Why We Look Tired Today
My daughter called from school mid-afternoon yesterday to report a blood sugar in the 300's. "Correct it and we'll see what happens by the time you get home," I suggested.
"Why do you think I'm so high? Do you think it's the site? I can't see it too well."
"Maybe. You've been high lately in the afternoons anyway you know. Not this high, but let's see what happens. You'll be home in less than 2 hours." By the time she got home, she was 82.
I didn't think of it again, at least in terms of it being an urgent problem. I recorded it on the log sheet and vowed to take some time this week to look at the after-lunch time frame. Her dinner number was good, and after dinner wasn't terrible either. By 10 she was creeping up to 200-ish, which I corrected.
At 1 a.m., the Dexcom was buzzing. HIGH. She was 310 and apparently I'd slept through it's first attempt to alert me. I got up, confirmed the number, and corrected.
By the time I got back in bed, the wheels were turning. Was it the site? Why hadn't I looked at it when she got home? What else could be going on? She had some Irish Soda Bread after dinner for which I approximated a carb count, but I can't imagine I was that far off. We've been changing basal rates overnight and things were starting to even out. What was with this number?
For some sleep-muddled reason I chose to wait out the correction and see what would happen.
Forty-five minutes later, she was higher with a diagonal arrow up. I un-snuggled her from her covers and unceremoniously peeled back her pajamas to take a look.
"Ick" is the G rated version of the mumbling which ensued.
I gathered the super-sized flashlight and the site change supplies. I woke her (which is her preference...I know of people who simply proceed with site changes while their kids sleep).
"You're super-high, sweetie. I need to put in a new site. I'm sorry I had to wake you up."
"(Unintelligible mumbles) I'd rather get up and do it. You can just turn on the light," she said in a disgusted yet somewhat understanding voice.
I got the new site in and operational as quickly as I could and tucked her back in with a kiss.
Now, how to do the "math" to lower the blood sugar? I'd corrected this number once, but nothing had happened. The pump now suggested only a small amount of correction because so much insulin was on board. Some of that insulin had probably been delivered, but certainly not all. She'd likely missed some basal insulin too from the gunky infusion set. I looked at the suggested dose and compared it to the total dose the pump told me it would take to drop her back to her target blood sugar. I picked a number in between and pressed 'o.k.'
An hour later, I was still awake but happy to see her blood sugar slowly trending down. At 3:30, Dexi roused me from my dozing. "FALLING," she said. The actual blood sugar was still in the low 200's, but insulin was infusing and doing it's job. I finally fell asleep.
The story has a happy ending. Her blood sugar at breakfast was 120. Now for another cup of coffee.