Showing posts with label dexcom. Show all posts
Showing posts with label dexcom. Show all posts
Slowly but Surely
Our household diabetes policy (yours may vary) has been for my daughter to take on diabetes responsibilities as she feels ready. The understanding has been that while we do not expect to live in her college dorm with her, she should not feel rushed. Every diabetes task will ultimately be hers, for the foreseeable future. For now, we're here to help.
Slowly but surely over the past sixteen years, one or two things at a time, my daughter has taken over her own care: blood sugar checks, carb counting, then insulin pump site changes, and so many more in between.
The Dexcom was at the center of the two lingering exceptions.
Because of the awkwardness of the G4's insertion device, I continued to assist with putting in a new sensor every 7 or so days. She did it once, to prove to herself that she could in case it failed while she was traveling without me, but it was super-awkward and I was happy to keep helping. The insertion device for the G6 is a much easier to handle one-handed push-button device. My daughter inserted the first and second ones with no problem. It's easy and nearly painless, she reports, though the spring-loaded insertion contraption is alarmingly loud.
The second area of responsibility we've recently relinquished (to some extent) is overnight diabetes care. Until the G6 arrived, the Dexcom receiver remained on a parent's bedside table each night. We got up to deal with its alarms while my daughter slept, or roused herself briefly for juice. That routine, of course, followed years of setting 2 a.m. alarms for fingerstick checks.
The new plan is that my daughter keeps her phone, and the Dexcom receiver, on her bedside so that she can awaken to deal with the alarms. She started with just the phone, but the Dexcom app alarms were not loud enough to consistently wake her (though they woke both of her parents in the next room). She's added the receiver, which she keeps on the bed with her to feel its vibrations, and so that two alarms are blaring at once. She still does not consistently wake to the alarms, while I, of course, still do. But things are improving. She did wake up and treat a low this week without my hearing anything, which was good news. And the alarms are diminishing after the Thanksgiving leftovers are gone, and as we use the Dexcom data to work on keeping numbers more consistently in range...which is the ultimate goal.
It's bittersweet to watch my kid take on these responsibilities. Yes- by all rights they're hers to deal with and it's important for her to practice with the safety net of mom and dad around to help. But how I wish she didn't have to.
G6
The Dexcom G6 is up and running, and it's keeping us running.
Technologically we're totally impressed. It's accurate. The readings flow seamlessly from the transmitter to my daughter's iPhone and the Dexcom receiver, and then on to my phone and the Dexcom Clarity page online. And no fingersticks? Amazing.
We used our previous CGM, the G4, only as a general guide. Heading up or down? Always alarms between 2-3 a.m.? Should she do anything before changing for gym? It was less accurate and had crapped out months ago on sharing numbers to anybody's phone, so unless it was alarming with an urgent low, it was mostly background noise to be addressed eventually.
The G6 feels less like a lowly assistant making suggestions from the corner of the conference room and more like the boss. What it says goes. Low predicted in 15 minutes? Eat something. Now! Suddenly skyrocketing? Drop your pants and check that site! Clarity shows you've gone over 220 after lunch five of the past seven days? Fix something!
Some of that is good for us. Most of us get lazy with diabetes at one time or another, and of late, we have. Having the G6 looking over our shoulders and nudging us at every turn is causing more action than had been happening here, at least in terms of more minor excursions from a target blood sugar range.
Some of it, though, is wearing. Already. After 12 days. (But who's counting?)
The alarms are driving us nuts. Starting it up over a busy school play weekend followed by a Thanksgiving week full of family and food certainly didn't help. Diner pancakes at 10 p.m., daily servings of stuffing, and pecan pie two nights in a row are rare treats, and as the schedule goes back to normal, alarms are settling down. We learned quickly not to have both the Dexcom receiver, and all of our phones set to alarm when all of them are in the same house. The cacophony and the subsequent process of silencing them all would jar anybody's nerves.
We're also struggling with information overload. The numbers are in our faces all the time. Because the previous system's data went only to its own receiver, my daughter would look at it at mealtime, before bed, and when it alarmed. Now can see numbers whenever she opens her phone. And with share operational again, I too can see numbers anytime I want instead of looking at the receiver once a day- or less. A diabetes-life balance is, in my opinion, a very important aspect of living sanely. It will take some time to figure out how to compartmentalize the extra information so that it does not overwhelm.
