I was nervous packing for the all-star tournament last weekend after the diabetes disaster the previous weekend. We made it through with no ketones!!! Yeah!
Andrew's team played two games Saturday morning & then was finished for the day. Will's team had a morning game and two afternoon games. We were set for one very long, hot day at the ballfield. Friday night, the father of one of Andrew's friend asked if Andrew could come back to the hotel & swim & hang out with his son & the other teammates instead of watching Will's games. It definitely would be more fun than baking in the sun for an additional four hours.
I knew I should say yes. The advice is, "If you would have said yes before diabetes, say yes now & find a way to take care of diabetes at the same time." However, the idea sent me into panic mode. I didn't commit, but I reminded him of Andrew's diabetes & and said he would at least need his sister to accompany him if he was going to go swimming. When I talked to Gene on the phone, he wasn't excited about him going swimming without me either. It is very difficult to notice when you are weak and sweaty when you are in the pool. Andrew is usually 50 before he knows that he is low if he is in the pool. And he drops FAST! At 9:15 Friday night, Andrew's BG was 323, & he took a correction. We went downstairs, disconnected the pump, and swam for about 30 minutes. He got ready for bed, checked his blood sugar at 10:19 & was 62. So I'm nervous about letting him swim without me watching...
Saturday, after 3 hours at the ballfield, Kaitlyn and Andrew really want to go with their friend back to the hotel. I explained to the dad my concerns about Andrew, and we agreed on this plan. They would go eat first, & the kids would use the Restaurants app on the iPod to count carbs & bolus. Andrew would check his blood sugar every 30 minutes to an hour while at the pool and, if he was anywhere close to 100, he would eat a snack. I gave him money to stock up on snacks and make sure there was plenty to eat. I made sure the dad had my number, and let them go. I was scared, but I did it.
I said goodbye in the parking lot and then hurried to Will's field, just in time to see him get nailed in the forehead with a ball that bounced up on the lip between the sod & dirt. I watched as the coaches checked on him & Will decided to stay in the game. When he came off of the field though, he began to cry again as soon as he saw me. I settled him down. Soon, the coaches called me back over. Will was dizzy and nauseous. Not good signs after a head injury. It was also very hot outside, and we had been at the ballfield since 8 a.m. When the game was over, the team had a short break before the next game. The rest of the team stayed & watched the other teams play. Will and I left the park to get Will cooled down & hydrated so that I could see if it was heat or injury bothering him. It was heat. My Will returned to normal and was able to play in the last game of the day!
I was exhausted by the time our 8 1/2 hours at the ballfield came to an end. I eagerly returned to the hotel to check on Andrew. I was still in the hallway when Kaitlyn called to say that Andrew's site had come out. No problem. We had it back in very quickly. I asked Kaitlyn if Andrew had gone low. She replied, "Yes, a lot. He spent most of his time sitting out of the pool." So I asked Andrew later how low he had gone. "The meter said Low, under 20!" I checked the meter, and sure enough that's true. Under 20. Under 20. The grace of God is the only reason he didn't have a seizure or pass out right there. In a pool. Pools aren't the best place to have seizures or pass out. No, the idea just sends chills down my spine. He's fine though. He treated himself. When Kaitlyn asked if he was okay, he just said yes, so she didn't know how low he was until he told me. That's not safe. He checked his BG for the first time at the pool at 2:43 & was 39. He treated, but felt worse. Recheck at 2:57 was LOW.
Being that low for that long depletes the body's ability to prevent and recognize lows. Sunday afternoon, he came to me & showed me Dex said that he was going low. He looked low & I wanted to be aggressive because of Saturday's low, so I dropped glucose tabs in his mouth before testing his BG. LOW, under 20 again at 3:55 pm! I gave him juice too. Will was finished, so we headed to McDonald's. Recheck at 4:17 after 31g of fast-acting carbs - LOW, under 20. Seriously? Under 20 for over 20 minutes. Is that even possible? Scary!
