-growth spurt
-illness
-rainy days
-a lot of exercise
-lack of exercise
-stress
-simple carb foods
-glitch in the pump site
-glitch in the tubing
It seems like the wind blows and there are changes and then I have to "get the hang of it" all over again.
Here's the latest blowing of the wind...
He's dropping, or should I say plummeting, at school, and then he's going high all evening. Why??? I don't know. Here's my latest instructions from the doctor:
I am not sure why Jimmy is dropping in school. He is actually on very little insulin for his size. He appears to be lower during school and then rise later that night. The rise and falls are also pretty quick. Some of the rises my be rebounds from lows though. I don’t want to lower his insulin to carb ratio anymore than it is already, so lets lower his basal during the school day. We can go from 10am – 3 pm at 0.25. This should help. The sensor will also help see what is going on. Also always try to give some insulin prior to meals to help better match up insulin and food doses. The only way to tell If he needs less basal would be to do a basal test…
feed him breakfast and cover foods and test him in 3 hours.
If the number is between 100-200 start the test
Do not give any food or insulin during this time
skip lunch and snacks… no food until 3pm
If he goes low, treat the low blood sugar and stop the test.
He should be able to maintain his blood sugar between this time. If not, then basal needs to be changed
Suggested dose changes
12am 0.225
3am 0.15
7am 0.325
10am 0.25
3pm 0.325
There it is. Anyone care to translate??? How am I supposed to NOT feed him from morning on???
The Molly Center thinks I'm doing great with the managing of his diabetes and the pump.
I feel like I know nothing.
Someone asked me recently just what I have to do for Jimmy... Here's a list of things that have to be done to manage diabetes:
-12 a.m. testing, giving a bolus if needed (correcting a high blood sugar), or waking him up to make him drink juice if he's low (the cake gel is a mess and just dribbles out of his mouth.)
-3 a.m. testing (same as above if necessary)
-changing his insulin pump site every 2 days (can take up to an hour if he's not in the mood, which is the usual case).
-uploading his pump information to the carelink site (takes about 20 minutes, and I usually do it while he's in the shower since his pump is off at that time - but that doesn't include interpreting the data... see below)
-trying to interpret his carelink information -see older post about the reports carelink generates - it's like reading top secret encoded scattergram type documents. I study them to try to find out what steps to take to fix the trends he's having - but I still have to contact the Molly Center for the final word...
-making sure his supplies are up to date - which reminds me, he needs more insulin viles
-daily communication - even several times a day - with his wonderful school nurse to figure out a course of action. Even though the pump does the math for us, it's not simple... there's a human factor involved. Less insulin if he's going to be active, more insulin if it's a rainy day and they're going to be inside and inactive all day. Trying to compensate for the lows he has. And when we think we have it, and we think the next reading will be perfect, his blood glucose number does something totally opposite of what we think it's going to do... You know the expression "it takes a village" well, it can't be just one person monitoring this - I thank God for Jimmy's school nurse and how she helps me manage his diabetes.
-counting carbs. not as easy as it sounds. Every time something goes in his mouth, I have to determine how much and how many carbs. I know it's 30 carbs for a regular sized banana - then what if he doesn't eat the last 2 bites??? If it's 22 carbs for 15 pretzels, what if he eats 22 pretzels - or better yet, what if he forgot to stop at 15 pretzels and I didn't notice him going back for more??? not to mention the difference between complex and simple carbohydrates...
-putting up with the whims of a 6 year old. one minute he tests himself with out incident, and the next minute he hates testing and throws the tester across the room. I still remember the darkness of the closet that first few weeks of his diagnosis when I had to search for him and finally found him in his safe place (they both used to play in my closet, so he was always happy there...) He doesn't cry about it anymore, but he still gets angry and hates testing and getting his new pump site sometimes...
-managing his appointments - of which there are MANY - every 4 months to the endocrinologist, pediatric opthomologist, pediatrician, dentist, pediatric dermatologist, neurosurgeon, support groups, pump classes, etc...
-Molly Center communication - just about weekly - to identify the trends and make modifications
That's all I can think of at the moment...
Then there's life in general - full time work, family, house, diabetes - doesn't leave time for much else...
So thankful that I have wonderful angels helping me to help Jimmy. Maybe - just maybe - I'll get the hang of it one day.
Peace,
June
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