Meet the newest member of our family!

Insulin family that is.

Let me start by introducing the long-standing members. From left to right we have; Pink Lady, Greenie, Mr. Blue, and Agent Orange.




Pink Lady. Our basal. NPH. Our behind the scenes gal.

Greenie. Humalog. The breakfast bolus. He handles the heavy lifting for us.

Mr. Blue. Diluted Humalog. U-20. Diluted to 1/5 the strength of full strength. Mr. Fix-it. He handles our screw-ups and is used for the smallest of jobs.

Agent Orange. Also diluted Humalog. U-50. Diluted to 1/2 the strength of full strength. Our NEW dinnertime bolus.

Why 4 insulins? Because we've been experimenting, and the U-50 is our solution. Remember all my posts about Elise's crashing dinnertime BG? It seemed no matter what we would do, we couldn't fix it. We'd give her shot up to an hour afterwards and she would still come crashing down. So Fred and I decided to try something.

A few nights ago, we decided to give her NO insulin at dinner. She was 94, ate 36g of carbs. She stayed steady for awhile, but about 1 hour after eating, she starting rising rapidly. So we chickened out and gave her 1/2 a unit of full strength. About 45 minutes later, she was 50. FAIL.

So the next night, we stuck to our guns. No insulin at dinner. She was 110 going in, ate 35g of carbs. Held steady at 180 for over 2 hours. We were elated. Except by three hours later, she was 357. FAIL.

When Elise was on U-20 for her bolus, she would get 12 units at dinnertime. That is just too huge of a shot. So we decided to make U-50. Here's how it went down on night #1:

She was 92 at dinner. We gave her 2 units of U-50 (theoretically the same amount of insulin as her full strength dose). She ate 36g of carbs and two hours later she was 213. One hour after that she was 133. YEAH!

Night #2
She was 129 going into dinner. She had 2 units of U-50 (given BEFORE her meal... something we haven't be able to do with full strength). She had 33g of carbs and was at 124 three hours later. Can I get a HOLLA?

Night #3
64 going into dinner (oopsie). She had 45g of carbs, and the 2 units of U-50. Three hours later, she was 134. I'm sensing a pattern. Again, no spike and no crash.

As an added bonus, her nighttime numbers have been so much steadier than they have been in a long time. It's so weird to me that she can received the SAME amount of insulin, and just because it's diluted, we don't get a crash.

Her 24 graph... Nice (well except for the low we had waiting for that 2-hour start-up)!



I am so relieved that we seem to have a handle on this dinnertime stuff. Those horrible crashes had been going on for MONTHS. We had wanted to try diluting her insulin like this for awhile, but it seemed so unorthodox, we were afraid to try it.

Let's hear it for thinking outside the box!

***Please Note*** This is in NO WAY medical advice. It's not. I'm not a doctor. Just a crappy stand-in for my daughter's pancreas . Just because this worked for us doesn't mean it will work for everyone. You should discuss changes to your child's treatment with their doctor.

Crash and burn

It seems to me that I may have asked this question before. But I don't remember and am much to lazy to search for it, so here it goes:

Lately we have to give Elise her rapid-acting insulin at least 20 minutes (and sometimes 30) after she STARTS eating her dinner, or she will CRASH. For example:

Yesterday her BG before dinner was low 100s. She ate (and finished her dinner - 40g), and I gave her her shot 25 minutes after she started. One hour later she was 45.

Two days ago she was low 300s (not sure why) before dinner, so I gave her her shot at the same time that she ate. She had 35g, and about 45 minutes later was 151 with double arrows down on the CGM. I rode it out and she ended up steady in the low 100s.

She gets between 35-40g of carbs at dinner. It used to be 30g, but we usually have to give her between 5-10g when she crashes, so we just added it to the meal time. Anything over 40g, she goes high after she crashes.

It's like her body absorbs the food soooooo slowly at dinner. This is the only meal it happens at. Breakfast I can bolus her up to 30 minutes prior to eating with no problem.

She only gets 1 unit of humalog at dinner. I don't want to give less because it is so imprecise to measure up 1/2 a unit. And I don't want to go back to diluted either.