I turned down his basal for 24 hours to avoid all lows until he could recover. I guess it was the baseball. It sure had the opposite effect last weekend.
Wednesday, June 29, 2011
Sunday, June 19, 2011
Rough Day at the Ballfield
Andrew is playing on the all-star baseball team, and his team, which started practicing together Monday, entered a tournament hosted locally this weekend. He enjoyed learning the new rules and even got to pitch the maximum 8 innings per tournament! He and his team did very well, and I am so proud of them!
Diabetes, however, did not play nice today. It's ironic because a parent asked how his blood sugars were early this morning, and I showed off the perfectly straight line on his dexcom. I know, "Pride goeth before a fall," but it was such a pretty graph! They won the first game which, considering we were the only non-travel ball team there, was fantastic! Andrew pitched the last two innings. It was 11:30 or so, and we had an hour break so we headed out for lunch and some air-conditioning. On the way, Andrew complained that his arm hurt. Not his pitching arm - his site arm. When checking on it, it pulled out. We thought it pulled out right then, but in hindsight, I wonder if it had pulled out earlier in the game. We had limited time, so I offered Andrew a choice. Would he prefer to put in a new site, or take a shot for lunch. He chose to take a shot for lunch. It's hard to get to legs or "hips" in public when in baseball pants, so it seemed like a good choice.
We ate at Subway. We've eaten there before, so I'm fairly confident of the carb counts. I used the pump to calculate the dose (8.7), so I didn't make a math error. I had to use the pump cartridge for insulin, so I fiddled forever trying to get insulin without an air bubble in my syringe. I added a little to replace the missed basal, but I didn't replace all of it since he had been active. I figured 9 units of insulin should carry him through the 12:30 game & then we could put on a new site.
Andrew was in the 200s before eating, so I wasn't that surprised when he hit 300's. I showed the pump to a friend who knows another recently diagnosed child. She asked about dex, so we checked and it read 388 going double up (up very quickly). The problem is that it had only been about an hour since the shot, so I really thought it would start to kick in. I pushed Powerade Zero and waited for the insulin to work.
First inning, Andrew pitched again and did a great job. No one scored. I think it was three up, three down. He came in, and I went to check on him. He asked to go to the bathroom. I know that's a symptom of high blood sugar, but it is unusual for him, so that was a red flag. He was still in the bathroom when he was supposed to be on deck. His coach (of one week) had to come looking for him. I was embarassed for him, but there was nothing we could do. Unfortunately, we had three outs before Andrew got to bat, but he still had to head straight to the pitcher's mound. I don't know how he still threw strikes, but he did. When he came back into the dugout, he said, "I'm so thirsty!" and chugged some more to drink. He was first up at bat, so there was no time to do anything but hand me dex. It read, "High" going double up. I wanted to cry. Thirst, frequent urination, high blood sugar... this wasn't good. When he crossed home plate, the opposing team got their third out at first, so Andrew hustled back to the pitcher's mound.
At this point, I didn't know what to do. Part of me said to pull him off the field right now & put in a new site. On the other hand, the tournament games are only an hour and twenty minutes. We had started late and no one started the time on the scoreboard, but surely there couldn't be that much time left in the game. Are minutes worth pulling him off the field? Once the first pitch was thrown, this was his last inning to pitch anyway. I was fighting tears. I lost a few, but I don't think anyone saw them. I know "Andrew can still do anything he wants to do", but I wish he could just go out and play ball like the other kids. I felt like throwing up. I could tell he was getting worse, and I just wanted the game to end so I could get the insulin going again. Andrew moved to short stop and started hanging his head between plays and just not looking right. Coach brought him in off the field, and I was so glad! I jumped off the bleachers and got him.
