Whack-A-Mole

Streaks of high blood sugar are becoming frequent visitors.  I'm upping the insulin:carb ratio, the correction factor and the basal rates regularly.  My methods are sometimes scientific, with thoughtful basal testing and downloading of information. Some other changes have been made more impulsively, in exhausted frustration.  Either way, numbers seem to settle in for a few days to manageable if not perfect.  Then it's over.  She's stuck at 250 again.

So we start again.  Because of her health, of course.  And also because a 13 year old with consistently high blood sugar is not someone you want to live with. Trust me.

There was a time when we adjusted very few things between endo appointments.  One basal rate might change, or I'd need to up the breakfast carb ratio.  A little growing, or a change from school to summer schedule would require a bit of work, but not much.  Sometimes we'd do nothing at all and she'd be just fine. For 3 months.

I was warned this was coming.  I knew I'd have to start making regular changes in her insulin regimen.  I imagined it would be hard work.  What I didn't fully understand was the emotional component of the whole thing.  It's akin to playing a never-ending game of whack-a-mole.  There's that brief moment when all the little moles are in their holes and you take a deep breath hoping you've whacked them all.  Instead they start popping up faster than before.

I'm certain my little smile at the flat dexcom line from 1 a.m. until 7 this morning will be justly rewarded with an astronomical  spike before the day is out.  Or tomorrow's 1-7 line will be straight at 200 instead of 108. If we ever hit a day completely in range, I'm sure it will include a request from my child to go out to lunch with her friends to restaurant with uncountable carbs, or be followed by another lethargic snow day.

This challenge, like whack-a-mole, will take some skills to get through.  We'll keep looking at the big picture.  We'll keep moving.  We'll stay calm. We'll show the enemy who's boss.  And we'll know that this era, like any game of whack-a-mole, must eventually come to an end.  It can't last more than 4 more years, right?

Stuck

The Dexcom buzzed incessantly for days.

Friday: High.  High.  High.

All weekend, Monday, Tuesday: High.

It was like we'd swapped out the insulin in the pump cartridge for simple syrup.

We tried every trick in the book:

Site change?  High.

New insulin?  High.

Walk around a museum for 4 hours (which has never failed to result in a low)?  High.

Walk around the mall (also tried and true).  High.

Another site change.  High.

Up the basals.  High.

Rage bolus, repeatedly.  High.

When she wasn't across the alarm line of the Dexcom, she was skirting it and dropped below the mid-100's only twice over several days.

Then suddenly after dinner last night?  120.

All night:  120-150.

This morning:  115.

Why?  I can't be sure but I think perhaps the hormone factory ceased its overtime production.

Since last week, she's been HUNGRY like only a 13 year old can be.  And she's been 13 like only a 13 year old can be.  A scientific explanation of growth hormone and puberty, and of their impact on blood sugars can be found here.

A less scientific description can be found above.