Was it worth waiting for? Absolutely. The steady stream of accurate data is incredibly useful. It helps with hour to hour decision-making. Once the bulk of the data isn't skewed by Thanksgiving food, the long-term graphs will be incredibly valuable in adjusting basal rates and bolus ratios. And maybe when the data settles down into a more predictable range we won't mind seeing it so often.
Another Wait
The Dexcom G6 finally arrived last week, after a wait which was entirely too long.And yet, we've decided to put off using it.
There are still 3 Dexcom G4 sensors here, and we've decided to use them up.
The wait is, in most respects, really hard. It's like getting a new toy on Christmas morning and not getting to play with it until February. Why would we torture ourselves like this?
We have our reasons:
We are grateful for what we have, and don't want to waste the G4 sensors. We're certain that once the switch is made, there's no way my daughter will want to go back to the G4 for a few weeks to use up the old supplies.
We feel much more comfortable with supplies in reserve. By waiting a couple of weeks, we build up a few extra G6 sensors in the supply closet for a rainy day.
We want to take the time to start it and to set it up right. Because of our family's marching band commitments, time is at a premium in October. We're waiting for a quiet evening, or weekend morning, to sit and learn the minimal but important basics of insertion and sensor start-up, download the apps and software, and learn how to use them. That might not be until November.
And the most trivial reason? The Dexcom receiver fits perfectly in the tiny pocket of the marching band uniform jacket, and my daughter's phone (which will be her new receiver) does not. Waiting until next year to solve that problem, which will likely involve some stealthy sewing, feels easier.
So we wait, the box of G6 stuff taunting us from the corner of the dining room.
No News
A couple of days ago, my daughter's Dexcom stopped sending data to her phone. So therefore her phone has stopped sending data to my phone.
Because we have a Dexcom G4 model with a receiver she keeps with her at all times, and because this receiver is still streaming her data, this is really no big deal. She never looks at her data on her phone, only on the receiver she wears on her person, so she was unaware, until I informed her, that the phone communication piece had stopped working.
Interestingly, I also did not notice for over 24 hours.
We know how to fix this problem. It's a glitch which happens occasionally and is repaired by disconnecting and reconnecting the Bluetooth connection between the receiver and my daughter's phone. It takes several minutes and sometimes a couple of tries, but it's not a big deal.
Yet now it is Friday and I still have "NO DATA." This is not a surprise, since everything about the past two days is a complete blur. In addition to the usual school schedule there have been 3 or 4 hour evening band rehearsals, a stage crew meeting for the fall play, the usual mountain of homework, and I think she managed to eat and sleep.
Having NO DATA at my immediate disposal has been interesting. I don't miss the alarms and the concurrent worry. I am not feeling anxious about missing the highs and lows, trusting that my daughter is handling any issues on her own, and knowing that she would have informed me had there been any major problems requiring multiple juice boxes or site replacements. We're still using the receiver in our bedroom at night to alert us to any nighttime blood sugar excursions, so I would have been involved in any overnight issues anyway.
No news is not all good news, though. What I do miss is being able to look at the big picture. One peek a day (or noticing alarms at the same time every day) provides an opportunity to fix problems in a timely manner. And, while I'm the third string back-up for any marching band emergency, I do miss being alerted to any significant blood sugars while she's at those nighttime rehearsals.
My daughter has a quiet evening tonight before the last big weekend of marching band. She'll need to get some homework done and practice the piano, but she'll get to eat dinner without homework in front of her, and maybe even watch a favorite t.v. show.
And she'll find a few minutes to reconnect her Dexcom to her phone, just in time for what promises to be a chaotic weekend diabetes-wise.
Cue the alarms.
The Drop-Off Line
For a couple of years now my daughter's had a little inventory she's run through before leaving the house for almost anywhere, except, for some reason, school:
"Phone. Meter. Dexi." If one of them isn't on her person or in her bag, she'll go get it. If she's got it all, she heads out the door.
On day seven of school I received a text: I forgot Dexi. The Dexcom receiver was, indeed, still sitting in the kitchen.
