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Wednesday, December 8, 2010

If I don't get off this coaster soon, I just might vomit

As I was perusing my D-Mom and D-Dad blogs a few days ago, I noticed a common thread... there are a lot of us riding the glucose roller coaster right now. And I'm wondering what planets are in alignment to unleash this hell upon us.

For us, it started off with just dinner problems; we had to start giving Elise her insulin about 25 minutes after she started eating because if we gave it any sooner, she would drop low, we would have to give her some fast-acting carbs, then she would sky-rocket from all the extra carbs.

But it's still not a fix... as we watch the CGM we see that she holds steady while she's eating (once we had a record 45 minutes steady BG, she didn't start rising until after she had finished eating). We usually give her the shot as soon as we see the slanted arrow up appear. Unfortunately with this method, we get double arrows up into the 300s, then double arrows down. All in the span of an hour. If I give it any earlier, she crashes.

Tonight, she was 151 going into dinner. I gave her 1.5 units for almost 40g of carbs. She held steady for 25 minutes and started to go up. I gave her the shot, and in 30 minutes, she's almost at 300 with double arrows up. I looked at the CGM 20 minutes later and she's at 179 with double arrows down. And 15 minutes after that, she's 96, double arrows down. She's 84 via her meter, so I give 7g. Now I'm just waiting for the spike to happen (and it will).

My brain is so fried from trying to figure this out. This issue only happens at dinner. Her ratio at dinner is now over twice what it is in the morning. I think our next step is to go back to diluted insulin at dinner time. I can't stand to see the peaks and valleys on the CGM, but I'm too afraid to take it off of her for fear of missing a crash.

I have never felt this helpless, useless, and downright hopeless before. Nothing we try has worked. And it's got me in a funk. I think we've had smooth sailing for so long, I don't have the capacity to deal when I can't figure it out. If you've been reading my blog for awhile, you know that we don't bother with the CDEs at our endo because they have proven themselves useless time and time again. Talking to them would drive me to tears.

Thankfully, we do have an endo appointment in 9 days. But I don't think I'm going to last that long.

11 comments:

  1. Oh my goodness! I was in tears just this afternoon for some similar problems we are having. It's like EVERYTHING has changed. His insulin absorbtion, his ratios, his basal profile, the rate at which his body metabolizes carbs, etc...it's all changing and I don't know where to begin to sort it all out. For a few days I thought we just had a crappy sensor on the Dex, but no, it's all just realy that volitile.

    Crap, crap, crappity, crap!

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  2. ((hugs)) I am feeling the exact same way. We've only been in this for 3 months, but they've been pretty smooth sailing until Adam's surgery. Now I know what it's like to see such high numbers and not be able to get them down no matter what I do. My head hurts from it all.

    We're here for you!

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  3. Oh man Joanne...I've been there many times, and Im sure to be again one day...if it helps any, I think you are AMAZING!! I'm always in awe of how you are just totally ALL OVER those numbers!! ((HUGS)) Maybe time is all that is needed. Sometimes things work themselves back to "normal." ((HUGS)) We are here to listen until "normal" comes back around!

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  4. I wish I had answers...some magical potion to sprinkle i all of our babes meals that made no spiking food and insulin that matched perfectly.
    My only maybe idea is splitting the shot if possible, we have to do this for Isaac as we can't give insulin ahead with evening meals, but sometimes if I notice a lot of ups and downs we give half the insulin when he starts eating and then the second half (or less if he doesn't finish the meal) after he finishes. Kind of similar to a combo bolus or dual wave.
    Anyhow, I hope you have a great day tomorrow and the planets align just right!

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  5. What Sarah said...is what we used to do for Joe too...but...he was on a pump. I am not sure how that would go over with Elise on shots.

    Jo...I hear you. I am kind of feeling "helpless" right now too.

    Hang in there. (((HUGS)))

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  6. Oh Joanne, I am so sorry that you feel this way. Can I suggest something that might help you? get yourself a CDE that you can talk to and can help you. Can I suggest someone? Gary Scheiner of Integrated Diabetes Services. He is THAT good my dear and worth every penny you might spend. He does remote consulting and is wonderful. I mean wonderful. He can help you. You can talk with him anytime and he solves problems, that's what he does, all day, every day. I mean, even the really hard ones. And he's Type 1. We use him. Think about it. It might help you.
    I wish you good BGs and calm times and know that I am thinking of you hon. You are not alone. keep posting and maybe someone has some ideas.
    Love to you my cyber-friend.

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  7. All I can say is I want to wrap my arms around you and take you away..kind of like a calgon commercial..
    SAME HERE. I have been so funked out about it I have even stopped blogging lately. I am sorry you are going through this rollercoaster ride too..it's a bitch!

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  8. D seems just so complicated with such a young child; more difficult. I think you have got it figured out; not possible to time the insulin exactly and not much wiggle-room on MDI. No combo bolus possible as with a pump. I don't think anyone could do better. Fall and spring are probably growth spurt seasons, which adds to the problems. From 6pm to midnight, we always need greatly increased basals, then she levels off to baseline. So in our case spikes at dinner can mean growth spurt induced basal changes but in the evening hours only. With a pump, if there is a huge spike for an hour, you can more gently address the issue with a temporary one or one and a half hour basal increase and then temp minus next hour. So you might be able to attack that 300 and lessen it without a huge crash. It will be equally difficult to figure out, just that you will have a better tool to address it. I realize you are comfortable on MDI and I am not "pump pushing".... just that I can't see how you can possibly do better than you already have. Maybe manipulate the carbs a bit so you are giving some of the carbs toward the end of the first hour, allowing some of the insulin to peak so you will have less than a 300 spike, then carbs eaten later will pick up some of the slack of IOB? It is a true puzzle.

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  9. Joanne....that just sucks. I wish I had answers for you. I'm sorry you're so tired, but Elise is so blessed that your staying on top of it. You are such a good mommy!

    Keep your chin up, Sweet Friend.

    By the way, I saw Mattias' picture on your other blog. Oh, I love his smile!!

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  10. Hang in there, we are riding with you! We too have been on the coaster lately and I am SO ready to be off for a litte while, or at least just have some little peaks instead of these huge hills and cork screws!!

    hugs my friend!

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  11. Jeez, thats touph. But what are you having for dinner? Beacause that ALWAYS happens to me when I eat pasta, pizza, or other foods like that. If you're having any of those types of foods or anything close to thos foods,I WOULD do a square bolus, but thats only for the pump. So I'm not sure. Good luck!!!!

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