Sunday, April 14, 2013

One day? I can't remember that far back...

I wanted to write a whole "one day" narrative to illustrate how Sarah's day with diabetes went, but I'm so tired after a pretty rough weekend of crazy bg's that I can only remember the highlights. So just think on this.

Sarah pierced her skin with a sharp metal object 15 times today, intentionally.

I'm pretty sure she doesn't actually enjoy that; I know I don't. She bolused for a Frappiccino at Starbucks which should have made her bloodsugar high, but instead she dropped to 78, then 61, then 59.

I laugh (somewhat maniacally) whenever someone asks me if we've got her diabetes under control, if we're managing it. Diabetes is like a rattlesnake, only the rattle is silent. And it's in your bedroom. It blends with the carpet so well you never see it but you know it's there, just waiting for you to step in the wrong spot or turn your back.

Tonight I completely expected to be dealing with highs, after a birthday party including the evil cake. But instead I'm venting my thoughts while I wait to check that the bg of 74 I caught 10 minutes ago is coming up. It's been over three years and diabetes still throws me a lot of curveballs.

And yes, they're fanged and venomous

Control is a myth, a daydream, a fleeting moment when all seems right.

It's 11:44pm, and I'm doing my best to stand in for a lazy pancreas. And my best is all I can do.

Thursday, April 11, 2013

Basal... the other low treatment

I've had a few people ask me about this, so I thought I'd throw it in a blog. My disclaimer. I am most definitely not a doctor.

I'm a mom.
I'm a decision maker.
I'm a pseudo pancreas.

So this all started a little over three years ago. The second type 1 mom I ever met scared the living daylights out of me - and one of her horror stories (she told a few) was how her daughter (who I believe was around 8) had teeth so rotted they were falling out of her mouth. Why? Because she was so frequently treating low blood sugar with frosting and other sweet gooeyness. Okay, well honestly that whole teeth rotting out of the mouth didn't really sound appealing, so, as soon as Sarah started on the insulin pump, I started experimenting.

I found that SOMETIMES, when her low wasn't TOO low, when she had only a SMALL amount of IOB (insulin on board), I could resolve a low without using any carbs by lowering the basal rate to essentially match the remaining IOB.

Example: I check Sarah at midnight and her bg is 84, and she has .3 IOB. Her hourly basal rate at that time is .6 per hour. So instead of waking her to eat, I set a temp basal to -100 (turn it off) for an hour. I usually check 15-20 minutes later to make sure she isn't still dropping. If she's much lower, I will wake her to eat or drink something, but if she's holding steady or rising, I won't.

This has gotten SO much easier since we got Scout because he lets us know when she's trending down, usually starting in the 90's, which gives us LOTS of time to act.

So while I wouldn't necessarily suggest this, it's how we handle lows probably 60% of the time. It works for us when done safely and with extra monitoring. It does mean a little less sleep, as I probably have to stay up longer to confirm her bg is back into the happy zone - but so far (knock on wood) she has no cavities - and this makes me happy. Because diabetes is not supposed to be a teeth rotting disease, but really who treats lows at 2am and then makes their kid get up to brush???