Tag Archives: Infusion Set

Vampire Cannula….the Worst Ever?

Sometimes when high blood sugars don’t seem to respond AT ALL to correction boluses, you know its not a carbohydrate issue, or bad insulin, the only thing to do is pull the site and start over.

And sometimes, low and behold, the answer is in the cannula. Or in this case, all the way up the tubing.

Worst occlusion ever.

Back to School!

This school year, everyone is going to be prepared!

Last year and the year before I wasn’t great about keeping a lot of supplies at school. A box of graham crackers for awhile….maybe a few extra juice boxes. But this year I’m not going to have the luxury of running up to the health room if someone pulls a set or needs more strips for their meter. So, in the hopes that as many issues as possible can be taken care of at school, I put together diabetes supply boxes for Evie and Luke:photo 1 (11)

I felt like I was packing for a week in the wilderness! Diabetes is all about troubleshooting and planning ahead, so there are multiples of everything that either of them could need at any time; anything they could need replaced, or forget, or run out of is in this box.

  • Glucose Tabs
  • Ketone Test Strips
  • Infusion Sets
  • Reservoirs
  • IV-3000
  • Skin Tac WIpes
  • Alcohol Wipes
  • Insulin Syringes
  • Disposable Lancets
  • Pump Batteries
  • Extra BG meter
  • BG Test Strips
  • Lancets
  • Meter Charger
  • Snacks
  • Juice Boxes

Did I forget anything?

The only thing not in here is insulin, which I will eventually have to provide per Washington State’s Disaster Preparedness Plan. I just don’t have enough right now to tie up two bottles at two different schools. That stuff’s like gold.

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It fits!!!

Well, we’re they’re as ready as we’re they’re going to be. Happy Back-To-School (with diabetes)!

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Infusion Sets Can Take A Lot of Abuse

Photo Credit: Jeff Dennison

Photo Credit: Jeff Dennison

Evie ran in a color-splashed fun run yesterday with some friends who sent me this picture, which I love. Besides the expression of pure joy on her face, I am pleased to see that her pump site survived the run! Although it is even more colorful than usual. Good call on the IV3000, Evie.

Hypoglycemia Unawareness

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“Actually, I’m feeling a little low…..”

This was Luke’s response when I asked if his blood sugar was high, a question brought on by some mildly squirrely behavior. (Although in hindsight, the alligator tears over a minor disagreement with his brother should have clued me into to the hypo-in-progress.)

I could not have been more surprised to see this number on the meter.

If, at 31, he just started to be aware enough of a low blood sugar to tell me, and I just started to see symptoms that would make me ask the question, what was going on in his body in between 30 and 80? Or is the meter/strip just too inaccurate at those low numbers, and he wasn’t truly that low?

He gobbled down 4 glucose tabs and a 16-gram yogurt, and when we rechecked a few minutes later he was up to 96. Phew.

This is the second time this week that he’s crashed into the low 30’s, with no symptoms or awareness, after a breakfast site change. Next time I change out his infusion set I’m going to do hourly checks until I’m sure his numbers are staying up!

The Perils of a Hotel Mini-Fridge

Two Bottles of Frozen Insulin

We took a road-trip North to Great Wolf Lodge (aka, Kid Paradise) yesterday to celebrate the end of the school year. The boys were in charge of packing the cooler at home before we left, and unpacking it into the hotel room’s mini-fridge when we arrived.

What I neglected to do is double-check their work.

What I found when I went to pull out yogurts for breakfast this morning is that my efficiency-minded little boys had packed all the smallest things into the smallest part inside the fridge. We grown-ups know this part as The Freezer.

Another small thing from the cooler? The little container that held the insulin bottles I brought with us for Luke’s site change he’s going to need this morning. *stomach drops*

Yes, my friends, this is what frozen insulin looks like. And consequently, now completely useless insulin. Dead insulin on vacation? Awesome. Let the trouble-shooting begin….

Surprise! A Ketone All-Nighter

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Evie came home yesterday from school with a headache and an upset stomach. She gets headaches pretty frequently and for a variety of reasons, diabetes being one of them. Sometimes with nausea, sometimes not.

Her blood sugar had been pretty high at bedtime the night before, over 500, but she came back down with two overnight corrections, so I figured she had just missed a bolus, as opposed to having pump problems. Her blood sugar had not been especially high yesterday at school, or at home in the afternoon….200’s, not great, but not that unusual for her.

She had the headache all day, and had a mediocre appetite at dinner. When I checked her at bedtime her blood sugar was over 500 again, and…..surprise! her blood ketone level was 2.3 mmol/L (red light zone!). I had her test with a urine ketone strip for comparison, and she tested out with Large ketones.

(Neither Evie nor Luke have been especially prone to developing ketones in the past, and we’ve gotten out of the habit of checking regularly. In fact, we check so rarely that I had to open a new bottle of urine ketone strips for Evie to test. Time to get back in the habit.) 

So I changed out her infusion set and insulin reservoir and did a correction bolus, had her drink a huge glass of water, and pushed her basal insulin rate to 175%. And then checked her blood sugar and ketone levels about a million times throughout the night.

By about 3:00 am she had negative blood ketones and her BG was below 100. I checked her again an hour or so later and she was 75, so she drank 4 oz of juice and went back to sleep. She woke up this morning at 65.

I figured she was in the clear until she texted me her blood sugar number from school this morning: 451 at 10: 30 am. Way too high for 2.5 hours after a carefully carb-counted breakfast. Sigh. Her dad brought some freshly opened insulin to school and changed out her pump reservoir again, and she bottomed out at 43 two-hours after lunch.

So the front-runners for probable causes are: bad infusion site, degraded insulin, stealthy illness, or maybe even hormonal insulin resistance?  I wish it was more clear, but, frustratingly, nothing about diabetes is ever cut and dry. Sometimes it just sucks.

A Hypo Mystery

I'm going to need to restock the juice box supply.

So many juice boxes this week….

If Luke is coming up on a site change and it’s close to bedtime, he usually asks me to wait until he’s asleep. No problem. I can pull off his old infusion set and place his new one and he doesn’t even bat an eye.

So last Wednesday night that’s what I did. I also took the liberty to place his new set on a little used place on his body, his upper thigh, for the sake of good rotation.

His BG the next morning was 48, which sometimes happens after a site change, so he downed a juice box to start his day. Pre-lunch BG was 270, he ate about a cup of ziti noodles with red sauce, we bolused for a small BG correction and 45 grams of carbohydrate, and I sent him off to school. An hour later he was 47.

What the….what?

The next day he had nearly the same scenario at school, plus a couple more low-40’s hypos at home. So I pulled his thigh site that night and placed a new one on the back of his arm, the old tried-and-true standby.

Incidentally, both days he was uncharacteristically irritable and aggressive at school and found himself in time out several times. He typically gets spacey and whiny when he’s low, but he doesn’t usually have so much trouble controlling his behavior.

My (loose) theory is that the thigh site was too close to the muscle (this skinny little boy is pretty short on adipose tissue) which caused a too-rapid uptake of his meal boluses. And then the resulting quick drop in his blood glucose caused extra irritability and crazy-boy behavior.

Either that or his pancreas has rebooted.

(Kidding, kidding….)