"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.

Welp, He Did Good. I Did Not.

We're up...

Been up since 5:30, avoiding the breakfast IOB...Joe's tryouts are at 8am.  Last night, as Joe went to bed, I asked him to wake me when he woke in the morning.  Told him that I would get his breakfast ready right away...plan was to hopefully feed him before 6am.  Breakfast, bolusing, and morning hockey have notoriously been problematic for us over the years.  Joe's body seems to be extremely insulin resistant with his first bolus to cover carbs.  His breakfast ratio is a 1:10 (the rest of the day it is a 1:20 to a 1:50...interestingly enough the 1:50 comes at morning snack to put the "brakes on" the 1:10).

OK...that's the boring stuff...onto the good stuff...

Tryouts (part 1) went well.  Well, that is, Joe did well.  He skated hard.  He did his best.  Dave and I were proud of him.  Most importantly, Joe was proud of himself.  Felt he did good.

I was, however, a bit disappointed in myself.  I share everything, too much perhaps, here.  I share the good, I share the bad.  I am not always pancreating perfectly and, as you know, my parenting tactics have their own set of issues.  Combine alternative parenting, with being a pancreas, and with being a hockey mom...well, I mess up.  A lot.

Here is what happened...please don't judge too harshly...I just wanted my kid to be evaluated on his skating...not on coming to the bench...I just so badly wanted for this chunk of time ...tryout-time ...for diabetes to not be involved.  I always say I don't really care about where Joe gets placed as a result of these tryouts.  My actions and behavior yesterday...well...they speak otherwise.  I need to take a look at that, in myself.

Joe's pre-tryout blood sugar was 288.  No IOB.  I did nothing, thinking he would skate it down.  Joe's and my plan included a blood sugar check half-way through the tryouts...at the 35-ish minute mark. 

There were about 40 children on the ice.  They were each assigned numbers and were wearing a corresponding pinnie.  Evaluators were sitting on the opposite side of the rink, with clipboards...  The kids do drill-after-drill-after-drill...repeating each one several times.  20 minutes into the session the kids are in like 6 lines...whistle is blown...a skater from each line takes off...skates hard to the blue line...hockey stops...whistle...another wave of kids takes off...first wave moves onto next line...whistle...third wave of skaters take off...first and second waves are moving on down the ice...skate.stop.skate.stop.skate.stop...they looked like soldiers. During this intense skating-hockey-stopping-drill, Joe peels out...to the bench...looks up at me and gives me the "finger-poke" sign, indicating he feels low.

Fine.

I noisily clump and clop down the bleachers in my newly purchased Old Navy ankle boots (bootlets?)...Woodchuck slung over my shoulder.

I was running fast.  I didn't want Joe to miss his evaluation time.  As I rapidly approached the bench, I hear a coach telling Joe to "get out there and hustle".  I chime in with a "he has diabetes...needs a blood sugar check".  He backed off.  Told us to take our time...meanwhile, Joe is missing out on evaluation time...looking like a ninny to the evaluator guys holding the clipboards across the rink.  They don't know our situation.  Not sure I want them too, but don't want them to think my kid is a big baby that needs to go to the bench to be coddled by his mommy.

In one fluid motion...I ran to the bench, pulled out the glucometer...loaded the strip...pulled out and cocked the lancet...Joe's number was checked.  He was 271. 

*thought here is that site is going bad...mid 200s all day...not budging...Joe's number will hold steady for the rest of tryouts*

So, I said to Joe something like ... "Don't come back over to the bench.  You are fine.  You are 271.  You're number hasn't budged.  They (my eyes dart over to the clipboard guys) are evaluating you.  You don't want to miss skating time for unnecessary checks. Don't come over...unless..."

"Mom, I felt low."

"Yeah, I know...but your not...go skate...and...have fun." (but what I really meant..go skate your patootie-off...screw the fun)

So, off he went.  He skated.  He stick-handled.  He did fine.

Then, with 15 minutes left...he comes to the side of the rink.  I am looking at him with a "what can you possibly need?" look...mascara-fringed eyeballs kinda buldging outta their orbits.  Through the glass, through the helmet, through his gestures, I make out that Joe now has to go pee.  Denied.  I somehow convey back by pointing to the clock and giving him a "what-the-what?!" look with exasperated arm gestures that pee-ing will have to wait.  He skated off.

Not sure how the mid to high 200s feels on one's bladder.  He finished though.  Did well.

Post-tryout number was 273.  Changed his site.  Only 1/2 corrected and bolused for dinner.  He came down to 100 within and hour, or so.  Had to stop the crash with a couple of glucose tabs.

A day-in-the-life of diabetes being part of it all...even when I wish it would just go away.

Never Let Your Fear Decide Your Fate

60 minutes or so...ago...

Driving back across town to buy a 564xl black cartridge for our printer.  Gotta have Code of Conduct printed and signed and Medical Form printed and completed by 3:30pm today.

...for Joe's hockey tryouts.

While driving, I am on the phone "directing " Dave, who is manning Joe.

"Feed him something now.  I don't want to go into tryouts with IOB if we can avoid it."  I've said it once and I'll say it again...never, never, never underestimate the power of IOB.

You see, I am nervous.  I don't wanna let Joe down.  A low or serious high can effect Joe's well being and subsequently his performance. I want to make his blood sugars be a non-issue today, tomorrow, and Monday (his three days of tryouts).

My favorite song these days...is "Kill Your Heroes"...I love the part that goes "never let your fear decide your fate"... Gets me pumped up and rings so true.



A day-in-the-life of fretting over my pancreating abilities for my son Joe.