Monday, November 9, 2020

400 and rising!

 We had our first challenge with our Omnipod Dash this evening.  It was a series of unfortunate events or poor planning or I'm too tired and not thinking straight since I'm waking three times a night to input our son's BG into our new pump...I don't know.

Our son's Dexcom and pod both expired today right around 4 pm.  I knew it was coming because I write it on our calendar since my son is not awesome about telling me when his devices give him alerts.  This also coincides with the time of afternoon that I typically cook dinner.  It was also a time when hubby wasn't home even though with coronavirus he has been working from home for months. I thought I had it all under control and then the universe decided to remind me that nothing is truly in my control.

I lost track of time and missed the expiration of the Dexcom so I had no readings for 30 minutes when I got the alert.  We changed the Dexcom.  We feel like old pros at this by now.  Remove the old, scrub up, wait about ten minutes, pick a new site, disinfect, turn on an amusing youtube video to distract son, press button and move on with the day.  Then I used a finger stick and took a BG, entered it into the pod and gave the bolus for dinner.  Off I went to the kitchen. 

Started making dinner when I remembered I had bolused for Nic's dinner.  With injections we usually waited 30 minutes between giving his bolus and giving his meal but on the dash we give food 15 minutes after a bolus because if we wait he drops below 70 (even from 250 sometimes).  Oops, poor planning or I am unable to think clearly.  I scrapped the idea of him waiting for the main dinner and made an alternate with the same carb count that would be done in time.  I gave him food and deactivated his pod.  Took off the pod (I have since heard from many expert parents that I could/should leave the pod on after deactivating it). I set up the new pod, we picked a site, scrubbed it with alcohol swab, turned on a youtube video, and did pressed start.  Went fine even though it was on his stomach.  

Son is very worried about his stomach.  First he is ticklish there and hates for anyone to touch his stomach and second he has this unfounded fear that something will pierce his internal organs.  No explaining or showing how his body is actually set up have really helped yet.  

Checked the site was set up and pressed go. Set an alarm so I'd remember to check his site after one hour and BG two hours after dinner. Checked the site at one hour and looked fine.  Went about finishing eating my dinner that I'd managed to get for the rest of us, left hubby's in the oven.  Then the alarm goes off on my phone that Dexcom is high, over 300 well it is about 90 minutes post dinner so not shocking.  Half hour later I get the alarm for no more data.  I go to investigate and find the BG on son's phone is 390. Ugh, make him do a finger poke and get 422.  Made him do it two more times while the dexcom changes to HIGH. 

Hubby arrives home so I alert him to the problems as he is busy complaining that he had to come home early because he has no data on the dexcom after getting a really high reading.  Sharing had stopped working. He went off to check the Dexcom servers for known issues and I followed the handout from our pump class.  I gave a correction - this was difficult because his pod thought he had 2 units of insulin on board and wanted to give only 2 units for correction but to correct completely we should give about 5 units.  Split the difference and gave 3.5 and set an alarm for an hour. Son's Dexcom still read HIGH at the 400 mark. My phone isn't receiving sharing data.  

I found hubby growling at the dexcom server error site.  No sharing right now.  At least we had the BG on son's phone.  Being new to insulin pumps we decided to call the on-call nurse just to walk through steps if the BG hadn't dropped within the hour.  Advised to give up on this pod and give an insulin injection then decide on a new pod or a long-acting insulin and return to injections until a more wakeful time.  We were mentally prepared when we went in to check at the hour mark, Dexcom is still reading HIGH so we did a finger stick and got 440.  

We did a ketone check then deactivated the pod and gave 6 units of insulin via injection.  It was about an hour until son's bedtime but I figure I'm not going to be sleeping for the night anyway and he'd rather have the pump than injections so we picked a new site, back this time, carefully followed our steps, and did a site change. Went as expected.  Of course the change earlier in the day went as expected too.  Set a timer for an hour. 

While waiting we called omnipod customer service.  Our rep told us to expect to have some pods that don't work as expected for a variety of reasons and to always call them in.  We do the same when a Dexcom sensor doesn't last the full ten days or has any other failure so not a big deal.  Remind me to tell you later how a customer service rep can make you feel better or make you feel worse and maybe they don't even realize the power they wield with just the tone of their voice. 

An hour later his BG is dropping in the low 300s and we felt relieved.  HA! Relieved that he was in the 300s.  Diabetes management is a fickle fiend. Checked for ketones, set another alarm, kissed son goodnight.  Here I am typing after that next check.  We're under 200 now but I have no way of knowing if this pod is working correctly or not right now because he has the active insulin from the injection.  Ideally he is about to level out and his pod will run his basal rate and he will have a steady line all night.  Alternately he could continue to drop because he had insulin that didn't absorb well but suddenly starts to take affect or this pod isn't working and his BG will start to climb because there is no basal and no long acting.  Fingers crossed because we have had enough for tonight.  

Alarm is set for an hour from now.  That will be three hours from the injection.  Another alarm will be set for about an hour after that.  If things are holding steady between those two checks then I can sleep for three hours before checking again.  I have to get up and check though because I have no sharing data and his phone has to stay near him to read his dexcom.  

So any unexpected good in this situation?  My sister takes all my phone calls and listens to me obsess on blood sugar and never complains.  Hubby makes sure there is a bottle of wine in our fridge for when I need to settle a bit and makes the phone calls because I just can't with people sometimes. I can post my stressful few hours on the facebook page for other parents in the same situation and they've all been there and done that and they provide a calming reassurance and make sure no one ever feels alone in all this. My friend sees that post and sends me funny text messages to make sure I know I'm not alone.  There is a "community" to being in the type 1 diabetes care club. Dearest son falls asleep never worrying that his life is may be on the line. Hey, and Dexcom sharing just showed back up.  

I am thankful we live now and not 100 years ago or even ten years ago. The continuous glucose monitor is amazing even though it doesn't work 100% of the time.  The insulin pump is amazing even though we don't have it working correctly and it also won't work 100% of the time.  I also believe that both these companies take their product seriously and want to ensure that any failures are remediated over time so they make a more reliable product with every update. All it takes is a phone call to get an item replaced that didn't work as expected and it shows up at our house within a week. Dexcom has even overnighted replacements to me when needed.  

Not going to make it to the next hour mark.  Been watching the BG drop by ten every five minutes for the last twenty minutes I've been typing this post.  In five minutes I'll have to wake son up and give him a juice box. I might be able to wait twenty minutes for that to make a difference or he might end up drinking a couple of juice boxes.  Our record is four juice boxes and four glucose tabs at 2 am to bring his BG to 108 from a scary LOW on the dexcom that stubbornly held on for over an hour.  I'm really not in ideal shape for breaking records tonight. 

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