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The absolutely LAST thing I have time for tonight is a post…but I feel determined not to let work get on top of me yet again. Especially after meeting Clare H (hello Clare!), a regular reader, in the gym yesterday. I’m thinking: do a post, do a post… And all the best for her daughter C’s move this week to a pump!
ANYWAY. All well here. Some weirdo numbers. Mostly too high. But not thousands. Just a few irritating ones. Pizza dual wave needs changing. Breaded chicken continues to be problematic. And spag bolognese is a pain in the bottom: the normal pasta dual wave is consistently a disaster with this; evidently the fat in the meat slowing things down. So E crashes. Treats hypo. Then hours later goes high.
Argh.
ANYWAY. Another fun one is that using the pump is SO automatic that last night it backfired the opposite way from usual: instead of forgetting to bolus for a meal, E accidentally bolused when he meant to have some free carb (eg without taking insulin to cover the carb content)! Ack. He hadn’t eaten all his meal, so needed to have some free carb to soak up the leftover insulin… Had a cereal bar, and automatically bolused for it. I realised too late, with a kind of weird retrospect, suddenly recalling the buzz from the pump of the dose delivering… an hour after. So in goes TWO boxes of juice (because the extra insulin in the meal still hadn’t been accounted for), and we’re in bed over an hour later than we wanted to be in order to see through this errant dose…
Sigh.
AND — as if life weren’t complicated enough (as ever), Cleo is beginning to pound the floorboards. Which can only mean one thing: the vet was wrong, and the breeder was right — she’s coming into season way before spring.
And Archie is obviously an adolescent. And you know they only want one thing…
Ack.
We’re thinking we’ll put her on the pill for a year or so — what do you think? A bit like when you have babies, it’s hard to stop having kittens…
With that: back to the coal face for me…
Okay so R is now in Japan. Has been there for 5 days, back in four. Having a fab time, taking lots of pictures, and really reveling in the extreme aesthetic differences. Would love to be there with him…! We skype in the odd in-between times, the miraculous hour when it’s not the middle of the night for him or us… This generally falls in the afternoon. In fact one day I shot home from work for half an hour just to see how visiting Kyoto went! So the children have only spoken to him once in all this time. For a family that talks — alot — this has been decidedly odd. And I imagine E especially misses his presence: it’s hard to overstate how much young men need their dads. And in E’s case, he depends on his dad’s objectivity, his clear-thinking, his rock-solid reassurance (the only one E really believes, I know this) around anything to do with diabetes. So it’s probably doubly stressful.
Though everyone’s generally holding up well.
Except for the uh… hour long hypos.
So this exact thing has happened two nights running: a short dual wave (dripping insulin in) for pizza in one instance, fries/chips in the other. (Here I reveal my almost complete lack of cooking skills: we are all struggling with fairly naff food, being used to the dreamboat and exceedingly healthy, home-cooked stuff of R… Ack.) ANYWAY (again), short dual waves. Which usually cause no problem. So an hour after each ends, there’s a plummeting hypo. A very bad one. Taking not one, or two, or three, but FOUR treatments over the hour to sort. E’s fairly swimming in apple juice, and ill from jellied sweets. The adrenalin has kicked in, and he’s panicky, upset, cross…
And who can blame him. Really, really, really a DRAG.
Then, having sorted the long hypo from the night before, yesterday morning I walked into his room and smelled it for the first time: pear drops. Sweets. I sniffed his bin. No, wasn’t that. I sniffed his covers. No, wasn’t that. I realised with a sinking, guilty heart that it was him, his breath. And that this meant he had possibly dangerous ketones. That he would be sky-high, and had been for hours.
Choice words, and crashing guilt. He was high indeed: 17 mmols.
In the event, the high cleared quickly. I signed him off PE (unsafe at 14 mmols plus), and by lunch he was in range. We communicated throughout by text.
Last night the same thing happened. Not just a funny turn then. Something going actually wrong. Four hypo treatments in the space of an hour. I got up in the night (because of the night before) and boy I was glad I did…Once again, he was 17 mmols. I corrected, and by morning he was still too high, but in a more sensible range, 11 mmols.
