I wanted this blog to be about my family's experience with my son's Type 1 Diabetes. My family is more than just diabetes, but I want this blog to be focused on how it affects our family. I hope other T1D parents find it helpful, and that my family and friends find it informative.

Friday, April 20, 2012

First Sick Day Part 1

(As a reminder, Johnny's doctor's want him between 100-200 pre meals and we correct anything lower than 80 or above 250.)

Short Version of this Post:
Blood Sugar levels yesterday-
  7:45am 137
  12:15 233
  2:40pm 60
  2:50pm 114
  3:15pm 87
  6pm 176
  8pm 310
12midnight 100
1:30am 167
6:45am 69
7:55am 168

Long Version of this Post:

Yesterday Johnny woke up and his fasting BG was 137.  There is nothing wrong with that number for his age, but typically he is between 80-130 more so on the lower side.  I thought it was odd but it wasn't crazy so no big deal. 

Johnny went to his Preschool from 9-12 and on the way home I thought I would run a quick errand and drop something off for a friend since it was between there and home.  My friend was just a few minutes behind me so I would have had to wait a short amount of time.  In the back of my mind I was thinking about how on Tuesday after preschool his BG was 69 when we got home, which it had never been before but now I am worried that he will be low after school.  I decide to drive thru good o'l McD for some chicken nuggets and apples.  I pull over after the drive thru, test his BG before I give him his chocolate milk and food and he is 233.  233!  That cant be right! I test him again, 245!  What?  I let it go and just move on.  There isn't anything I did or didn't do.  He doesn't get extra insulin for that number, it just is high.  I am driving to my friends and in the back of my mind I am thinking of calling the school and questioning the teachers about snack time and if he got a hold of anything else than what I brought him.  But that is crazy, the teachers always take great care of him, they have told me once or twice now that "Johnny ate a gold fish cracker before I could get it away" so if they are willing to tell me about ONE gold fish... I am sure they would have told me if he ate something today.  I let it go.

We run our errand and get home.  I give Johnny his insulin to cover lunch.  He is on a 1:23 ratio at lunch which means he gets 1 unit of insulin for ever 23 carbs he eats.  He at 43 carbs.  Technically I am not supposed to give him 2 units because it isn't 46 carbs.  I should give 1.5 units.  Basically I am to always round down.  But I decide that 3 carbs are not a big deal and he was running high anyways.  I give the 2 units.  Its about 1pm now.

At 2 we decide to go play at the Ark, where we had Johnny's birthday party.  I bring his snack for 3pm as well as a few extra fast acting carbs since I know he will be playing hard.  (I actually always bring this stuff with me everywhere we go but felt I should mention it in this trip.)  He loves it there!  He is running like crazy, sweating, his long hair is plastered to his head in a sweaty tangle of curls... pure 3 year old bliss.  At 2:40 he stops playing and tells me his is hungry.  Okay, for Johnny to stop playing when he is having that much fun is a big red flag that he is low.  I tell him to sit and he does.  I check him and he is 60.  ugh!  I am pretty calm, we have had numbers in the 60's now but this is our new official lowest.  It helped that he was calm and I knew what to do.  I gave him some juice (16carbs) and he gulped it down.  I am supposed to give it 15 minutes and check him again, but he is hungry still.  I let him eat his cheese crackers and test him only 10 minutes later and it is 114.  Whew, I feel better.  I figure we would be leaving in the next 30 minutes and technically not all the carbs he has eaten (total of 30 now) are into his system yet so I feel he doesn't need more and let him go play again.  20-30 minutes go by and he is getting into typical 3 year old boy trouble, wanting to wrestle with the other boys (Why don't us mom's just let it happen?  All the boys WANT to wrestle and all us moms are saying "no, play nice."  I am not worried about Johnny getting hurt, I am worried about the other mom's getting P/O'd when Johnny hurts her kid.  I kinda want Johnny to get a little hurt so he understands what playing like that will result in, but socially this isn't acceptable... LOL) He is getting frustrated that I keep stopping him for doing what he wants and seems to be more fussy about it than I would think is normal so I check him again, 87.  Not super low but geesh.  I know that the BG readings I get are a snapshot of his current levels and that they are typically going up or going down, based on the other readings I decide he is going down and give him skittles 15 carbs (and yes the doctor said to give skittles for this situation.)  We go home soon after that. 