Day 10 brought a similar text, except she'd also forgotten the meter:
The school is only a couple of blocks away- a two minute drive at the most. Unless it's 15 minutes before school starts. Then it's an excruciating crawl with both vehicular and foot traffic clogging every route and intersection. Which is why, no matter the weather, and even though it's essentially a straight uphill climb, my daughter walks to school.
Accessing the school after classes begin is, as I learned last year when dropping off the Dexcom receiver, it's own kind of challenge. I was buzzed through two sets of locked doors and talked with a couple of school personnel, after which my daughter had to run through the nurse's office between classes to pick up the missing item.
So I drove to school, both times, pulling into the drop-off line with my flashers on while she ran out of the building to take things from me through the open car window before the first bell. She was efficient both times, but I imagine the people behind me still looked on with a combination of confusion and irritation.
While the texts may look terse in the photo, my daughter was, in person, both upset she'd forgotten her supplies, and incredibly grateful that I could drop them off. There's a spare meter at school, which she could have grabbed from the nurse's office if she had needed to. But the absence of the Dexcom info she's used to relying on made her uncomfortable, especially in the first week or two of school when the routine is still new and is therefore messing with her blood sugars.
"Phone. Meter. Dexi."
The inventory is now part of our morning farewell routine. If she doesn't say it, I do. One of the perks of our current house is that I, theoretically, should never have to withstand the ordeal of the morning drop-off line. Nobody should have to do so without a child in the car.
Sharing is Caring
Back in October of 2014 I wrote a post entitled, 'Why We're Not in the Cloud.' My reasoning centered around allowing my daughter to problem-solve her own diabetes issues as independently as possible. I did not want to be hovering over her metaphorical shoulder, texting ' You're 68- did you go to the nurse?' Or 'Why are you still 250, didn't you correct that yet?'
Fast forward 2 years and we've just received and activated a Dexcom G4 Share receiver and downloaded the app on our phones.
1. My daughter wanted to be able to see her numbers on her phone. She's a 14 year old high school freshman and that's the kind of stuff they're into. She thought it would be both 'cool' and convenient to be able to use her phone as her primary source of dexcom information.
2. Our family recognized that having a virtual diabetes care team was increasingly important. Gone are the days of a parent, nurse or other diabetes-aware individual being within shouting distance at all times. My daughter is doing more and more of her care and troubleshooting on her own, which is great. But especially during the transition, it's comforting to know someone else has an eye on her numbers in case problems arise.
3. This one's all about me. Being able to see her blood sugar on my phone will, I think, give me a little peace of mind when she's traveling on a school bus with the marching band, out late with friends, home alone, or when the school days are followed by long theater rehearsals. I'm already not sure how I survived the first birthday parties and sleepovers without it.
4. Because my daughter is busier, we'd rather spend the moments we have together talking about something more interesting than how her blood sugar went all day: was she low in gym, did she spike again after lunch, did the breakfast correction work okay? If there's an issue, then we can get straight to fixing it, otherwise we can talk about other, more interesting, news of the day.
For now the constant stream of information is addictive. We're entertained, and occasionally alarmed. Only time will tell how this will end up working for us. I look forward to sharing the plusses and minuses in the weeks to come.
What's That?
Little kid (pointing at Dexcom receiver on my daughter's belly): What's that?
My Kid: I wear it to keep me healthy!
(Little kid swims away/ continues eating popsicle/ asks about something completely different)
This conversation has repeated itself several times this summer at our town pool. These are usually kids who know my daughter's friends (neighbors, kids from camps they've volunteered at, relatives). These kids enjoy the opportunity to hang out with the 'big kids' for a while in the water or on the volleyball court. My daughter chose her stock answer at the beginning of the summer and so far it's worked every time.
These conversations are in significant contrast to those she's had this summer with new peer and adult acquaintances. These people want (or the case of the band director, for example, need) more complete answers to what the devices she wears and uses are, and how they work.
Through middle school, her social circle remained fairly static. As she starts to spend more time with the band kids, and with the people her middle school friends are collecting as they start new activities and endeavors, the explaining has begun again and the conversations have become longer. Recently examples include, 'why do you still have to poke your finger if you wear the dexcom?' and my daughter's personal favorite, 'what's your blood sugar usually?' These are a little harder to answer but they're thoughtful questions.
