Take this D and shove it

Elise starts pre-school tomorrow, and I'm a bit freaked out. And yes, a lot of it is due to the fact that she has never been apart from me (aside from the time I was in the hospital having Mattias).

But most of it is because we have not figured that freaking full-strength insulin crap out. And I'm a little frustrated, can you tell?

I can give her the same dose at breakfast, same food, same EVERYTHING and she either goes crazy low, or crazy high. There is no in between with this stuff. Plus her blood sugar is roller-coastering all over the place. Today, only 45 minutes after breakfast, she went down to 63 and skyrocketed to almost 400 after lunch. I didn't go crazy on the carbs for the low, because she was 132 right before her lunch.

But on other days, she stays in the 200s right after breakfast up until about 3:00 pm, when she starts to go down.

I don't get it, and I am so afraid to send her off to school if she's having these lows (which she does every other day or so). I don't even know where to start to make changes and I freaking HATE the fact that we can't even turn to the CDEs for help.

I think the worst part is how it's affecting her behavior. If she's sporting any kind of attitude or throwing a tantrum, it's always when she's rising or falling fast on the Dexcom. It's getting downright nasty these days and we're kind of at the end of our rope on how to deal with her.

Part of me wants to go back to using diluted, because we never saw her numbers roller-coaster like this before. But I know we just need to try and figure it out. Right now is just a bad time to be doing it.

To top everything off, Mattias has reflux something terrible. He spits up at least 5 times after every feeding (that's per side, not the whole feeding). He is so miserable all the time, even though he's on medication. I think yesterday I changed his outfit 8 times and it seems that all I do these days is laundry.

I don't think I'd be as stressed about this if it wasn't for the fact she was starting school tomorrow. How do you guys handle making adjustments on days when your kids are away from you? Should I keep her home until we somewhat get a handle on this?

Man oh man... it's a "diabetes-can-suck-it" kind of day.

Back to the drawing board

After a day of Elise's BG not going below 350 and ketones ranging from 0.9 to 1.9, we're going back to using diluted insulin. We talked to the endo on call and she agrees that this is the best course of action.

It seems a little counter-intuitive right now, but we're hoping this will work.

Poor Elise is feeling horrible and keeps telling me, "I no feel good." It is absolutely heartbreaking.

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.

Slowly crazy update

So we gave her 3 units last night and she woke up at 145 (30 minutes later than usual because somebody overslept and didn't wake up until 8:15... who me?)

Nice. Except...

Except when she woke up crying around midnight, she was 315.

Except when we checked her around 2 am, she was 340.

So then, what of these middle of the night numbers now? What do we do to get rid of them? It can't be another growth spurt (can it?), she just went through one.

Back to the drawing board.

I am slowly going crazy...

Man are we having issues with Elise's bed time insulin. She's on NPH, and it seems if we give her 2.5 units, she wakes up in the mid to upper 200s. If we give her 3 units, she wakes up in the 50s and 60s.

Really? Can 1/2 a unit make that big of a difference? Really??? I just don't get it.

When we do her middle of the night check (when we give her 3), she's usually about 190-220 range.

I really want to figure this out.

A question for all you NPH'ers or ex-NPH'ers: When did you give the bed time snack, and the bedtime insulin? Around the same time? A little bit apart? How far apart? Which did you give first?

Okay, that's 5 questions, but I'm trying to figure out if we need to alter her schedule. As of now we give the snack first (15g), and the insulin about 30 minutes later.

Sorry about the disjointedness of this post... I'm really tired, but wanted to put my questions out there in case anyone had some wisdom to share.

Good night... (I hope!)

If it's not one thing...

Okay, I know I've done my fair share of whining lately, but the funny thing is, it doesn't really describe my head space right now. Things are actually going pretty good with Elise, diabetes-wise.

That being said, some annoying little things keep popping up that are making me want to rip my hair out.

The latest one has to do with Elise's diluted insulin. From the beginning, the endo let us do all the diluting ourselves. They gave us the supplies (syringes, sterile vials and diluent), the "recipe", and told us to have at it. Which we did for the first few months. Then, thanks to some bureaucratic decision (which our endo was none to pleased with, although she couldn't say it in so many words), they were not allowed to give us the diluting supplies anymore.

The only option they could give me was to drive out to the pharmacy at the hospital (30 minutes each way with no traffic) every three weeks and pick it up myself. Um, no thank you. So I did some research and found out Eli Lilly will drop ship the sterile vials and diluent to a pharmacy of my choosing. Yay, problem solved.

The first time I did it, I worked wonderfully. Until we ran out of the diluent and never realized we had used the last vial. Of course, we only figured it out when it was time to make more diluted humalog! And an even further of course, it was the weekend.

So we called Eli Lilly on Monday and asked the to drop ship the diluent only. The first time I had them ship it to the Costco pharmacy, because I really like the staff there, but their hours are not as convenient, and they don't have drive-thru pick-up (sometimes it's mandatory with a toddler in tow). So I chose the CVS up the road from us.

I called on Tuesday and found my shipment was in, so I went and picked it up only to find Eli Lilly had shipped us 20 sterile vials instead of the diluent. ARGGGH! And it was too late in the day to call them to re-order.

So we call Wednesday, and re-order. Both times we've ordered, the shipment has always come in the next day. Thursday, no shipment. Friday, no shipment. And by the time I called CVS to find out that they didn't have it yet, Eli Lilly was closed (they close at 5:00 pm EST) for the weekend!

Our diluted humalog is now expired by a week, although if you read my last post, that's not affecting it's potency in the slightest! And we have to wait until Monday to call Eli Lilly again to figure out what is up. Although, I'm not 100% convinced the problem isn't with the CVS. The people that work in the pharmacy at our CVS aren't the sharpest tools. Needless to say, I don't get many prescriptions filled there!

I've decided the way I'm going to avoid the problem of running out of supplies without realizing it, is by writing on one box of each prescription (test strips, insulin, lancets, syringes, diluent, etc), "LAST ONE", and not use that box until I really and truly can't find anymore. Hopefully this will work until I figure out a better system.

I fear change

I just wanted to thank everyone for their comments. I truly appreciate all your advice and prayers.

I should have explained that one of the reasons we don't want to change insulin is because things are going so well right now. Except for a few blips due to illness, Elise's BG numbers have been really good. And for the first time I feel like I have a handle on things.

Going back to square one really frightens me. With NPH, I know what I'm doing. I have an understanding of how the insulin works. Switching means starting over and the memory of those first months are burned in my brain with such intensity, I actually start feeling sick to my stomach thinking about it.

I know that you guys all know what I'm talking about. Trying to find the dose that works and the completely crazy numbers that follow until you do. It's all too fresh for me to want to go back and do it again this soon.

And like I said before, what we're doing now is working and I'm enjoying that wee bit of normalcy in our lives. I think if we were not having good numbers on the NPH, I would be more open to change.

As for the pump, I just don't feel ready for it. One day; but not right now.

Elise does seem to be feeling better; she woke up with a BG if 155, but on a whim I checked for ketones and she was at .8. Weird. They were gone by 10:45, so I have no idea what that was about. Can you have a relatively normal BG and ketones at the same time?