Are You High? (365:10)

Until recently, Dylan didn't experience distinguishable or telltale "signs" when his blood sugar was high. His low blood sugars have always been apparent to him and to me, but highs not so much. Even today, there is really only 1 symptom that accompanies every high.

Walking to the local library recently, we noticed something wasn't quite right with Dyl. He was a bit quieter than usual, and not his lighthearted, cheerful self.

He was focused and deep in concentration; so much so, that he didn't see this sign and proceeded to walk right into it, bonking his head on the bottom. Normally, he would laugh something like this off, and we would laugh along with him. Side-note: I realize it may seem mean to make fun of someone who has just potentially hurt themselves, but Dylan has a very particular sense of humor, plus I knew he wasn't hurt, just caught off guard because he literally didn't see the sign coming.

No, no joking around today. Today he got defensive and bitter, snapping at his sister and I for giggling, accusing us of making fun of him. Totally out of character for him.

I didn't think too much of it at the time. Maybe he was tired, or a little warm (we've had a hot summer and he reacts easily to the heat and humidity). But then on the way home, we crossed a street together, his sister and I turned left to continue down the next street and Dylan kept walking straight. He was headed in a direction that would have taken us further from our destination, and he normally would know this. 

After about 10 yards or so we realized he wasn't with us anymore and called out to him, again chuckling a little. This time he got really mad at us and then it dawned on me.

"Are you high?" I asked him - a legitimate question to a child with type 1, but also a bit of an inside joke between him and I because he's entering high school next week and is very anti teen drug use (again, his sense of humor...).

"I was 10.4 (mmol/l (187 mg/dl)) when we left the house." 

We had been walking for about 15 minutes. Ahhhh, that explains it.

Anyone else experience big mood swings with elevated blood glucose levels?

Swimmer's High (365:7)

Swimming is one of Dylan's favorite activities, and he's a great swimmer to boot. But for someone with type 1 diabetes who wears a non-waterproof insulin pump, managing blood sugar while in the water can be a challenge.

We've been lucky in the past and the carb-burning exercise of swimming has always balanced out the lack of insulin. So much so, that on vacations in past years, we've let Dyl disconnect from his pump for 3 to 4 hours at a time, without an increase in bg afterwards. No pre or post swim bolus required - the swimming simply replaced the pump. Easy peasy...

But diabetes, being like Murphy's Law, throws a curve ball when we least expect it. When we think we have it all figured out. When we try to use almost 8 years experience to base a decision today. It shows us that even after something has worked time and time again, it won't necessarily work today.

Between increased insulin needs, the early onset of puberty, a higher body weight, and possibly dozens of other factors, swimming no longer burns enough carbs for Dylan to be disconnected for any length of time. We learned this the hard way yesterday when he hit the pool with friends for an afternoon swim. 

After 3 hours in the pool diving, flipping, swimming, and playing in deep water, he came home with a blood glucose level higher than I've seen in a long time. A whopping 20.6 mmol/l (370 mg/dl)! A big bolus (6.25 units) and a 30 minute wait later, we faced a 24.8 mmol/l bg (446 mg/dl) and a pump telling us Dylan had too much active insulin to bolus further. A manual override of another unit bolused, and another 45 minute wait, and bg was down to 9.6mol/l (173 mg/dl) and still dropping. 2 hours post-swimming we were down to 6.4mmol/l (115 mg/dl) and I finally started breathing normally again.

On days like this, being a d-mom is extra difficult. It's so easy to focus on the negative and worry about the damage that's being done to his heart, kidneys, nerves, or eyes when his blood sugar is high. It's easy to feel like a failure as a parent and a caregiver, for not keeping my son away from harm. It's easy to let diabetes win.

But this 365 project is about staying positive and not allowing diabetes to be all bad all the time. Because like it or not, he will have type 1 diabetes for his entire life, and I don't want him to think of it as a death sentence, a disability, or a hindrance in any way. I don't want him to mope around focusing on how diabetes gets in the way.

I want him to understand that living with type 1 diabetes can be a challenge, but there is absolutely nothing he cannot do. I want him to accept it, to own it, and to know that when bad s*#t happens, we pick ourselves up, brush ourselves off, and we get ready to take on the next challenge.

Skating Along

The ice surface has been so smooth and sheen, free of cracks or dents, that we didn't even notice the big open hole ahead. Blindly we skated forward, bearing down, picking up speed, hurtling towards the gaping pit of freezing cold water. Before we knew it, we were submerged; soaking wet, struggling to get out before falling below the surface forever.

No, we didn't really fall under the ice, but this metaphor seems perfect to describe our family life with diabetes lately. Diabetes here has been uneventful, routine, common even; each day predictable and manageable. No lows, no highs, just a whole lot of 6's and 7's.

We were enjoying the skate, getting comfortable, and even temporarily forgetting that ice couldn't be perfect forever. Inevitably D would rear it's ugly head and we would fall. And that we did last night when Dylan's pump ran out of insulin in the middle of the night.

My own fault really, I should have refilled the reservoir earlier. I should have understood that with the stomach bug Dyl's has had the past couple of days, his insulin needs would have been higher. I should have been on top of it. But I wasn't.

Around 3:30am his pump alarm went off, signifying the end of the insulin and in his half-asleep state he heard it, but ignored it. By the time he woke up this morning his bg was 22.4 mmol/l. A quick site change, refill, and bolus, and we waited for the new insulin to do its job. We waited, and waited, and waited some more. Half an hour later we tested to discover a bg of 24.1 mmol/l. Crap. Another bolus, another wait, another test, and finally it started to come down.

A sudden and effective reminder for us to never get too comfortable with D because it has always been, and always will be, anything BUT predictable.