Sunday, June 3, 2012

Tripping on basals

Do you hear it?  It is the swooshing of insulin, tiny little puffs, certainly going off right this minute delivering insulin to my boys.  The sweet nectar of life.  Swish, puff, drip...insulin is constantly being delivered via their insulin pumps 24/7.  It is called BASAL insulin and it is a tricky little sucker to control.  It is the insulin that works in the background.  It doesn't cover their meals, it simply keeps them alive.  The changes made to this basal insulin generally needs to be very is a delicate process.  A delicate process that sometimes requires much trial and error. 

I think by now you should all know how I feel about adjusting basals...

(When I get really upset I do this thing I like to call the "frustrated Yeti."  It is a gurgling noise that sounds like it comes from the back of my throat, but really it comes from my soul.  I'm  Yeti-ing all over the place people.)


Summer cometh!  And as such, so doth the basal changes!

It happens like clockwork every year for our family.  Last day of school and WHAM!  High blood sugars.  A new routine means new basal changes for the boys.

It is a necessary evil that comes along with Our Diabetic Life.

I made basal adjustments on L and B, JUST before we left on our little vacation last!

To make up for the lack of basal lately, I've been rage bolusing at every meal.  Rage bolusing means bolusing WAY more than needed to make up for the extra insulin needs the change of year/routine requires.

Now that I've changed basals, I need to dial down my raging and find the sweet spot.  That takes trial and error, and leave it to me to pick the days we are going on vacation to do said trials and errors...

Boo yeah!  I'm wicked wild like that!

We've seen more lows the past three days than we have seen in the past three months.  Not cool...but a bit of a relief not seeing so many highs.  I now feel confident enough to bolus what I SHOULD be bolusing at meals, rather than padding the boluses to compensate for the lack of basal.

(In my world...that means progress!)

Poor J had to learn the hard way when it is right to change basals.  As you may or may not be aware, J is 95% on his own diabetes wise.  He counts his own carbs, he boluses himself, he changes his own sets.  He does it all.  When we were in Santa Cruz this weekend, and we all had some ice cream on the boardwalk, I asked J how much he bolused for it. 

"40 carbs," was his reply.

"Huh," I said.  "I bolused the littles 60 carbs."

"Trust me mom...I'm always right."

And you know what...he usually IS always right.  But man, that one little mistake brought him to the high 400's.  Somewhere he hasn't seen in a long while.  He was MISERABLE.  He refused dinner and would only drink water. He was whiter than usual, he had the chills and felt crappy from head to toe.  I had him sit next to me while I ate dinner and we had a heart to heart.  We talked about basals, and I asked him how his numbers have been. 

"Pretty ok." he said.  "Not great. Not horrible."

"When was your last low?"  I asked.

"I can't remember."

Which is great.  But if you can't remember when your last low was...then maybe you are running too high.  This is the first time in awhile that "I" have changed basals for him.  Usually it's our endo who changes it up.  They have some kind of great system, because his A1C's have been great in the past.  But it seemed logical to me that if B and L have MUCH higher insulin needs right must J.

Time will tell.

Blah.  I want answers now.

Patience is a virtue I'm learning to tolerate.  (Man that sentence is the story of my life.  For serious!)

The boys went to bed 87, 102 and 79.  They had a bit of a snack and now I'm off to see if we nailed it or not.

God, grant me the serenity to accept the basals I should not change, the courage to change the ones I can...and the wisdom to know the difference.

That should be on a T-Shirt.

That is all.


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