This is my theory, and R concurs (skype this afternoon!): first, his dinner ‘ratio’ (eg how much insulin needs to be given for each 10g of carbohydrate) needs tweaking. On the pump, ratios are set for different times of day and different meals, depending on insulin sensitivity. For us, traditionally dinner has needed the least amount of insulin (I think this is common?), and it is also the one meal that we change the ratios for quite frequently.
Second, the treatment of the hypos is inefficient. He almost always treats hypos with juice in the first place. Juice is very efficient, enters the bloodstream quickly. He doesn’t like, however, to drink LOADS of juice. So he chose to alternate the juice treatment with fruit pastilles.
The problem was, he was ‘dropping’. This meant that the peak of the insulin was not yet reached when he went hypo (this peak is around 2.5 hours after a dose, or in the case of dual waves, about 1.5 hours after it ends). So it was not a question of ‘recovering’ from a low, it was a question of keeping from going lower… Which didn’t work, both times. Both times he dropped like a stone.
I think I’m pretty clear that fruit pastilles simply aren’t quick enough in for that situation… They don’t work, so you treat again, it sort of works, but you must treat again…My thought is that they kick in well after they need to, stack up, and… result in a scorching high later on.
So. In that situation, no more pastilles. Just juice, just direct sugar. I feel sure that the lows could have been controlled sooner if only we’d stuck with juice instead of alternating with pastilles.
And we’ve changed the dinner ratio. And no dual wave tonight. So we’ll see what happens.
Sigh.
***
It may not surprise you to know that today, instead of marking or doing any number of other domestic and work-related things, I’ve just had a little breather: I met my dear friend Nancy for breakfast, and then later made a spontaneous appointment for the second manicure of my life. My fingernails are now a glorious deep teal blue. E says he’s ‘never really got why girls paint their fingernails’ — and I can sort of relate. I don’t really get it either.
But it is quite unadulterated fun. When I picked M up from school, she saw my nails and said, under her breath so as not to draw attention to them/her/me: how cool are they? how cool are THEY?
Here is a girl who relaxes by lying in a bubble bath, a bowl of chocolate on the side and an audio book playing. She’s as chaotic and non-girly and wacky-arty (seriously more so) than I am. But she gets it, which must be some kind of parenting triumph!
Looks black but is really deep blue/green...My eyes have barely a wrinkle -- but my hands look my age!
Hello everyone. And hello again. So many hellos indeed that it’s hard to know how I will start this post… Apologies? Reassurances? Thank you firstly to those who sent messages via email or facebook about whether we were okay.
Yes, we are really fine. Truly fine. I just had to let things slide in the middle of what was the busiest teaching and admin term for me in several years. It became a case of only the absolutely essential bits of life survive! And the blog just went — poof! — like dust. Before I knew it so much time had passed. It is only with the New Year now upon us that I can sit back a little and think now I can get back to this. Thank goodness.
Because I’ve missed it. Lots.
***
Catching up info: E is now at least three inches taller than me! Yes, choke in surprise. It has happened so fast that I keep thinking he’s either wearing heels (not likely!) or standing on his toes (also not likely since he gave up dance about a billion years ago). He is now creeping toward his father’s height of 6 foot, which his father categorically refuses to acknowledge. M too has shot up: fits my shoes and also wears the smallest women’s size 6 (uk, that is. American it’s 2 I think?).
What the heck?
But it’s the sheer food consumption that is doing our heads in. Forget monitoring carb intake. Just forget it. The best we can do is try to get him not to eat too late in the night, so that we don’t have to get up and test. He’ll sit down and have 400 g of mashed potato, eight small sausages, and a pile of vegetables. Faster than any of us can finish our meals, he’s done and standing up for ‘more food’. He returns to the table with a cereal bar, a pot of yoghurt, more sausages… Our food bill has gone up by 50% in the last six months. SO alarming. He eats all the time. We go through boxes of cereal bars, probably one per day. He also doesn’t seem to want non-carb, like meat and cheese. He really, really wants carb, big time. His body must just be building itself, putting together the infrastructure, like constructing a building… It’s incredible to watch.
I realise I’m not telling you anything many of you won’t know. But I am really reveling in it: his growth means his diabetes is controlled. Which is a source of intense relief.
And controlled it is. The last HbA1c was again very good. This is not to say that we don’t have days of weird swings and runs of highs and lows — but we are blessed with a young man who is admirably keen to stay in some control. He never does not act on the information his testing kit gives him, and he never (unless out with friends in town) doesn’t test. This is hugely to his credit, and how very lucky we feel in this.
