Friday, July 26, 2013

Joke's On Me!

Joke’s On Me

For the lucky folks who don’t have to deal with Type One Diabetes or live their lives as a pancreas…a little background:

Diabetics get bolus insulin, which is the amount of insulin given at one time to cover the carbohydrates in their meal.  They also get basal insulin, which is the small amount of insulin that is constantly given to provide insulin for their organs to function.  It can come in the form of 1-2 shots of a very long-acting insulin or tiny amounts each hour on their insulin pumps.

From time to time, for various reasons (such as growth, progression of the disease, the color of the patient’s underwear, and/or stupidity), the blood glucose numbers will start spiking at random times or rising for no understood reason, which necessitates a “basal test” to make sure the person is getting enough of that “underlying” basal insulin.

A night-time basal test involves giving the child their meal, then nothing else afterwards.  They are not supposed to eat or drink until breakfast so we can see how their bodies respond.  I have to do this every 4-6 weeks at least.  Trust me, I’m constantly analyzing numbers to see if they need more or less bolus or basal insulin at any given time.

So, it’s been a few weeks, and I have noticed each twin boy keeps spiking his blood sugars during the night at random times for no understood reason.  I opted to do a basal test last night.  I really think I need to call it something else, because they minute Mr. Diabetes hears “basal test”, he jumps into the front row for the show!  It’s full scale mockery from that moment on!

My boys’ bodies have a knack for screwing around for days at a time, then correct themselves or go/stay ridiculously low when I do a basal test, thus giving me inconclusive results. Last night was certainly the worst showing ever!

Twin A
Twin B
5pm:  235 (Fed, SWAG’d carbs, dosed). I guess we got a small post-pizza spike.
5pm:  155 (Fed, SWAG’d carbs, dosed). Take THAT, Pizza!
6:45 pm: 53 (given 20 g of carbs). 
Really?  Already?
6:30 pm:  88 and “feeling low”
Bunch of bull crap. That’s what I get for getting sassy!
7:30 pm (2hrs after meal): 101
7:30 pm (2hrs after meal): 69 (20g given)
8:00 pm : 73 (given 13g milk)

8:30 pm: 81 (given 5g more before bed)
8:30 pm: 63 (15g given)
10:00 pm: 57 (given 15g)
10:00 pm: 83
11:45 pm: 78 (given 15g)
11:45 pm: 64 (15g given) Feel like I’m on a roller coaster!
12:30 am: 118  (exhale).  Now, bring the spikes on, Mr. Diabetes! 
12:30 am: 126 (exhale). Now I can actually sleep for a bit.
3:00 am:  105. Survivable.  No spike, naturally.
03:00 am: 87. Cool. No spike here either.
06:00 am: 70 (given 15g)
06:00 am: 86 (5g given since we’re sleeping in).  Well, someone is sleeping anyways!

Before any T1D parents launch off, let me say:

1.        I KNOW that, technically, once I have to correct a low or high, the basal test is over and has to be redone at another point in time.  But, I have had luck in the past where I correct a post-dinner, post-activity low and can carry on with the test.  Also, now I’m just morbidly curious and worried, so I MUST check them (coincidentally) at the same basal test intervals.  And, obviously, I have ALL the spare time in the world and NO need for sleep, so I can just stop and restart on a whim!  No biggie!

2.       Yes, some of the carb corrections DID have protein in them!  I was out of my “staple” Chocolate Milk, but we had regular milk.  They weren’t all quick carbs.

3.       And, yes, I fully understand that Diabetes is Stupid!  No need to remind me!

I just shake my head.  And, as I think over the course of yesterday, I realize I had too many strikes against me for this test to be successful.  Mr. Diabetes held all these cards in his hand and slapped his knee as he laughed at me from his front row seat!  He was holding a Royal Straight.

Ten of Spades:  I told myself and the boys, “We’re going to do a basal test tonight”.  It always makes them SO happy!  *(insert mandatory moans and groans here)*  I tried to whisper so Mr. Diabetes couldn’t hear me, but he obviously heard!

Jack of Spades: First, my Dad treated the kids to Cici’s Pizza for lunch yesterday.  My Diabetic twins can eat their birth weight in pizza, which subsequently wreaks havoc on their blood sugars.  But, I was with them, suffering through the Hell that is Cici’s, dosing them all along the way.  They had insulin up front and extended insulin to cover the later glucose spike that occurs when pizza’s crap is metabolized.

Queen of Spades: Following the high quality lunch, I took the boys to the Trampoline Park.  Two hours of practically non-stop activity.  We checked while there and they are in the 200s, but not as terrible as it usually is after pizza.  It came down with each jump! Besides, I was really waiting for that 4-6 hour-post-pizza glucose spike.  I had my dukes up!

King of Spades: Twin B’s pod failed on the way home, so I had to change it promptly and reschedule that extended bolus.  Twin A’s pod was changed after the extended bolus since it was due to be changed.  Each boy got 0.5-1 unit extra with pod change to prevent/minimize the post-pod-change high. Apparently, the new sites were really absorbent!

Ace of Spades:  I made a fantastic dinner.  Meatloaf, Mashed Potatoes, Wheat Rolls, Salad, and Fruit.  So, let me tell you, when I say “fantastic”, that means my kids won’t eat it.  The better it is, the less likely they are to eat it.  I made sure they had stuff to eat, because with Diabetes in the room, I can’t say, “You eat what I cook or you don’t eat.”  Doesn’t really work that way with this disease.   So, they did not eat nearly as much as usual, and they certainly did not consume enough protein.  Naturally. 

They followed their low protein meal by a rare playtime outside where they actually played nicely, didn’t fight, and didn’t run in every 5 minutes!  (I KNOW!!!  Call the News!)  Hide-and-Seek was the order of the evening, which means they ran off any and all carbs they’d just consumed.  I’m pretty sure Mr. Diabetes whispered subliminal messages to them to encourage such abnormal behavior, thus further complicating my basal testing plans!

Needless to say, I’m the JOKER here.  I just shake my head and laugh, or else I’ll cry.  And, I try to see what went wrong.  I learned a few lessons after this fiasco:

1.        Mr. Diabetes has Super-Sonic hearing and a wicked sense of humor.
2.       Apparently, two hours at the Trampoline Park obliterates any post-pizza glucose spike. Too bad I can’t afford to do that every time.
3.       Apparently, my boys are NOT kids who belatedly spike their sugars after heavy exercise.
4.       Maybe I should cook a less “fantastic” meal if I plan to do a basal test.
5.       There WAS Chocolate Milk in the fridge…hidden behind two jugs of juice…I’ve since discovered!  DOH!
6.       As DH said, the only thing consistent about Type One Diabetes is that it’s inconsistent!
7.       I’ll watch the middle-of-the-night spikes for a few more days then try to repeat again.  Any suggestions on what I should call it?

I folded on this hand Mr. Diabetes, but I’m not out of chips!  I will win eventually!

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