BOLUS HISTORY

Its 4:36am. I had my alarm set to check Maddison after a night of swimming until
10pm with the neighbors. The CGM reads 89------with a nice flat line. Actual BS is 49, with .3 units still working. .3 units still working? WHAT? I check back through the pump history and what I see I still cant believe......

Last bolus, 29c at 2:23am. UMMMMMM.....Maddison DID NOT eat ANYTHING at 2:23am. I was asleep at 2:23am. HOW THE HELL DID SHE GET INSULIN FOR 29C AT 2:23AM!??!!!????!!

DANGEROUS. SLEEP DEPRIVATION IS FRICKIN DANGEROUS. I dont know what just happened, but I'm pretty freaked out.

Getting There

Those first crazy stressful days of swim training are behind us. Today we had a day off, but tomorrow we are back to the pool. Yesterday Maddison was stable in the
140's during swim. Afterward she spiked a bit to the 210 mark, came down, then hoovered in the 280-300 range again while sleeping. I think I may be cutting back her basal too much (20%)when she sleeps....maybe not. Maybe it really is a weird Adrenaline after swim thing that is keeping her high. Who knows. All I know is night time is the hardest. I'm fearful of lows when she sleeps, so its hard to make the right decision when my paranoid mind worries that I should prevent the lows (reducing basals) rather that treat them when I see them......becuase WHAT IF I dont catch them? I'm just doing what makes sense right now, but unfortunetly the sleeping hours dont make sense!

After chasing highs all night, Maddison woke up at 100. She hit 67 within an hour after breakfast despite a 50% reduction in her basals and a ratio increase from 1:13to 1:15, which means I still have some adjusting to do. She did great all day after I got the low back up (thanks to the CGM) ....her basal is down to .10 per hour!! Thats 50% of what she used to need during the day!

Funny thing...I made sure Maddison wanted to swim today in our pool right around the normal swim training time. It just made sense. I feel like if I keep every day with the same swim schedule for this first week or two I can adjust things so much faster based on routine. So swim she did. WEIRDNESS struck. 297 after swimming, even though she started at 156 (.3 active) and had 15c of Gatorade with a cheese stick. The days are never the same, even though we try to replicate what we've done and learned! Now its Midnight and Maddison's low (67) with .3 active. Go figure. Last night I reduced basals and she was too high, now tonight I didnt and she's too low. Imagine that. :( Long night ahead!

I'm feeling much more confident and less dramatic about this whole swim team stuff. Amazing what a little sleep will do. :) We have NOTHING planned in the morning, except for me sleeping in. Kind of. I still have to wake up and chase or check blood sugars, but I WILL stay in bed until 10!! My goal for the day is ME! Friday for ME!

I myself didnt wake up scary low last night either. I made several changes in my pump settings to avoid lows overnight. I went to bed at 175 to be safe and woke up at 140. SAFE. No scary low and not terribly high. Taking it slow right now. Thats all I can do. Getting "there" a little more every day.

Speaking Too Soon

If you say it, Diabetes will change it. Haven't we all learned this by now? Yesterdays victory over swimming highs was short lived. Like, just a couple hours. Dinner brought low after low once again. How was I supposed to know Maddison would be low instead of high like yesterday?

The CGM sensor plopped out, right to the ground after Maddison's bath! I guess thats what I get for letting it "breathe" before applying new bandages. It was the weirdest thing I've ever seen. How can a 1.5 inche sensor just plop out? I was on my own to watch lows. Back to old school finger pokes every 15 minutes. Lows continued for 2 hours despite a decreased basal rate and multiple double low treatments. Did I mention Maddison was sleeping? Asleep again early. Those laps are really making her tired, as Im sure the lows are.

