Wednesday, January 26, 2011

Flip Flopping

3 days of post breakfast highs for Maddie equaled some basal increases a couple weeks ago. Luckily, I've been able to flip back to her "higher" basal pattern and everything works out lovely. It didnt used to be that way.

It used to be I'd have to change EVERYTHING. Dramatically. And I was afraid to do so, in fear of causing bad lows at school, even though it was obvious a "touch" of change wasnt gonna help much. I'd change this basal. That basal. 5am. Maybe 6am. This time. That time. Try this. Try that. It would take WEEKS to get things set right. It was horrible. Exhausting. The guilt of not figuring things out from one day to the next would eat me alive. Maddison's dark circles under her eyes would haunt me. Today, I'm thankful for flip flopping. Being able to flip flop already finely tuned basal patterns and have them be just right has saved my sanity lately.

Last week Maddison was high for 3 days. So, Flip, flop. MUCH better. 5 days of "perfection" followed. Two days of lows. FLIP, FLOP. Much better. We shall see what today holds. You just never know.

6 comments:

Meri said...

A method to the madness! I love it!

Beaner said...

I know how you feel, hang in there.

Reyna said...

Keep up the great work Mama Pancreas! You are doing such a wonderful job by Maddison.

Anonymous said...

Understood.

Before software linked to meters and pumps, we used a spreadsheet to record EVERYTHING and we alos programmed the stat analysis on all the data (for our young son). After the first 10 YEARS of A-Z diligence ala T1D, the pattern was: "no pattern." So the docs told us "your son really has no pattern you have to manage hour by hour, day by day. Oh really? I thought. As if I didn't know this?

We got asked the dumbest questions by some of the office nurses so finally I made a LIST of the 25 THINGS I do before making (or helping my son to make) insulin decisions, every time...

It's not wisdom it is just daily life but I told them to read this before they ask me all their questions... Here it is:

TITLE: Decision Factors When Managing Insulin Dosages on a Daily Basis

A Mother's Note to Nurses: These are the facts and/or questions I ask myself every time I make s a decision about how much insulin he will need, or should be getting, in response to his blood glucose level...

1. Time of day

2. Current activity level

3. Past activity level(s)

4. Near future activity level

5. Prior BG levels (24-48 hours)

6. Insulin type if temporarily using Lantus vs Pump

7. Age of insulin (i.e., vial in use for 30 days or more)

8. Most current basal dosage recommendations delivered via pump

9. Most recent outcomes of dosage adjustments to basal, bolus, correction factors, I:Carb ratio

10. Site of injections/pump infusion set

11. Ketones (pos/neg)

12. Growth spurt (Y/N)

13. Food intake by TYPE:

a. Carb
i. How many grams carb per serving?
ii. Quick acting
iii. Slow acting
iv. Glycemic index of carb
v. Fiber content of carb (subtract from grams of carb)
b. Protein intake (type and amount)
c. Fat intake and composition (amount of fat in food combo)

14. Food intake TIME OF DAY

15. Food intake AMOUNTS (relative proportions)

16. Overall health

17. Age/hormones

18. Stress levels (either physiological or psychological)

19. My son's input to the decision process (this is important !! )

20. Logistics (i.e., will I be able to get to my son in the event of an unpredictable response to changes in his/her insulin dosage)

21. Overall BG goals - both daily and average

22. My son's level of understanding

23. Current weight in lbs and kg

24. Change in body weight (Y/N)

25. "GUT" feel or intuition

Epilogue: they didn't get it.

Sincerely, another mom

Boston said...

Understood.

Before software linked to meters and pumps, we used a spreadsheet to record EVERYTHING and we alos programmed the stat analysis on all the data (for our young son). After the first 10 YEARS of A-Z diligence ala T1D, the pattern was: "no pattern." So the docs told us "your son really has no pattern you have to manage hour by hour, day by day. Oh really? I thought. As if I didn't know this?

We got asked the dumbest questions by some of the office nurses so finally I made a LIST of the 25 THINGS I do before making (or helping my son to make) insulin decisions, every time...

It's not wisdom it is just daily life but I told them to read this before they ask me all their questions... Here it is:

TITLE: Decision Factors When Managing Insulin Dosages on a Daily Basis

A Mother's Note to Nurses: These are the facts and/or questions I ask myself every time I make s a decision about how much insulin he will need, or should be getting, in response to his blood glucose level...

1. Time of day

2. Current activity level

3. Past activity level(s)

4. Near future activity level

5. Prior BG levels (24-48 hours)

6. Insulin type if temporarily using Lantus vs Pump

7. Age of insulin (i.e., vial in use for 30 days or more)

8. Most current basal dosage recommendations delivered via pump

9. Most recent outcomes of dosage adjustments to basal, bolus, correction factors, I:Carb ratio

10. Site of injections/pump infusion set

11. Ketones (pos/neg)

12. Growth spurt (Y/N)

13. Food intake by TYPE:

a. Carb
i. How many grams carb per serving?
ii. Quick acting
iii. Slow acting
iv. Glycemic index of carb
v. Fiber content of carb (subtract from grams of carb)
b. Protein intake (type and amount)
c. Fat intake and composition (amount of fat in food combo)

14. Food intake TIME OF DAY

15. Food intake AMOUNTS (relative proportions)

16. Overall health

17. Age/hormones

18. Stress levels (either physiological or psychological)

19. My son's input to the decision process (this is important !! )

20. Logistics (i.e., will I be able to get to my son in the event of an unpredictable response to changes in his/her insulin dosage)

21. Overall BG goals - both daily and average

22. My son's level of understanding

23. Current weight in lbs and kg

24. Change in body weight (Y/N)

25. "GUT" feel or intuition

Epilogue: they didn't get it.

Sincerely, another mom

Trev said...

Hi there, I share the genetic thing as well with two of my kids. I have Type 1 and 2 out of my five daughters have Type one. It is comforting to know we are not alone. Hope you folks are doing well. Lok forward to reading your blog on my roll daily.
Cheers
http://www.three2treat.com