away from heavy carb snacking into the night.  In general, Joe does not eat carbs after dinner.

So far so good.  I have not heard from Joe or Joe's-friend's-mom since 10:30pm last night.

Up to that point Joe had consumed pizza (2 slices), ice cream (1/2 a cup, which he thought was a cup and we bolused for a cup, and he then called me back to say it was 1/2 a cup and we then made up the difference with Starbursts, which I believe ultimately lead to a low...but whatever), salami, salami wraps (cream cheese spread on salami that is then rolled up into little cigar-shapes), and pickles. 

His numbers have ranged from 55 to 270. 

I'll take it.

A day-in-the-life of support pancreating remotely.

Freak Show

"If he is unconscious or has a seizure - Glucagon is in his camo bag OR call me and I'll run over and give it..  AND call 911". ~  Yeah, so writing that part seems a little over-the-top..but what am I to do?  It could happen.  I like how I added in the part of just calling me so I could "run over" and whack him with the Glucagon.  It is so very difficult to not appear like a freak show.  To top it off I am sending Joe over with a jar of pickles and salami-wraps for "free" snacking into the evening hours.  Freak Show...

 

My Head On Village Person Body...Don't Ask...

 

10:56pm last evening, Joe's blood sugar was 25.  Haven't seen a number that low since he was 3 years old.

 

Tonight is the sleepover.  I am a little nervous, due to Joe's low trend through the night over the past week.  I cannot back out of this though.  I know it.  Joe is thrilled and I need to make this happen AND keep my composure to give the illusion of "normalcy".  So,  I analyzed his numbers this morning and backed off his basal rates. 

 

I then proceeded to type out "instructions" to accompany my 10 year old child. 

 

Here is what I came up with (I added the red just for my readers here on Beta Buddies.  No red was added to the actual document for "normalcy-appearing-purposes"):

 

Joe should check his blood sugar: every 2-3 hours and/or before he eats and/or if he feels "LOW".

 *Joe is going to call me with blood sugar numbers and carb counts and he/I will bolus over the phone.

 * I did talk to him about not "over-carbing".  I told him a couple of pieces of pizza were OK, but no more.  One carb snack in the evening would be OK, but he should not graze (unless he is running low, then it is OK).  It is OK for him to snack on the non-carb foods (the pickles and salami-wraps that I sent are for this purpose).

 LOWS - A low blood sugar for Joe is a number less than 70:  If Joe's number is less than 70 he needs sugar.  Sugar is in his camo-bag.  He needs either 3 Starbursts OR 3 Glucose Tablets.  He then needs to wait 15 minutes and then he should do a re-check of his blood sugar to make sure the number has come up to 70 or higher.

 If he is unconscious or has a seizure - Glucagon is in his camo bag OR call me and I'll run over AND call 911.

 NIGHT TIME CHECKS - Please check Joe before you go to bed and call me with the number.  Then at 2 am (sorry...ugh).  For the 2 am number, if Joe is < 70 please give him 3 Glucose Tablets (he will chew them while he sleeps) and then re-check his blood sugar in 15 minutes to make sure his number came up (double sorry).  If Joe is 70 - 100, please give him 2 Glucose Tabs.  If Joe's blood sugar is 100-249, do nothing.  If Joe's blood sugar is 250 or greater, then he needs a "correction" dose of insulin.

 Using the Glucometer/PUMP remote for "correction": (NOTE: You should be within 5 feet or so of Joe to deliver the insulin from the remote) Once the blood glucose number appears on the glucometer screen, you can select "bolus" (at bottom of screen) by using the down arrow to highlight "bolus" and then pressing the "OK" button.  The glucometer will then give you a menu of "types of boluses" , you will select "EZBG" using the arrows to highlight "EZBG" and then pushing the OK button.  The screen will then display the current BG/where we want his BG "120"/and a correction factor...the math so-to-speak.  Push "OK" (Joe's current BG will be highlighted).  The cursor will then be highlighting "show result", press the OK button.  There will then be a screen suggesting how much insulin to give (the amount will be next to the word "TOTAL=").  You will need to push the up arrow until the suggested amount is reached.  Once the amount entered is the same as what the Total suggested you will press the "OK" button.  The cursor then moves to "Go".  You will press the OK button again to deliver the insulin.

A day-in-the-life of authoring an "Instruction Manual" (of sorts) for Joe, my ten year old son who has type 1 diabetes.

Fickle D'

"What was he?" ~ Dave to me at 3am...

"144"

My "one-eye" started to close and then I thought perhaps maybe I should ask why he was asking. 

My "one-eye" reopened ~ "Why?"

Dave's sleepy voice yammered off something about 9 glucose tabs and something about the 40s.

Me ~  "oh, I forgot to tell you that I never bolus for all of S'mores ... just half ... he always goes low after eating them."

Joe had a rough diabetes day yesterday.

6:54 am 337
9:06 am 306
10:05 am 319 (ketones 3.9)
11:18 am 248 (ketones 2.4)
12:14 pm 319  (ketones 1.4)
1:46 pm 448
2:14 pm 422
2:53 pm 406
4:01 pm 255 (ketones 0.0)
5:35 pm 56
6:56 pm 46
7:15 pm 110
8:15 pm 77
9:00 pm 80
10:49 pm 52
11:09 pm 41
11:29 pm 65
2:30 am 44
3:16 am 144


He handled it with grace.

A day-in-the-life of fickle d'