After the first hour of lows I began to panic inside. How the hell can I trust Maddison to be safe through the night? Do I need to get her to 200? 250? to keep her alive until morning? How do I know when and where her muscles and liver are going to steal back what glucose she does have in her blood? Obviously this was already happening, but what if these lows are just the beginning? What if I'm deep asleep at 3am and don't wake up for my alarm? What if WE are the parents that next grieve for their child who passed in the night because Diabetes and exercise are an incredibly tricky balance? Josh and I talked for quite awhile about these scary realities. Its hard to grasp that this could really happen. But, they can and have too often this past year, as we all have heard.

Needless to say, I couldnt sleep last night. Maddison ended up at 250 again all night, which was welcome after all the low nonsense. I finally fell asleep around
2am. Again at 4am I was woken by my own low. 32. THIRTY FREAKIN TWO. Scratch what I said in yesterdays post about the low I thought was going to do me in. This low, was my lowest ever and I do believe I saw the light! My entire body was numb, freezing cold. It was a total out of body experience. I sat at the kitchen counter slurping down gatorade frantically, yet at a slow pace because I couldnt hold up the bottle. I almost had to lie down on the floor, I just didnt have any strength left in my body. I swear things turned black for a second or two. I couldnt see. After what seemed like an eternity, I was able to roll back into Maddisons room and check her blood sugar. 260. That worked for me at that point. Safe. I crawled in bed with Maddison and held her tight, cherishing every moment.

By day 2 of no sleep I begin to feel irrational and super tearful. That would be today. We will see what the day holds. I'm still foggy minded after my terrible low. I feel drained. Entirely drained.

The Day After

All day today Maddison trended low low low. I expected this after swimming yesterday, weird how just that hour of intense exercise changes EVERYTHING. THANK GOODNESS for the CGM! All day today we avoided what would have been some very nasty persistent lows, all because this little piece of medical technology. I LOVE YOU CGM!!

Last night was horrid. I couldn't get Maddison under 250 for ANYTHING. She conked out early after her swim meet, eyes glossy and exhausted from the highs. Poor girl. I stayed up until midnight correcting her BS hourly, even after a site change. Of course, what I was fearing by midnight was the blood sugar drops since swimming was 6 hours prior. Usually 6-12 hours after activity the lows hit hard. Not last night! CGM showed a flat line at 250-280. I was up at 1am, and 230am. Still flat lines. Meter verified. Stuck in the 250's. At 4am Maddison's CGM alarm was again blaring, when I realized I was seriously low. Heart pounding. Sweaty. Confused. 42. A horrible night all around. I remember popping 2 glucose tabs after staggering into the kitchen. I kept thinking this was it. I was too late. I thought I'd wake up in the ER for sure. I sucked down an unknown amount of juice, and the next thing I knew I was waking up for my 530 alarm. SCARY. I'm not sure how I made it back to bed, but I do remember my mind repeating over and over "Stay awake, you need to recheck." Apparently I didn't stay awake, and today I'm thankful I'm alright! That could have been bad! (Josh worked at midnight last night, no one to help me if I needed!) I woke up at a nice 102 this morning. -Whew!-

So anyway, morning came too fast today. Not sure how I made it out of bed being so exhausted. Maddison was FINALLY coming down under 200. She was starving by 8am. Maddison has been having alot of tummy pain and not eating well, especially after the vomiting episode last week. So, I was cautious of bolusing breakfast for that reason plus SWIMMING! I kept my eye on the CGM every 20 minutes starting with Maddison's breakfast bolus. I just knew that lows were coming. And, there it was right away. 20 minutes after eating the CGM showed a 150 with double down arrows. CRAP. I gave Maddison 4c of juice, hoping to bump her up. NOPE. 15 minutes later her meter showed 110 with double down arrows. WTF?!! By now I was wise enough to see that swimming has gone and changed EVERYTHING. I decreased her basal. I gave her 15c. CGM shows 74. Slowly, the 74 trended upwards. Did I mention I LOVE YOU CGM!!? Two hours later Maddison was in the 80's again. 15 more carbs. She hung out in the 90's until lunch. Thats alot of extra carbs. Same thing after lunch. Multiple times the CGM alarmed to an impending low, and we caught them ALL.

