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.

When you should listen to those little voices in your head

We interrupt Diabetes Week to bring you the following post that can only be filed under "what the CRAP?" So today was gym day. That's when I take Elise to the local rec centre where she can run, jump, and play with all the other free-range children. There's a bounce house, tricycles, gymnastics mats, and all sorts of goodies to play with. Then I get to sit on my butt for 90 minutes while she is having fun. It's a win-win. I test her BG at snack time... 10:30. She's 129. Wonderful, especially considering she woke up at 268 this morning. She gets her 15g snack and off she goes. I keep a very watchful eye, for reasons you will read about tomorrow. I start getting ready to leave around 11:30. I wanted to check her to make sure the NPH hasn't peaked. I clean her finger, shunk (thanks Karen!), 5... 4... 3... 2... 1... aaaaaand 377. WHAT THE CRAP??? I look at the meter. Shake it. Turn it upside down even. And still the 377 mocks me. "There's no way" I tell myself, "did I miss a low?" One of the many voices in my head (let's call him Harold) tells me to check her again. But I'm in a hurry to leave, so I don't. During the 5 minute drive home, I pass a McDonald's. Their fries are calling to me, so I make a quick detour (yes, yes... I know. Leave me alone, I'm pregnant). As soon as I get the bag, Elise starts whining, "fries? Fries? Hungry!" She's actually starting to have a meltdown, so I quickly drive home. When I get there, one of the many other voices (let's call him Lenny) tells me I should really re-check her. This time I listen (Lenny has more pull than Harold). I clean her finger, shunk. 5... 4... 3... 2... 1... aaaaaand 57! WHAT THE CRAP??? How does she drop 320 in less than 30 minutes? Wha' happened? Why didn't I listen to Harold? Her finger was clean... what did I do wrong? As you can probably tell, this is the first time I've ever experienced something like this. And the worst thing of all, I ignored my daughter's pleas for food because I thought her BG was high. UGH... Worst. Mom. Ever. The only thing I could have done worse, is gone by that 377 and given her a correction. That would have been most excellent (please read that last sentence with a large helping of sarcasm). I will never ignore Harold or Lenny again.

I had to go and say it

Rewind about seven hours ago. I'm chatting with the undisputed champ of the diabetes world, Meri, when she asked me how Elise's numbers have been.

I told her that it looked like things were stabilizing, and we had seen a trend towards some higher numbers. My thinking was Elise had gone through the mother-of-all growth spurts during the month of December and it made her BG totally freak out.

But lately all her numbers seemed to be following a trend, so we were pretty sure it was all over.

Until tonight. Check THIS out:

7:30 pm - 168
At 8:15 pm we give her her night time N.
8:45 pm - 15g carb snack plus nursing
9:30 pm - she asks for water, and some banana. BG is 48 (huh?) We give her 10g.
9:45 pm - BG is 57
10:00 pm - 62. We decide to give her 5g more.
10:15 pm - 68
10:30 pm - 76. Again, we decide to give her 5g more.

At this point, it is now way, way past Elise's bedtime, although she is being such a trooper about it and not complaining at all. So we just put her to bed with a BG of 76, knowing that in about an hour, the N should start to peak. Of course we choose tonight to up her dose by .5 because she had been waking up in the mid-200s.

I'm just wondering if at some point we're going to see a major BG spike because of the 20g extra carbs we gave her. Better that than crashing low I suppose.

Going to be a long night.

Edited to add: 11:30 pm - 111. Groan.

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.

What the???

This diabetes stuff has me scratching my head again. It all started last night when Elise got home from her night out with Poppa at the ballgame (I got to eat some fabulous food with some fabulous ladies at our Girls Night Out).

She had her normal snack (15g) at her normal time (8:o0), and 2.5 units of NPH 30 minutes later. Pretty much how we do it every night. Except last night she was up later than usual, so subsequently I nursed her later, but that was the only change. When we checked her before bedtime (10:30), she was at 110. Much too low for a bedtime number, but we let her be, hoping that her BG was on its way up.

One hour later, 100. Two hours after that (at 1:45 am), 70. So, we give her 7g of carbs and 45 minutes later she's at 208. Yay! Back to bed. She wakes up at 7:45 with a BG of 76.

I decided to give her about 5g more of carbs for each meal (I had noticed she was trending lower a few days prior), and we pretty much stayed in the mid to low 100s all day.

Then dinner time came, and she was 155. We gave her the usual 9.5 of DH, an approximately 35g of carbs at dinner. About an hour and a half later, she's acting whiny, so we check her and she's at 87. A pretty low number considering her meal consisted mostly of pasta. We decided to wait and see. When we checked 45 minutes later, she was at 70.

So we gave her 10g of banana (carb grams, not weight grams), and when we check her an hour later, she's still at 70! At this point my husband and I are looking at each other, not quite sure what to do. Since it was snack time, we gave her a 20g snack, her insulin, I nursed her and we put her to bed. At last check (one hour after snack), she was 201.

Is it just me, or are those some crazy numbers? She hasn't been any more active than she usually is, so I'm thinking honeymoon? I just hate seeing those lower numbers at night. It doesn't lead to a very good night's sleep. This is the first time we've experienced anything like this, so I'm a little unsure of how to handle it. I know I have the head knowledge, just not the confidence that I'm doing the right thing. I'm thinking I should start off by lowering her dinnertime DH?

I'd love any advice (or acknowledgement that I'm on the right track), ideas, etc.

You know what I'd really love? A pancreas that was miraculously being healed.