Case in point: yesterday he was inexplicably 16mmols before lunch. It scarcely matters how that happened, and although it was less than two hours since he’d eaten his snack, he still felt the number was too high. So he overrode the pump and gave himself a partial correction. By PE two hours later he was down to 6mmols — he didn’t eat to bolster up for exercise because he was worried about having been high (is this a run of highs? for instance), but within an hour he’d hypo-ed and had to stop. He treated, and by the time he was home he was a nice even 7mmols.
I told his father the story. He’s a good lad, he said. Indeed. Much better to have tried to get things lower than leave a high and allow himself to get insulin resistant. We know by now that if we don’t act quite harshly, he can stay high for hours sometimes, depending on why it’s happened. In this case, it was inexplicable. He rightly thought the mostly likely reason was not because of a previous bolus, but because of feeling slightly ill, or from a cortisol high. It was unusually high even for the middle of a bolus.
As it turns out he probably didn’t need to do this, as evidenced by his quick fall in blood sugar. But better to do what he did.
***
Enough extolling! Suffice it to say that we press on. Funny night highs continue, and we just tweak the pump when we think the high might have set in…whereupon it goes away and of course he’s too low. Sigh. We’ve had a good enough few weeks at the moment such that we are hardly ever getting up to test. Thank goodness, because we have been on the floor with exhaustion, both of us. E understands this, and is careful not to eat late if he can help it. We also almost always aim to have any pasta or rice earlier in the evening — before 7.30 pm — so that we can test him right at the end of the dual wave, at 12.30am. I confess that staying up even that late is fairly dire. And once last week OH spilled hot tea over himself in bed after falling asleep waiting for the right time to test… But it’s better than a 3am alarm, for sure.
***
While I’ve been away, some folks have carried on an intermittent reflection over on A Place to Talk. And one question that’s come up from Angela is what people think ‘triggered’ or ’caused’ their own or their children’s diabetes?
Medicine knows quite a lot about genetic predisposition and about viral triggering… I can trace I think E’s trigger through to a stomach bug he had in Italy in 2008. Everyone else had it too, though we only had cramps. He had cramps AND a fever, was really quite poorly. Three months later he was diagnosed.
What are others’ theories, and experiences? As Angela points out, it can feel so random, especially, as in her case and many others’, there is more than one child in a family affected?
And of course it can feel unfair. Does feel unfair. Is unfair. And arbitrary. And stupid, stupid, bad luck.
So there.
Any thoughts welcome.
For now: great to be back.
Well, after reaching the summit to Tryfan two days ago, yesterday the boys in Wales apparently bog-walked (ewww! E reports bog water over his boots), taking measurements or some such — and then swam. Which I reckon was sorely needed, after several walks and no running water (ewww!).
Number wise he was okay all day, though a little high, but in the evening things went seriously awry. For whatever reason (too much free carb? too low a temp? the set becoming non-viable? — probably all three), at 6.30pm we got a message that he was 24 mmols (over twice as high as the high end of what we were all aiming for while he was away) and feeling rotten.
It was dark by then, and they have no electricity. E had been trying to change his set (due a new one) on his own, with a torch, ill from being high, and stressed to the max. And wouldn’t you know it, for the first time since changing over to sil sets, his pump read NO DELIVERY.
A number of things then cascaded into wrongness. E was holding up, but only just holding on.
OH talked him through. Minute by minute, several phone calls, clear instructions. Try a new tube. Then a new cartridge. We gritted our teeth as E described all his pump equipment strewn around his bed in half-darkness. Talk about stress!
Tell someone, I texted him, in some desperation. They will be sad to know you are struggling.
He was still 21 mmols, despite a huge correction.
All of us had forgotten that he remained on a low temp from earlier in the day.
At last the new set was in with insulin that looked viable. But E was terribly shaken, still high, and of course would not be able to join the others for dinner (it’s unsafe to eat when that high for obvious reasons: more glucose stacks into the blood).
When E is that high — and I think this is a common reaction — he becomes emotional and muddled. He has to make a supreme effort to exert his considerable strength of mind and intelligence to trying to gain control, to understand sequences. The added stress of being away, in the dark, and on his own, meant that for a short time, it was a losing battle for him.