Then comes swim class again tonight. CRAP. Today is another story. Maddison's 80. There goes my plan. I begin to panic inside! Now what do I do if she's already been low all day!? I can see where this is going! Zero active. 12c of fruit. One scoop of PB. 127. Ummmmmm......I chickened out and didnt give basal up front for Maddison being disconnected during swim. She hung out at 126. 20 minutes after swimming started she was 158. I actually RELAXED. She sipped Gatorade a few times over the hour. She left the pool at 126. Did you hear me cheering over there in your neck of the woods? *EVIL VOICE* SCREW YOU DIABETES!! I DID BETTER ON DAY 2!!! Reconnected right after swimming. Bolused .2 missed basal. An hour later, 197. I'll take it. So, who knows what tonight will hold....BUT, I feel SO MUCH BETTER ALREADY!! Maybe I really CAN do this without losing my mind!

Day 1 Swim Practice

I can finally breathe. Man, that was a stressful first swim practice! Not because of lows. Not because of highs. Simply because I didn't know what to expect. Would Maddison crash quickly? Would she feel it? How much are they going to swim? I gave Maddison her snack without insulin and what if they just sit around and blow bubbles? Then I'll have to pull her aside and give insulin in front of all the gawking eyes. Which would then cause all the kids to question. Which would then make Maddison feel different. Which would break my heart. Diabetes is so hard.

My plan worked out perfectly to start. I made sure Maddison had her lunch timed right so she wouldn't have any active insulin working from food by the time she was hitting the pool. A perfect 160 to swim, no insulin working. A flat line on the CGM. I really lucked out! My brilliant idea? Chocolate and Peanut Butter. Both work magic in keeping Maddison's numbers steady, without a spike. I bought 10c mini M&M packets the other day. PERFECT carb amount to swim. Maddison added the M&M's SO happily to her peanut butter scoop. I just had to smile. Arriving at the pool CGM reads 201. Perfect for 45 minutes of constant lap swimming. Off goes the pump. SHIT. Do I bolus the basal she is going to miss over the next hour? No. I didn't. I REALLY SHOULD HAVE! What the hell was I thinking!!??

20 minutes after strokes started, Maddison raised her hand to flag me down. She felt low. Here we go. I could feel ALL eyes on me as I walked over to the edge of the pool. There had to be 60 parents there. I could feel ALL the eyes. Every single pair. That really sucks, and, it sucks EVEN MORE that in a second they will be staring at my sweet little 9yr old as I poke her finger. My heart was palpitating. PLEASE PLEASE PLEASE don't be low!!! 238. Nope. Must be the rapid heart rate from laps that is making her feel low. Maybe she's nervous. Maybe she's worried that she is going to go low. Stupid freaking Diabetes. You suck. Can't my girl just swim!!? Then all the kids started to ask questions. "Whats that?" Maddison's only reply was "NOTHING." It used to be that Maddison would proudly explain. Not so much anymore. Sometimes, you just want some damn privacy. My heart was broken.

Maddison had a BLAST. She swam her little heart out. That's all that really matters. I'm pretty irritated that our pump isn't waterproof, and that the CGM cant communicate if you are over 8ft away from the pump. The CGM is useless during swimming, but AFTER......I'm in LOVE.

Now, do I bolus the missed basal? Bolus half after all that workout? Maddisons blood sugar was 238 when class was over. OH. SHIT. I can see it coming. All the past summer swim chaos is flooding my mind. Now comes the high. Is it an adrenaline high? Is it the liver giving back after such a workout? Did a tiny .2 missed basal cause this craziness? Two up arrows. Do I correct in full or will Maddison crash because all that exercise? I correct in full. 268. 289. 330. The CGM shows me exactly where this is going, which helps me make the educated decision to bolus aggressively and not worry about a low at this point. No, the low will come later. Like, in 6-12 hours. As in, when my sweet Maddison is sleeping. 362 with two up arrows. Fabulous. Now Maddison feels sick. She wont eat or drink. Good move Mom. Now look what you did. !!!!!!!!

