So there was some SERIOUS weirdness going on with the BG readings tonight.
5:15 PM, I did a quick check of the CGM and was surprised to see it showing readings in the mid-200s. Eric hadn’t eaten since lunch and I was anticipating a low, not a high. Took his BG and found it at 288. On a hunch, took a blood ketone reading and found it at 0.3 – not worrisome, but I was expecting a flat-out 0.0, and in tandem with the high BG it made me suspect a failed site. Looked at the site and, well, it looked iffy to me. So on went the IV Hand patch with the EMLA cream, and I used a syringe to give him the 0.9 unit correction (actually 1.0, since I can’t measure 0.9) the pump told me was called for. And, as is my usual practice, I unclipped the pump tubing and programmed the same amount into the pump and let it drip out so that the pump would have the bolus recorded in its computer’s memory.
So about an hour later, I put in the new pump site. The old site, sure enough, was no good – not only was the cannula bent in half, but it was all full of blood too, probably a result of all the roughhousing he’d been up to with his brother. Then I checked Eric’s BG before dinner. It was 112. He’d dropped 176 points in one hour having utilized, according to the pump, only about a fifth of the unit of insulin I’d given him. At that rate, he was going to be in seriously hypoglycemic within 45 minutes. I gave him dinner and backed off the bolus by 0.8 U, figuring that the ~0.8 U that was still in his bloodstream and hadn’t yet peaked would take care of the rest.
At bedtime (8:30) he was at 92. Lower than I like, and definitely lower than I expected. I gave him a little bit of juice to see if it could boost him a bit. His CGM, which I checked just now, indicates it did – he’s risen substantially, to ~174, which is about right for this time of night.
I’ve seen Eric’s BG plummet before, but almost 200 points in one hour? That’s new to me. Anyone else seen it?
VERY WELL DONE ELIZABETH!!! You caught it doing what it does best and that is being silent, sneaky and severe. At this point we can only speculate on a NUMBER of simultaneous variables that may have been occuring. Quite often I will say to someone I’m proud of you, and this is certainly true here.
Insulin requirements change, and we don’t know why. It is another one of the very important pieces of this puzzle bar none. Diabetes has a mind of it’s own, almost it’s own sliding scale (silent of course) which makes things more difficult however YOU CAUGHT IT (ha ha).
Many people before me have used the “elevator analogy” and this clearly shows that although the finger pricks are not nice, they are by far preferable to being completely out of control. Right now this is the best we have, and of course as always, timing is everything. Much like my mom, your a hero! Please continue to do what you are doing and if anyone finds a better way to manage this beast please let me know. We should all be looking for better ways to manage our sugars.
Love Always
Anonymous Diabetic.
P.S. EVERY diabetic and thier families should have a copy of the book “Diabetes Solution” by Dr Richard Bernstein. He is both an Endocrinologist and a diabetic and his success is incredible and his story is AMAZING. It is worth the read for the story alone.
I cried as I read it because not only did it remind me of some very rough times my mom and family went through, I could strongly identify some of my shared experiences, and for the first time in very simple terms, I understood the science behind this monster. You see most doctors learn the theory of medicine, and never know the practice. Diabetics learn the practice first, and then the theory about what goes on with many other diabetics, and thier own individual biology as well.
I hope this helps, and give Eric a big hug from all of us at tudiabetes. Sooner or later, everyone who comes in contact with Eric is going to understand or learn something from him and your family unit. In time Eric will come to know just how much you love him, as did I with my mom. KEEP FIGHTING/KEEP WRITING!!!.
Thank you for that! I did realize very shortly afterward that part of it was likely due to whatever the virus is that is running rampant in my house – Eric has it, I have it, and now it looks as though big brother Nate has succumbed (fever of 101.8 at bedtime, ugh). Eric didn’t have much in the way of symptoms until the next day but if his immune system was working overtime, it would explain matters a bit. Although if I were to tell Eric’s doc my thinking, I know what he’d say:
Me: …so I think it was X + Y + Z that made Eric’s blood sugars crazy like that. What do you think?
Dr. O: I think your son has diabetes, and diabetes makes blood sugars screwy.
(A very smart man, is Dr. O.)
Sometimes with bad infusion sites the insulin is not immediately absorbed and accumulates and hours later it finally kicks in. I had a bad site tonight and now I am waiting to see what happens. I will test before I go to sleep, and then wake up in the middle of the night to test again since it is so late.