Embracing Life & the Child with the Disease

D.O.C. Needed, Please

Not sure which cartoon accurately describes how I feel this morning: 

As I mentioned in yesterday’s post, LOWS have not been a major issue with us until pumping (aside from the stomach bug which landed us in the ER out of sheer panic when more experienced moms probably would have rode out the storm).   But last night was our first time of actual “battling lows” and I want a little d-momma input.  I did make minor basal changes yesterday, BUT they were pulling back on nighttime insulin wanting him to wake up a little higher in the mornings.  And I’m trying to follow Meri and her sound, and even my endo recommended, three-day rule.  I remembered her rule at 3am last night when I was sitting on the floor in tears from frustration and total exhaustion and went digging for the blog post again this morning. 

But what I am looking for, D-mommas, D-dads, Adult T1ers is just a little hands-on-what-do-you-do to treat stubborn lows in the night.  I have had a few minor 67ish lows in the night that a little juice would fix and seemingly would get him up into that safe range and sustain him all night long (after the sugar spike, of course).  But last night, in my “green-ness”, we entered into new territory.  I don’t have his PDM in front of me to give you exact numbers and times on all the checks, but here’s the gist of our night.

  • 8p – 124. Two hours after dinner (which was steak and potatoes on the grill, nothing complex or complicated like pasta or chinese), had an 11g carb snack that had a little peanut butter in it and headed to bed.
  • 9:30 – 68. (And I checked him at 9:30 instead of 10:00 because I wanted to go to bed early – HA!) So, I gave him a 16g carb Capri Sun because I couldn’t get him awake enough to do anything else).
  • 9:45 – 57.  Wwwhhaaaaaaaaaatttt (said like a Minion from Despicable Me) ?!?!?  Still couldn’t get him awake, which was truthfully making me a bit nervous (made him sit up but his eyes were closed the whole time), so he had another juice.  Also set temp basal for 75% for .5 hr.  Very little  experience with temp basal rates too, really.  Endo suggested we do this with lows this past Friday. 
  • 10:00 – 90. I went to bed with him on the love seat in my bedroom and set the clock
  • 11:30 – 190-something. I actually left this one alone figuring there was a spike and it would come down after the sugar “ran out”
  • 1ish – 230-something, maybe 240.  I figured this was getting a little too close to having to check for ketones, so I gave a correction, but only half of what was suggested.
  • 3a – 84.  Really.  That kind of drop in 90 minutes? 
  • 4a – 64. Stick a fork in me, I’m done.  He sleeps so hard, and the only thing we can get him to do in his sleep is drink.  He won’t chew sleeping.  So another juice.  Hating this decision, but again, we are GREEN. 
  • 4:20 – 78.  Jason got up and did this 4a check (but I was awake lying in bed).  He gets up at 4:45a to go to the gym before work and said he’d check him then.
  • 4:45 – 106. 
  • 6:15ish – 115ish (numbers are beginning to run together but he was barely over 100 still) When we normally get up for school, Ryan asked to sleep a little longer and I let him.
  • 7:30 – 89 breakfast.

Now, I’m sure I may not have done all the right things here and there are some better suggestions on how to treat this.  I’ve even thought that maybe I checked too much and didn’t allow his body enough to regulate itself.  But from you more experienced momma’s, what would you have done differently?  Be gentle.  I’m exhausted.  I know not everyone does the same things and not everything works for everyone.  But if I could gather some suggestions here, I would appreciate.  Meri says not to change anything for three days.  This was our first day.  I have two more nights to potentially battle out.

Help?

Btw, nurse just called at 9:38a and he is 71!!!!!!

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Comments on: "D.O.C. Needed, Please" (7)

  1. How long ago was the flu? If it was less than two weeks ago…he would still have a hard time absorbing his food and you would find lots of lows.

    Otherwise…at his 8 oclock snack, did you bolus for that? If you did he would still have half of that insulin on board at that 9:30 check. Also…if you can, it is nice to get some fat in with that juice. Our family uses pudding, but that doesn’t work for everyone. The sugar brings the bg up…but the fat keeps it up. Sometimes juice just doesn’t have enough staying power. Also, look at what your nighttime target is. Is his pump programmed with a nighttime target under 150? Maybe you can change that so when you correct him, it corrects to a safer number?

    Grasping straws here…but I hope it helped! Hang in there. You are doing everything right! Sometimes the results don’t show our efforts at all. We get knocked down…but you’ll get up again! (hehehe that is the theme of my post today. 🙂

    • Thank you, Meri. It’s all good advice. Flu has been further back that two week, we’re in the clear of that. I knew giving him juice wasn’t the best option particularly after the first treat, but my brain was mush and couldn’t think clearly. Just getting little panicky and very tired. The target is interesting. It’s set at 130-150, so it corrects to 130? I know that’s not a scary low number, but i definitely would prefer 150, at least for now. The PDM is at school but I will make note to change it when he gets home.

      Mostly, thank you for the encouragement. The feeling of inadequacy is the worst.

      Sorry I didn’t “link” you to the honorable mention. I was blogging on the fly . . . it was a great post from several days ago. 😉

  2. I have noticed that at night juice just doesn’t cut it. I always suspend the pump at night to avoid coming up slowly hopefully. I have also started giving 4 tablets instead of the juice. I feel the juice is “healthier” but sometimes I have to check and treat again which I don’t like at night. Once the bg has come back to a good range then I resume the pump. An adult type 1 I know treats with orange juice and a spoonful of peanut butter. Haven’t tried that but something to consider. Good luck and go take a nap today!

  3. Yuck 😦

    I’m so sorry you had a rough evening/night/morning!

    As long as there isn’t IOB (usually there isn’t overnight, but you never know!!), we do 15c juice for 70 or below. We add an hour of basal suspend (off) for 50 or below. But that’s all subject to change, depending on variables like how much activity she had that day, what we had for dinner, the color of my toenail polish, and how the planets are aligned at that particular moment.

    Honestly, looking at your evening/night, there isn’t anything different I would have done. I would have corrected 240 @ 1am. I would have given 16c for the 68 at 9:30.

    It’s the unpredictability of the beast that makes it so complicated.

  4. We get stubborn lows as a result of more exercise than usual. We immediately reduce temp basals 20 percent for the whole night if exercise more than normal occurred (for ice skating, biking; Swimming we use minus 30 percent). If, despite reduced basal, first overnight low, juice. Second overnight low, juice to come up; temp. reduced basal for 3 hours (usually only 10 percent MORE); and follow juice after she has come up with 10 grams of Gogurt or full fat milk; Parmelot choc. milk with straws works really well and ten grams will be just a few sips (it’s 30 grams a choc.milk.box). Set the alarm for every 1.5 hours and check from there.

  5. Missy Slusser said:

    I obviously do not have ANY advice to offerother than to tell you now I understand a little bit more how to pray for you Amy! AND your family! PRAYERS to you all!

  6. Always thinking and praying Amy…. love you all!

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