Fighting off the lows

Since we’ve started on the pump, a number of people have asked if I can breathe a little easier now. The short answer is, “Kinda.”

The long answer is, “No, not really, because I’m not confident that all of the pump settings are correct yet, so I have to watch him like a hawk to make sure things aren’t going awry.” I have to keep reminding myself, it’s going to take some time and some patience before things are fine-tuned. I just have to keep logging his numbers faithfully, and eventually we’ll see patterns emerge.

In the short term, though, I am finding it difficult to relax at all, because it seems like when I do, things spiral out of control really fast. Take last night, for instance. Richard O managed to spill his very carefully measured food everywhere towards the end of his meal last night. I thought I did a pretty good job of estimating how much of which food he actually consumed, and when entering the numbers into the pump, I shaved an additional gram or two of carbs off of my estimation as a precaution. When I did his bedtime check he came back right on his nighttime target. Since the bedtime check was before his dinnertime insulin would have peaked, I let him nurse himself to sleep without giving an additional bolus of insulin, and then put him down in his crib. I was especially thrilled that he was sleeping soundly in his crib, because he has struggled with that, even more so since the pump start.

In the meantime, I settled in to do some writing and a few other tasks that needed attending to. The next thing I knew it was 11 pm – it had been 2.5 hours since his last check, but because I hadn’t bolused Richard O for nursing, I figured he might be a little higher than usual. He was still snoozing soundly as I pricked his finger, his little hand curled awfully tightly against mine.

I waited as the meter counted down. 5-4-3-2-1.

My heart just about stopped. I can count on one hand the number of times Richard O. has dropped below 50 on the meter. I scooped him up and yelled for Hubby to go get his emergency carbs, and we began treating the low as Richard O lay trembling like a leaf in my arms. We could still rouse him to consciousness, which was reassuring, but it was terrifying to see him so shaky. I could almost picture the glucose-starved neurons in his brain struggling to fire.

And after the immediate crisis had passed, I felt so tremendously guilty. If only I had checked him sooner, I might have caught the low before it became severe. Why didn’t I check him at 10 pm? Did I count his carbs wrong? Was his basal set too high? Is his pancreas spontaneously spitting out insulin, after barely functioning for months? Could it have been because he did so much running around outside during the day? Should I have fed him something else for dinner? Should I have scooped up all the goop that got smeared on the floor and on the chair and tried to measure it, so my estimations would have been more accurate?

I am throwing all of my mental, emotional, and psychological resources at managing this disease, and it just kills me when he is so far off of target. And while rationally I know that perfection is not possible, I feel like some measure of glycemic control should be within reach. I sense that I’m missing some crucial part of the picture, but for the life of me, I can’t figure out what it is. And I worry that since I can’t pinpoint my error, I am likely to repeat it – but what really gets me is that if I screw up, it’s not me that has to suffer the consequences, it’s my baby. My beautiful, loving, caring, affectionate baby, with whom I would gladly trade places if I could.

Six months or a year down the road from now, I hope I can look back and say that all of this incredible struggle was worth it, that we were, in fact, able to learn from these early mistakes and minimize their recurrence. Until then, I just have to keep my guard up and keep doing the things I know how to do – test, measure, record, call, and adjust. Over and over and over again.