Round 2

January, and now into early February, will go down as the sickest month for Dylan since diagnosis. For years, he has been the child that rarely got sick. He had a near-perfect attendance record at school, and got colds and flues much less often than his brother or sister. It was something I was constantly thankful for, because those rare times he did sick, he'd get VERY sick, usually requiring hospitalization with intravenous fluids to keep bg levels from plummeting. So the less illnesses, the better.

Well, we've gone full circle this season. After a week long achy feverish-coughing flu in mid-January, he returned to school for a few days, only to leave at recess last Tuesday vomiting. The stomach flu had arrived.  More vomiting that day, followed by no appetite, and moderate stomach pain for 2 days. By Friday, he felt up to returning to school, and then (remember, hindsight is 20/20) proceeded to have a very active weekend. Friday night he attended the Vancouver Canucks game with his dad (eating stadium chicken fingers and mini-donuts for dinner), then Saturday he played in a 70 minute soccer game, followed by a 90 minute performance class (singing). Immediately after the class we raced home so that he could don his snow gear and go tubing with a dozen of his classmates (followed by hot chocolate and popcorn). Sunday morning he lounged around the house, and walked up to a friend's house, before they went swimming for 2 1/2 hours in the afternoon.

I tried to balance out the day with a healthy Paleo dinner consisting of wild salmon pan-fried and served over an avocado remoulade, along with mashed sweet potatoes, and steamed vegetables, but I think the damage was done. He simply did too much too soon. When I woke up at 7:00 am this morning I had the nagging feeling that something wasn't right with him, and went to wake him up.

"How are you feeling this morning Dyl," I asked, expecting a response related to his stomach.

"Low," he replied.

Surprised, because he never wakes up low in the morning, I grabbed the kit and did a quick check while he was still in bed. 2.7 mmol/l (48.6 mg/dl)!! After 4 dex tabs and a 15 minute wait, he was up to 6.0 mmol/l (108 mg/dl) and complaining about how much his stomach hurt. So here we are again, home from school nursing a persistent stomach ache.

Sickie-wickie

Yup, Dylan's sick. The nasty flu bug that seems to be hitting everyone lately. Today is day 4.

It started Friday when we were at the endo appointment, though at that time it was only a stuffy nose and sore throat. By Saturday morning he was vomiting (only once thankfully), weak, achy, coughing, and had a fever ranging from 101 to 102. With no appetite, bg levels were the biggest concern, but they held steady for once! Sunday was more of the same all day. He managed to get up long enough to have a shower and change into clean pj's, but that was the extent of his activity.

Today I am hoping he is on the mend. Fever is down to 99, but nothing else has changed. Appetite still absent, weakness still present, and the cough is getting nastier and nastier.

I have been texting back and forth with the endo all weekend, updating her on his status. With his bg in range and no difficulty holding down fluids, however, there is really nothing she can do for him. We just have to wait this one out and hopefully he'll be back on his feet in the next couple of days.

The Mystery of Increased Insulin Use

Earlier this week I posed about how Dylan had gone through about 125 units of insulin in 48 hours - a first for him. His intake is usually pretty consistent, with daily insulin ranging between 35 and 40 units per day, so using over 120 units in 2 days is alarming. Was it a pump/tubing issue? Faulty insulin? Major growth spurt? None of the above actually.

The mystery was solved when we woke up Wednesday morning to find a sick little boy, complete with nausea, a stuffy nose, and nasty cough. He stayed home from school all day Wednesday and then tried to return Thursday, lasting all of 15 minutes (I dropped him off at 8:45am and he called from the school office at 9:00am saying he wasn't feeling well enough to stay). This morning he woke up feeling a whole lot better, though still not 100%.

In the meantime, insulin dosage seems to have to returned to normal. We've been monitoring closely, but BG levels have returned to "normal" at his regular pump settings. Thinking back, I can't recall having experienced this before, where insulin dosage increased by 50% in the couple of days leading up to an illness, but then returned to typical amounts during the illness. Anyone else noticed this before?

Extreme Wake-up Call

"Complacency": My new scariest word in the "diabetes dictionary". Worse than "low" or "ketone" or "A1c" or possibly even "hypoglycemia" or "complication." Complacency almost cost us last night. BIG TIME.

