Wednesday, February 11, 2009

Lows, highs, high, high. I love our school nurse!

I'm finally feeling good about Maddison's overnight basal changes....nearly a month later she's looking fairly steady overnight. Last week in the afternoons and evenings Maddison had too many lows. I chalked them up to warmer weather (80's!!) and needing to adjust a few things for the amount of time Maddison was spending running wild in the streets with friends enjoying the weather for hours on end. This week, Maddison is 250-300 all day at school. So, I'm back to adjusting some morning basals for the school days. -Sigh-

Today is the first day of Maddison's increased basal rates so being the totally cant-wait-another-second-to hear the results mom that I am, I emailed the school nurse to see what she was for her 9:30am check. Yesterday she was a horrid 285, so today I was really expecting a much better number ..Nope. 287. What the hell would she have been without me increasing her basal for today?

If I haven't said this enough, I LOVE Maddison's school nurse. She emailed me back almost instantly and asked if she should replace part of her snack today (the 15c yogurt drink) with a flavored water. YES, YES, YES!! I love this woman!! She is right on the same page with me! She knows I am a total freak with letting Maddison eat if she is over 200. She also knows that Maddison eating a 23c snack with a 287 blood sugar = wholy crazy spike to 350's before the insulin actually starts to work well enough. That kind of spike/drop cant be good for learning, or her health. I love you Mrs L!!! Thank you for caring so much about your "D" kids!

Another email pops up, this time the Nurse is asking if we should start pre-bolusing Maddison if she is over 200 for her snack. Of course at home we do.....BUT, this would mean that Maddison has her blood sugar checked, is pre-bolused and then sent out to recess for 15 minutes. Ummmm......yeah. Not such a good idea for school. So now I bet the Nurse REALLY thinks I am crazy because I told her it was too risky. I mentioned my reasoning's, all the "what-if's" we need to think about....What if Maddison chases boys that day and runs her little heart out with a pre-bolus working? Would the insulin catch up before the snack? What if she stops by the bathroom before eating her snack within that time period? What if she doesn't eat her snack? Yeah....not such a good idea. I thought about a square wave bolus over 30 minutes, but then that means part of the bolus would actually be 15 minutes AFTER she eats her just can't win. No fancy tricks at school I guess.

Of course, if Maddison's 2nd grade class wasn't the LAST of 1400 student to go to lunch they wouldn't be having a snack every day anyway! (lunch is 1.5 hrs before dismissal!) Sheesh. For now we will assume basal adjustments will lead to the answer and we won't need to worry about snacks if she is high. Maddison shouldn't be coming in at her 9:30am check over 200 EVER anyway. I have to laugh....I can dream can't I?

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