This end, we were losing our own battles too. OH was preparing himself to drive six hours and go get him. I was wrestling with useless tears. Daughter M, once again, had wisely set herself up for dinner in front of the box.
At last OH convinced E to go to a teacher. Who phoned within minutes. She had taken control quickly. Found things he’d lost. Sat him down to wait. Established how long he’d been high.
We tried to explain how he’d be feeling. We said it should get better. By this point we’d set a high temp, and anticipated him coming down fast. She’d saved some food for him. If he’s not down in a couple of hours, OH began — we’ll drive him to the hospital, the teacher said.
Probably not, OH said. They won’t know what to do either.
And this is true. Don’t even get me started on what medics don’t know. How they will remove pumps. How they will run both glucose and insulin in simultaneously (completely counter-productive). How they might think that 2 mmols is fine (when it’s mega-hypo), or that 6 mmols is too low (when it’s within range). Or that, so long as the person is feeling okay, 18 mmols is not bad (three times as high as you want). I’m sorry all you medics out there, but these are true stories. The training for hospital diabetes treatment must be seriously deficient, and is entirely crisis-oriented. By hook or by crook, diabetics survive hospital intervention. But so often it is ridiculously and even near-dangerously cack-handed.
Anyway. E had some carb free food: cheese, ham, cucumber, and immediately began to feel better. In 20 minutes his level was 17 mmols. He ate. In another hour, he was way down to 9 mmols. By this point the high temp was off. He had to have some free carb or he would crash. In another hour he was, yes, low at 3.8 mmols. Some juice, and more free carb.
Like a yo-yo. Poor lad. He set a 70% temp to reflect the exercise of the day, and we all agreed he could make it without night testing. Crisis over.
Only guess where they are headed today: SNOWDON. The highest mountain in Wales.
He must be shattered. Up until nearly 1 am. A walk lasting many hours in front of him.
We’ve barely heard from him this morning — a rush getting out, apparently. I’m fearful that last night will hang over him, tempt him into insecurity, into double-guessing his judgement. He’s SO good at all this. He’s great. We keep telling him.
A little prayer then: let last night go. Start the new day. Trust your instincts. Know that you are strong, and can do anything.
Just a word here to say that living with Type 1 and getting out into the world and doing challenging things requires it. Lots of it: grit.
E and we have been in good text contact over the last two days. Lots of ups and downs. The cottage is disorganised and dirty. He wants his space and a sense of structure and control (a bit control freakish, like lots of well controlled diabetics, one suspects!). Can’t have that. A bit of a struggle.
I forgot to pack the scales. Don’t even go there.
So lots of estimating. A little added stress.
So far he’s had two mornings of heavy walking accompanied by almost constant dragging the bottom — floating around 4 mmols, with occasional hypos — for hours. He’s on 0% temp, eg no background insulin, and eating loads of food without insulin: cakes, cereal bars, sweets, juice, chocolate, sandwiches…
Then last night he had to negotiate raising the temp a bit to account for higher numbers in the afternoon — 12 mmols for too long to leave.Â
Managed everything perfectly though: 60% temp all night, waking on 7 mmols.
Wow.
So today he undercarbs breakfast in an attempt to start his walk higher, and spikes way high (20 mmols). Under corrects but anyway dips low again all morning. He tells us they are taking a mountain guide and going out to climb a mountain with a rope. I send back a whoo whoo enjoy it kind of message, but feel myself battling the urge to check my phone all the way through class…
Discover that this is what he’s climbing. I can barely bring myself to look!
And then this: constantly around 4 (he writes) and having tons of carb. But having the time of me life at the moment.
Bursting with pride. I’m at work, loads to do. But I’m about to walk upstairs and find someone just to say this to: anything is possible.
Well that was an incredibly quick but somehow slow and full few days! Heavens.
E left for Wales this morning, wary of bringing too much with him and therefore seeming different. I squeezed apple juices, fruit pastilles and extra diabetes kit into every crevice. Upon arrival, at least two other boys had much more stuff. Phew! He’d given us all our hugs before leaving the house. At the school it was a wave and a ‘bye’ in his nearly-deep voice, up the minibus steps, and they’re off.
Sniff!
