Sunday, March 23, 2014

Defusing the bomb.

 Last month, L’s Diabetic Life was in turmoil.  It seemed like an angry tiger materialized out of thin air atop his blood sugar monitor.  The numbers were stubborn, scary and impossible to tame.

Breakfast was by far the worst.  It was like the dawn phenomenon on steroids. 

He’d eat breakfast, spike to the moon, and then dive.  Dive to the depths of the deepest ocean…all in the span of say, two hours.

To be clear, I’m no novice when it comes to dawn phenomenon or breakfast spikes.  But there was like an eternal black cloud over every one of my old tricks.  Nothing was working and for the first time in a LONG time, diabetes was actually affecting L’s life.  It all just snuck up on us, quietly enough that I didn't take it too seriously.  I simply started putting out fires as each one flared up. 

But then it all came to a head.

He was off.  As if a marionette, his blood sugars seemed to control his limbs.  Even worse, his brain was muddy, he couldn’t concentrate.

“Mom, my fingers are shaky and my body doesn’t feel right.”

He would wander the classroom completely in his own world.  Trying to figure out what he was feeling.  Was he low?  Was he high?  He didn’t know.  All he knew was something was so way off, it was reason for concern.  He checked his sugar so many times during the day, he was becoming obsessed.  Usually food or insulin would fix the feelings…but in this instance, it seemed there was no quick fix to what was happening.

The Friday a few weeks ago was the last straw.

“Mom, I can’t concentrate because my body keeps telling me something is wrong.  My stomach feels shaky.  Can you pick me up?”

That day his numbers spiked to the high 500’s and then an hour later he was in the 40’s with a million units on board.  I picked him up from school.  That was huge.  I don’t leave work to pick my boys up from school for diabetes unless it’s a big deal.  This was a big deal.

I called the Endo.  Pre-bolusing.  Super-bolusing.  Rage-bolusing.  Nothing was working.  Do I raise the insulin to carb ratio for breakfast?  But he’s spiking and then dropping dangerously low.  How would more insulin fix that?  Does he need more basal prior to breakfast?  There were like a hundred scenarios running through my head.

The Endo suggested a load of changes.  But my swelly brain wondered how I would know which one was fixing the problem if I did them all at once?  Making a decision was never so heart wrenching.  I didn’t see how I would ever be able to fix this for him.  I honestly felt like I was defusing a bomb.  One wrong move and it could all blow up in my face…even worse…blow up in his face.  This was affecting him WAY more than it was affecting me.  I was scared to do the wrong thing…as a mother, I felt more than anything, like a failure.

Ironically, I did end up upping his breakfast insulin…it was soon after I had the epiphany to change his insulin sensitivity too.  It seems since he was waking up so high in the morning, (another issue…3 correction boluses wouldn’t budge him from where he was at night,) it seems the morning correction bolus was too strong and that was what was bottoming him out an hour or two after breakfast.

I upped his nighttime basals a tad and soon he was waking up in range.  Things were better the next two weeks, but not perfect.

And then, like magic…it all ended.

Like honestly, the tiger decided to pack up and park himself somewhere else.

He began going low at night.  I have to do half corrections or things get scary.

He’s not spiking at breakfast anymore, in fact he’s more predictable than ever.

It’s just insane to me that diabetes can come into our lives, throw a tantrum and then go sit in a corner like nothing happened.

It seems the culprit was a growth spurt.  To be fair, it was the most insane growth spurt chaos I’ve ever encountered.  And I’ve encountered a lot.

Last week during spring break, he spent 24 hours in the 300’s and 400’s.  I gave him enough insulin to kill an elephant and he wouldn’t budge from those numbers.  Flashbacks, a bit of PTSD from the month before and I was panicking.  My sister in law kept encouraging me to change his set and I said, “No…he’s getting insulin!  He has no ketones!  He must be growing again!  CALL IN THE GUARDS!  I’M GOING TO BLOW!”

But then I did change his set and…nirvana.  Everything is back to normal.  Well, you know, maybe normal is a pretend word, but like…regular.

Sometimes I got diabetes in my back pocket.  Other times, it has me by the throat.

I’m just glad the fates have smiled upon us, for a while anyway.  I think both L and I need to catch our breath.  Breaths?

Breath.

Breathe, Meri.  Just breathe.

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