A note to Jimmy's Nurse

A note to Jimmy's Molly Center nurse... I just wanted to let you know that I think you are wonderful - you have a way of making us feel that Jimmy is the only patient you care for - even though we know that's not the case... anyway, it's midnight - and I'm just up testing Jimmy - at a whopping 292 - and there's a reason... Here's the background... He woke up at a 123 this morning and had at least 3/4 of a regular size banana at 8a.m. I covered 20 carbs . He felt low just after 9a.m. at school but tested at a 290. At 10 a.m. he was a 168. Had cashews for a snack (his new favorite) and his nurse ONLY covered for the carbs - no correction as per Jimmy's plan. At 10:56 he plummeted to a 59 - but he seemed ok. Was it the fat in the nuts? not sure, so ... 15 carbs of juice and a retest revealed he was only a 62 at 11:11 (15 minutes later.) His nurse gave another juice box, and at 11:27 he was only up to a 93 at which time she gave him a 20 carb snack. Seems to happen lately... Yesterday morning, at 11:30 he was a 90, so he had a decent snack, for which I covered only some of ... thinking he was going to be sitting in church for an hour at 12:30. Then, while in church at 12:45 (Lunch would not be until after mass, where there was to be a basketball ceremony in the gym complete with snacks and pizza at 1:30), he said he felt low. He was a 168, but he insisted he felt low - he even insisted he was dropping - which he seems to be able to recognize when he's trending down (can't wait to start the sensor...). I didn't do anything, but he complained again that he felt low and at 12:59 he was a 159. He INSISTED that he was dropping, so I gave him 1/2 a juice box being that we were in church, and let's face it - you know Jimmy and how it's hard to keep him quiet/entertained/well behaved, etc... , and the 1/2 of a juice box made him feel better. At 1:45, he was a 150 and good to go for lunch. Wondering what's happening with his plummeting at lunchtime... Joann sent us an email form pedsmolly to raise his basal rate at 10 am because she felt he was rising after lunch, but I'm wondering if she only saw the result of us trying to raise him from a low. since it seems to be happening at that time. p.s. I didn't raise his 10 a.m. basal. So. on to today. He had his low (above) and was off to his 2nd school (to which he attends Monday's and Thursday's from noon to 3:30 pm. They are great (but no nurse on site - just loving wonderful teachers who are moms and know Jimmy since way before his diagnosis). They always call me at a moment's notice with a low or a high, or a question and have been so willing and ready to help with his diabetes. Today, I went to cover him at lunch - normal occurrence. He complained that he didn't' want pretzels for his 2pm snack, so I decided to bring him a different snack at 2 (the school is right across the street from mine) - He also needed test strips, so I brought them, too. I'm SO GLAD I went -I got there with is strips and snack and he told me that his site had just come out. He hadn't told his teacher - not sure why - looking in to that... So- because I had a class at 2:15, I decided to cover him via novapen shot for his snack. Then I picked him up at sometime between 3:30 and 4 as usual, and Jenna had piano at 4:30, so by the time she got home after 5 and he wanted a snack, he insisted on another shot and even declared it was time for a pump vacation (a term we introduced if in fact he joins the swim team this summer). Not a chance. I delivered another shot via nova pen since he was quite busy playing outside with the neighborhood kids (we LOVE our block) and he didn't want to take the time to insert a new site. As soon as I could catch him and keep him for a bit, I inserted the new site. A bit later, it was time for dinner - he was a whopping 500 plus. (no keytones.) YIKES! We delivered a bolus, and Jimmy declared he never saw the pump give him a 2.7 before - he said it was a record. Not sure about that, but I repeat, YIKES! So, now at midnight, he's a 292. The pump said to give him 0.9, but I chickened out and gave him 0.6. I'll do my best to check him at 3,but it's already almost 1a.m. My husband's been pretty good at testing him at 3.a.m. and 6:30 a.m., so I'll send you an email in the a.m. with an update. Don't want a low in the middle of the night. He's such a HEAVY sleeper. Ok, have to go to bed - I'm going to try to look into Apidra now... never heard of it. willing to try whatever is best for him. On another note - I'm trying so hard to feed him well - not always easy - trying to give him more complex carbs instead of simple ones... He's 6, so of course it's near impossible. Loves bananas, cashews, yogurt, cheese sticks for snacks, but then there's always the birthday party treats, desserts, grocery store check out line candy, etc... You're right about the glycemic index. I'm learning AND trying. One thing we definitely noticed it that he's always high after pancakes (Aunt Jemima original mix - I know - terrible - and Lite syrup (lower carbs) and bacon - I know it slows down the carb absorption.) Will look into keeping track of foods and carbs and trends - always do it for lunch for his nurse, so why not continue... He's a "grazer" as you mentioned, so it's tough... I'll keep you posted. Thanks so much again for getting back to me not only today, but Friday as well. We thing you're w onderful, and feel so blessed to have you on Jimmy's side!!! Peace, June