Sunday, May 31, 2009

Sometimes we forget/ All in a day

Sometimes we forget just how Diabetes can turn ugly in an instant. Sometimes we forget that a unusual high may not be that innocent. How do you know if a high is a random high or a site going bad? Injections give the security of knowing the insulin is for sure making its way into the body. Unfortunately with an insulin pump you have much more troubleshooting to consider. Air bubbles, malfunctions.....sites gone bad. All are sadly "common" misfortunes when using an insulin pump that can lead QUICKLY to high blood sugar. In worse case scenarios the dreaded KETONES develop.....nearing DKA.....when NO insulin is making its way into your body. Darn insulin pumps! Why isn't there a technology that can determine a site gone bad!!??

Last night I not only programmed a temp basal reduction after swimming for Maddison, but also changed many of her early morning basal dosages after she woke up at a heart stopping 52 that morning. Bad timing this morning. Lots of basal decreases for todays morning hours lead me to not recognize a bad site until it was too late and poor Maddie paid the price.

And so the story midnight last night Maddison was 82. She had already been receiving just 50% of her normal basal rate for the last two hours. 15c of juice and some PB.....30 minutes later she was 130...perfect for sleeping. An hour later she was 214. Too much juice? Basal decrease catching up? I half corrected the 214 and set the alarm for 3 hours later. 244 flashed. Maybe the PB was too much? Corrected the 244, and by now those early morning changes I programmed in the pump will start to take effect. When Maddison's meter flashed 209 at 6am I figured we would be okay. Not so. At 9am Josh woke Maddison up to take her on a fishing date. In my sleepy haze I asked him to check her BS, when he said 309 I was SURE the basal changes I made for today were wrong! Who would have known the site went bad? Well, somewhere between midnights 82 and the mornings 309 it surely did! Wouldn't you first assume the basal changes you made were wrong? It's so damn frustrating! And so we corrected the 309 as usual. Underneathe my breath I cussed at myself for causing such a high by decreasing basals TOO much. I had no idea it was anything more. Maddison and her Daddy went on their way to enjoy a day fishing.

After catching 3 fish Maddison wanted to come home. She complained of nausea and a headache. Arriving home just 2 hours after leaving for their fishing date, Maddison's blood sugar was 312. For me, it was obvious. Blood sugar hasn't moved. Nausea. Nausea is the obvious ketone give away. I immediately changed Maddison site, bolused a correction plus a tad extra. Set temp basal for an hour to 200%. I got Maddison the ice and puke bowl she requested and fumbled through a million meters to find the blood ketone meter. Ketones rang in at 2.1 (LARGE)

Sometimes we forget just all we do in a day to keep our kids healthy (alive!!) Sometimes we forget just how fast Diabetes can turn. Of course I feel guilty that I should have seen the bad site sooner.....but with just having made all those adjustments the rational side of me said it was just that. Poor Maddie was sick as can be for several hours because of a bad pump site. She was pale, lethargic and possibly nearing DKA. She felt horrible. Just that fast Diabetes turned on us. Diabetes is scary sometimes, it amazes me that people fail to recognize that insulin keeps our children (and us) ALIVE. ALIVE!!!!!! Insulin is the reason Maddison and I are alive today. A quick reality check today. Days like today I'm ever so grateful for something so "simple" as that vial tucked away in the refridgerator. Dose by dose insulin is keeping my child alive. Sometimes we forget that.

Maddison was back to skipping around the back yard and humming a little tune within two hours of that life saving site change. TWO HOURS. Kids amaze me how they bounce back so quickly. Although I'm still kicking myself for not changing her site sooner (which was on just day 2) I realize that I shouldn't beat myself up over it. Easier said than done. Today I can't forget just how much that little vial of insulin means to our family. Insulin is LIFE. Insulin is my 8yr old daughter humming a little tune again, and a smile back on our faces instead of fear in our hearts. All in a day with Diabetes.


Wendy said...

Yuck! I hate the thought of sweet, vibrant, beautiful Maddison being down and out with those blasted ketones.

This disease is so hard...Kel, I would have thought the same thing about basals. Don't beat yourself up. You're doing a fantastic job!!!

I'm happy to hear she's feeling better :)

Scott K. Johnson said...

I too totally would have assumed it was the basal rate changes, and maybe even some more other stuff besides a bad site. Sometimes it is so hard to know which thing is doing what to us!

Poor little thing. But it sounds like she made a quick recovery and is back to feeling great.

These things happen, and it is not your fault. Sure, it is a risk we take by choosing pump therapy, but the benefits of being able to do all of that adjusting usually outweigh the risks. I guess that probably doesn't seem right after dealing with ketones and misery!