Always Something

The weeks before our vacation went smoothly, blood sugar-wise.  We'd hit a groove. The majority of numbers were in range, and predictability allowed us to fine-tune the rest.  Then we went on vacation, which was less predictable but all things considered the blood sugars were not outrageous.  I'd hoped when we returned home we'd pick up where we left off, but that's not the way it went at all. We've been undermined by the following forces:

• A doctor's appointment this week confirmed my suspicion that my daughter's annual spring growth spurt has hit full stride.  It's great to grow, but the growth hormones and added physical mass are throwing her numbers, particularly the night and morning ones way out of whack.  It's clear that her overall insulin needs are increasing faster than our programming of her pump's rates and ratios.

• As usual, daylight savings time threw us for a loop over the weekend.

• Softball started this week with 5 practices in 7 days, all at different times in different locations. After a sedentary winter, exercise, adrenaline, and a more flexible schedule have come into play.   

• Yesterday, during an afternoon of high blood sugars, I pulled a site which was quite clogged.

• Last, but not least, she came down with a fever and cold last night.

For me, the challenge when faced with a laundry list of problems like this is not to treat them as excuses for high blood sugars and hope they'll go away on their own.  Instead, I have to muster the energy to address them head-on.  The only way to do this is to systematically work through the problems one at a time.  The clogged site was a simple fix, and the illness is an unpleasant diversion but manageable with frequent checking, aggressive correcting, and lots of liquids. The softball routine is coming back to us quickly, and her bag has been fortified with plenty of granola bars and smarties.

It's the major, long-term changes that are the hardest to tackle.  They require answering all those questions:  Are the basal rates too low?  Does the correction factor need to be changed?  Is the insulin:carb ratio correct for all meals?  Or just some?  Or none?   We have to start writing things down again...every time.  We'll want to check in with our diabetes team. 

The bottom line, though, is that this needs attention beginning now.  No excuses.