So, any ideas? Anybody have this happen to them? I know I could work around it on a pump, but with everything going on in our life right now, we have put the pump decision on the back burner.

Edited to add: This has been going on for about three weeks. We dealt with it about 3 months ago, but it went away in it's own. Unfortunately, it's back and doesn't seem to be going anywhere.

Edited further to add: So tonight she was 191 going into dinner. I gave her her insulin right as she started eating. Via the dex, her BG went down to about 150, but always with a flat arrow (her BG would lower by a few points each update). Weird. We never saw a crash, but we never saw a spike... just a flat line for almost 2 hours post-dinner. Maybe she's starting to come out of whatever this is. Glad to know we're not the only ones.

Don't judge me

I have a secret, and I feel the need to tell you. And when I do, I don't want you to judge me. I just need to get it out. Maybe because one day I'll look back and be able to see what an idiot I was. Here goes...

I don't want a pump for my daughter.

Whew... I said it. I feel better now. Maybe you're reading and re-reading the above statement; scratching your head and asking yourself what I've been smoking. Let me explain.

To do that, you might need a little background. Elise was only 12 months old at diagnosis, and we caught it VERY early. She was put on diluted Humalog and diluted Humalin (NPH). She was put on NPH because it is the only long-acting insulin you can dilute. Her daily doses were 2 units of diluted NPH at breakfast (no fast acting), and 1 unit of diluted Humalog at dinner. If you translate that into full strength, her carb ratio at dinner was 1:100. So you can see, she was on a pretty small amount of insulin at first. A pump was never offered as an option, and of course, we didn't know enough to ask.

So 2 1/2 years later, we're still on NPH as a long-acting insulin. I have had people tell me that it is a horrible insulin regimen. That it's archaic. That we're doing a disservice to our daughter. And yet, we're still using it. Why?

Because for us, it works. Elise's last 4 A1C's have been 7.1, 7.1, 6.6, and 7.0. Unless we're dealing with some unholy hell like an illness or growth spurt, her numbers typically range from 90 to about 200 during the day. I know what to expect from NPH. I know how to tweak it. I understand how it works and how to make it work for us. But, it is a very stress-inducing insulin, and there are days when I am so over it that it makes me cry.

And still I say I don't want a pump. So why? Why would I say something so dumb?

Because I don't want everything that comes WITH a pump. I don't want to deal with sites that get ripped out.

Or air bubbles in the tubing.

Or infections.

Or scar tissue.

Or bad sites.

Or a site that bleeds.

Or seeing yet ANOTHER thing attached to my daughter 24/7

Or any of the other problems I've read about that happens when you pump.

For us, trouble shooting a high BG is fairly simple... either her insulin to carb ratio has changed, we messed up on her carb count (something that rarely happens since we weigh everything she eats and use carb factors), or the insulin has gone bad.

Easy.

A pump involves way more trouble-shooting. Something I don't think my brain can deal with right now.

Having said all that... we are taking a pump class this Thursday. And I will go into it with an open mind, and really listen. I know there are a lot of positives about a pump. And maybe in a few months you'll hear ME ranting about how awesome it is.

Stranger things have happened.

Wanna know another secret? I'm not so good with change, and I think out of everything, that's what's bugging me the most.

Thank you and maybe an explanation

First, thanks to all who responded to my last post. I was still pretty shaken up when I wrote that. Not because of the number, but because of how Elise was acting. We once had a 32 and she was acting completely normal. I have never witnessed anything like this before, and it still makes my heart race when I think about it.

One piece of good news, I think we've figured out that it wasn't anything I did. Rather, Elise has suddenly become more sensitive to insulin over the past few days. She has gone low after every meal that she's received a shot of humalog for (lunch she doesn't get a shot, so she's usually fine afterwards).

For example, this morning after her shot and breakfast, she only went as high as 136... and that's just after she finished! And that 136 was via the dexcom with a slightly downward arrow. We had to give her 7g just to keep her in the 80s, and after her mid-morning snack (15g), she never went any higher than 100. Dinner last night was a similar story to what happened on Friday, except we caught the low before it got bad.

