Monday, May 12, 2014

Light Bulb!

We are finally home from our 10 day vacation! As you know from my last post, we attended the Kentucky Derby and from there we went to Florida to enjoy some Disney World magic and celebrate J's 5th birthday.

From the time that we arrived in Kentucky we started what seemed to be, the never ending battle of high blood sugars. Over the course of a few days we gave correction.....after correction....after correction, and even did multiple insulin pod changes but nothing seemed to keep him in range. He would drop for a short period of time and the shoot right back up into the 300's and just hover there. We knew the insulin wasn't bad because it would bring him down and we knew it couldn't be a site issue since we had gone through multiple pod changes, and then we had that light bulb AHHH HAA moment! BASAL- we needed to change his basal rates!

We decided to do a temp basal setting to see if this would be the missing piece to this ever frustrating puzzle and bingo it worked like a charm! The remainder of the trip his blood sugars were right back where they needed to be. Hallelujah! There is always a level of guilt that comes along with this learning curve. Why did it take us so long to think of changing the basal rate? It breaks my heart that he was running so high and nothing we did seemed to work or keep him down in range. Although he was acting normal, I know that he couldn't have been feeling good on the inside. That is hands down the hardest part of being a D-Parent, the majority of the time you're the reason for the high or low blood sugar, but we just have to be thankful that we figured it out when we did and that he didn't have to go the remaining 6 days with high blood sugars. We are not a pancreas and we can't predict what his blood sugars are going to do in new situations or environments. However, now we know when he is traveling and in exciting/stimulating situations he tends to run on the high side (which I'd prefer over running low, as that is the most dangerous) and basal rates will now be one of the first things we change when a situation like this arises.

I am forever thankful that we have the Dexcom CGM because if it wasn't for that valuable tool, it would have taken us even longer to figure out what the problem was and what we needed to do to fix it. The Dexcom allowed us to see exactly what his blood sugars were doing and how the changes that we were making were affecting him.
For example- On our flight home from Florida, I was sitting next to J. I always have the Dexcom out so that I can monitor the numbers and trend arrows. J was sleeping and I noticed that his numbers were slowly creeping down. I let the numbers get to about 110 and I decided that I better give him a 1/2 of a juice box just to give him a little boost. He drank it and it didn't really give him a boost but kept him steady for about 20 minutes, then I noticed that the numbers started to drop again and he was now at 82. I gave him the remainder of the juice box and something in my gut told me to check his finger.......64!!! Queue moderate panic mode! I didn't want to fully wake him, so I opened another juice box and made him drink another 1/2. He had 0 insulin on board so there was no valid reason this low was happening. I waited 5 minutes and checked his finger again since the CGM was still saying low 60's and the arrows weren't changing after 1 1/2 juice boxes. Finger check 67.....not good, gave the other 1/2 of the juice box, so he now had 2  juice boxes in his system (30 carbs)! Dexcom arrow still showed angled down and the numbers kept dropping, they were now in the 40 range. I decided to check his finger again because sometimes the lag time on the CGM makes the accuracy off and it was 45!!!! Ok, it's time for FULL panic mode! I quickly woke him up and made him eat a fun size pack of skittles (14 carbs) LOL he of course didn't fight me one bit eating those! Now comes the wait....I just sat there staring at the arrows and numbers on the CGM praying that they would start coming up. After about 10 minutes and no real change on the Dexcom, I checked his finger and he was 130 and I could finally breathe! I got up and asked the flight attendant for a banana so that he could get some real carbs in his system to sustain his blood sugar and gave him the insulin needed to cover the banana and a bit of the skittles, because I didn't want him to rebound with a high blood sugar from too many carbs.

This was a situation where that Dexcom could have saved his life! He was asleep on the plane and I was in and out of sleep as well. He was showing NO signs of a low blood sugar! This is why this disease is so dangerous! Situations like this happen all of the time, out of no where with no rhyme or reason! Without those extra 44 carbs, he would have crashed and probably had a seizure on the plane and needed a glucagon shot. It took me nearly an hour to get him back up and I had full knowledge of what was happening with his body, as it was happening! Priceless! Simply Priceless!

Well aside from the high blood sugars and a few other D related hiccups the trip was a huge success and we all had an amazing time. We will never let diabetes hold our family or J back from traveling and doing the things that we love to do. Each trip we will learn how his body reacts, so that the next time we are in that situation again we will have the knowledge needed to be proactive rather that reactive. Trial and Error is our life, but I will take it and continue to learn and be able to pass on that knowledge to him as he grows and takes over his own care.

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