I'm glad her friends are interested in and concerned about her diabetes. High school means she'll be spending lots more time with her friends. The more they know, the better.
Though the conversation is certainly simpler with a 4 year old.
You Don't Know What You've Got 'Til It's Gone
At first it was kind of a novelty to live like we did in the olden days.
The element of surprise added interest to every finger stick.
The highs and lows made us think a little harder about the why's and the what next-s.
The nightly 2 a.m. finger sticks let us relive the old familiar moments of rescuing the stuffed rabbit from the floor and wrestling a hand out from beneath layers of covers.
The once-again regular calls from the nurse's office made my day less lonely.
But the lack of a working Dexcom is beginning to take its toll.
We miss the ability to see highs and lows coming on before they're 50's and 300's.
We miss relying on the graph to show us a steady upswing after a low instead of drawing blood every 15 minutes until we're absolutely sure the number is stable.
We'd like to sleep.
We're all caught up on everything that's going on in the nurse's office and its environs.
So I was glad this morning to find in my inbox the shipping notification for our Dexcom's new transmitter. A combination of my slowness to order it as soon as the low battery notification appeared and the slowness of getting insurance approval for and shipping a new one has left us Dexcom-free for a week.
Which isn't the end of the world, and I'm grateful we have the technology at all, but now that we're used to having the data and the safety net, it's really hard to do without. Even my daughter, who is still understandably ambivalent about the insertion of and constant wearing of another device, asked yesterday about the status. "I can't wait to have it back- I'm so tired of not knowing what's going on." Me too.
150 All Night
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| Dexi spent the night making wild guesses. And I spent the night telling her she was wrong. First world problems, I know- But why does she spaz out like this sometimes??? |
Wordless Wednesday: Airplane Tricks
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| 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. |
Panic
As I rolled out of bed this morning, I grabbed Dexi for a peek.
Turns out the signal had been lost for about half an hour, which happens from time to time. It's usually not longer than that, and usually not a big deal. Per the graph, blood sugars had been been skirting the 80 line for an hour or two before communication was lost.
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| I wonder if this is physiologically possible? |
I was relieved to easily wake her with a gentle rub on the back and a 'good morning.'
Meter in hand, I wasted no time checking her blood as she began to rouse herself.
113.
Good news, if a bit unexpected.
I fed Dexi the number and followed up with another as she requested (which was close to the first) .
As my daughter put her toast in the toaster, a mere 10 minutes later, more alarms: bzzzt, bzzzt.
High.
Impossible, I decided. Clearly, Dexi's in some sort of panic mode at this point and making wild guesses.
"Just let her settle down," I advised. My daughter actually gave the Dexcom a little pat and told it not to freak out.
By the time we'd finished breakfast, Dexi was reading in the low 100's and her imaginary crisis was over.
Why We're Not In The Cloud
Making mistakes and learning from them is, in my opinion, part of being 12.
When my daughter says, "I don't need to study for the quiz. We reviewed in class and I've got it," I say o.k. When she puts off a chore until the last minute, I don't nudge. When she's upset by the results of these decisions, we talk about what happened and she learns from her mistakes.
"Didn't Dexi alarm?"
"Yeah, but I was only 200 and I was in art and my hands were all gross."
"O.k., but now it's over an hour later. What could you have done differently?"
"Checked after I cleaned up."
"Yeah...you'd probably be lower by now if you'd corrected, right?"
"Yeah. I'll check sooner next time."
In this scenario, she made some decisions. They weren't great ones. But we talked about it, calmly, and I'll hope that the next decisions she makes in these circumstances are better. Had I been watching that CGM graph on my mobile device in the hour before she got home*, I'm not sure I would have handled the conversation as calmly. I may not have seen the opportunity to let her take a lead in problem-solving for next time. I would have spent that hour getting increasingly irritated that her blood sugar wasn't coming down, and probably would have texted her to test and correct as soon as she turned her phone back on after school.
In the scenario we've chosen, the numbers are hers to deal with in the moment they occur. Then, help is available if she needs it.