Oh, and thank you to Tracy (Superhero and the Princess), and Denise (My Sweetest Boy) for my Versatile Blogger award... I need to do my post so I can put my award in my trophy case!!!

Here we go again

As most of you know, Elise is on diluted insulin for her fast-acting. Her dosage is enough that we can switch to full-strength, but each of the two times we've done it, it has been a disaster.

We currently dilute her insulin to U-20 (which means there is 5 units of diluent to 1 unit of insulin, or 10 units of the diluted stuff = 2 units of full-strength). Right now, Elise takes 11 units of DH at each meal, which in theory means she should get a dose of 2 (well, 2.2) units of full-strength.

Both times we've tried to switch , we have the exact same problem... her numbers seem fine at first, actually on the low side of normal. Then, they go up, and up, and up until they're in the high 400s. The more insulin we give, the higher she goes. Which is totally backwards, right?

Our theory is that the full-strength stuff is just still too strong for her (the first time we did this, we started out with a dose that was below what she should be getting). We think that her liver might be kicking out extra glucose because of the strength of the insulin. This, of course, is our non-medical opinion... call it an instinct. The NP we saw at our endo appointment yesterday thinks it's more likely that she's going low, then rebounding. My gut says no, just because I think we would have caught a low, since we test her so much.

But our NP encouraged us to try again, especially since she wears a CGM and we'll be able to see what happens. So today is the first day... right now she's out with Fred at a local farm festival where they have a petting zoo, pony rides, hay rides, and lots of open space to run around. I'm VERY curious to see what happens!

And if we get weird results again, we have to go ahead to give her a less-diluted dose of insulin (this was the wonderful Meri's idea!), like U-60 instead of U-20. The idea is to ween her off the diluted stuff. The NP wasn't too excited about the idea, but he checked with Dr. T (Elise's endo), who gave us the green light. So at least we have a back-up plan!

So here's hoping that it works! To end this post, I have a picture of the lovely Eileen; who is displaying 6 hours of absolutely bea-u-tiful numbers. The best part? These numbers are after Elise had ice cream for dessert at lunch and pizza for dinner. That's not usual around here, but yesterday was just a pizza and ice cream kind of day!

I made a mistake

I am human. I am not a pancreas, although I try really hard. And as much as I hate it, I make mistakes. What makes it so hard to handle is that they affect my daughter. My screw-ups hurt her, and it kills me.

Within the past week, there have been some evenings that we've added some diluted Humalog to Elise's nighttime NPH shot, so she can enjoy an extra treat. We've discovered the vast bevy of frozen yogurt shops, and we've found that if we time it just right, Elise can have about a 15g serving. And if we add the right amount of DH to her shot, it all evens out.

The problem lies in finding the right amount of DH. Elise's ratios are a bit weird, especially right now since her illness. She's about 4:1 (4g of carbs to every 1 unit of insulin - remember, she's on diluted) at breakfast, and 3:1 at dinner. She doesn't have a lunchtime ratio because she's on NPH. Also, all her snacks are uncovered.

Last night, I screwed up. I thought I had it all figured out. I didn't. The problem was two-fold: I think I over-shot my WAG at how much insulin she should get, and I lost track of time and gave her her bedtime snack about 45 minutes too late. It was a perfect storm.

For almost two hours, her BG hovered in the 60s. It was late and she needed to sleep, but I couldn't put her to bed like that. The extra carbs I put into her just maintained her BG; though I knew it was just a matter of time before it all caught up to her and her BG went through the roof.

Finally at 11:15, she could take no more, so I lay in bed with her; waiting for the moment Eileen would show me the beautiful sight of an upwards arrow. And as I watched through my tears as Elise slept, I cursed myself and this stupid disease.

How is it fair that when I make a mistake, it hurts her? It is my screw-ups that cause her harm, and I remain unscathed. I should be the one feeling crappy. It should be MY tummy that hurts, not hers. I made the mistake and she pays the price.

I take it all back... we suck.

