Tuesday, September 25, 2012

Routine

So I noticed on Sunday that Alex's numbers were higher than they've been and staying up in the 200s. I immediately started the question game.

  • Is she getting sick? Her nose is running. She is coughing a little. I checked, but she didn't have a fever. But perhaps there is something going on there.
  • Did she eat something uncovered? We did eat out and that's always a guessing game.
I don't like the 200s but I've seen worse so we just tried to push the water and correct when we could. I got up twice overnight and corrected.

Monday morning Alex woke up with a nice 123. I figured we beat this thing. She had her normal eggs and bacon and a very small portion of cheerios because it was PE day and she has PE first thing in the morning. Last week after PE she dropped to 49 and had a rough day all around. So, this week we decided to beef up her carbs at breakfast to help. I subtracted 12 grams of carbs from her bolus and sent her onto school.

At 8:45 I received a phone call from the nurse. "Mrs. King, we have Alex here and she is 352. She wants a snack. What would you like to do?". I asked the nurse to put Alex on the phone. After talking with her about not needing a snack right now I suggested she hold off on her snack which she usually doesn't have until 10:30 anyway. She complained that the class was snacking now after PE. I suggested she have one of her cheesesticks and she told me she ate them on the bus. Now, mind you, I have never known that she ate any snacks on the bus AND she isn't supposed to (school rules not diabetes rules). I then told her there was NO earthly reason she needed a snack and it had NOTHING to do with her blood sugar. She had a massive breakfast followed by 2 cheesesticks. I told her to go back to class and come back in an hour to retest.

At 9:45 I received yet another phone call. "Mom, this is Alex. My blood sugar is 332. It won't let me correct".  At this point I was frustrated. She finished her breakfast at 6:45. She had PE which tends to drop her like a rock. She had been corrected. She started the day at 123! I told her I'd come up to the school and I could take a look at her pump site.

I grabbed a small insulated bag and filled it with insulin, an infusion set, cartridge and alcohol preps. I also grabbed the baby oil to help pull off the old pump site.

I don't know why but she had retested yet again and when I got there was in the 360s. I pulled out her blood ketone meter first. 0.1 so no ketones to speak of which was good. I then disconnected her pump and tried to prime it. The insulin flowed freely from the tubing. I had the nurse check her temperature and she was 97.6. No fever. So I decided it was time to pull the site and get that out of the equation. It was pump site change day anyway - we usually do it at dinner time. Alex was a little miffed about missing recess and getting a site change in the busy health room. The health room was full of about 10 kids - 3 laying on beds, 4 sitting in chairs, and another 3 milling around doing who knows what. Lots of band aids, ice packs, and kids with sore throats. I sat Alex down in a chair and washed my hands. Then we prepped her arm and I readied the cartridge and infusion set. I saw 2 kids in beds watching us curiously. I always wonder what they think....I'm glad I'm not THAT kid...

As I put in the new site, I thought to myself how I was oddly calm about the whole thing. That isn't my usual demeanor in my past non-diabetes life. It just goes to show you how routine this has all become. I remember when Alex first went back to school and I was embarrassed to give her shots in the health room because I felt like I was being watched by the nurse and worried I looked like I was doing something wrong. I hated giving her shots, blood tests, etc. anywhere but in private. (It didn't help that at a JDRF conference last spring, the nurse in the playroom actually criticized me because she THOUGHT I didn't replace the nano needle on the insulin pen which I did by the way). Now I just don't care really. It just happens. It's part of life. I may not be a pro, but I manage, right?

Once we had the new site in, I pulled the old site. Immediately I noticed it looked funny. When we pulled it, liquid oozed out tinged with blood. That isn't what normally happens. Usually nothing comes out except maybe a small speck of blood that doesn't even require a cotton swab. But this site was red, a little bruised looking and liquid oozed out for a bit. I don't know much about bad sites but I am guessing this was one. We've never had a bad site before so this is new territory if in fact this qualifies.

I put some antibiotic on the site and covered it up and walked Alex back to class. The rest of the day her numbers were between 91-130.

I got in my car in amazement of how calm and smooth the process was for Alex and for myself. She sat quietly and calmly as I fixed the new site while the kids on the beds stared at us wide-eyed with a bit of curiosity and fear. She mumbled about missing recess but never threw a fit. She did as she was told as far as going to the nurse for tests to correct and make sure things were moving along with actions for high blood sugars. I guess it really has become routine.

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