We are now at 2 hours after swimming. Ive bolused and bolused according to what the pump suggests, every half hour. 389. Can I just say I FREAKING HATE YOU DIABETES!!! So much for the plan hugh?

Tomorrows plan. Hmmmm.....I'll start with bolusing the basal that will be missed BEFORE we take the pump off. Less carbs for swimming? Bolus half? No Chocolate? Maybe a different food? How the HELL am I supposed to know? Try it again this very same way and see if anything is different? Whats the deal? Am I supposed to bolus insulin after each swim meet expecting this high? Turn up her basal? What if the high doesn't come next time? Then what? Where's the damn book on how to be a pancreas anyway? Ladies?

Summer!

Today was Maddison's last day of 3rd grade! Adios! Goodbye! On to 4th grade we go! Could it be, just like that Diabetes changes? The excitement of summer? The relief of school pressures? Seems like it to me! As of this morning at 11am when the school bell rang, we started chasing lows. Low after low after low. Interesting!

Our afternoon today was spent doing our traditional first day of Summer shop for swimsuits! We met Josh for lunch, it was NICE just to be out and around with BOTH my girls. Hannah tends to be a stranger these days. Always with her friends! I'm feeling a bit neglected! Hannah also had her first sand Volleyball tournament tonight. Thank goodness it was a "cool" 90 degrees when they started, that wont last long. In the next couple weeks I'll be sweating to death out there! Hannah and her partner took 4th tonight. Not bad for just getting back on the sand courts. Sand is TOUGH, but these girls LOVE IT!

Guess what I got? FLAT LINES!!! Actually, if I'm not low, I have flat lines! There they are all day on the CGM and even overnight. Today I flatlined at 83-87 for THREE HOURS!! Maybe getting rid of that bad tooth was what I needed to gain back some D control. SHEESH! Now if I can just make a few more adjustments to basals I should get rid of all the lows following me. :)

Last night proved to be very hard to sleep. It wasn't really pain in my jaw that was the worst (though I would say it was a 8 on the pain scale!) it was the pain in my ear and down my neck. You know me. Paranoid! I was sure I was getting an infection spreading all through my body from this dang tooth. I was sure Diabetes was causing some serious complications with healing. Somehow I managed to fall asleep between pain surges. I just popped a few Ibuprofen today and I was good to go. A much better way to start the Summer!

I'm SO ready for SUMMER. Not so much for swim team that starts next week though. As always, we have alot going on this summer! Hannah is going on a cruise with her Auntie who JUST finished her Ph.d (SO PROUD OF YOU) as their promotion and graduation gift. Hannah's Vball team is also going to the NATIONALS tournaments in Reno. My Mom is retiring, which means the girls and I will be able to spend some much needed time with her. We have plans to paint her house, buy some new furniture and do some fun decorating stuff. All the while, we will be healing our broken hearts together. My Niece is Graduating high school and will be coming from Germany to attend NAU....lots of fun stuff this year being crammed in around swim team and sand volleyball. Summer....WE ARE READY!

Ouch. Oh Dear. Good News.

I've still been emotional! Silly tears are coming in an instant without warning! I feel like such a sap! Earlier last week it was the whole D blogging world that had me turned upside down, along with worrying about Maddison's Endo visit and concerns of growth failure. And, thrown in there was a touch of nervously awaiting Hannah's
8th grade promotion. I just cant BELIEVE my Hannah is going to high school!!! Thats enough to make me teary eyed....proud...excited for the next steps in life....but YIKES! Oh, and then the tooth pain hit. -Sigh- I've put this off for a long time. (tooth that had a root canal that was never crowned) Dental insurance is the worst of the worst, which makes me want to cry when I see the cost of what I need to have done on top of our other medical expenses. My tooth pain struck in the midst of all this craziness which made me irritable and sleepless....which made me even more teary eyed in the drop of a hat!