Calling on all my D-Peeps for some help here. Fred and I are stumped beyond belief at a trend of numbers Elise has been having lately. I blame it on my proclamation that we are "freaking rock stars".

Anyway... for the last three days, when we check Elise for her pre-bedtime snack, she's in the mid-300s. We give her a snack and her bedtime NPH, and usually somewhere between 9:30 and 11:00, she falls low. We give her some carbs and she rebounds into the 300s during the night, waking up in the mid-200s. The timeline looks like this:

5:00 pm - shot + dinner. Usual carb ratio.
7:30 pm - bedtime check. In the 300s.
Between 8:00 - 9:00 pm - bedtime snack (15g) and NPH.
Between 9:30 - 11:00 pm - Elise's BG is in the 70s. We give her carbs.
1:30 am - BG in the 300s.

Is it possible that her fast-acting insulin she gets at dinner (diluted Humalog) is peaking 4 - 5 hours after she gets her shot?

Is it the combination of her DH and NPH making her go low (are we giving the two shots too close together, which is approx 3 1/2 hours apart)?

Is the NPH now peaking earlier than it ever has?

Keep in mind, we are doing EVERYTHING the exact same as we have before. Same schedule, same carb ratios, same snack. I just don't get it. The weirder thing is the numbers are pretty much IDENTICAL for the past three nights (for example, last night at 7:30 she was 331 and tonight at 7:30 she was 331... WEIRD).

As far as I've been told, Humalog starts to work in about 20 minutes, peaks around 2 hours, and is gone by hour 4. NPH (in most people, we've found differently with Elise), starts to work in 1 -3 hours, peaks by hours 4 - 9, and is gone in 14 - 20 hours.

So... anybody have any pearls of wisdom for us? We're going to try giving her a few more carbs for her bedtime snack to see what that does to her BG at around the 10:30 mark. Otherwise we're out of ideas.

I never should have opened my big "rock star" mouth.

Three cheers for sugar-free antibiotics!

We are now almost on day 3 of using the sugar-free Amoxicillin, and I have to report that I am very pleased! We did see a bit of a spike on the first day of using it, but we made some adjustments and only have to give her one unit extra of diluted Humalog, as opposed to the 3 extra units with the full sugar stuff.

And the pharmacy we got it at is wonderful... before they filled it, they saw the special order for sugar-free and called to ask if we wanted to do the flavouring or not, and if we did, did we want to add a sweetener. They said that without it, the antibiotic would taste pretty bad and they were worried she wouldn't take it. Thankfully, they offered stevia (which is a natural sweetener).

Then, after my husband brought it home, I had to call to ask some questions about the dosing instructions. The pharmacist double-checked everything, and even asked me questions about Elise's age and weight to make sure she was getting the right dose.

What a far cry from Dr. Surly (if you don't know who Dr. Surly is, I posted about him on my other blog... click on his name to read it).

And I'm also happy to report that Elise has been fever-free for 24 hours and seems to be feeling better. So yay for sugar-free antibiotics!

By Jove, I think we got it!

And by it, I'm talking about the correct dosing for the Amoxicillin Elise is currently taking for her strep throat.

I knew it was the antibiotic making her run high, and not the infection, because she was constantly running high (in the almost 400 range) about 2 hours after getting her dose (breakfast and dinner). We usually see numbers in the mid-100s or lower at these times. Her numbers at other times during the day were fine.

The incredible Meri suggested adding a correction dosage to the shots Elise was getting at breakfast and dinner to see if that would help. Elise gets 1 unit of diluted Humalog for 301-400, and 2 units for 400+. I decided to start with 2 units, which didn't make much of a difference, so I got bold and upped it to 4 units. We're now seeing numbers in the high 100s. Not perfect, but I'm reluctant to up the dosage any more than I already have.

THIS is why I love my D-community!

Disclaimer: This correction dosage for Amoxicillin, of course, pertains to Elise only. Every child is different, and will respond differently to medications and/or insulin. Please follow your doctors advice, and use caution when giving your child a buttload of insulin.

Much ado about naptime

The winds of change are blowing here at our house, and Momma is not happy about it. It's looking like Elise might be on the verge of dropping her nap, which is troublesome on a few fronts.