Another boy with T1 is going this week too: E and T have been getting to know each other — first by hearsay, then by proximity — over the last year or so. They are both music bods, and though they have very different diabetes regimes and needs, they get on. This week when E was feeling wobbly about it all, he kept reminding himself that T would be there. They could look out for each other. And more to the point, understand something about what the other may be going through, even if it’s only a version of what the other feels.
I confess to feeling relieved myself about this good fortune. To the point that as they pulled out, I saw that E and T were sitting next to each other. They’ll catch each other’s hypos, I thought.
A bit silly, I know.
***
It will not surprise anyone to know that it took me (and E) over four hours yesterday to pack him up, going through everything again and again, situating it so he’ll remember what’s where. This, and the hours I put into pre-ordering sets and reservoirs, extra insulin, lancets and strips… and getting him the normal stuff (somehow thought one pair of jeans wouldn’t do, duh!): trousers, fleece, walking socks, base layers… Fortunately, perhaps unlike some of the boys going, E is used to hiking. We have a picture of him sitting on top of the first mountain he climbed rather than was carried up, the Lakes below and behind him, at age four, smiling his head off.
For this trip, I really hope he takes a lot of pictures! 12 boys (including sixth formers). It will be a scream. Imagine the state of the air on the bus back…
***
It’s been a week of oddly used time too, whole patches of stretched out stuff mixed with manic hours.
Now that I know what happened I can tell you the following: on Friday I lost the kittens. Well, three of them. I had lowered the barrier in the sitting room, and out they flooded. We’ve been having a hard time with little poos in corners, and I figured maybe Cleo wanted to show them HER litter tray in the bathroom (which she did, immediately, to be fair). Anyway they were having such a good time, all of them racing around the house and Cleo very happy, that I went upstairs to do my emails.
Fifteen minutes later I came down, and could only see poor Artemis, wandering around the place meeping piteously.
Cleo wanted to go outside, unconcerned.
So, I looked for the others. And looked and looked. With a torch. Moved the washing machine. Emptied bags. Took the suitcases out from the under the spare room bed. Absolutely everywhere I could think of. For an hour and a half.
Cleo came in. Artemis cried. Cleo fed her and did not call the others.
She’s given up on them! She’s saving her only kitten!
I went outside and called and called. I could not imagine how they would have pressed themselves through the bricks to get there. But anything, at this point, seemed possible.
I phoned R. We decided it did not yet qualify as an emergency. He advised me to have a drink.
I went outside again, Cleo following. Oh lord, she thinks they’re out here too!
I went back in. And lo there was Archie, stretching his way around the sitting room. Toad, I thought.
The chocolate twins Athena and Eudora were no where to be found. But I figured if he was safe, they were too, probably still sleeping wherever. I went out to get E some trousers!
I had to be out until about 6.30pm, R under clear instructions to get home as soon as he could. At 5.30 I got a text: four fluffy kittens present and correct in the sitting room.
Argh!
***
So last night I heard a meeping in the sitting room. We were all there, sitting around. Looked under the sofa, where it seemed to be coming from.
Just in time to see a white kitten emerge from INSIDE the underneath of the sofa, just DROP DOWN and shake herself off.
Crumbs!
No wonder I couldn’t find them!
I could have wrung their necks. Except that they are so cute.
And a few minutes ago, I peeped under the sofa again. A grey tail hanging down.
Honestly.
***
Here is the vid as promised, now quite old. I’ve taken another one today of them playing with a wastebasket, which I’ll put up.
Time is not really on my side at the moment. But E just texted to say he’s 5.4mmols and all well. How grateful I am for modern communication… And for having a lovely young man for a son.
1) no kittens yet, though prowling mama won’t settle and then sleeps for hours. I’m off out this morning to get rubber gloves (eek) and antiseptic. Just in case.
2) E’s nighttime numbers have been CRAZY. First we up the basal, then we lower it, then god knows…. Not meeting with much settled success at the moment. Messed up my alarm last night and didn’t wake til 4am. Tested and he was 2mmols. Mega ugh. CHILDREN DO NOT WAKE WHEN HYPO. Â All this when having been 7mmols the night before, and 14mmols the night before that. Sigh.
3) we have not had an unbroken night’s sleep since about 20 July. Feeling quite used to it, but if we can’t get on top of this in some form before school starts, we will be dishcloths. I cannot help but feel that being in our late forties has something to do with this…Not built for it anymore. (Sorry, OH!)
