Wordless Wednesday: Airplane Tricks

A +50% basal rate was just the thing for last week's
5 hour airplane trip west. 
We did the same thing on the way home
and fought lows.  
I'll take a half success over none. 

What Happened in Vegas

Last week's spring break adventure was a colossal road trip beginning and ending in Las Vegas.  As usual, we dragged diabetes along for the ride.  Between the restaurant food and the time change, there was an incredibly wide range of blood sugar numbers but thankfully no major disasters.  Until the last night of our trip.

My daughter's blood sugar was an amazing one-something-something after thoroughly enjoying the Golden Nugget buffet. We checked out the light show on Freemont Street and then walked back to our room leaving the remaining adults our party to enjoy the casino before bed.

No alarms were set.  We relied on the Dexcom to alert us of any problems.  At 4 a.m., it buzzed.  The first buzz is supposed to mean she's crested over 200, and that's what the graph showed.

I located the meter and the flashlight.  '505' read on the meter screen.  It was so far from what the Dexcom said, I thought there must be buffet residue on her fingers.  I wiped a different finger as clean as I could.  '485.'  So, in my less than awake state, I plugged that number into the meter remote and gave a bolus.  Then I thought about it.  Something must be wrong.

Indeed, a glance at the site confirmed it was done for: a bloody mess.  So, at 4 a.m. in a casino hotel room, I dug out a new set and woke her up.  She further confirmed she was very high by immediately chugging half a water bottle.  We inserted a new site by flashlight so we wouldn't fully awaken my husband. Why didn't we just do it in the bright light of the bathroom, you might ask?  We were half asleep, clearly, since the idea didn't occur to me until just now.

I then guessed at another correction dose, balanced by what might or might not have gone into the bad site a few minutes before.  She was in good shape by the morning, and in the end I'm grateful that it didn't happen earlier in the trip.  I wouldn't have wanted to be overtired here:

Tetherball

A couple of weeks ago, my daughter found herself explaining the need to keep her pump attached somewhere under her costume for the school musical.  It brought to mind this post from a few years ago:

My daughter had a softball “workout” a couple of weeks ago.  All of the girls playing this spring were summoned to demonstrate their skills at batting, catching pop-ups, and fielding  grounders.  Groups of 5 at a time entered the gym to be evaluated by at least that many adults.  Based on their skills, the girls were sorted into evenly-matched  teams. 

Fielding grounders is my daughter’s best skill.  She can hit when she gets in a groove, but given the amount of snow on the ground, she hasn’t swung a bat since October sometime.  And she’ll readily admit that she can’t catch a pop-up beach ball, let alone softball.  So she was excited to demonstrate her infield skills. 

I was not allowed in the room, but as she tells the story, here’s what happened:

Someone bounced a grounder to her.  She was ready, leaned down, and got it.  Then her pump fell out of her pocket.  She threw to first, grabbed the pump and stuffed it deeper in the pocket of her sweats.  From behind her, comes the coach’s voice.  “Can I hold that for you?” 

Diabetes has been part of my daughter’s life since she was 13 months old.  And it’s always been interesting to watch how she responds to people responding to it.  She tends to be very matter-of-fact about the whole thing, and is developing an increasing vocabulary to answer questions and to respond to potentially awkward situations.

“Um…well…actually, it’s attached to me.  So I don’t think that would work too well, but thank you.”

I couldn’t have said it better.  

Of course, on the way home, we became hysterical envisioning her fielding grounders while the coach tried to hold the pump. 

Tetherball, anyone?

A Volleyball Spike Would Have Been More Fitting and Less Exhausting

Volleyball started this week.  We tried to hearken back to volleyball a year ago to figure out how to handle it diabetes-wise.  We could recall very little.

We did know she needed to eat dinner before the 6 p.m. start time, not wait until after.  At 5, her blood sugar was on the high end, around 240.  Dinner was a chicken pot pie with biscuit topping.  I don't usually make this version anymore because there seemed to be no way to bolus the biscuit part that worked.  But I'm still recovering from my accident of 2 weeks ago, and looking for anything soft to make that we can all enjoy. So the ease of making one meal all of us could eat won out.

We bolused dinner and corrected the bg, assuming the pot pie topping would be hanging around helpfully during volleyball.  She poured a bottle of G2 - the low carb gatorade - to bring to practice.  Sipping a few carbs of this at each break seemed helpful last year, as best as we could remember.

After practice, at 7:30, her bg was 142.

Frozen treat season started in earnest this week too.  It was a friend's birthday, so her mom took the girls for ice cream or italian ice after practice.  My daughter bolused for a cup of root beer italian ice at a place we've been before.

At 9:45 as she finally crawled into bed after a shower, finishing homework and regrouping for the next day, her blood sugar was 115.  Which seemed great.

At 10:20, I heard footsteps.  "I just checked and I'm 34."

34.

She drank eight ounces of juice (double her standard amount for a bg of 50-60).  We cuddled on the couch for the end of the baseball game.  She checked again.  56.  Better.  After another four ounces of juice she crawled back into bed around 10:45.  Now may be a good time to note that when the dexcom sensor came out on Tuesday we decided she could go a few days before starting a new one.

I stayed up, checking every 15-20 minutes.  The next check was 82.  I realized we should have set a temp basal as soon as 38 read out on the meter screen, but did so belatedly hoping that would preempt the need for more juice.  Next check:  78.  I waited it out, hoping for a turn around, not wanting to overdo. Fifteen minutes later:  65.  Another juice box.  A few more pages of my book later: 116.  Maybe we were finally out of the woods.  But for some reason I didn't trust it, so I stayed up.  Twenty minutes later?  72.  I reset the temp a little lower for another hour and went back to the sofa for another chapter.  87.  I finished my book.  One more check: 95, and my husband's alarm was set for 45 minutes from then.  I couldn't keep my eyes open any longer.

