Thursday, December 29, 2011

12 D-resolutions for 2012

I don't really "do" resolutions. Mostly because I am so perfect the way I am.


Now that we've all stopped laughing, I thought I'd jot down a few things I'd like to change for the upcoming year.

Hopefully the Mayans are right and the world is ending... that way I won't have to do any of this stuff.

1. I will not let Elise's numbers get me down. I will test, correct and move on. Those numbers are not a reflection of my pancreaticing ability, except when they are good (tee hee). The bad numbers are due to the fact that diabetes sucks ass.

2. I will learn how to properly bolus for pizza and say YES to pizza for dinner (right now, pizza is something we only eat at lunch).

3. I will SWAG more and weigh less. I am getting tired of carrying around a scale. My diaper bag is heavy enough.

4. This coming year I will bake more with Elise. And I will write down the carb factor of each thing I make, so I never, ever have to figure it out again. I've always wanted to make meringues.

5. I will *try* not to roll my eyes and swear under my breath when people ask me (what I deem to be) stupid questions about diabetes. Instead, I will see it as a chance to advocate and educate for my daughter. I will, however, beat your ass if you insist on telling me about Brazilian moss.

6. I will stop checking my Mattias's BG just because he's cranky. Or not sleeping well. Or sleeping too much. Or not eating. Or eating too much. If he looks at me funny. Or because the wind is blowing out of the east that day and I feel like it.

7. I will finally order and read Pumping Insulin.

8. I *may* get on facebook so I can be better connected to my D-peeps. That's a big, fat *MAY*.

9. I will not let D invade my thoughts 24/7. I will allow myself to sometimes forget that my daughter has diabetes.

10. Instead of beating myself up when things go wrong, I will try and remember how well we are doing, and that Elise is a very healthy and happy little girl.

11. I will not be so hard on people that complain to me that they are sooooooo tired because of one interrupted night of sleep. Or that they haven't been on a date night with their husband in almost a month. Or that their child's one-time prescription was sooooo expensive. Or that they only got to get away without the kids once this year. I will smile sweetly and only punch them in my imagination.

12. I will do my best to do all of the above, but give myself grace when I fail. Being a perfect pancreas is tough, yo.

Monday, December 26, 2011

Pod change highs

Well, it's been almost two months since we started pumping, and things have been much better after a very rocky start.

(That is until, as you all predicted, those lows that we were having turned into heinous highs when the full-extent of Elise's illness showed it's ugly face and that coupled with the craziness of Christmas her numbers have been so coo-coo bananas that I don't even know where to start to fix them).

Holy run-on sentence, Batman.

Anyway, the one issue that is vexing me every three days is those pesky post-pod-change highs. Elise skyrockets into the 300s and doesn't come down for a looooong time; sometimes it can take up to 8 hours.

I don't think it's due to stress. Elise is pretty cool when it comes to changing the pod. I hand her the PDM and she presses the button like it's no big deal.

We also usually do it right before a meal, so I can give her a big-ass bolus. Take today for example:

She was 108 pre-change. We had an issue, and had to discard two pods, so the change took a bit longer than usual, but she was only "disconnected" for 10 minutes.

I bolused her for her dinner, plus another .5 of a unit for good measure. That's a lot of insulin for Elise... a dose like that should drop her by about 125.

She ate, and two hours later was at 340. I corrected and 2 hours after that she was at 359. BLERGH!

I'm hesitant to give her too much insulin because we're without the dex, and I find I am so much more cautious when I don't have a continuous flow of numbers to help guide me. I'm also less aggressive with corrections.

Can anyone tell me what I am doing wrong? Should I bolus her more? Do a change when it's NOT a meal time? Do a temp basal after I change? Does anyone have any tips that have helped them with this? And is this just a pod issue, or do kids who wear Animas or Medtronic also go through this with site changes?

Help me DOC, you're my only hope!

(yeah... I'm a nerd. So?)

Friday, December 23, 2011

Merry Christmas to all...