4) AND Schubert disappeared for 12 hours yesterday. Scared us silly. Last thing we need is a runaway cat. Would rather trade in the kittens than that! He is now zonked out, not even rising for breakfast…
Over and out… And around and around…
If you haven’t explored the Urban Dictionary, you might want to think about doing so. I say might, because if you do, you also have to be prepared to run across some shall we say colourful definitions. All the words are input and defined over time by readers….so some of them are decidedly wacky, and many of them are not fit for under 16s.
However. Having a 14 year old in the house does mean that these totally unheard of words enter common usage. Hench is one of them, and one of my favourites. For anyone who doesn’t click through to the dictionary, it means large, muscular, fit. As is the way with slang words, it’s also used with this kind of smart boy self consciousness. And it really does make me laugh. As in:
1) from OH: I’m going to go to the gym now, and get hench.
2) from E, while watching the World Cup, about the players in turn: hey Mum, is he hench? Well is he hench? How about him then?
3) from M, about our large fluffy white cat Schubert: he’s not chunky, he’s hench.
4) from E again, two nights ago, on the verge of inserting his first CGM sensor: this is one hench needle.
******
Yes, we have finally but finally ventured into CGM land. And the jury’s out so far. The sensor insertion is, I have to be honest, pretty grim. The needle is VERY hench, and scary for a slim boy with virtually nothing extra on him to fire it into. He really had to screw his courage to the sticking point. Did not want us to do it. And it was quietly a little heart-breaking to witness. Like the sil-sets, the needle goes in at 45 degrees, and like the sil-sets, the insertor sounds like a small firework being set off. Disconcerting if you’re not prepared for it. But by far the hardest thing really is the clunkiness of it all. It’s big on his stomach, with sticky tape over it, and that combined with a pump set… well, we will need to see how this goes. At the moment, it’s feeling invasive, and a little brutal, somehow. Perhaps this will pass.
We long for it to pay off, for his quality of life to be improved. It’s all worth it then, and he’ll learn to do it, exploit it, and live with it.
At the moment though, the readings are still up to 2mmols off and the hypos had in the first 24 hours weren’t picked up in the readings.
I suspect there is considerable skill to this, learning when to calibrate the machine for maximum benefit and accuracy, when not to.
For now, the best we can hope for is that in the next day or two he may be able to have a snack without testing. Or we may be able to get up in the night and look at the graph rather than wake him and poke his finger. This would start to feel like a promising path.
In another five days, there’s the prospect of the next hench needle to contend with. He doesn’t have much room on his stomach for the CGM and the pump, certainly not enough to guarantee good rotation of sites. So he’ll have to circulate the CGM elsewhere, to his leg perhaps. Which will be another leap of faith for him, and more courage. He has terrible memories of painful injecting on his legs.
Sigh. Every change and improvement in control and quality of life is preceded by a period of insecurity and SUCH hard work. And stamina, and courage. And belief. We’re in this together, but it ain’t half hard sometimes. I don’t want this for him. We don’t want this for him. Sometimes it feels like we would trade ANYTHING for him not to have to deal with this, day in and day out, morning noon and night… And when it’s like this, useless anger comes in waves: why, why why?
Sigh again. Just because.
It continues to be all-go in our household. There are times when I feel like a drill sergeant. Sigh. And I’m sure my family would say the same (!).
However. Good news from last week’s clinic appointment is that E’s HbA1c is once again back down to below 7%. This is approaching the high end of ‘normal’ (I love this word – NOT. It means here the high end of a non-diabetic person’s HbA1c). SO this is all good news, and confirms our suspicions that the vast majority of the blip last time was down to the dodgy sets, the missed boluses, and some plain wacky numbers. Two weeks later and those blips have disappeared more into his ‘blood history’, the measurement is 50% from the last month, and the proof is in the pudding. As it were.
It’s a wonderful clinic. Sensors for the CGM are arriving tomorrow, thanks to their help. The doctors and DSNs are open, kind, congratulatory, and we always come away having learned something — or at least with something to think about. This is incredibly rare nowadays for us: diabetes is such an individual condition, that what works for one may not work for another, and the pattern of x may not be the pattern of y. Not to speak of how things can vary day to day. So a new thought is, unfortunately, not usually one we haven’t already thought of. Nevertheless, in this clinic (our pump one, not local) we come away with food for thought. For instance: one of the doctors picked up what might be a pattern: E tends to have a hypo (below 4mmols), about 8 hours after changing to a new infusion set.