Right now (since the stupid time change) she naps from about 3 pm - 5 pm. I actually put her down around 2-2:30, but it takes he awhile to settle down and fall asleep. These days she's falling asleep closer to 3:30-4:00. This presents a problem because the later she naps, the longer she's up that night. When she naps until 5:00, she's up until about 11:00 pm. We put her to bed at 9:00, but she tosses and turns for almost two hours!

The days she doesn't nap at all, she becomes a quivering puddle of Elise-goo at about 7:00 pm. It's enough to make you want to run and hide. Any other child you would say, great! Put her to bed at 7:00 and be done with it!

Except Elise isn't any other child, and because of when she eats dinner, it is impossible to put her to bed any earlier than 8:00.

We eat dinner at 5:00 (which in my opinion is sooooo early). Elise takes about an hour to finish everything, so she's done by 6:00. There is no way we can test her an hour later and get an accurate bedtime BG number. Not to mention giving her a bedtime snack and her insulin. It's too soon after her dinner.

We've also discovered that we have a very slooooow absorption rate with Elise's diluted Humalog. We find it peaks closer to about 3 hours after she gets it. I know, weird. But it's true. It's just not safe to give Elise her bedtime NPH that close to her dinnertime DH because it will drop her low while she sleeps, even with her snack.

So what is a mother to do? Drop the nap and just fight to keep her up until 8:30 (I get ulcers just thinking about it), or let her nap late and go to sleep late? I'm stumped.

Stupid diabetes... why do you have to make EVERYTHING so bloody hard?

ETA: Oh for the love of all that is good and holy, I went to get Elise up at 4:00 because it sounded like we had another failnap, and when I tried to open her door, I couldn't. She had fallen asleep right in front of it. I usually check her BG at 4:30, but I can't even get in her room. Unless of course I wake her up. I give up.

Odds and bits, ends and pieces

I have really been bad about posting over here... it's not for lack of things to say, I've just been posting quite a bit on my other blog and have developed a very bad case of carpel tunnel (edited to add: it's not carpel tunnel after all... sounds more like Ulnar Nerve Entrapment. Oh internet, is there anything you don't know?) . It's gotten so bad my pinkie finger on my right hand goes numb whenever I start typing.

Anyway, here are my various thoughts in short form before this gets too painful:

• We seem to have steadied Elise's overnight BG by lowering her night time N from 3.5 units to 2.5. That's a pretty big decrease, but it seems to be working. We're still having some issues with her BG dropping after her bedtime snack (going from an okay bedtime number to a not-so-great one).
  
• The endo thinks this may be because of a delayed response to her dinner time DH. No idea why she's having this response all of a sudden. Anyone else ever experience this?
  
• We had GREAT Christmas day numbers. In fact they were the best they've been in awhile.


• I wasn't going to do any Christmas baking because the thought of it made me very sad. But after I kicked myself in the butt (a very difficult maneuver by the way), I decided to try a somewhat healthier version of gingerbread cookies using a recipe I came up with. And by that I mean I used whole wheat flour. They still came out tasting AMAZING, and Elise and I even decorated them using a touch of royal icing and one M&M.
  
• Even though we've been getting by with fewer night checks, I'm still very, very tired. I was so spoiled over the holidays... Fred took over the morning duties and I got to sleep in every day until about 10:00 am. So sad that it's over.
  
• Still having issues with her going low during her nap, even with a snack right before nap time. Since Elise has moved to her big-girl bed (you can read about that on my other blog), she's started taking longer to fall asleep. Today I used this to my advantage to figure out what was happening:

1:00 pm - BG is 130. I give her about 6g, which should nudge her up by 30 -50.
1:40 pm - BG is now 108. I giver her another 6g.
2:45 pm - BG upon waking up is 164. That's more like it.

• Yesterday She was 146 going into nap time, and I gave her about 4g. When she woke up she was in the 300s. At dinner, mid-300s. After today, I definitely know she's going low sometime during her nap. We're trying a combo of less NPH in the morning and more carbs at lunch.