... and to all good numbers and a good night!

Tuesday, December 20, 2011

Sniffles equals... low?

Once again, diabetes has managed to confound me. In my experience, illness has almost always led to higher than normal blood sugars. Except, of course, when Elise is riding the vomit comet.

But over the last few days, Elise has had a cough and the sniffles. Nothing terrible. A few nights she did cough so hard that she threw up, but otherwise she's acting fine. The only other thing she's been complaining of is a tummy ache. No ketones, thank goodness.

And I haven't been able to keep her BG above 100. She hovers in the 80s. And when I bolus her for her meals, she's usually in the 50s at about 2 hours post-meal. Last night we did a temp basal of -50% for almost 4 hours. And she woke up at 96.

Have her insulin needs plummeted across the board all of a sudden?

Is the illness causing the low?

Is the tummy ache trying to tell us that there's something else going on that I can't even bring myself to think about?

I just did a pod change and I'm very curious to see if that affects her BG at all. Plus I under-bolused her for her snack. It's times like these that I really miss the dexcom!

If anyone has any thoughts, I'd love to hear them!

Monday, December 19, 2011

Can I eat some stuff?

Ahhh, Costco. The land overflowing with 3-packs of milk and honey that comes in bottles the size of a small child. Where you can buy a pack of toilet paper that will last the same length of time it takes the earth to go all the way around the sun.

I've often joked that if I were ever to become homeless, I would take up residence in a Costco.

Back when Fred and I were in debt up to our eyeballs and every spare cent went towards bills, we used to hit up Costco on Saturdays for a little "redneck dim sum". We were there so often that all the sample people got to know us and would give us extra little helpings of the treats they were handing out.

With the arrival of kids, we started spending less and less time at the free buffet. Especially when diabetes came to town. Watching people just hand food to their kids all willy-nilly hurt my heart a little too much.

We still go from time-to-time. Just often enough for Elise to know that people will give her food if she looks cute enough. We went this past Sunday. As we arrived in the parking lot filled with people who would kill their own mother for a good spot, Elise said, "Costco... yay! Can I eat some stuff?"

Used to be, if we went to Costco when Elise was on NPH, she could "eat some stuff". Within reason. She could snack on a few things and it would have no adverse effect on her BG. I could eyeball the food she was eating and know when enough was enough.

Now with the pump, she also can "eat some stuff", but I'm still trying to figure out how much stuff. And when to bolus. And how much.

So we checked her before. At 74, I decided to let her have at it. And boy did she eat some stuff. Ham, cheese, greek yogurt, sausage with chicken and spinach, perogi, brown rice and quinoa (which both of my kids loved and I ended up buying), and the definitive winner of the afternoon; TWO samples of cheesecake (chocolate and creme brulee).

I didn't bolus her and she ended up at 144 90 minutes later (right before dinner). Now, 4 hours later she was 349 (two hours post-dinner). BUT... I think the high BG could have been due to excitement. We were at our town's Polar Express, and as we checked her, we were just about to get on the train.

Or maybe I should have bolused her for some of that "stuff".

Either way, we corrected and she came down by the end of the Polar Express. Enough to have a hot chocolate with whipped cream and cinnamon sprinkled on top.

Yes Elise, you can "eat some stuff". Next time, your Mom just needs to bolus you for it.

Elise excited about the Polar Express

Having some fun before the train ride

"snow" falling before we boarded the train

family pic. Note Mattias using the Iphone.

Wednesday, December 14, 2011

The trouble with 20%

Meter accuracy (or lack thereof).


I think I speak for the entire DOC when I say it makes our collective butts itch. It still makes me want to scream that a 20% accuracy is acceptable.

The problem for those of us that have wee ones is that when a high number pops up on that ol' inaccurate meter, there is a greater margin of error.

Take, for example, what happened the other night. It was 1 am. Elise was 352. I decided to check again. This time 305. That's almost a 50 point difference!

And what does 50 points mean to Elise? Well, just for chuckles, I popped both numbers into the PDM, and there was a difference of .2o units of insulin. Not a big deal if you're an adult.