We immediately looked for a "private" spot in a crowded ballfield. I was so nervous that I put the site in upside down in his arm. :( You want the tubing pointing up so that it can feed through your shirt. We had to redo it. By the time we finished, the game had ended and he had even missed the shaking of hands and team talk. As soon as we had the new site, he did another blood sugar check (599) and we did a full correction. I knew now he would be okay, but it was still hard. When we got home, I had him check ketones to see how bad off he was. MODERATE ketones! How? How did 9 units for lunch allow him to get that kind of ketones? Nine units is alot of insulin, and I still can't believe it wasn't enough. I wonder if the site came out early in the first game and he was pitching without insulin. I feel like I let him down. He's fine now. It took until 6 pm to get him in range, ketone free, and steady.
Yes, the risk of ketones goes up with the pump. A lack of insulin gets serious quickly. With that level of ketones, Andrew shouldn't have been playing. On the other hand, if he had his pump on, I wouldn't be waiting for the shot to kick in. I would have been able to increase his basal rate. When it was obvious that it wasn't working, I could have given a bolus with the remote while he was putting on his helmet and batting gloves. I could have done ... something. I haven't felt that helpless in a long time.
I'm scared too for Fall. We're going to let him play football. I asked about it at our check-up on Thursday. The textbook answer to playing football on the pump is to disconnect the pump (it would be destroyed) and reconnect to replace missed basal every hour. It's probably good advice. However, imagine yourself covered in football pads. Every hour, in front of your teammates, reach down your pants, find your site and connect the tubing. The site is either on your leg or rear. Seriously? There has to be a better plan. We are considering using shots for corrections instead, which is why today's shot for lunch sounded like a good plan. No, I'm not feeling it. Scared to death. I hate diabetes.
Diabetes, however, did not play nice today. It's ironic because a parent asked how his blood sugars were early this morning, and I showed off the perfectly straight line on his dexcom. I know, "Pride goeth before a fall," but it was such a pretty graph! They won the first game which, considering we were the only non-travel ball team there, was fantastic! Andrew pitched the last two innings. It was 11:30 or so, and we had an hour break so we headed out for lunch and some air-conditioning. On the way, Andrew complained that his arm hurt. Not his pitching arm - his site arm. When checking on it, it pulled out. We thought it pulled out right then, but in hindsight, I wonder if it had pulled out earlier in the game. We had limited time, so I offered Andrew a choice. Would he prefer to put in a new site, or take a shot for lunch. He chose to take a shot for lunch. It's hard to get to legs or "hips" in public when in baseball pants, so it seemed like a good choice.
We ate at Subway. We've eaten there before, so I'm fairly confident of the carb counts. I used the pump to calculate the dose (8.7), so I didn't make a math error. I had to use the pump cartridge for insulin, so I fiddled forever trying to get insulin without an air bubble in my syringe. I added a little to replace the missed basal, but I didn't replace all of it since he had been active. I figured 9 units of insulin should carry him through the 12:30 game & then we could put on a new site.
Andrew was in the 200s before eating, so I wasn't that surprised when he hit 300's. I showed the pump to a friend who knows another recently diagnosed child. She asked about dex, so we checked and it read 388 going double up (up very quickly). The problem is that it had only been about an hour since the shot, so I really thought it would start to kick in. I pushed Powerade Zero and waited for the insulin to work.
First inning, Andrew pitched again and did a great job. No one scored. I think it was three up, three down. He came in, and I went to check on him. He asked to go to the bathroom. I know that's a symptom of high blood sugar, but it is unusual for him, so that was a red flag. He was still in the bathroom when he was supposed to be on deck. His coach (of one week) had to come looking for him. I was embarassed for him, but there was nothing we could do. Unfortunately, we had three outs before Andrew got to bat, but he still had to head straight to the pitcher's mound. I don't know how he still threw strikes, but he did. When he came back into the dugout, he said, "I'm so thirsty!" and chugged some more to drink. He was first up at bat, so there was no time to do anything but hand me dex. It read, "High" going double up. I wanted to cry. Thirst, frequent urination, high blood sugar... this wasn't good. When he crossed home plate, the opposing team got their third out at first, so Andrew hustled back to the pitcher's mound.