So this turned out to be quite long and now my whole arm is numb. I hope I can fix this soon... what will I do without my therapy?

Pancreas, we have a problem

It's official. My brain is fried. I can no longer think, reason, talk, remember my name, walk and chew gum at the same time (although that one was always a little dicey), or figure out the BG numbers.

I am flummoxed, stumped, puzzled, bewildered, confused, befuddled, discombobulated, and just plain at a loss.

And yes, this is yet another post where I bore you with the breakdown of Elise's numbers.

Last (Monday) night:
7:40 pm - 93. She gets her new lowered dose of 3N, and 17g (2 more than usual) of carbs
12:11 am - 74. She gets 8g of carbs
12:47 am - 102
1:16 am (crying) - 138
2:19 am (crying) - 125
3:54 am (crying) - 63. She gets 8g of carbs.
6:45 am - 91. We realized we never re-checked her after her last low. We're not too worried about this number as all her N should be out of her system by now.
7:54 am - 152

Today we had a pretty good day, numbers-wise. Then as then sun sets, Elise's pancreas starts at it again.

Tonight:
5:05 pm (dinner) - 234. High, but we give her a normal dose of 10DH and her usual 30g of carbs. We're eating a Chick-fil-a, so she plays in the play area for about 30 minutes afterwards.
7:42 pm - 196 - Still give her the lowered dose of 3N, and her usual 15g of carbs. We figure she's on the high side, so this should be okay.
9:15 pm (crying) - 44. What the FREAKIN' WHAT? How do you go down by 150 AFTER eating 15g of uncovered snack??? We give her 15g of carbs, plus almost a block of cheese (I may be exaggerating a wee bit). She also drank a sippy cup and a half of water. Ugh, can you say midnight diaper change (and no, I don't mean mine)?
9:32 pm - 69. Going up slowly. Gonna be a looooong night.

One thing I'm wondering is how much is exercise affecting her? I have noticed a pattern on nights where she's more active, she tends to go low.

But we also have these night time lows even when she's not active. Like last night for instance. Another thing I can't help but wonder is how long the DH stays in her body. I know they told us it peaks at about the 2 hour mark, then is pretty much gone by hour 4. But this does not seem to be the case with Elise, especially at night. It seems to peak a bit later and last longer. But how can that be?

Tomorrow we are going to be contacting the endo. Not the CDE, but the actual endo. Fred and I can't take much more of these night time issues. We have been testing her 6 - 8 times through the night almost every night. And it's not leaving much time to sleep. Even lowing her dose isn't having much effect. Last night when we lowered it, she had more lows that night than she did the night before on the higher dose.

If you didn't understand that last sentance, don't worry. Neither did I and I'm the one who typed it.

Bah, this post has already gotten too long and I need to go check Elise.

Flummoxed AND stumped

Although it's better than it was, Fred and I are still up two to three times a night checking Elise. We are seeing some seriously WEIRD numbers.

The one that has us stumped during the day is her post-nap number. She is waking up in the low to mid-300s. We can't tell if we're missing a low while she's asleep, or her morning N needs to be increased. For example, to day she was 184 right before her nap at 1:00pm. It took her awhile to go to sleep, and when she woke up at 3:30, she was 304.

I think the only way we'll be able to figure it out is with a CGM, but I don't know if insurance will cover it or how expensive they are (or even if Elise will tolerate such a thing).

We've also been giving her DH(only 1.5 - 2 units) with her bed time N shot because we're having trouble getting her down after dinner. She's high going into it, and no matter how much DH we give her for her dinner time shot, she ends up at almost the same number three hours later. So tonight she was 315 at dinner, we gave her 14 units of DH (4 units more than she usually gets), and exactly three hours later, she's at 335.

I HATE giving her DH at bed time, because it's so scary for us to let her go to sleep with rapid-acting in her system.

Can anyone offer any insight from their experiences? I know it's hard to tell just by what I've written out here, but I'd welcome any advice. I think an email directly to the endo is in order on Monday if we can't figure it out before then.

