Thursday, August 20, 2009

37 Part II

After work today I just couldnt wait for Maddison to come home! I needed a BIG hug, I needed to see her for myself. 37 37 37 is all I could think at work. I didnt get much done, needless to say. I just wanted to have Maddison home with me, home where I can deal with Diabetes myself and not wonder every second whats happening next while Maddison is away from me. Damn lows. They really get in my mind. I cant help but wonder all the "what ifs"

I expected the nurse to call me after school with details of WHY Maddison was sent to her office alone when she said she felt low. No phone call. I'm sure the nurse talked with the teacher and left it at that. It turns out, in speaking with Maddison tonight she says she was actually in Art class when she complained of feeling low, and YES, a "buddy" accompanied her to the nurse, but the little girl turned and left as soon as they approached the nurses office. That makes me feel SOMEWHAT better....but the "what ifs" are still nagging at me. In regular class, the nurse is to come to Maddison if she feels low. I guess the Art teacher needs to be clued in on this too!!!

The truth is, the area in which Maddison is in during school hours is probably around the size of a very large house. All the specials classes are close, and Maddison's regular classroom is just a few halls from the nurses office. The nurse can be at Maddison's class to test for a low in seconds. (assuming she isnt busy) Maddison also has a meter at her desk with glucose tabs. Of course, she doesnt carry them WITH her to specials class. I'm thinking as of tomorrow thats all changing.

Starting school, I told Maddison to pop a glucose tab while the teacher calls the nurse if she feels low. So far, she has been 79 and 78...not lows....YET. But they would have been. Why Maddison didnt take a tab those two times while she waited for the nurse to get there is beyond me. Today's 37 comes after those two "almost lows" on Tues and Wednesday. Of course, today everything was adjusted to avoid those impending lows, to no avail. That leaves me with taking DRASTIC measures tomorrow, which will probably cause a high. Better a high than a 37 at school! I need to rethink our testing plan.

Maddison has the meter there in class. She has the tabs. She knows what number equals a low. When I have previously mentioned to our nurse that I felt Maddison should take a tab and test in the classroom for a low, the nurse wasn't so comfortable. Trust me. I understand why. Too many variables. How much insulin is active? Is Maddison dropping fast? Did she not drop yet but is about to? Does Maddison really need to even think about all that at the age of 9? Is she steady at 90 after breakfast? Of course Maddison should treat an obvious low.....sometimes its just not that easy. I'm wondering if I'm sheltering her from having to do this herself........Logically being that the nurse is so close to Maddison at all times, it should be an easy hop, skip and jump for the nurse to check a low. Why do I make it so difficult?

Then there is the side of me that wants Maddison to have privacy testing. I know what its like to be low and feel like everyone around you is staring at you while you sit jittery, pale and sweaty slurping down juice or gnawing on glucose tabs. You feel alienated. At your weakest moment, you feel like everyone thinks you are a crazy weirdo. At least I do. Its uncomfortable. Of course some lows aren't even the feel bad ones, you treat the low in an instant and move on. But those lingering just want some TIME to recover without feeling like a freak show. I never, ever want Maddison to feel like everyone is watching her. PRIVACY is a good thing in my mind. Maybe I'm wrong. Being that I was diagnosed as an adult, maybe Maddison just doesn't know any different and doesn't notice those things. I just don't know.

37 37 37....tomorrow will be a better day, with a better plan for Diabetes at school. I just haven't decided what the plan will be. The meter is there, the tabs are there......I just don't know.

1 comment:

Anonymous said...

There is a better plan, but unfortunately, it is not noninvasive, and the child needs to wear two sites. Our new plan, after a few years of incidents such as you just described is called Dexcom 7 Plus. Our girl is 12, diagnosed at 8. Completely hypo unaware if seated. Her only symptom of a low is if she feels "shakey" and she must be standing up to feel this. We have a Minimed pump and tried the Minimed sensors. Hated it! The size of the introducer needle, the three day restart... so painful, even after insertion... so inconvenient. Got our Dexcom 7 Plus approximately one month ago. Now it is not perfect in that it is 15 minutes behind her blood glucose readings and there can be a 20 percent variation in readings between Dex and the meter. Took me awhile to wrap my mind around what this means. 20 percent of 100 means the meter can read 80, Dex can read 100 but 20 percent on a high number means meter can read 200, dex can read 250. And the alarms are not persistent... Vibrate, one beep, wait five minutes vibrate, another one beep. But Dex will save her at school. Because if Dex reads 100 and she cannot test, she can take two glucose tabs immediately before doing so. So even if she is 60, that will bring her up to 105. And Dex keeps beeping and vibrating if BS is 55 until you clear the alarm and treat. We turn off the high alarms at school so she is not aggravated and have only asked that she look at Dex and only test BS if reading is 200 (which would mean she would be quite high; Dex almost always reads a lot lower for her on the highs). She used EMLA to insert Dex the first time; now does not want to use EMLA. I would still use EMLA for most kids, though, she has a high pain tolerance. We have found Dexcom 7 Plus to be much more accurate than the Minimed; Dexcom has 26 guage introducer needle (MUCH smaller than Minimed's 30 guage needle); Dexcom lasts a full 7 days, but we have always gotten 10 days out of each one AND when you want to restart Dex, you do NOT ever so gingerly remove it and recharge the transmitter, hoping not to mess up your sensor insertion, you leave everything right on her body, pull out your receiver, hit "stop sensor," OK, then "start sensor." Wait two hours and calibrate. She does not wear the receiver but carries it in her purse. A waist-it would work great. When we remove Dex, we have a smaller red dot than we do with her infusion sets that are removed every three days. It does take getting used to wearing the two sites but I believe it would be so helpful fine-tuning basals, ICRs, etc. even if worn once a month. Dexcom 7 Plus, a God-sent device! Dex is Mama's little helper while away from us, kind of like a babysitter.