Friday, January 27, 2012

WTH - my most frequently asked question.

I'm still new at this blog thing - wish I could say I will be as diligent as my favorite bloggers and blog everyday but alas I am a mom of 3, wife, substitute teacher and not very organized regarding any of the above mentioned roles. I started this post yesterday morning and saved it when duty (also called laundry called) - the evening discussed was not last night but the night prior.

At 8pm (bedtime for my two elementary aged kiddos) we checked my dear son's BG. He was 242 - huh? When attempting to correct his BG with insulin it was discovered that he had not reattached his pump after his shower an hour prior. My dear husband asks him to retrieve his pump from the bathroom upstairs prior to having a cup of milk before bed and all of a sudden everything hurts. His hair huts, his head hurts, his legs hurt, etc. No mention of these alignments while watching TV before bedtime was announced but now it seems his entire little body is on strike. He (ds) decides to skip the milk and requests to be carried up stairs. I holler up a reminder to my husband to attach pump and provide a correction (insulin dose). I go up a few minutes later to check that they brushed teeth (my question - "did you brush your teeth?" Nearly always is an answer in the negative at which time I make my boys get out of their beds and brush their teeth - at least those that they want to keep.) and tuck them in for the second time really since I nearly always give hugs and kisses prior to asking the teeth question. Thus a second round of hugs and kisses is needed - likely their plan.

My ds with D talked his way into my bed because his legs and head hurt. My husband and I were not going to bed but we let him lay down in our bed. At 10pm I came up to go to bed. Checked my dear daughters BG and she was right as rain (YES!), then on to my dear son. When I came into the room I could hear him grinding his teeth. That isn't a good sign - he always grinds when he is high at night. He was 432. Thus the WTH?? He should have been in the 100s. Check the history on his pump - no correction - oops daddy forgot. But why 452? Why not just still be in the 200s? I will likely never fully understand where some numbers come from. I get the sky high numbers that come from a missed bolus - yes we have missed doses of insulin, I get the high numbers that come with sick days - dang illnesses. I get the high numbers that come from infusion sites gone bad - lack of organization leads to sites left on for more than the recommended 3 days. I get high numbers due to the beginning stages of puberty in my dd - Lord help me when we are in the thick of puberty. I get the high numbers caused by eating high fat/high carb meals like pizza - although we are getting better at combo bolusing. What I don't get are the numbers that seem to have no rhyme or reason.


Thus, alarm was set for midnight. Midnight check resulted in in 231 so my ds was going down but n additional correction was needed. Alarm set for 2am. 2am check came up with 107. Checked dd at the same time and she was within range so I canceled the regularly scheduled 3am check and took pleasure in the following 4 hours of uninterrupted sleep.

I know not all parents of cwd get up every night, and not all diabetics themselves get up to check every night. I know many parents and and patients use CGMs (continuous glucose monitors) that alert them to rogue blood sugars. I pass no judgement on any of the decisions regarding night checking. I don't always check at night. Although the nights that I don't have at least one if not multiple alarms set are few and far between. Sometimes the moon and stars are aligned so perfectly that I allow myself longer uninterrupted sleep. On those nights I don't go to bed till midnight, both kids must have numbers within range, no IOB (insulin on board) and it must have been a fairly average day with no super long periods or sitting or overly strenuous activity. You can imagine how often all the stars and the moon align in this fashion for not just one Type1 but two. Why do I set alarms and get up so often - because I feel better about them and their diabetes knowing they are safe. Knowing that if a blood sugar is high 200+ I can correct it and help keep their A1Cs (yes I know not a perfect indication of diabetes care - but a good indication of future possible complications if regularly too high) more in check. I recently spoke with a parent whose son is nearly an adult. He was diagnosed as an early teen. Her doctor told her that night time checks were only necessary the first couple weeks post diagnosis. Her son's A1C varies between upper 7's and low 10s. What a wild roller coaster. Yes puberty is playing a large role in the crazy numbers but still - I hope my kids will not be so wacky.

One day I hope to get a CGM on both of my kiddos. Right now the fight is ugly. Neither of them want to wear or carry an additional device. They already wear their pumps and take their diabetes packs (meter, poker, strips, juice, extra batteries, extra lancets, and fruit roll ups) every where they go. My dd who is now 12 frequently complains about the profile of her pump (although I believe Animas has the lowest profile). She wants her skinny t's and her skinny jeans to be seamless - not possible with a pump attached thus wearing the Dexcom (which we purchased and has collected dust for 2 years) is not a happy thought for her.

Well this has been a babbling mess. Thanks for baring with me as I learn how to blog effectively.






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