Friday, February 8, 2013

Complacency

Complacency...a feeling of contentment or self-satisfaction, especially when coupled with an unawareness of danger, trouble, or controversy.

Every once in a while I think complacency creeps up on us with diabetes - that I can solve a blood sugar problem based on assumptions one should never make without going through precautions before taking action....like last night...

I was super rushed as we always have a busy Thursday night routine. Ben is after school until 4 PM. I have to feed dinner to the kids at 5 on the dot to get out the door at 5:30 to get Alex to her volleyball practice. There is no room for error or I am late picking someone up or getting someone somewhere else.

Alex came home from school and she was 78. She had her normal crackers and cheese snack after school and we spent the hour studying for a science test and on her times tables. Then we scurried to the car to pick up her big brother.

We were home at 4:30 and I had to start gathering what we needed for volleyball practice; help Ben with his project for school; and start dinner. At 5 PM, it was time for dinner and about 1.5 hours since Alex last tested and was 78.

She tested for dinner and was 303. She calibrated Dexie who thought she was 212. I was in the middle of helping her brother and finishing his dinner and didn't think much about it other than the fact that it was odd for her to be so much higher in 1.5 hours with just cheese and crackers amounting to 10 carbs which she bolused for and was 78 at the time. Her pump began alarming that the cartridge was low. I immediately thought that her site was probably old and that was the reason for the 303. As she ate dinner, I popped in a new cartridge and a new site on her other arm and figured all would settle down in the next hour or so.

Still thinking about being on time and what my son had left to do for his school project, we hopped in the car for volleyball without checking our diabetes bag for supplies. I assumed I had everything.

We pulled up to the school and Alex tested as usual. She was 231 and all seemed to be going in a good direction. Off to practice she went as I held Dexie (AKA DexCom G4) and watched it's little constant arrow and played with my phone on the bench.

About 10 minutes in, the girls were running laps hard. While on my phone, Dexie started screaming with double arrows down and showed Alex at 191. I figured that wasn't a big deal...191 wasn't even her target number so good that she was going down but she ought to test.  I pulled her off the court to test. 73 and double down. I entered that number in Dexie who then shut off asking for blood in an hour. Great! And then I checked her insulin on board. 4.55. My heart sunk. I've never had double down arrows...a low blood sugar...and that much insulin on board...and she'd been running hard.

Alex was crying at this point about missing practice on the sidelines. She was shaky and pale. I was shoving glucose tablets and a QuickStick at her. 15 minutes later she was 60. Not going in the right direction! And to add insult to injury her meter started alarming that the battery was low. I checked the bag and had only 1 lithium AA battery for her pump. Her meter takes a non-lithium battery. So it wasn't dead but it sucked because what happens is that you insert a test strip and the stupid thing goes to a screen for low battery instead of the apply blood screen. In our panic and rush, we were sticking blood on the strip on the low battery screen instead of the apply blood screen and then it would error. Then we'd apply blood right and her blood was all watery and thin and wouldn't stick to the strip. Then it would error. I think we went through 12 strips in all during the practice.

Needless to say, Alex never returned to practice. It took 12 tablets and 1 QuickStick to get her number to 93. She never rebounded and went high that evening and I even bought her a mini milkshake on the way home to cheer her up (which we did bolus for).

The only thing that makes sense (although I should know not to make sense of things) is that she wasn't 303 because she was low and had insulin on board equivalent to a correction for that 303 that she obviously did not need. I asked her if she washed her hands and she said no. I was too busy with dinner and schoolwork to check that before she corrected at dinner.

The thing is you always have to be on the ball with this thing. It can be so frustrating when you're juggling several balls and you have to ALWAYS remember the diabetes ball and every factor. And as time goes on...it's easier to get a little "lax". Last night's tears and frustration reminded me it's never okay to be complacent. It's never okay to assume something is fine based on past results.

Oh...and thank God for Dexie...because I'm sure without her screaming at me with her double down arrows, I wouldn't have caught her low before it was under 50!

No comments:

Post a Comment