According to dictionary.com, complacency is a noun, meaning a feeling of quiet pleasure or security, often while unaware of some potential danger, defect, or the like; self-satisfaction or smug satisfaction with an existing situation, condition, etc.

I'm not suggesting that I suddenly became unaware of the dangers of diabetes after 6+ years of my son living with the disease. Rather, I think, for a little while, I stopped worrying so much about the possibility of danger to him specifically because his numbers have been so good for so long. I got so used to the good numbers that I temporarily forgot that diabetes is anything BUT predictable. 

I do nighttime checks almost every night, and for the past few weeks, Dylan's nighttime numbers have been pretty close to perfect. Usually 5.0-9.0 mmol/l, (90-162 mg/dl) with the odd 4.0 mmol/l (72 mg/dl) or 10.0 mmol/l (180 g/dl). Nothing too outside of ideal range. 

Last night I was going to bed just before 11:30pm and I knew I had a very long day coming up today, working 11 hours straight (I have since taken 1/2 the day off). Plus, I was sick earlier in the week and still wasn't feeling 100%. I was exhausted. And yet for some reason it suddenly occurred to me that I should test Dylan. Not at 2:00am, but right then, at 11:30pm. I grabbed his tester and went in to room, to discover him lying in bed, awake. He had thrown off his covers and was lying in his boxers only. An alarm went off in my head. Because Dylan has had nighttime hypoglycemic seizures in the past (see Dear Seizure), my first thought was that he had had a seizure and I had somehow missed it. After a brief check for evidence of seizure, and talking to Dylan, I realized that was not the case, he was just really warm. Another alarm went off in my head. A quick finger poke revealed a blood glucose reading of 1.6 mmol/l (28 mg/dl). I shook my head in disbelief, thinking I must be really tired and the meter is really reading 11.6 mmol/l. No, it was 1.6 mmol/l! A retest with a finger from the other hand came back with a 2.0 mmol/l (36 mg/dl). Holy crap! 1.6 mmol/l is the lowest Dylan has ever been in the 2251 days he has lived with type 1 diabetes.

7 minutes later, after 25 grams of fast acting carbs and a temp basal set at 75% for 4 hours, and he was up to 2.2 mmol/l (39 mg/dl). Another 8 minutes and he was 2.5 mmol/l (45 mg/dl). 30 minutes after the first test he was up to 4.3 mmol/l (77.4 mg/dl) and I finally exhaled. At 1:30am he was 5.1 mmol/l (92 mg/dl), but at 4:30am he was back down to 3.7 mmol/l (66.6 mg//dl). Another 25 grams of sugar and another temp basal of 75% for 4 hours. By 5:30am he was 7.4 mmol/l (133 mg/dl) and at 7:30am he was 10.4 mmol/l (187 mg/dl).

Fast forward to now, where we sit with blood glucose levels stable, but on the low side all morning. Dylan has a full blown cold, complete with sore throat, stuff nose, and low grade fever. The exact same cold my daughter had last weekend, and I had earlier this week (see Immunity Breakdown). I know the illness is responsible for the low readings, and his numbers are always wacky when he's sick, but when Dylan went to bed last night he felt fine. As so I was complacent. 

I honestly have no idea what caused me to test him at 11:30pm last night. Call it intuition, motherly instinct, gut feeling, whatever. All I know is that one test very well might have saved his life. And though I know it will drive my crazy, I keep asking myself, what if I hadn't checked?

Immunity Breakdown

One of my biggest day-to-day fears with Dylan is that he'll get sick. So much so that we take extra precautions to minimize his chances of his contracting any type of virus. We wash hands often, we use hand sanitizer, we shower regularly, I disinfect doorknobs and other commonly touched household surfaces probably more often than I need to, and we avoid close contact with anyone who is sick, even if it's just the tiniest of tiny colds.

Why do I do this? Because Dylan doesn't get sick often (less than his brother and sister actually), but when he does, he usually gets VERY sick. His last simple "stomach flu" resulted in lethargy, a fever than ranged from 102 degrees to 107.1 degrees, multiple days of vomiting in which he was unable to keep anything down, including even water, and dangerously low blood sugar for days on end (because of the lack of carbohydrate intake). He was admitted to hospital for intravenous fluids, where he remained for a few days, until they figured out that he had also developed a secondary infection that required antibiotics. This virus-gone-hospital-stay has happened more times than I care to recall.