Flummoxed

I like the word flummoxed. It looks cool when typed out, and it's just plain fun to say. It means; bewildered, puzzled, confused. As in; I am so flummoxed by Elise's BG numbers yesterday.

It all started around 4:30 yesterday afternoon. Elise had woken up from her nap about 2 hours earlier with a BG of 158. It's a nice number, usually guaranteed to get us through to dinner. But at 4:30, Elise complains that she's thirsty. She had been playing at an indoor playground at our church, and I thought it was from that, but my gut told me I should check her anyway.

She was 61. I gave her some yogurt, and her before dinner check came in at 95. She got her usual dose of DH, and about 5g more of carbs than usual, because we were eating dinner at the church, and Elise would be going back to play on the playground afterwards.

An hour after dinner, she was 63. All I had left for her were some goldfish crackers. I gave her about 8g worth and then we went home.

Bedtime check, she was 102. Good. She got her usual bedtime snack and dose. She actually got her shot late because we were decorating the tree. Only 2 hours after her shot (way to early for the N to be peaking), she was at 60. We give her 10g. She's 78 at next check.

At 1:00 am, she's 54. Crap! we give 10 more grams of carb. I don't remember what happened after that (I think we both passed out from sheer exhaustion), but when we checked her at 3:00 am, she was 69. She gets 7g more. Finally by 4:00 am, she's 144. But down to 119 at 6:00.

When I woke her up this morning, she was 242. This was only 2 hours after the last check, so I'm wondering if she went low again and we missed it. She's been running in the mid to high 200s all morning.

Right now she's been napping for almost two hours and I'm wondering if I should sneak in there to check on her. We contacted the CDE at our endo, but they weren't much help.

So yeah... life is crazy right now. Thank goodness for impromptu kitchen dance parties to make you feel good.

My aching head

Today is the first full day that we switched back to diluted Humalog. We finally got rid of the ketones about midnight last night, but she crashed at about 4:00 am with a BG of 49. We gave her some DH in her bedtime N shot, and I am so surprised at how far her BG came down (from 476 at 9:00 pm to 49 in 7 hours).

She woke up at 166 this morning and stayed at about 150 until after lunch. Her BG before naptime was 371 (usually it's in the high 100s). This is telling me she probably needs her morning N adjusted, but that I can handle.

My brain is hurting trying to figure out why the full strength Humalog made her BG go so high, and the diluted makes her numbers normal. The only thing I can think (and you wily veterans please correct me if I'm way off base) is that the full strength made her BG so low that her liver was kicking out a tonne of extra glucose. That is the only thing my pea-brain can think of.

Even the on-call endo last night was puzzled. Now I don't feel so bad.

Out of the loop

Wow, I feel so far removed from what has been happening with all you guys. Life has been crazy since we returned home and I haven't really had a chance to catch up on all your blogs. It might take me a month, but I'll do it!

First (and worst) of all, Elise's BG has been all over the stinkin' map since Thursday, which was the day we switched from diluted Humalog to full-strength. It has seriously been a nightmare, I think we were up every hour last night checking her and had to stop a low on two separate occasions.

Then tonight as we were putting her to bed, she started asking for banana and goldfish, something she does only when she's going low. I started to disregard her, chalking it up to wanting to stall the inevitable (the timing just didn't make sense for her to be low), but my Mommy-instinct kicked in and I checked her anyway. She was at 66.

It was weird for a bunch of reasons, #1: at that hour (9:30), she should have had no active insulin. She received her dinnertime H at 5:10 (with a BG of 334). Reason #2: she had a 15g snack at about 7:50 (BG was 169), that amount of carbs at that time usually shoots her into the low 200s by 11:00. Reason #3: she received her bedtime shot of N (a decreased dose by .5 units) at 8:30 and 1 hour is way, way too early for the N to be doing anything to her BG. We usually see it affect her BG by hour 4.

The only thing that was out of the ordinary was that as she was nursing before bedtime, she started to cough so hard that she threw up (milk only). It was about 30 minutes later that she started asking for food. I don't think it was enough to cause her to go that low.