So, the good news is, Maddison's bone growth has almost caught up! She is only delayed by about 9months-1yr now instead of the 2yrs 9 months at last check. This indicates she is a "late bloomer" rather than facing a growth hormone issue. THANK YOU JESUS!! Now I just need to decide if I really think the Endoscopy is necessary. Hmmmmmm........I think I'll ask about vitamin deficiencies first.

Hannah's promotion was last night. SHE WAS BEAUTIFUL!!

I absolutely adore all her friends and the parents are all awesome. Promotion was a ton of fun and I didnt even tear up! Afterwards we took Hannah with the family to dinner at Ah-So, her favorite Japanese Tepinyaki restaurant.

((Hannah and my Mom))
YUM! Even with all the excitement going on I kept wishing how my Dad was here to see Hannah off to high school. It seems when I get overwhelmed with ANYTHING it leads back to me terribly missing my Dad and remembering all the horror he/we went through those 25 days of hell in the hospital. -Sigh-

Hannah had 8 girlfriends sleepover last night for a little promotion party and they all ran around in the cul-de-sac with the neighbor boys while Dad had a beer (or two) with the adults. OH DEAR! They didnt come in until 4am!! YES, 4am!! YIKES. I dont know WHAT Dad was thinking, the cops even came to ask why there was a bunch of teens in the streets! But it was all innocent fun. They played Volleyball, ran from house to house and played some good old hide and seek. (which they call ditch 'em)

I however was TRYING to sleep. Maddison still had school today and my tooth was about to explode. I'm pretty darn pain tolerant, but I freak a little with tooth pain. I despise the Dentist. HORRID past experiences with hitting nerves. Yeah. Not good. So, today I went in to see the scary no good Dentist and they ended up informing me that my tooth was infected to the jaw bone and needed to be extracted. (my back molar thank goodness!) FABULOUS. My CGM had already caught 2 morning lows and I was a mess by then. Tears. I was feeling low again! Tears always come a bit too easy when I'm low. I didnt have any juice in my purse. NOTHING but one tab left with the Dentist staring down my throat. Long story short...I was sent to get antibiotics and Percocet and told to come back at 2pm for the extraction.

Low again. It was noon and I still hadnt eaten anything. Went home, ate, slept for
30 min and went back for my Appt. This Dentist was a JERK. No eye contact. He treated me like a number. He had no concern of my Diabetes or the fact that I was worried about going low again. All he kept saying was "you'll be fine." That was it. Silence. I checked my CGM as I waited for the numbing injections to take effect. 168. Ummm.... That could go anywhere after the day I've had with lows! Have you ever had a tooth pulled? I felt no pain at all, but the "tugging" is enough to make you freak out. Then came the drill to "polish off" my jaw bone where the infection started to spread. THAT was HORRIBLE!!! No pain...but FREAKY!!! Over and done in 30 minutes. You should have SEEN what the CGM showed in that 30 minute time frame! I went from 168 to 130 with 2 down arrows within 10 minutes. Then from 130 to 286 by the time the torture was over!!!!!!!!

My face is swollen. I'm numb up to my ears. I'm starving. I just popped a Percocet which is starting to whack me out. I never take pain meds because I hate how they make me feel. Kinda lowish. Dizzy. Slow. I've had many surgeries and avoid taking meds, but give me tooth pain and I MUST take the meds! In my paranoid mind I'm imagining this infection spreading and putting me in the hospital on an IV antibiotic drip. When I worked in the ER years back I saw a patient that had the WORST facial swelling from a bad tooth. I will ALWAYS remember her. Poor girl spent over a week in the hospital....from a tooth!! Ok....time to go....this medication is making me want to puke....I think I need applesauce. CGM says 268. Oh geez!