Johnny naps on the couch when we get home.  Its a blessing and a curse when your 3 year old naps late like this.  He slept from 4pm to almost 6pm.  I did check him during his nap and he was at a safe number so I wasn't worried.  By dinner at 6 he was 176.  For him that is kinda high, but still in our target range.  I thought it was weird that he went up from 87 to 176 after just eating 15 carbs but I am not going to try to figure out every WHY in this game... or I will go crazy.  He doesn't eat much at dinner and gets the dreaded 1 unit of insulin.  I HATE giving one unit.  It is like a drop of insulin but I still have to go through the processes of giving a shot and hearing my boy say "ouch your hurting me."  I also feel that the 1 unit shot ALWAYS screws up his numbers.  After every shot I have a tiny droplet of insulin on the needle after I pull it out.  Its the same size droplet if I give Johnny 1 unit or 2.5 units, so when he is missing this droplet from 1 unit its a larger percentage of that shot than of the 2.5 unit shot and therefor his BG doesn't go down as much as it should.  And guess what...

2 hours later at bedtime it is 310!  Geesh  I have not seen a number in the 300's since we left our insulin in the car and it went bad.  So yes I hate the 1 unit shot, but even so its never been that high after a 1 unit shot before.  Eh... so annoying.  310 is high enough that I have to give him ANOTHER 1 unit shot now.  I haven't had to give him a bedtime shot in 17 days... so he is not really on board with this since he thinks shots are done after dinner.  Oh well, he gets his 1 unit, and his bedtime snack.

Bedtime sucks tonight but I blame the nap not the 310 BG.  He is up 5-6 times (don't shoot me, my kid rarely ever gets out of bed once I put him in it.)  He just isn't tired.  He asks for cheese, this is funny because he will not each cheese during the day but has learned if he asks for it at bedtime I will give it.  It is good for his blood sugar to have something like cheese at bedtime so if he wants it I will give it.  Then he wants water... my husband tells him no and that he just drank a full sippy of water.  I remind John that when BG is that high he ACTUALLY is thirsty and that his body needs to flush its system and that we should encourage water.  Does it suck that it is at bedtime, sure.  So I make johnny go potty first, then fill up his water sippy and send him back to bed. Its 9ish now.  I go to bed about 10 and ask John to check Johnny before coming to bed since his numbers have been all over today.  He checks at 12:30 and his is 100.  This is the biggest roller coaster day of BG numbers yet.  I set my alarm for 1 hour and check him at 1:30am, 167... I don't get it.  How did it go up in 1 hour if he didn't eat anything?  I thought for sure it would just keep going down, slowly maybe until he eats breakfast... agh!  I am about to pull my hair out, but instead go back to bed for the night. 

At 6:45am Johnny is in my room and telling me he is hungry for chicken and yogurt.  This is that red flag.  He is never asking for food like this unless he is low.  He might normally come in and say "good morning mama, are you awake, I'm hungry."  Today it was just a straight demand for chicken.  I get him tested and he is 69.  I give him juice and notice he feels warm, a slight fever.  FEVER!  I have been told over and over about "sick days" with diabetes and how numbers will be all over the place.  I finally feel like I have some kind of explanation of why yesterday was wacky.  I wake my husband and tell him to find me a thermometer.  Of course the only one he can find is one with low batteries.  I test him after his juice and it is 168... really?  15 carbs shouldn't raise him 100 points in 10 minutes... but okay he is just sick.  He coughs a few times, but really he is fine.  If he didn't have diabetes I wouldn't think he was that sick.  I guess I know he isn't "that" sick but I just don't trust his BG today.  I call his doctor's office at 7am and the on call doctor returns my call in about 2 minutes.  I tell her that we have never had a sick day and I wanted to know if there was anything different I should do for his insulin doses.  She goes over yesterdays numbers with me and tells me for now, not to change anything because we don't have enough data.  He isn't always high, and isn't always low so she doesn't want to increase of decrease anything.  She said to call again at lunch though.  I have to say I LOVE this team of doctors.  I read nightmare stories about doctors who don't want phone calls, just emails, or who can't be reached after hours or take days to return messages.  My team is awesome!

Johnny ate his chicken a yogurt, got his normal shots, and has been acting like a toddler who doesn't feel perfect.  Just relaxing on the couch with his toys and watching cartoons... with the occasional outburst of "Watch out Littlefoot!" (yes land before time is on)  Definitely not super sick, but just a little out of it today.  We will see how the rest of the day goes.

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