Friday evening was site change night. The low battery symbol was appearing on the pump, so I decided that instead of waiting for it to alarm at midnight, I'd go ahead and take care of that too.
My daughter had an unusual and not easily explained low blood sugar Friday evening. She was low again around 10. By morning she was in the higher range. Mid-morning, she went to bolus for a snack and the pump alarmed. "Exceeds total daily dose," was the message. Her pump allows us to set up maximums for total daily dose, and for each bolus. It's a safeguard against, for example, giving 2.5 units instead of .25, or wildly miscalculating a dosage. We run into the single bolus maximum occasionally for an enormous meal, but we'd never hit the total daily dose maximum before.
Her insulin needs have been slowly increasing over the past couple of months, and my initial assumption was that we'd crested over the somewhat arbitrary maximum we'd set up when we first programmed the pump a couple of years ago. Looking back, however, the total it was showing was a good eight units over the twenty-four hour totals for any days in the previous week. She hadn't eaten anything unusually high in carbs. I began to flip through the recent history to see if there had been some sort of accidental bolus. As I scrolled backwards, it clicked. The most recent bolus was recorded as 7 p.m.
You may recall the Seinfeld episode in which Jean Paul comes to stay with Elaine for the New York City Marathon. He has recently overslept and missed the marathon at the Barcelona summer Olympics. How could this happen, Jerry wants to know. Was it the snooze alarm? No snooze. Perhaps a.m./p.m.? No. Not a.m./p.m. For Jean Paul, the alarm volume was his downfall.
In my case, it was a.m./p.m. When I reset the clock after changing the battery, I made it 5 a.m., not p.m. We were fortunate to escape with just the confusion of the total daily dose alarm and some somewhat strange blood sugar patterns. Her bolus ratios and basal rates are really quite different throughout the day, and yet thankfully we had no really scary situations. We reprogrammed the total daily dose to a higher number, set the clock back again and moved on. Saturday evening, we realized the need to reprogram the date. We set the clock back so many times that somehow it lost a day in time travel. But all's well that ends well. We really didn't miss out on much because of this, unlike poor Jean Paul.
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