This is going to be extremely difficult to write but I think I need to write it. The other day, I accidently overdosed Eric with his Lantus. How could that happen?? I am usually extremely careful and conscientious. But, it was the day after Thanksgiving… I was all stressed out because my whole family, including Eric, had had a stomach bug, and I’d been unable to go to work at all (this two days before a crucial project had to be finalized for launch), and I’d been arguing with my stepdaughter over who got to do the dishes that night. In short, I was not in the frame of mind to be doing insulin calculations. We give Eric diluted Humalog because the amounts he needs are so small (anywhere from 0.2 to 1.6 units, usually) that we can’t measure them accurately in whole units, so I have to mix up a batch of 10% insulin/90% saline every couple of weeks. So with the Humulog, we multiply the number of units he needs by 10 to get the right dose from the diluted solution. Ergo, if he needs 0.5 units of Humulog, he gets 5 units of the diluted solution. However, he gets whole units of Lantus—prior to honeymoon, it was 2 units, but lately we’ve taken him off it altogether because it was impossible to tell (between honeymoon and stomach bug) how much he really needed—see my earlier blog post about his multiple BG crashes for details!)
Friday night was the first night we were reintroducing the Lantus. We’d seen 3 days of consistent high BG readings in the morning, so it seemed like he was over the stomach bug, and that whatever insulin he was producing wasn’t enough to serve, so adding Lantus was the thing to do. I’d intended to be cautious and start with 0.5 units. But, distracted as I was—I drew up the Lantus the same way I drew up the Humulog, that is, multiplying by 10, completely forgetting that the Lantus is not diluted. And I gave it to him, said “all done!”, started to put everything away… and froze, realizing abruptly that I’d drawn up 5 units, not 0.5, of Lantus. One minute too late to do anything about it.
I called the clinic immediately; it was nighttime so I got their answering service, but I knew they’d call back right away. Then I had hysterics. Rationally, I knew that the insulin I’d injected wasn’t going to have an immediate effect on his blood sugar—it is a long-acting form, after all. But let’s face it—when you’ve got your child’s health and well-being in your hands and you blow it that badly, hysterics is the least you can do. I envisioned another trip to the ER, Eric on a glucose drip, with everyone looking accusingly at me as the lousy mother who’d OD’d her kid… I even feared he might die, and I’d have to live with the fact I’d killed my own son. Even when the clinic called back and told me that the solution to the problem was simply to make sure he got 20 carbs every 2 hours round the clock till the Lantus wore off, I still felt horrible. What if I hadn’t realized what I’d done right away? What if we’d put him to bed without knowing he’d been overdosed? He does usually wake up and cry when he’s low, but not always… and although I usually wake up when he cries, I was unusually tired that night from taking care of my sick family, so I might not have heard him. So to make a long story short, I spent a couple of hours contemplating the possibility that I very nearly killed my son by making a very stupid mistake.
Obviously, things turned out fine. We gave Eric lots of chocolate pudding that night, even though he wasn’t really “into” it at 3 a.m., and kept his BG up in the 200s for the duration with remarkably little trouble. Even so, I can’t say I’ve gotten over it yet. It’s not something I’m likely to forget any time soon, which I guess is a good thing—makes it much less likely that it will happen again. But I’ve at least come to realize that what the clinic nurse and my mother both told me is the truth: mistakes happen. Parents are human beings, they make mistakes, and sometimes the mistakes are dreadful ones. (My mother offered to tell me about the painful near-misses she had with me and my brothers; I declined.) I got lucky this time, and it will make me more cautious in the future. Moral of the story is, when you’re taking care of your child, focus on that and only that. If you can’t, then don’t draw up the insulin till you can. It’s a lesson I hope never to have to repeat!