She knows she can text or call me whenever she needs my help. The nurse is there all day at school, and my daughter doesn't hesitate to stop in her office. The Dexcom receiver reaches our bedside tables so she can have the night off from responsibility. But when she's at school or out with friends, it feels like it's time to let her flutter around outside the nest a bit. We watch carefully from a short distance ready to come to her rescue whenever needed. Once she's home we talk about any glitches that occurred and about what she could do differently next time. For her, this seems like a great way to learn all she'll need to know when those safety nets aren't around anymore.
If I had a kid who regularly ignored highs and lows I'd think differently. If her Dexcom receiver didn't give us readings when she was in bed, I'd think differently. If she was littler, I might even think differently. If at any time I feel she creeps over the line of 'learn by doing' to a place where her safety is compromised, I'll not hesitate to reconsider all of the technology available to us. Everybody's experience with diabetes is different and we all need to do what works for us at any given time.
For now, though, this is what works for us.
*If you're unfamiliar, an explanation of 2 CGM in the cloud technology options are here and here. Essentially it enables the data from a continuous glucose monitor to be sent to a designated smartphone so that there is another set of eyes on the information.
Old School
The Dexcom sensor died on Thursday after a long and helpful life. We took a day and a half off and put a new one in on Saturday. This one showed a variety of timer and blood drop symbols much more often than it showed any actual numbers. The actual numbers it did show were often up to a hundred points off. After 24 hours of trying to settle itself in, the ominous 'sensor failed' message appeared on the screen at 6 p.m. Sunday. We decided to wait another day or two to insert a new one.
So essentially, we've been without Dexi since Thursday morning. Aside from a post burger and fries restaurant high on Saturday night, the numbers have looked pretty good. Granted, for all I know, she's been spiking to 400 and then dropping down just in time for a finger stick. But that seems unlikely.
What I do notice is this: we're doing things more thoughtfully and intuitively. This has its pluses and minuses. Today I'm intrigued by the pluses since they seem so much more unlikely.
While those Dexcom arrows are often helpful, I just as often find them to be misleading. If I wake up at 2 a.m. to a 189 with a diagonal down arrow, I'll roll over and go back to sleep. If the alarm goes off on a Dexi-free night, I stumble to the bedside, sort through the blanket and stuffed bunny pile to find a hand, check her blood sugar and see 189 staring back at me, I'll correct it. Correcting it is much more likely to be the right thing to do.
Without that graph and those arrows to guide me, I find myself considering more of all of the other information available to me before I make decisions. I think more about insulin on board, what particular foods were consumed, what she's been up to for the past couple of hours, what the next couple of hours will hold, and what things looked like yesterday and the day before around this time.
She checks her blood sugar more without the Dexcom. During a regular school day, this only means one or two more tests. But on weekends we've come to rely on a quick glance at Dexi now and then, often only checking at mealtimes. Waiting for alarms to sound prevents us from catching problems sooner than later.
I love the safety net aspects of the Dexcom. I've come to rely on its information as a major part of diabetes decision-making. But it's intended to work in conjunction with all the other tools we already had in our toolbox. This week has been a good reminder to continue to use all those skills we worked so hard to hone in the 11 years before Dexi appeared on the scene. They're actually quite handy.
A Minor Miracle
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| AFTER Calibration!!! |
Maybe once a month we get a perfect match between the glucometer reading and the dexcom. It's always very exciting and everyone in the house is summoned to see it with their own eyes.
On occasion these matchy moments occur at the same time the dexcom needs to be calibrated. In the past, every single time we've entered a meter number that matches the dexcom's number we've been left shaking our heads. Without fail, Dexi will decide my daughter's blood sugar is not exactly the matchy number at all, but one just one or seventeen points in one direction or the other.
For this and other reasons, Dexi's strong-mindedness has become a running joke in our family.
This morning, I was summoned to view the breakfast numbers- which were a little higher than I'd like but did indeed match. I then stayed to watch as the dexcom calibration took place, waiting to see what whimsical number Dexi would decide was the real one.
"Mom...look...she actually agreed!"
"Wow...maybe she's mellowing out."
Probably she's just thinking up some other way to torture us later on.
Weird
All day: confusion.
