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!

Wednesday, July 10, 2013

Enemy Torture Tactics

As a family, we’ve been dealing with Type One Diabetes for over 16 months now.  Some things have gotten easier, some things have remained just as crappy as day one.  I’m the Pilot of this craft, and I have a great co-pilot, but it’s a tough job!  Most just don’t understand all it entails until they live the life…even if just for a day or two. 

In February, just prior to Aiden’s One Year “Diaversary”, I was sort of having a hard time.  Everything diabetes was getting me down.  Mostly, I hate it for Aiden, and it’s not fair to him….and there’s nothing I can do to change it.  All I can do is continue to run the marathon, and hope the finish line shows up eventually.  We’re now a couple of weeks away from Asa’s One Year “Diaversary”, and I’m back to having a hard time again.  As I ponder and brew it all over in my head, I’ve decided it’s because Type One Diabetes is the work of the Devil.  T1D is the enemy, and he uses unfair tactics in this war!

One known and primary tactic of enemy forces is sleep deprivation; Type One Diabetes is my enemy and his primary torture tactic is sleep deprivation.  Let’s take this week for example.

Sunday:  I worked until 0100, and when I work partial shifts, I always check the boys when I get home.  Exhausted, low and behold, the Devil made sure one boy was low when I arrived (50, I think).  So, I have to give the sleeping child carbs…and wait.  Of course, the one who was low is the one who is also very slow to rise.  Thirty minutes later, 72.  Barely above normal.  More carbs, wait again.  By the time his sugar was good enough to go to sleep, it was 0230.  Alarm sounded at 0630.  T1D gets the last laugh!

Monday:  No rest for the weary.  I take one kid to Golf Camp and run errands while he’s occupied…taking Diabetes with me wherever I go.  Once I get home and get all settled, I decide I’ll take a little nap while the boys watch a movie. Literally, as soon as I start to drift off…..*tap tap tap*  “Mommy, I feel  low!”  No kidding.  The Devil’s handiwork again.  Joke’s on me thinking I could get some sleep.

Evening and middle of the night numbers have been screwy, so it’s time, naturally, to do a basal test.  I have to do one every 4 to 6 weeks it seems.  I’m constantly working to keep insulin rates ideal in order to manage their blood sugars as close to normal as possible and in order to minimize complication as they grow.  It feels like an exercise in futility. Mostly one boy needs it this time, but if I’m up doing one, they’re both getting it.  Doesn’t matter to them; they sleep through it all. They’re tortured enough just having this disease, my torture is worry, fear, and sleep deprivation. (For those who don’t know, when I do a basal test, I basically have to get up or stay up through the night to check their sugars every 2-3 hours-- from 6pm to 6am-- to make sure they are getting the proper amount of overnight insulin.)

10pm bedtime.  Up at midnight to check sugars.  Stuck awake until 0230.  Go ahead and check sugars then.  About to fall asleep when the kicking Preying Mantis (also known as Jace) joins us in bed.  Up at 4.  4:30.  5.  5:30.  Check sugars at 6.  Guess what?  LOW.  Did you count the lack of hours of sleep there?  Yeah, me neither.  I estimated about 4 broken hours. I've always been the kind of chick who needs lots of sleep, so this is the cruelest torture!  Does wonders for my attitude!

Tuesday:  Up at 0600.  Take kid to Golf Camp and run errands, dragging T1D along, while kid is at camp. Attempt to nap again before lunch for an hour or so.  10 minutes in…*tap tap tap*  “I feel low”.  Devil’s play.  So, I get to suck it up all day with burning eyes.  10pm bedtime.  Up at midnight to recheck the low sugar of the boy who was high the night before!  He’s low.  Recheck at 0100.  Recheck at 0300.  Up at 0600. 

Wednesday:  Took one hour nap, at the beginning of which I was awakened to “Did you bolus me for my side item?”  I really think an alarm sounds when I’m dozing off. (Same as when I pick up the phone or sit on the commode, but that's another blog!) The Devil plants the seed in their heads, “Alright boys…go wake her up!”

To make matters even sweeter, I get to carry on during the day like I didn’t just lose SO much sleep the night before…..nights in a row now. NOBODY cares!  The dogs don’t care.  The kids don’t care.  They still want breakfast, lunch and entertainment.  The laundry doesn’t care.  The cooking doesn’t care.  Get the picture here?  I still have to be chef, chauffeur, cruise director, maid, launderer, nurse, wife, mother, and referee…on top of being two pancreases!  With all that being said, I get down on myself to boot.  My perfectionist attitude doesn’t like not being able to be the best wife, a great mother, a good friend….because my energy is spent being two pancreases, causing other important areas of my life to fall.

Type One Diabetes is a formidable foe.  He’s got great torturous moves, like the Devil.  T1D leaves me filled with worry.  I’m sometimes paralyzed by fear.  My hands are tied as to the amount and hours I can work….needing more money but not able to obtain it.  My hands are tied as to with whom I can leave my children.  Any “basic” event and task takes foresight, thought and planning that isn’t ordinarily necessary (and I’m sure is taken for granted by the non-T1D family). I’m left looking, daily, at this unsolvable puzzle of numbers, trying to make sense of the nonsensical.  My foe has “rules” by which he doesn’t play; there’s no Geneva Convention here.  The gloves are off!  And, I’m left knowing this invisible beast inhabits the bodies of my babies, and until there’s a cure, I can do nothing to make it go away.  All I can do is hit it with my best shot(s) *pun intended*.

So, I’m wondering at what point am I supposed to crack?  What am I being coerced to do? Why are my boys, me, my family being punished?  I’m sure this is a violation of my human rights, but who do I hold accountable?  When will that finish line be an actual finish line instead of a mirage?  When will this Devil leave us alone?

I’m hoping for sleep tonight, but I’m not holding my breath.  You can bet your sweet behind that one boy will be too sweet, and the other won’t be sweet enough! (And, they’re likely to switch beds and roles in the night!)  I’m looking forward to a weekend getaway when I know my co-pilot will take the reins and pancreas-it-up for me.  I’m looking forward to getting a soul dope infusion, aka…Bon Jovi and time with girls!  And, I’m looking forward to a cure!

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