Deep breath, and we’re here.

Mimi and Peaches are at the vets.

BUT doing fine. Mimi had the sniffles. Suspect that this is a price of being so VERY beautiful.

E’s blood sugar numbers have been perplexing-ish, but no nightmares. OH enters all the values (6-10 finger pricks a day) into the computer. Each value comes up RED (for too low, <4 mmols, eg ‘hypo’), GREEN (for in range 4-8 mmols) or YELLOW (>8 mmols). We look at patterns of numbers that are out of range (the red and the yellow), and try to see what can be shifted. At best, 75% of the time it looks like something can be done — it’s worth a punt to change the insulin and see if it settles. The other 25% of the time we treat as blips: why’s that number out, we ask? Just because, we answer. And try to laugh.

OH also enters how each hypo is treated (how many grams of carb consumed without taking extra insulin), any problematic foods and how they were dosed (eg spreading the insulin out using a dual wave — which type of dual wave, what percentages, for how long?), any changes in basal (the constant drip of insulin, as opposed to the bolus, which is the one-off insulin taken for each gram of carb eaten) for exercise or illness, etc…

***

This is what E does each day: tests his blood before every meal and most snacks, and usually 2-3 hours after eating each one. Also tests before bed. Estimates any grams of carb not figured into his meal. Controls his pump: inputting any changes to his regime (almost daily at the moment!); entering blood sugar levels and the amount of carb in every meal or snack, in order to help determine how much insulin to deliver with each meal or snack. Remembers to do this! Make decisions about how much exercise he’s had and what adjustments to his insulin to make as a result.

Every night he tolerates us testing him at 2 or 3 am. Every weekend morning he tolerates us testing him at 8 am, before he really wants to wake up.

Every three days he changes his set. 

This is what we do every day: make sure all the above happens, to the best of our abilities and without nagging. Weigh and measure all of his food, in order to calculate carb intake. Enter his blood sugar values and foods etc on the computer, in order to spot patterns and make changes. Decide whether to make changes. Be at the end of a phone, in case he texts and needs advice in the day.

Blood test him when we go to bed, and in the middle of the night. 

Every three days OH fills an insulin reservoir, in preparation for the set change. Remember the set change days.

Keep track of blood test strips, lancets, insulin, batteries, reservoirs, cannula supplies. As well as hypo treatments, upstairs in his bedroom, and downstairs in the cupboard.

Keep decent, healthy, low carb (NOT low sugar, this is different) food in. Do not resort to pasta or rice on days when you don’t know what else to make (these are very difficult to dose, and sometimes just not worth it).

Keep track of local and pump consultant appointments (two different hospitals), eye screening, flu shots.

Liaise with school for all trips, everyday regimes and any practical difficulties. 

***

I’m sure I’ve forgotten something, but oh well.

Every child with a pump and his/her family does these things. And every adult too — usually with sole responsibility. 

Every person with insulin-dependent diabetes (all type 1, and some type 2) does a version of this sort of vigilance in order to achieve anything close to ‘good control’.

Just thought I’d write it down. 

***

Saying all this, the sun IS shining. We’re here.

It’s incredible how much life can accommodate. But no surprise I guess that sometimes it’s a bit too much.

Though not today.

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