Check: 115. Dexi: 250.
Check: 287. Dexi: 140.
Lots of 'Recheck...that doesn't make sense.'
And 'Really...that's what it says.'
All day.
It probably didn't help that we left Dexi home for an errand outing. Or that we went to the pool. She finds that very confusing. Always.
Yet from dawn to dusk, nobody could agree.
Beditme was the most bewildering.
Check: 270. Dexi: 240. We thought there had finally been a meeting of the minds. A small correction was given and some reading began.
Fifteen minutes later, Dexi asked for more blood.
Check: 138. Dexi: still 240. I thought we were in for a long night for sure.
But by 10, the anticipated low had not occurred and did not occur all night. Dexi and the meter had kissed and made up. Today, they were all in synch...like they'd been together forever.
Technology is great. We really love it and are grateful for all the help it gives us in managing diabetes every day. But please visit www.stripsafely.com. Sometimes things to awry. They shouldn't.
Dexi's Vacation
Dexi survived the first few salt water laden days of our vacation. Initially, we were checking and reinforcing tape regularly. They we got sidetracked by swimming and beach walking. As we prepared for the outdoor shower after a long beach day, she was discovered to be slightly dislodged. A delicate operation to attempt to resuscitate her failed and she was removed.
Our deal when we first started the Dexcom was that breaks were o.k. The request was to take one at this point, so we did. I must say there were plusses.
It was hard enough to remember the meter kit every time we left the cottage. The constant transferring of the meter and other necessities between my purse, a small string bag and the beach bag was challenge enough. The Dexcom receiver would have been just one more thing to track down - or forget.
While the alarming is, of course, helpful to alert us to high blood sugars, there were a few frozen treats and fried seafood meals I'm glad Dexi never became aware of. We didn't ignore the highs - we tested and corrected regularly. But there's at least one night I'm sure Dexi would have ended up sleeping in the car so she didn't keep us up all night.
Wearing the sensor in the ocean makes me just a smidge nervous. No- it's never fallen completely off, and I don't expect it will. But were it to do so, I'm certain we'd never see it again. It would turn into a mysterious item for someone's beachcombing bucket some day.
I think my daughter was happy to have her belly free. It felt nice to swim and boogie board and dig around in the sand without a protrusion. Also, nobody was looking at it or asking questions about it. The tankinis cover it when she's standing still, but it becomes exposed with movement, and certainly when the bathing suit ruffles float up in the water. The pump site is invisible under her suit, and when she's walking or playing, she wears terry cloth shorts with big pockets to put the pump in. She's willing to answer questions - but a vacation from doing so is nice too.
Dexi's back up and running, and alarming, and being forgotten when we go to the library. We missed her information, and are finding her graphs helpful as we transition from an active vacation to a quiet week at home. There was no objection to starting her up again, and my daughter's glad to have her around on days like today when she's at the pool with a friend.
But the break wasn't bad.
Dexi's Wordless Wednesday
Helpful Hint:
The Dexcom ceases to be useful if you pack it in your mother's purse instead of your own before leaving for the day.
Time Suck
A sampling of annoying events from the past few summer days:
I received a lunchtime phone call from the beloved nurse-free music program. "I'm 72. How should I bolus?" The question took several minutes to sort out.
While at the pool, she had to stop to disconnect or reconnect her pump while her friends were already running for the diving boards/ping-pong table/snack bar. This scene repeats several times daily.
She had to leave her friends in the pool to treat a low blood sugar.
We delayed leaving for the pool to replace the tape on the Dexcom.
We delayed leaving for music to add tape to the Dexcom.
I spent half an hour online searching for tips to keep the Dexcom stuck when frequently submerged in a swimming pool, lake or ocean. (Suggestions are still welcome...).
We expected to do a quick site change, only to find that the pump battery needed to be replaced and the supply of wipes needed to be replenished from the downstairs closet.
A desire for a summer peach turned into an ordeal involving the food scale and the calorie king app since it was the first peach of the season and we couldn't remember the carbs.
A group of friends descended on the kitchen for a snack break. She was the last to eat, as usual, since she had to stop to check her blood sugar, read the nutrition label, and bolus for her food.