Kind of a big deal if you're 4 years old. When I did the math, I figured out that .20 units of insulin drops Elise by 50. Elise's target at night is 140. That means that if I corrected for the 352, Elise could end up at 90. Not a good number for the overnight. Me no likey.

And I'm not even taking into account the fact that Elise tends to drop at about 6:00 am, especially when she has received any sort of correction in the night (we're still fiddling with the numbers and trying to find what works). She has been in the 50s a number of times in the 6-8am time period after a correction that has taken place over four hours prior. If we don't have to correct her, it's pretty smooth sailing.

The problem as I see it is this; the higher the blood sugar, the more insulin you give. And the higher the number on the meter, the bigger the margin of error. To me, that's just dangerous when it comes to our tiny kiddos with D.

When I get a high reading, I shouldn't have to check again (as we all know, those suckers are expensive). And I shouldn't be worried that I'm giving Elise too much insulin, causing me to lie awake all night, fighting the urge to check her every 30 minutes. Shouldn't we be able to trust our technology?

For the record, I corrected using 305. And she woke up just fine.

Tuesday, December 6, 2011

Missing the in-between

We are going on day 5 without our trusty dexcom, and I have to say I'm handling it better than I had expected. After being bombarded with a constant stream of information for almost 1 1/2 years, my world has become a little dimmer. Finger pokes allow only little glimpses of what is happening in Elise's body.

I won't lie to you... It has been really hard. Especially in the middle of the night when foggy, sleep-deprived brains are trying to make decisions.

We pulled our sensor on Friday, after four days of the dex giving us the middle finger by way of the ???. On the last day, I think we got 3 full hours of actual data (not consecutive hours, mind you). Friday night to Sunday afternoon were awful due to two pod failures. I miss correcting and seeing that downward arrow to let you know that it's working.

We've had a run of bad luck with our pods... we went through 7 this weekend (not all of them made it onto Elise's body). When we'd get a working pod, we would see some beautiful numbers... although having lived with the CGM for this long, I have to wonder what's going on in the in-between.

As of now, we have no plans to put it back on anytime soon. With the addition of the pod, Elise's skin is a MESS. There is just no real estate left on her tiny body.

But I miss it. Who knew one could love a piece of technology so much?

Friday, December 2, 2011

JDRF Luncheon with Dr. Nat Strand

I am so excited that the JDRF put this video of Dr. Nat Strand's speech from the luncheon we went to in November... now everyone else can hear just how AMAZING she is!

Thursday, December 1, 2011

Things diabetes has taught me this month: November edition

-We really, really, REALLY need to get it out there about the difference between the two types. The ignorance is laughable, really. When I called my mail order pharmacy company to find out what my out-of-pocket cost would be on the new strips we were going to have to use with the pod, the guy asked me, "how many times a day do you test your daughter... one? Two? Keep in mind, he knew she was 4 and on insulin. ARRRGHHHH! I actually laughed at loud at him and said, "I wish!"

-Pumping is awful. Not wait, it's awesome! No, it sucks. No, I love it! I'm starting to feel like I have a split personality.

-Pumping DOES make holidays like Thanksgiving easier, though.

-I thought I had gotten past letting Elise's numbers affect my mood, but they still do. I guess I had forgotten because we hadn't seen such ugly numbers in a long time.

-Seeing anything on Elise's meter start with a 5, followed by two numbers makes me want to hit something.

-People are STILL trying to order the World Diabetes Day shirts I designed two years ago. I get emails from people enquiring about them and one guy even sent me a payment through paypal (which I returned, of course!). All this interest has me thinking of getting my act in gear and whipping up a batch for next year. If you're not sure what I'm talking about, here are some pictures from WDD 2009.

Sooooo, perhaps we'll have to do this again for World Diabetes Day 2012! I'm going to try and plan to NOT do something chaotic (like start pumping or have a baby), so I'll have time to organize this if anyone is interested.