Wednesday, February 2, 2011

Ice cream before sleep means no counting sheep

When I was a teenager, I loved staying up all night watching Star Wars, writing the greatest novel (that's never been finished or published), reading, or talking on the phone (yeah, I totally had a spare phone I used to pull out when I got grounded and mom took one away. Sorry mom, too late to ground me now!!!). Three in the morning - ha! No problem... I was just getting started. I laughed at the newscaster who used to ask every night, "it's ten O'clock, do you know where your children are"? I didn't have children. I had books, movies, friends, and homework that always managed to get done on the bus ride to school.

Fast forward twenty-something years...

Where the heck did that carefree kid go? Oh yeah, she got all growed up and responsibilified. She has to get up at 6am and go to work, and she can't go to bed because she gave the child ice cream five hours ago.

Yes, if you've made it this far you have again entered the world of type 1 diabetes, a disease that affects about one of every 400 to 600 kids. A disease that somehow hasn't gotten a whole lot of attention. I wonder why this is? My best guess is that we parents do such a great job of managing this disease, that it doesn't seem like a big deal to the rest of the public. But as much as I hate to mention the serious downside of type 1 diabetes, I think it needs to be said. Type 1 diabetes is a deadly disease. Without intensive and constant treatment, the outcome is death. Until the advent of insulin in 1922, the average lifespan of a type 1 diabetic was about two years from diagnosis. Sadly, far too many type 1 diabetics still die young.

In fact, not long ago I met a woman in the waiting room for Sarah's Endocrinology appointment. She was there with her 10 year old granddaughter, who had type 1 diabetes. The woman was in tears. Why? Because she is now raising her diabetic granddaughter, because the little girl's mom died in her early 30's of complications from type 1 diabetes.

Yeah, it's that serious.

It's absolutely critical that Sarah stick to a strict regime of testing, counting carbohydrates, and delivering insulin. Here's what a typical Sarah day looks like:

6:30am - prick finger and test blood sugar - count the grams of carbohydrates in each part of her breakfast, enter the data into her insulin pump, confirm insulin injected, eat breakfast.

10:00am - repeat for snack

12:30pm - repeat for lunch

2:00pm - repeat for afternoon snack

5:00pm - repeat for dinner

7:00pm - prick finger and test blood sugar during/after activities - maybe have an evening snack

-- Every third day we load a new cartridge of insulin and use a really big needle to shoot a small tube into her tummy. Fun!

9:00pm - prick finger and test blood sugar before bedtime.

So let's see... According to this, my daughter pokes about 8 holes in her fingers each day. Might I remind you, she only has ten fingers, and 2-3 of them don't like to bleed, so we reuse the bleeders a lot.

And that brings me to the reason I'm writing this entry at 10:30pm instead of snoring. Tonight we splurged a little and let Sarah have ice cream for dessert around 5:30pm, knowing that ice cream always makes her blood sugar spike. I was actually kind of hoping that because we had dessert reasonably early, we'd get the spike out of the way before bedtime. But no... She tested at 9:00 and her blood sugar was 240. Her goal is 105-135, and I usually prefer her to be over 120 (but under 160) when she goes to bed.

So, because she was 240 Seymour ordered a correction (Seymour is the name of her pump - the name makes a lot more sense if you've watched Little Shop of Horrors) of 0.80 units of insulin. But before I can sleep, I need to confirm that:

  1. Her blood sugar didn't plummet to the danger zone (hey, it happens!)
  2. Her blood sugar didn't continue to rise (yep, this happens too!)
  3. Her blood sugar is in the normal bedtime range 

I vote for door number 3!!! Who's with me?

So now I creep into her bedroom and turn on the light, hoping she doesn't wake. I insert a new test strip into her meter. I prime the lancing device, then dig under the covers for the nearest available finger. I gently squeeze the finger, bringing the blood to the surface. I push the lancing device against her finger and push the button, hoping I'll get enough blood so I don't have to do it all over again.

And the verdict is??? Dang it, door number 2. She's only down to 228. Seymour orders another correction, and now my 10:30 bedtime is pushed to 11:30.

Does anyone really wonder why I chug down so much coffee???