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.
“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!
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….
Evie planted some radish seeds in the garden a while back, long before any of us were really ready to be doing any spring gardening. The ground wasn’t prepared, but she cleared a small spot and planted her seeds. Owing to a warm winter and some surprisingly diligent watering, those seeds sprouted up and leafed out quickly!
She proudly showed me the leafy tops. I casually mentioned thinning the plants so the radishes would have adequate room to grow, and she said “But Mom, the radishes have already grown. I can see them!”
Lo and behold, a dozen fat and gorgeous radishes had popped up above the dirt.
She carefully pulled up her radishes and then took them inside to wash them off. As we stood at the sink together I felt proud and happy. We talked about what radishes taste like, how to use them, and how we could incorporate them into a meal.
We decided on fish tacos, and started making a grocery list: 1/2 a pound of cod, cabbage, limes, cilantro, tomatoes, onions, yogurt and mayo for white sauce. They were absolutely scrumptious, and everyone agreed it was a great dinner. We even threw together a quick fruit crisp for dessert with some of last summer’s apricots I pulled out of the freezer.
Next up from the garden: Will’s cabbage and garlic, Luke’s zucchini. (Zucchini plants are a hit with my kids….see last summer’s post here.)
- Corn Tortillas
- Mild white fish (cod, halibut, Barramundi, and tilapia, are good choices)
- 1 head cabbage, shredded
- White Sauce (1/2 plain yogurt mixed with 1/2 mayo)
- Pico de Gallo (see recipe below)
- Lime wedges
- 4 ripe plum tomatoes, seeded and finely chopped
- 1 small white onion, finely chopped
- ½ cup cilantro leaf, chopped (or more to taste!)
- 2 jalapeno peppers, seeded and finely chopped
- 1 tablespoon lime juice
Warm the tortillas in the oven. Grill fish, or bake in the oven at 350 degrees until cooked through and easily flaked. Alternatively, lightly oil a skillet and cook ov er medium heat until lightly browned and cooked through. Flake.
Prepare the white sauce by stirring together mayo and yogurt. Prepare the pico de gallo. To make up a taco, scoop fish into a tortilla, pile on cabbage, pico de gallo, and radish slices, Drizzle a little white sauce on top and a squeeze of lime juice. Then, put it in your belly and smile!
Pico de Gallo
Combine all ingredients and refrigerate up to 1 day.
Click for the We, The Undersigned – Tuesday 5/14 Link List
“Recently various petitions have been circulating the Diabetes Online Community, so today let’s pretend to write our own. Tell us who you would write the petition to – a person, an organization, even an object (animate or inanimate) – get creative!! What are you trying to change and what have you experienced that makes you want this change?”
Re: The MiniMed Paradigm® Revel™ Insulin Pump
Petition: We, the undersigned (me), feel that the MiniMed Paradigm® Revel™ Insulin Pump should be programmed to, at the very least, flash brilliantly and emit a siren sound when the pump reservoir completely runs out of insulin.
Yes, I know there is an alarm that tells me when the reservoir is low, and I know I have control over at what remaining volume the alarm sounds.
But I have lots going on. And two insulin pumps to keep track of. And one child who rarely even tells me when her pump alarms. And while the regular “boop beep boop” sound is fine to remind me that the reservoir is running low, there really should be a different kind of alarm for when the insulin level finally reaches “–.–” (empty).
Because there’s not a different alarm, there’s no way to know when the pump runs dry, and then its a guessing game to determine how much insulin they’ve actually received. (“How long has your pump been alarming like this??? It’s completely empty!!!“)
I need something that will get my attention.
Like flashing LED lights and a horn sound. Which would also serve as a deterrent for my forgetful daughter. Can you imagine having that happen in the lunchroom at school? She’d never forget again!
I love my kids’ pumps. They are fabulous and I have no other issues with them besides this. So please, Medtronic, help out a busy mom and build this flashing-light-loud-and-insistent-can’t-miss-it-alarm feature into your future models. Is that too much to ask?
Click for the Share And Don’t Share-Monday 5/13/13 List of DBlog Post Links
DBlog Week is an entire week in which diabetes bloggers will be posting daily using pre-determined writing prompts. I’ve never written every day for a week before, so this is going to stretch my brain in a new (and hopefully interesting) way. I can’t promise that the chaos of my life won’t interfere….some posts may happen in the wee hours of the night….but I’ll do my best to write on every topic!
So here goes….
“Often our health care team only sees us for about 15 minutes several times a year, and they might not have a sense of what our lives are really like. Today, let’s pretend our medical team is reading our blogs. What do you wish they could see about your and/or your loved one’s daily life with diabetes? On the other hand, what do you hope they don’t see?”
First off, our endo provider is also a parent of type-1 diabetic kids, so I know he already “gets it” in the visceral sort of way that providers without type 1 kids can’t. All of the anxiety, stress, worry, chaos, uncertainty, and fatigue that I feel is something I know he understands. That’s a blessing when it’s time to come in for those dreaded check-in appointments.
So for all the other providers out there who don’t have such a personal connection to Type 1, I wish they could see that I eat, sleep, and breathe diabetes. It’s ever-present in my mind; sometimes at the forefront, when I’m in the middle of carb counting or a set-change for instance, and sometimes just as a low-level anxiety, like a mosquito buzzing in my ear.
I download insulin pumps every two weeks to search for patterns and make pump adjustments. I memorize food labels and ingredient lists. I organize and keep inventory of our myriad diabetes supplies. I skip sleep to make sure I get middle of the night blood sugar checks and corrections done. I read about diabetes. I research available technology. I troubleshoot, and I problem-solve, and I teach, and I teach some more. I haggle with our insurance and mail-order pharmacy for hours. I worry about exerting too much control over their food choices. I worry about exerting too little control over their food choices. I worry about everything, and yet I know that I’m doing the best I can.
I take that on as a mom so that my kids don’t have to feel that, and so it doesn’t dictate our family life. I keep a straight face even as I’m stressing about their upcoming A1C results, so they don’t ever feel like they’re burdening me. I talk with them about their diabetes in an age-appropriate way, all the while thinking about the very real and life threatening implications of the disease.
It’s a lot, and sometimes it’s overwhelming. What I never want my providers to see (but which I have to cop to), is that we sometimes go 4-5 days on an infusion set because I don’t have a great system for remembering to change them. My kids eat more treats than I’d like and is good for them. A lot of the time we’re rushing around and I do things like forget their diabetes kit, or that they needed more strips. Lancet-changing….doesn’t happen.
An although I know I’m doing the best I can, there’s always room to do better. I’m going to be so happy when I’m doing enough to finally see some good Hemoglobin A1C numbers. More on that another time….
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.