This may be nothing. But it may be something. What we would do about it is place him on a slightly lower rate of 95% of his insulin for that time. Maybe it will work? One of the lows was a severe low — the ol’ favourite, 1.8mmols of ten days ago. Ack. Each time, we count our blessings that he seems to weather these well. I am touching wood like mad for luck, but so far even these lows have not caused him to lose consciousness, fit or even become particularly disoriented. As I say, I realise we have been lucky.
And speaking of temp basals, it’s been ‘low insulin’ city in our neck of the woods the last two weekends. E is keen to earn money, so has been doing a lot of gardening work: sweeping the drive, weeding, hauling cut down branches to the bonfire. Etc. Last weekend he went onto a 50% temp basal to try to account for the exercise, and still had four or five hypos (I know, I know)… This weekend we tried a different approach. On Saturday, a shedload of hypos. One after the other. We reduced him to 0% for at least half the day. By evening he was stable again, though on 95% through the night, again to account for the exercise.
On Sunday however, we whacked on a low temp basal (20%) AND under-carbed his food. For instance: scampi and potatoes plus veg weighed out and added up to about 80g CHO. He bolused for 60g, thus receiving about 75% of his ‘usual’ dose.
Interestingly, this seemed to work (aside from two hypos in the morning, before we cottoned onto this new idea, sigh!), combined with the temp basal. We did the same for the evening meal — risotto, a slightly awkward one, that he normally doses at 25/75% (eg 25% up front, 75% spread out) over 7 hours. Again, no hypo.
What’s been useful to think through is that it makes a kind of sense that if the body is sensitive to insulin generally at a certain time, then it will also be sensitive in all instances: so any insulin going in during a sensitive time is bound to lower the blood sugar more than is desirable — whether it’s a ‘long-acting’ basal insulin, or a ‘short-acting’ bolus one.
This is not something anyone has ever mentioned to us. I’m mentioning it here, and will do so on the forum. But it makes sense, and worked.
Will it work the next time, however?! Ah, who knows….
***
The reason we have been so happy to let E work like a dog (and yes, I have a list for him after school this week!), is that we have about 30 people for dinner on Thursday. Eek. Spare a thought. The GREAT news is that the weather looks very promising: hot and sunny. (And DON’T even mention the possibility of a thunderstorm to break it, as is the tendency is this part of the country! Just keep it to yourself. Touch wood….)
Last year at the same party E had been on the pump for less than a month. We had lentils. And it sent his numbers all over the shop, being low GI. That would be very unlikely to happen this time. Incredible the distance you travel. We have travelled.
copyright Tim Haynes
After barely three days’ respite, little girl cat Cleo is on heat — AGAIN. We are gritting our teeth. She is doing something altogether different, but no doubt just as taxing. About another two weeks of this, all being well. We hope for another little mini-break for her. Then maybe making babies. And everyone will be happier… there is too much hissing in the house now, and not just from her brother Schubert, who is fed up to the eye teeth with all her moaning and constant IN YOUR FACE – ness. We keep putting her in the bathroom with a litter tray, food, drink and a bed. Her boudoir, in which she can recline. Fat chance.
AND: a day when E has helped me make a postcard for my hut poems. Okay, he’s done the whole thing (:-)). And here it is, the front image, and the back poem. Splendid job.
(Sorry, on my computer you need to click once to go to some page in space that says ‘Hut postcard’, then click on that and then it finally downloads. Why? Who knows.)
So we go for a milkshake from the dreaded McD’s. Very unusual. Get a medium milkshake. Read the carb content from the handy placemat. Hurray, McD! Says 70g CHO. Sheesh! We think: a load of carb. Sounds TOO high. Settle on 55g CHO, and agree to pick up the pieces later if he goes sky-high. Two hours later he’s a steady 5.8mmols… Hmm… And still hasn’t gone higher.
So we wonder: Mr McD, what you playin’ at?! If we’d done the full 70g, it would have been hypo city! Oh dear.
Just another day in the land of managing diabetes. And life. And getting through both. For the moment!
Waving and Drowning 