So it frustrates me hugely when we have had virus after virus rampaging through our house lately and the majority of them have been brought in by me! I have had at least 4 colds since September and to say it's starting to bug me would be putting it mildly. Just last week I had a brutal sinus cold for about 3 days. By Thursday I started to feel better. Then Saturday my daughter complained of a sore throat and runny nose and was sick all day Sunday and part of Monday. Monday night around 2:30 am (well, technically Tuesday morning), I awoke to discover I had the same symptoms, and here I am nursing my second cold in just over a week.

Sadly at this time of year, I have to blame my job. I am a substitute teacher and specialize in primary education, so mostly Kindergarten to grade 3 (though I teach anything from K-7). While I adore young children and love my job, 5-8 year old are not exactly the most hygiene conscious group. They are sticky, runny, oozing messes in winter, and their classrooms are loaded with germs, not to mention that I'm usually called in to cover for a teacher who is at home sick, so the germs are recent. Part of the job I suppose, and I know my immune system will strengthen with time, but for now, it sucks.

Unsolicited Advice

I cannot even begin to count how many times I have been given unsolicited advice about diabetes. "Eat this," "drink that," "take this," "do that." There are so many supposed quick fixes and "cures" for diabetes, ranging from dietary choices, to supplements, to activities, etc. and yet none of them actually work. 

As a parent of a child with type 1 diabetes, I wish and hope for the day there IS a cure, but until then, it both frustrates and saddens me to receive unsolicited advice about a cure.

Today I stumbled upon this cartoon about a cure for the common cold (which I am suffering from myself at the moment) and was immediately struck by how easily it could also be applied to diabetes...

The Revolving Door

Some days life with diabetes seems so busy. And I'm not just talking regular busy, I'm talking insanely, over the edge, almost too much too handle busy. This has been the case for us lately.

Years ago I worked in the marketing industry. I was in my mid-twenties, with a communications degree and some very ambitious career goals. My oldest was 4 and Dylan was born 3 months into what I thought at the time was my dream job. I worked 70 hour weeks and traveled 1 week out of every 6. It was a crazy job; so much so that one of my coworkers at the time said that working for that company made him feel like "he was standing in a revolving door during a hurricane." At the time I thought it was quite a clever simile, but then again, I thought my life was busy then. I had no idea how prolific his words truly were.

I had no idea what busy was.

Last night I watched "I Don't Know How She Does It" with Sarah Jessica Parker. A semi-entertaining movie about how a working mom with 2 small kids balances everything in her life. And yet all I kept thinking while watching it was, seriously? She thinks that's busy?

She has no idea what busy is.

Busy is being a parent of a child with diabetes. Between the day to day care, the worry, the nighttime sugar checks, the highs, the lows, the carb counting, and the juggling of basal rates and exercise, it can be pretty onerous at times, but it's manageable. Then throw in a teenager who seems to have given up on school altogether and is at risk of failing the year, and a d-mama who has been completely blindsided and slapped across the face with the wicked head cold, and what do you get? Busy like it's never been before. And as if that's not enough, the child with diabetes is sent home from school mid-morning with what appears to be a fever and a sore throat; possibly the beginnings of a flu.

It's gone from simply busy to diabolically bananas.

All in a typical week of a d-mama.

Cold & Flu Season, Round 1

Wow, what a whirlwind the last 12 days have been! I can't believe it's been 12 whole days since my last post. So why the hiatus? Our first round of illnesses for this season.

Beginning Thanksgiving weekend, Dylan got sick with a cold. It was slow coming on, starting with a sore throat for a couple of days, then a stuffy nose, then body aches, then a cough, and finally a very persistent headache. His blood sugar certainly went on a bit of a wild ride, up and down repeatedly, but tough-guy as he is, he didn't miss any school!

Just as he was finally starting to feel better, my 15 year old started the same process, except that his body stuffed the whole illness into 2 very sick days, before making a quick recovery.

Caring for 2 sick kids back to back, plus the lack of sleep from all of the extra nighttime blood sugar checks left me in a bit of weakened state too, I guess, because just as my eldest returned to school, I got hit full on with the cold. Like a freight train from out of nowhere I went from feeling great, to feeling absolutely terrible in a matter of hours. That was last Thursday and I have been basically unchanged since. Today is the first day that I can see the proverbial light at the end of the tunnel. I can't wait to feel like myself again. Ugh...