At this point, I didn't know what to do. Part of me said to pull him off the field right now & put in a new site. On the other hand, the tournament games are only an hour and twenty minutes. We had started late and no one started the time on the scoreboard, but surely there couldn't be that much time left in the game. Are minutes worth pulling him off the field? Once the first pitch was thrown, this was his last inning to pitch anyway. I was fighting tears. I lost a few, but I don't think anyone saw them. I know "Andrew can still do anything he wants to do", but I wish he could just go out and play ball like the other kids. I felt like throwing up. I could tell he was getting worse, and I just wanted the game to end so I could get the insulin going again. Andrew moved to short stop and started hanging his head between plays and just not looking right. Coach brought him in off the field, and I was so glad! I jumped off the bleachers and got him.
We immediately looked for a "private" spot in a crowded ballfield. I was so nervous that I put the site in upside down in his arm. :( You want the tubing pointing up so that it can feed through your shirt. We had to redo it. By the time we finished, the game had ended and he had even missed the shaking of hands and team talk. As soon as we had the new site, he did another blood sugar check (599) and we did a full correction. I knew now he would be okay, but it was still hard. When we got home, I had him check ketones to see how bad off he was. MODERATE ketones! How? How did 9 units for lunch allow him to get that kind of ketones? Nine units is alot of insulin, and I still can't believe it wasn't enough. I wonder if the site came out early in the first game and he was pitching without insulin. I feel like I let him down. He's fine now. It took until 6 pm to get him in range, ketone free, and steady.
Yes, the risk of ketones goes up with the pump. A lack of insulin gets serious quickly. With that level of ketones, Andrew shouldn't have been playing. On the other hand, if he had his pump on, I wouldn't be waiting for the shot to kick in. I would have been able to increase his basal rate. When it was obvious that it wasn't working, I could have given a bolus with the remote while he was putting on his helmet and batting gloves. I could have done ... something. I haven't felt that helpless in a long time.
I'm scared too for Fall. We're going to let him play football. I asked about it at our check-up on Thursday. The textbook answer to playing football on the pump is to disconnect the pump (it would be destroyed) and reconnect to replace missed basal every hour. It's probably good advice. However, imagine yourself covered in football pads. Every hour, in front of your teammates, reach down your pants, find your site and connect the tubing. The site is either on your leg or rear. Seriously? There has to be a better plan. We are considering using shots for corrections instead, which is why today's shot for lunch sounded like a good plan. No, I'm not feeling it. Scared to death. I hate diabetes.
Saturday, June 18, 2011
Thankful for a "Normal" OGTT for Kaitlyn!!!
Yesterday was Vanderbilt Day. Kaitlyn went for her oral glucose tolerance test, & Andrew had his check-up. Last year, Kaitlyn's ogtt was so high that I thought that a type 1 diagnosis for her was right around the corner. Six months ago, her fasting glucose was in the pre-diabetic range for the first time, but her two hour number was much better, though still pre-diabetic. We don't have official lab results, but the meter read 95 (normal) before starting the test. We tested her blood sugar again after 2 hours on our meter just so we wouldn't spend the next few days worrying about whether the phone would ring with bad news. It was past the 2 hour mark, but her number was 125. That's NORMAL!!! She hasn't had a normal test in years!!!! A year ago the researchers commented that it would be interesting to see if she made it through puberty. Insulin needs really shoot up during puberty & blood sugars are difficult to manage. I understand that the antibodies are still there, but I am so thankful that the Lord has given her this time and that she is doing so well! Praise God!
Andrew is doing well too. His A1c (3 month average of blood sugars) was down from last time & lower than Dex predicted. He is growing well. His alarm is going off now though...