A quick prayer to God, and the diabetes gods - just to cover all the bases - and I crashed.

By the time my husband checked, she was up to the 160's and stayed there until morning.

Lessons learned?  Volleyball catches up with her. (This lesson sounds familiar in retrospect).  This establishment's italian ice seems to have fewer carbs than the standard calorie king estimate.  (This lesson also sounds familiar).  She probably should have stayed up until she hit a blood sugar of at least 70-ish and followed the juice with some peanut butter crackers.  (This lesson was taught to us while still in the hospital 12+ years ago).

Last lesson?  If you're going to have a night like last night, it should always precede a beautiful giant-iced-coffee-worthy day like today.

The Diabetes Card

I hate playing the 'diabetes card.'  Saying, 'but she has diabetes,' goes against my whole, 'diabetes can't stop you from doing anything' mantra. Also, invoking diabetes has the secondary problem of necessitating a longer, more complicated conversation than I ever want to have. We are often able to problem-solve diabetes stumbling blocks so that my daughter can participate fully in things without making a big deal about them. But sometimes that becomes impossible.

Before the weekend performances of the school musical I received an e-mail stating that all cell phones would be collected when the kids arrived at school an hour before curtain.  They would be kept 'in a safe place,' and made available 'in case of emergency.'  This was happening at dress rehearsals as well.  Sometimes my daughter turned hers in. Sometimes, like on days of crazy diabetes issues, she claimed she didn't have it but really kept it with her. The collection was kept in clear ziploc bags on an accessible table, so she knew she could reclaim hers and use it in an emergency, answering questions afterwards if needed. 

For the show, however, I had to say something.  We have a system of her texting me her numbers a few minutes before curtain time and at intermission.  We try even harder than usual on show days to intercept any problems early on, and to keep things on an even keel.  A fuzzy brained high could lead to forgotten lines.  A low on stage has all kinds of potential ramifications.  So we've got a system of checks and balances in place.

I contacted the director and plead my case through a (probably) over-explanatory e-mail. Not only did she need to keep her phone, I explained, she had to use it at least twice backstage.  I hoped that would not be a problem. The director's response?

"Of course she can keep it!"

Which is what I assumed the response would be from anyone with an ounce of decency and common sense.

But I still didn't like having to ask.  Playing the 'diabetes card' invariably puts a qualifier on 'diabetes can't stop you.'  It says that she needs some sort of special treatment to keep her safe.  Which is sometimes hard to ask for or to admit.  But sometimes it makes sense.

At Least We Got A Treat

My grandmother was clumsy.  My mother was clumsy.  I have inherited this gene.  And as I get older, the consequences become more dire.  Last Wednesday's incident leads me to consider living the remainder of my days in a hamster bubble.

I was leaving a meeting at my church and walking to my car with something in each hand when I tripped and found myself airborne and parallel to the sidewalk.  With my hands full, and not as much reaction time as the slow motion vision of the incident going on in my head would suggest, my chin was the first thing to hit the sidewalk.  As I started to try to get up, I realized my chin was bleeding heavily and that my mouth and jaw had several significant injuries.

Thankfully, someone I knew came along who had been at the meeting with me.  He walked me back into the building where a friend helped me clean up and then took me to urgent care.  No stitches were needed, and x-rays showed no broken bones.  Follow-up with the dentist on Thursday showed that a disk which cushions the bones around the intersection of the right side of my jaw was intensely swollen and inflamed, making it impossible to open my mouth more than a crack.  I am still unable to chew, and brushing my teeth is torture, but with rest and a variety of treatments the problem should continue to resolve over the coming weeks. Then the dentist will be able to fix the broken teeth. 

I'm guessing you're feeling badly for me but wondering what this has to do with diabetes.  Read on:

As I lay on my sofa Thursday morning, everything hurting, the phone rang.  It was my husband calling from work, who had conferenced in my daughter calling from the nurse's office.  In tears.  "I'm 385 and I was 300 an hour ago and corrected it and we're doing jump rope for heart today so I've been jumping rope and my blood sugar won't go down and I didn't want to bother you and I know you're not supposed to talk, but I don't know what to do and the site looks pretty yucky and .... what should I do???"  

I took a deep breath (one of us had to) and mumbled through clenched teeth, "Sounds like it's probably the site.  Do you think you can do it yourself?  I'll come down there if you really need me to but if you think you can do it, now's the time to try." 

"I think I can." 

"Are you sure?"

"Yeah."

"O.k.  Make sure the nurse sits with you and watches.  Call me if you need to.  It's o.k.  And if I need to come down there, I absolutely will. But I definitely think you can do it."

When she did her first site change a couple of weeks ago, I never would have seen this particular need coming.  I envisioned a site falling out on a day trip with another family, or a failure during a night with grandparents while her dad and I were off doing something fun.  But here we were, me looking like I'd been in a prize fight and in intense pain on the sofa, and my husband an hour's commute away at work.  

It took only 2 more phoned in questions to accomplish the task (I don't have to prime again, right? Can I leave the old site in until I get home in case it's a gusher?).  By lunch time she was in the 200's and by mid-afternoon, back under that 200 line.

As our little family reconvened around the dining room table that evening, and I sipped my pureed lentil soup through a straw, my husband decided the day needed a happy ending.  It was the warmest evening yet, with the hope of spring in the air, so I was loaded in the car and we headed to our favorite ice cream stand.  My daughter enjoyed her first italian ice of the season.  My milkshake was the most calories I'd consumed in 36 hours.  It was a well-deserved treat.