Wednesday, May 6, 2020

Birthday Diabetes!

Nighttime Highs & Lows

This is my son's first birthday with type 1 diabetes.  He is still sleeping this morning while I have been up for two hours sipping coffee.  Incidentally, I was also up for two hours last night but I wasn't sipping coffee then.

I am so thankful we have the Dexcom continuous glucose monitor that lets me "follow" his blood sugar on my phone.  I can crawl into my bed each night and know that I don't have to check on him because my phone will let me know if something isn't right.  I said I don't HAVE to, I find that I do stand outside his room peeking in at him several nights a week.  Having a newly diagnosed type 1 is like getting a new baby - you pretty much are fiddling with the child every few hours and when things are finally settled and good you watch them sleep.

Well last night the thing that wasn't right was he started running high.  This is a pretty rare nighttime occurrence for him; low is the usual play.  I don't know if his insulin just wasn't covering correctly, or maybe we didn't get a good injection spot but it was like we hadn't given him insulin at all for his bedtime snack.  Up and up he went.  I have my phone set to alert when he is over 180 for 30 minutes although that isn't a number that concerns me much these days.  Half hour later he was over 200 and half hour after that he was over 250 and still arrow pointing up.  I did peek into his room and he was very rosy cheeked, all his covers were kicked to the foot of the bed, and his fan was aimed right at him...poor guy!

Since we don't have an insulin pump yet or an intelligent insulin pen we have to wait 3 hours before giving more insulin to avoid the "stacked insulin" low.  But I did wake him last night and deliver an extra insulin injection to get those numbers back in range.  Not a great sleeping night for me but thankfully the extra injection did the trick and he was back in range about forty minutes after I gave it.  Then I slept poorly for a while worrying that he would be low next but he held a steady line for the rest of the night.

The night before last I was up for two hours too.  That was a more typical event for us, the dex woke me at about 11:30 pm with a low alert.  I woke him up and gave him 15g of carbs in the form of apple juice.  Then I waited and watched and waited some more.  It was about 12:15 when his levels started coming back up; I knew they would so I avoided the urge to give another 15g when things didn't turn around right away.  It is funny how much we've changed our management since those first few nights home.  Originally I would give 15g, wait 15 minutes, and give more carbs if his numbers hadn't turned but what we've found by looking at our data over the past few months is that he takes a long time to digest.  So if we follow the 15/15 at night we end up taking him from a low to the upper 300s about 75 minutes later.  We have to be a little more patient which is hard when your phone is beeping and the number is just sitting in the low range and you are a worried parent. 

Happy Birthday & Celebrating = Food?

As I was saying, my son is turning 11 today!  Such an exciting time for him.  He is having a quarantine birthday since our state is still on "stay home, stay safe" orders.  No friends over, no going to the trampoline zone, nope, nope, nope.  He'll get a quarantine birthday story & maybe I'll get him a t-shirt about it. Stores here have been closed for weeks and shipping from online options is delayed but we have our fingers crossed as his gift says it will arrive today (after being delayed 3x). 

Since N's diagnosis I have become VERY AWARE that we use food as a celebration in our family.  I knew this before but it is very apparent now that our celebrations and joyous times are often tied to sweets and foods.  I've been struggling with this over the past five months as we've gotten more accustomed to life with type 1 diabetes.  Cupcakes, cookies, brownies, root beer floats, french fries, chicken nuggets, fast food, eating out, bread, rolls, biscuits, yep - we like food rewards in our family.  Makes us happy but for one member of our family it doesn't always make him feel good.  Today we will try to balance our food-based celebrating with other ways of celebrating.  We've done this with some success at each celebration since our December diagnosis.  I'm sure as the years roll by we'll be less and less food driven and create new norms but this year it has been difficult to figure out what to substitute in for our previous habits.  

Today we are going to have home-made air-fryer mozzarella sticks and veggies for dinner to keep our carb count low so we can add in a cupcake or two.  We have to get creative due to Covid-19 anyway so we are adding chalk highlights to our hair for fun and if the weather cooperates we'll be doing some tie-dye in our backyard!  Here's hoping this birthday is memorable for being unique and fun!

(At bedtime my son says "today was great! wasn't it mom?" Yes it was)

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