Okay, I'm back. His continuous glucose meter (cgm) said his blood sugar was 45. I had already given him juice, so I needed to recheck him before treating again. I had to pull his hand out from the covers. He opened his eyes and stared at me strangely. Nighttime lows are the worst because you never know if your child is out of it because he's that low or if it's just because you woke him in the middle of the night. I asked if he was okay. After a long pause, he replied, "I guess so." He wasn't helping with the finger prick like normal, so I just took his hand. He pulled our hands up to his face and began kissing my hand! That's a first. I can honestly say he has never kissed me while I'm trying to prick his finger before. He won't remember it & will deny it in the morning. His blood sugar was already coming up. It's 71 now, and I fed him a complex carb (yes, he eats in his sleep), so he should be fine.
Andrew is doing well too. His A1c (3 month average of blood sugars) was down from last time & lower than Dex predicted. He is growing well. His alarm is going off now though...
Okay, I'm back. His continuous glucose meter (cgm) said his blood sugar was 45. I had already given him juice, so I needed to recheck him before treating again. I had to pull his hand out from the covers. He opened his eyes and stared at me strangely. Nighttime lows are the worst because you never know if your child is out of it because he's that low or if it's just because you woke him in the middle of the night. I asked if he was okay. After a long pause, he replied, "I guess so." He wasn't helping with the finger prick like normal, so I just took his hand. He pulled our hands up to his face and began kissing my hand! That's a first. I can honestly say he has never kissed me while I'm trying to prick his finger before. He won't remember it & will deny it in the morning. His blood sugar was already coming up. It's 71 now, and I fed him a complex carb (yes, he eats in his sleep), so he should be fine.
Thursday, June 9, 2011
I Like Your Mom!
We are finally out of school, so I should catch up on this blog soon. Here is the quoteof the day:
This morning, a bagger at the grocery store was helping us unload the cart for purchasing when I spotted the sale on candy. I turned to Andrew and said, "There is a sale on starbursts and skittles. We're getting low so let's stock up." I've grown accustomed to the strange things that only a parent of a child with diabetes would say, so I chuckled when the bagger turned to Andrew and said, "I like your mom!" Realizing that he mistook me for a cool mom who actually buys candy for fun, I clarified that I had to buy candy because my son is diabetic. That sounded crazy too even though it is true. Safety step #1 when on insulin is to always have a source of fast-acting sugar in case your blood sugar goes too low. At home, we use glucose tabs and juice. The ballfield on the other hand ...
Andrew pitches and hits better if I can keep his blood sugar close to normal. Insulin, heat, exercise, excitement, and adrenaline are an interesting mix, so sometimes I need small doses of sugar to keep him from going low without spiking too high. Chocolate won't survive the heat, so skittles and starburst are the portable & tolerable glucose sources of choice. He'd probably rather run high through the game than have to eat glucose tabs all the time. Now, I'm stocked up & the bagger likes me today!
This morning, a bagger at the grocery store was helping us unload the cart for purchasing when I spotted the sale on candy. I turned to Andrew and said, "There is a sale on starbursts and skittles. We're getting low so let's stock up." I've grown accustomed to the strange things that only a parent of a child with diabetes would say, so I chuckled when the bagger turned to Andrew and said, "I like your mom!" Realizing that he mistook me for a cool mom who actually buys candy for fun, I clarified that I had to buy candy because my son is diabetic. That sounded crazy too even though it is true. Safety step #1 when on insulin is to always have a source of fast-acting sugar in case your blood sugar goes too low. At home, we use glucose tabs and juice. The ballfield on the other hand ...
Andrew pitches and hits better if I can keep his blood sugar close to normal. Insulin, heat, exercise, excitement, and adrenaline are an interesting mix, so sometimes I need small doses of sugar to keep him from going low without spiking too high. Chocolate won't survive the heat, so skittles and starburst are the portable & tolerable glucose sources of choice. He'd probably rather run high through the game than have to eat glucose tabs all the time. Now, I'm stocked up & the bagger likes me today!
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