Beta's Last Stand

March 13, 2013

Beta’s Last Stand

I’m fightin’ here.  This time, not to bring a nasty blood sugar down, but to keep one up!  It’s equally frustrating and terrifying, but at the opposite end of the spectrum.  You see….high blood sugars cause damage over the long-term, have long-term complications and consequences.  And, each time I see one, I worry what damage is occurring.  But, low blood sugars can have immediate short-term complications:  Loss of consciousness, seizures, no fuel for the brain, etc.  You know?... fun stuff!  There’s more urgency to amend the situation.

Refresher for non-diabetic folks:  When a person develops Type One Diabetes, his or her body attacks the beta cells of the pancreas, which are responsible for making insulin, and kills them off.  For the first few months to 2 years, a newly diagnosed patient is considered in the “honeymoon phase” of the disease.  This means, all those antibodies aren’t done working yet.  They haven’t killed ALL the beta cells, just most.  The ones that remain continue to function.  Like a bench-warmer, they jump in the game sometimes.  Eventually, the autoimmune antibodies will win the war and kill them all off.  In the meantime, the battle ensues.

My twin son, Asa, was diagnosed 5 months after his twin brother.  Asa was diagnosed in August of 2012.  Since it’s only been 6 months, he’s still in his “honeymoon” phase of the disease, but with all THREE antibodies attacking his pancreas beta cells (most kids only have 1-2), he’s rapidly leaving this phase.  His insulin requirements are rising on a regular basis.

It seems the last 5-7 days Asa’s last remaining beta cells have decided to launch an offensive.  They are fighting for their lives, but like Custer and his troops, they are being and will be annihilated eventually.  They’re doomed.  (Oh, the thought of knowing something inside my baby’s body is DYING is just SO comforting and heart-warming). I have affectionately named Asa’s last five beta cells Larry, Moe, Curly, Alfalfa and Buckwheat.  The “boys” are cranking out insulin right now with all their might.  They don’t understand it’s an exercise in futility, and eventually the Anti-Islet Cell, GADA, and the Insulin Autoantibodies tribes will defeat them in this autoimmune siege at the Battle of Little Pancreas.

Larry, Moe, Curly, Alfalfa and Buckwheat have caused mayhem!  10 days ago, with average blood sugar numbers climbing, I did a basal test.  We marginally (MARGINALLY, only like 0.05 units per hour difference) changed Asa’s basal rates (that’s the insulin that infuses continually so that his organs have enough insulin to function).  We looked good the first two days after the change.  Then…BAM!!  Stumbling, dropping, falling off a bride with no bungee cord attached.  Usually, a 10-20g carbohydrate snack elevates the blood sugar back to a normal range.  With Buckwheat and company participating, nothing that usually works is working.  These inadequate bench warmers just really aren’t as good as the starting line-up.

March 11:

Time	Blood Sugar	Action/Comment
0830	48	15g free
0900	76	37g, covered with insulin
1000	41	15g free
1100	51	10g free
Noon	72	10g free, 40g covered
1300	45	15g free

 

NOW?  NOW you want to show up and work? For FIVE MONTHs, I’ve been working with very little help from these nincompoops, and now they want to wreak havoc on the routine!  They clearly are not following the rules. It’s been much of the same since.  These guys are acting like your dying relative who has that one last blast of energy before the end comes.  Everyone thinks, “He’s doing so well today” and the next day it’s over.

March 12, I dropped his day time basal rate to LESS than what it was before we changed it on March 7. 

Time	Blood Sugar	Action	Comments
Noon	46	30g free	That should fix it, right?
1230	47	15g free	Yeah, joke’s on me!
1300	50	20g free	Larry, SIT DOWN and let the experts work, please?!
1400	69	10g free	I’m starting to think I want the tribes to win!
1600	70	Early dinner with free carbs and insulin	Does that make me a traitor?
2000	104		Can I get some rest now?

 

 

If I were to feed myself as much as I’m pouring into the kid just to keep his blood sugar up, I’d have gained 10 pounds already!

So, March 13, we go to Six Flags for my other son’s birthday.  Since activity lowers blood sugar, I TURNED OFF his basal insulin.  OFF…getting NO insulin!  I raised his meal insulin-to-carb ratio to 1:15, which he was using in December!  He only got insulin for meals….and less so than usual. Here’s how his day went:

Time	Blood Sugar	Action	Comments
0900	51	15g free, 25 covered	This is what sleeping late does for you
1100	59	15g free	We’ve JUST entered the park
1200	77	20g free
1400	104	15g free, insulin, extended so only received partial insulin initially (later cancelled second portion of extended bolus)	Carby picnic lunch outside the park that could easily send non-diabetic into a coma!
1430	46	20g free	30 minutes after consuming over 100 carbs and only being treated for part of it!
1530	62	13g free
1700	71	10g free
1800	92	Dinner with free carbs and insulin	Wouldn’t you know, he didn’t finish his food?  Adding insult to injury here! I think he may be consorting with the enemy.  Wait, who’s the enemy again?
1900	55	20g free	Yes, I’m adding protein sources, too, all along.  It’s not only simple carbs!
2000	105		Basal insulin remains OFF
2100	36	20g free	REPEAT…THIRTY-SIX
2130	39	20g free	Sleeping, sweaty, didn’t change! This is the dumbest disease EVER!
2200	100		Exhale
2300	232		Resumed basal insulin
0200	325		WTF?  Correction insulin given.
0900 March 14, 2013	158		Back to normal

 

 

Yep, ALL day, the child had NO insulin except for meals, and apparently, even that was too much because Larry, Moe, Curly, Alfalfa and Buckwheat decided to join the party.  That’s all well and good, but if they could shoot off a flare, tag in, or fire a warning shot to let me know they’re helping, I’d really appreciate it.  I’d be much obliged.  Since they don’t believe in open and honest communication, I’m losing sleep, getting an ulcer from worry and wasting a hell of a lot of money on test strips!  Did you count those FOURTEEN checks in 14 hours?!  Furthermore, they’re TERRIBLE shots!  Clearly, wasting way too many bullets, misfiring, throwing punches in the dark with their eyes closed…  I feel like I’m an experienced Navy SEAL paired with inadequate and untrained Iraqi soldiers. They are more of a hindrance than help…a liability.

I’m not sure if it’s good news or bad news, but his blood sugars are more “normal” today.  I haven’t seen the death certificates.  I haven’t seen the tribes hang Larry, Moe, Curly, Buckwheat and Alfalfa’s heads in effigy.  I haven’t been presented with a Peace Treaty. But, I think the battle may be over.  I don’t want anything to “die” on my baby, but we can’t be duplicating each other’s efforts!  If you’re going to die inevitably, then die already! The way the past few days have been, I really feel like his Type One Disease Management IS being run by the Three Stooges!

Now, I’m left wondering.  Is this it?  Is the honeymoon over? Did the Betas fall, or have they only retreated?  Are they lying in wait, preparing to attack again when I least expect it? Only time will tell. In the meantime, I lie in wait.  I’ve got my gun cocked, loaded with chocolate milk, peanut butter crackers, Quick Sticks, Candy and Glucose tabs. I’m mixing adequate amounts of fats, proteins, simple carbohydrates and complex carbohydrates.  I’m dosing insulin using the “Mixing Bowl” philosophy (see prior blog).  And, I’m just waiting to hear “Mommy, I feel low!”

Rhonda