If you read my post yesterday then you know that I was tracking my day of J's Type 1 Diabetes management. Well it was the perfect day to document because diabetes was rearing it's ugly head all day and keeping us on our toes!
We started out the day with a forgotten backpack. This normally wouldn't be a big deal and I would have just had to have his lunch to school in time for him to eat, but when you have a child with T1D that backpack is literally their lifeline! It contains his Insulin Pump PDM which is also his blood glucose meter, CGM monitor, Low Kit, Snack Kit, Ketone Meter and the almighty Glucagon Shot! Needless to say I had to rush the backpack to the school as soon as I saw it on the table! As I have mentioned in the past we live about 30 minutes from his school so I was very thankful no problems arose during that lapse in time.
The rest of the morning went normally. We got our daily text during snack time telling us his BG 186 and what they had for snack that day. We sent off the carbohydrate count to bolus for and that was all we heard until lunch.
Our lunch text was normal as well but the only problem that made me a little concerned was his blood sugar number before eating only being 88. That's a little on the low side and lately when we have these types of numbers he tends to drop low after getting his meal bolus. At school we have them wait until he is finished eating and then they give the entire bolus amount, when J is with us we split the dose into two (the carb amount we know he will eat up front and the remaining after he has finished his meal) this way he has insulin to start working while he is eating to prevent his BG from spiking so high because insulin takes 2 hours for it to reach it's peak. Since he was getting his bolus after his meal (around 12:30-12:45) I convinced myself that he should be ok because a majority of his carbs would be kicking in and prevent the low.
At 1:37pm I sent out a tweet saying "Wondering what's going on with JPs BG at school since bolus and wishing I could see the Dexcom right now!!"
1:47pm I get a text from the TA
I KNEW IT! Ugh, I need to start listening to my gut and text them to see what's going on so I could prevent things like this from happening!
Anthony picked him up from school early yesterday and took him to his dentist appointment with him. Of course one of the first questions we ask each other is..."what's his number doing" Dexcom CGM reading 102 angled arrow up. Whew, thank goodness for the quick reaction from J's teachers.
Anthony and J got home around 4:00pm and J was hungry for a snack. We checked his BG 231. Classic rebound high from treating a low. We gave him the bolus for the snack and the correction for the high BG
5:41pm J was wrestling around with Hope (his diabetic alert dog) and he started crying. Anthony went over to him and checked him to see what had happened and noticed that his pump site was bleeding (there is a little clear window so you can see where the cannula inserts into the skin)
Cue the pump change battle!
We got the new pump all set up and sat down to eat dinner. BG 159
After dinner we gave J his bolus and went about our normal routine. Cleaned up the kitchen and down stairs toys and made our way upstairs to give the boys a bath and get them ready for bed.
7:36pm J and Hope were playing upstairs in our game room and we noticed Hope alerting like crazy. I looked at the Dexcom 314 one arrow straight down. Good High Hope! We gave her treats and told J it was time to settle down and get ready for bed. He sat down on Anthony's lap.
7:42pm Anthony noticed that the adhesive was lifting on J's new pump site and turned on his flashlight to see what was going on with the cannula.......sure enough the cannula was pulling out from the skin!!!! UGH another pump change (this has NEVER happened to us before)
Cue the pump change battle!
We got J's new pump site all set up and put E to bed. J fell asleep on the couch and Anthony carried him off to bed. I decided around 8:50pm to go and check his Dexcom CGM to see what was going on (if the site was bad his blood sugar would be going up) 147 double arrows down! This means that he is dropping fast. I was a little concerned because that is a pretty low number to have double arrows down and he still had over a unit of active insulin on board. I went back every 5-10 minutes to check and see where his numbers were at and waiting to see the straight across arrow indicating he was steady at a safe level.
9:27pm on my last check up the Low alarm went off on the CGM. BG check 82! I knew it! Ugh, I ran downstairs and grabbed a juice box. By the time I got back upstairs Anthony was sitting on the bed with J and trying to wake him up. This is no easy feat, he often tries to physically fight you off and go back to sleep, so we have to pick him up and hold him in our arms to coach him through drinking a juice box while sleeping. It took until 10:00 for him to bump up barely above 100 but the arrow just remained straight across which wasn't comforting.
11:00pm another low alarm from the Dexcom. I ran downstairs and grabbed another juice box and started the fight to wake him up all over again.
Finally at 12:00am the arrows changed and his blood sugar check was 112! I looked at the CGM a few times over the next hour to make sure that he was continuing to rise, he did so I finally fell asleep.
3:30am ANOTHER low alarm!!! I checked his BG 116, I ran downstairs and grabbed another juice box and like Groundhogs Day I fought him again to drink it.
Around 4:15 he finally started to climb on the CGM and I did a BG check to confirm 156! Thank you Jesus and back to sleep I went :)
6:15am came quickly and it was time to get him up and ready for school. I came downstairs to check his school calendar (I thought it was free dress day but needed to confirm) when I walked back into the room Hope was alerting to J and waking him up. BG check 169! Good High Hope and a little shocking that he wasn't higher from the 3 juice boxes during the night!
I can say this is NOT a typical day. This was just one thing after another and while most of these things do happen on a regular basis, they almost never happen all together on the same day! However, T1D picked a perfect day to give you a unique glimpse into just how exhausting and ruthless this disease can be. You can never rest easy and you can never predict what is going to happen next!