I know Humalog is supposed to peak around the 2-hour mark and be pretty much gone by hour 4. But could the full-strength be affecting her differently because her body is used to diluted? She used to get 10 units of DH at dinner, and now we give her 2 units (although tonight was 2.5 because she was so high). Or is it just a coincidence that we've started having all these issues when we moved from diluted to full-strength?

There are also a bunch of other variables going on; Fred's family is in town and she's so busy having fun playing with her cousin, all this visiting has led to late bedtimes and a somewhat disrupted schedule.

I just feel so overwhelmed right now. I'm not sleeping. I'm barely eating. My house should be declared a disaster-zone. I have no food in the house since I haven't had a chance to go grocery shopping since we got home. I'm too tired to try and make any sense of Elise's numbers and how to fix our insulin problem. My to-do list is about 3 miles long and I can't get my act together to take care of any of it. Our Christmas tree is up, but has no decorations or lights on it and I have yet to take all the Christmas stuff out of storage. And let's not even get started on the Christmas shopping. I might just start to cry if I think too hard about it all.

Instead I will just emotionally vomit all over you guys while I try to figure out a way to clone myself.

Checking In

Just wanted to let you know that I am checking my blog, but this weekend we're out in the middle of nowhere, Texas doing our "cabin-ing" thing with some friends, so I won't be on here as much.

I think Fred said he had received some pricing for the shirts, which may be a bit different now if we're going to add something about T1 on it. We asked about two different styles, regular and women's. If we do add kid's sizes the overall price goes up a bit because they have to resize the image to fit properly on the smaller shirts.

Anyway, I just wanted to let you know that I'm still here and working on the shirt thing.

And because this is a diabetes blog; We are STILL getting screwy night numbers. We drove out here after dinner and when we checked Elise two hours after dinner, she was 315. We attributed it to her sitting in the car, doing nothing and maybe some excitement. When we got to the cabin, we checked again (40 minutes later), and she was 158. Huh?

She also started going low over night, so we had to give her about 6g. Her night numbers have been so weird. The night before (after we went from 3.5 units of N to 3), her BG went up to 438 at around 2:00 am! Though our endo said we should only correct at meal times, we felt she was way to high to leave it alone, so we gave her 2 units of DH.

I can't figure it out. One night she'll be sky high, the next she'll be low. All on the same dose.

I think on my shirt I'll write something like, "help kick type 1 diabetes in the groin".

I've got a case of the Mondays

Blah.

Ugh.

Can I just go back to bed and sleep throught the rest of this day?

We are still having night time issues with Elise being in the mid to upper 300s, even at wake up. So last night when her BG was 154 before her bedtime snack (154 is high for her at that time of night, she's usually between 90-110), we decided to try to give her a bit of diluted Humalog to keep her from going so high around 11:00.

By a bit, I mean 1 unit of DH. Her ratio is usually 1:3 in the morning and 1:4 at dinner. So I thought 1 unit wouldn't touch her.

WRONG.

At 11:30 she was 78, and the N most likely wasn't even starting to peak yet. Ugh. We gave her 6g, and she was up to 109 by midnight. An hour later, 151. Okay, good.

Except she woke up low (don't remember the number, but it was below 80) at 6:00 am, had 6g more, went back to sleep and woke up at 7:45 at 125.

Not to mention I sat up all night obsessing over what went wrong. I just couldn't let it go. I kept thinking of different things we could try to help get this problem worked out; less DH, same snack, less N. Same amount of DH, less N, more snack. Less snack, no DH, same amount of N. The combinations are endless! Okay, maybe not, but you get the idea.

Today Elise's numbers have been on the lower side of normal so maybe last night she just got done with her growth spurt. I think we'll just go back to our original plan tonight... same ol' N, same ol' snack and let's see what happens.

We're also going camping (rather cabin-ing) with three other couples this weekend and my brain is spinning trying to remember everything we have to bring. I am a total over-packer, but I have to figure out how to fit enough stuff for two adults, a toddler with diabetes who still sleeps in a crib, and stuff for our dog (not to mention the dog) in our SUV. It's going to be tight.

Time to stop feeling blah and get to work on my many lists for this weekend.