A cure and/or a bionic pancreas will some day dramatically improve my daughter's health. That, in the big picture, is the reason we want these things.
The other benefits are indisputable though. When the day comes, we'll go through every day without any of these kinds of stops and detours. She'll stop being the one lagging behind at the pool. She'll dive into her friend's pantry right along with everyone else. Diabetes won't delay the fun. We can't wait.
Armed (and Dangerous?)
The birthday party challenges keep coming this spring. The latest was an invitation to a celebration at a restaurant serving a buffet brunch. Mulling it over, I shared the invite with my daughter, offering her an alternative option. If she didn't want to manage the diabetes aspects of a buffet brunch alone, she could join the group after brunch for the pool party which would round out the afternoon.
"I really think I can do it!" was the overwhelmingly self-confident response.
What could I say?
What was the worst that could happen?
How would we ever get to an overnight road trip with friends without first allowing smaller steps like this one?
So she went to a very nice restaurant with beautiful water views to have brunch with a few of her friends and two brave parents. Armed with her pump, dexcom, cell phone and calorie king app, she was otherwise on her own.
After a two mimosa brunch of my own and a comforting mid-afternoon ice cream stand stop, I picked her up at the pool at 5:45. She was smiling from ear to ear and recounted in great detail all of the food she'd enjoyed. She loved the restaurant, being with her friends, and playing volleyball at the pool.
Diabetes-wise? The Dexcom graph included dots on almost every level of its screen. By 6 it just read 'high,' and stayed that way for over an hour despite two major corrections. The meter's remote showed that over 100 grams of carbs had been bolused for at brunch, and that corrections had been given at 2 and 4 for numbers in the 150-200 range. She had unplugged the pump twice to swim but not for long since the water was "freezing."
As far as I can tell, she did all that she could, and I made sure she understood that. A discussion of the desserts she sampled leads me to believe she under-calculated their carbs but since miniature pastries aren't on our regular menu, she was forced to guess. The real problems didn't start until almost 4 hours after brunch, probably when the fat from the {still unclear to me number of} pieces of bacon she ate met the 105 + brunch carbs and the handful of pretzels she bolused for at the pool. Truth is, she could easily have hit 400 whether I was with her or not. Buffets are hard. Mystery foods are hard. Add into the mix frigid pool water which tends to spike her, unplugging to swim, and a healthy amount of excitement, and the results are not entirely unexpected.
All we can do is try to learn from the experience. Mini pastries have more carbs than expected and should be consumed in limited quantities. Balancing high carb and fatty foods from the buffet with a few lighter options might mitigate disastrous blood sugar results. Following a heavy meal with an adrenaline-producing dip in ice water while the pump is unplugged shouldn't be a regular occurance.
You may think it was dangerous to send a 12 year old with diabetes to navigate a buffet brunch. Perhaps a little bit. But really, on some level, it's dangerous to send a 12 year old with diabetes anywhere. The best I can do is to arm her with the tools and knowledge she needs to take care of herself, and with confidence. Despite the results, this was definitely a confidence-building experience. For both of us.
Dexi Sings Queen
Saturday night went a little like Queen's song, 'Bohemian Rhapsody.'
My daughter's Dexcom, 'Dexi,' buzzed around 1 a.m.
Caught in a landslide
No escape from reality
Open your eyes
Look up {to the skies} and see
I squinted at Dexi's message:
"LOW" How low? I clicked to see the estimate. "67."
I shuffled off to my daugher's room.
Flashlight, meter, test strip, lancet. "207." Huh?
Is this the real life?
Is this just fantasy?
Back I went to grab Dexi from my bedside table so I could set her straight. I informed her of the meter reading, and she asked for another. Once I'd put that in, the graph showed a reasonable '193.'
As I started do doze off again, the buzzing resumed. "HIGH" "275." Unconvinced, I checked anyway. I informed Dexi both through her computer buttons and verbally with a few choice words, that "170" was the number she should be aware of. An apology would have been nice. Something like
Mama, ooo
Didn't mean to make you cry.
No apology was forthcoming, but she did get herself straightened out by morning, having overcome her night of ambivalence.
A little high, little low
Anyway the wind blows, doesn't really matter to me...to me.
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