Category Archives: high blood glucose levels

Welcome back to life with diabetes!

The new pump is on. The old basal rates have been retrieved. All rates are now posted on a sticky note beside my computer on top of the “MOTHER” heart my oldest son made for me back when he was probably in Grade 5 or so. 

My youngest son arrived home yesterday.  Together we sat down and uploaded the new pump and decided to try something different–we put food into the menu section of the pump.  Its a “thing” that allows you to have the carbs for favorite foods right there. We added the important things like Big Macs and Tim Horton’s Smoothies.  He was then good to go.

I really wanted to look over his meter and see what he had (or hadn’t) been doing while he was away.  I decided to let him settle back into his own routine first.  I thought about not looking at the meter at all.  What was it going to tell me? 

It would probably tell me that he ran way higher than I would like. It would probably tell me that he wasn’t testing when he was supposed to. It would probably just elevate my blood pressure and frustrate me.  There was nothing that I could do about the past. I was best to just focus on today and go forward. 

That was in an ideal world but by now you should know that I am far from ideal.  I had to look. I had to know. 

Just before bed, I asked him to see his meter. Despite the fact that I was sure that he was out of One Touch test strips, he swore that he had used an old green One Touch meter while he was away and left it behind (convenient!).  To make life simple for me however, he had found an old log book and written down all of his readings!  What a great child with diabetes.   

The logbook showed readings from every day.  There was one low.  There were some highs with notes as to what had happened. There were a few readings in range.  

My son waited for my reaction.  I said that I liked that he had written everything down but sadly he had logged before and created every single reading. I was not so sure that I could trust this book either. Part of me felt terrible for saying that. Part of me knew that there was a very good chance that I was right to doubt him.  Part of me hoped I was wrong.  I wanted to think that he did test when he wrote down that he did. I want to believe that the readings were all correct.  The diabetes police inside of me said that while some readings were right, he most likely did not have enough test strips for two weeks of using that meter.  His readings were far from perfect but not as bad as I would think that they should have been for all of the sites he swore he lost (four site changes in one day) as well as a pump that was failing. 

He just shrugged. I don’t know if that was saying “well I tried to get it by you.” or “I logged, you don’t believe me. Whatever.”  I hope its the first. Either way, today is a new day.  Last night was a night of highs.  Welcome home diabetes! 

Give him an Inch

I stumbled into my son’s room at 3am.  I grabbed his meter and tested. He was 18(325).  What the??? He was almost low a few nights ago.  He was a little high the night before but this is more than just a little high. What was going on?


An eye looked back at me. “Do you feel high?” I asked. 


“No” He mumbled from his bed.  


I checked his pump and he had corrected at 1am.  What was up? I asked him and he made some sort of excuse. I looked a bit closer. When was his last site change? BINGO!


The site reminder said he should have changed his site two days ago…around the time of the mysterious increases in bg levels.  Did said son do this? No, he pressed ignore and continued on with his XBox game.  


I have been obsessing over his testing. I have randomly checked his meter. I have made small tweaks BUT I did not write down on my calendar when his site needed to be changed (I am sooooo going to miss this feature when we have to give up our Cozmo).  Mom not nagging plus son ignoring equals a bad site that was causing unnecessary highs.  

Moral of the story…Mom needs to be more on the ball checking readings and noting when sites are to be changed followed by harping until those sites are actually changed.
 

And then there was the bad news

A few hours after my son got home from his time away, I asked to see his meter. I knew there was going to be a problem when the excuses began.  


“Well you see, you won’t find all of my readings on that meter. I used another meter in my shed.”


I asked where the other meter was.  Of course he had left it behind at his father’s.  That was convenient! He said that he had done a lot of testing on the meter he brought home in the last few days so it would give me some idea of what had been going on.  


As I scrolled through the meter I found readings that were between 20-30mmol (360mgdl+).  I tried to breathe.  I asked him what was going on. 


“Well, I was high this morning because I didn’t want to go low last night and interrupt the little bit of sleep I was going to get.  You see how I was low at 11pm? I had a juice and a granola bar to cover it.” 


“A little bit of overkill don’t you think? You were just low (3.7/65), a juice would have done it.  If you weren’t going up that quickly after 15 minutes then you could have added more without sending your readings through the stratosphere.” 


I continued to scroll through the meter and note the results.  I continued to work to breathing.  All of the readings were high and higher! What was going on? 


“I think my site was going bad.  See, my readings dropped once I changed the site.”


“Dropped? When? Where? How long was this site in? You were running over 20 (360) for days!”


He replied that his site was a little old. He had probably gone over by a day or so.  Perhaps his site was as much as seven days old I asked?  He just shrugged his shoulders. I wanted to scream but instead I asked him about a cut on his hand. 


“When did you do that?”


“Yesterday.”


“What do you think it will look like in seven days?”


“I hope it will pretty well be gone.”


“So when you lance a small hole in your body for your cannula, how much healing do you think has gone on around it in seven days? When the tissue around it heals, it can’t absorb insulin any more.” 


He replied that he thought he could go 5-7 days before a site change.  I know that some people will with no problem but he has insurance, he is young, and I really didn’t want to go down that alley with him so I replied that ideally sites are changed every 2-3 days. 


“Oh, well you see all of these highs have meant that I learned a lot this trip. I should probably do this more often. I never realized this stuff before. Now I know it. Wasn’t this a good thing?”


I had to laugh because otherwise I would have strangled him.  None of this information was new. It was all stuff he knew before.  I told him that continuing to run that high would result in serious complications. He told me that he had been told that was hogwash.  I replied that maybe one or two highs would not kill him but doing this forever would quickly result in problems. To help him understand all of this, he was now definitely going to the Friends for Life Conference in Vancouver.  He needed some more training.


Once again he shrugged that teenage shrug and went back to enjoy being home.  I just sat and shook my head.  Maybe he would learn because of this.  Maybe one day everything I tell him about his diabetes care will have some meaning. In the meantime, I will continue to pray, to hate summer vacations and extended periods of insane bg levels. 
  

“Good” is not a number

Does this happen in your house?

“What was your reading?”

“Good”

“No, what was your reading?”

“I don’t know but it was good.”

Arggghhhh!! “Good is not a number. Good is a four letter word.  Yes, “four” is a number but good does not necessarily mean “four”. “

At this point, my son usually looks at me like I am completely insane.  If I am lucky he has figured out that I would like to hear a real blood glucose reading and not his generalization of his take on his reading. 

“10.0” (180)

“That is not good.  That is actually a bit high since you just woke up and should technically be under 7.” 

“I like it. Its good for me. I think 10 is a good number.”

“And that is why good is not a number. What you define as good and what I define as good are not the same.”

The teen years can be trying enough, but a teen with diabetes? Well he may well tip my sanity scale! Time to buy some more hair dye to cope with the dozen new grey hairs he just caused me.  

When perfect isn’t so perfect

I was tempted today to just re-post My Favorite Number blog.  It kind of fits with my night. My son’s readings have been all over the map. I am sure that is in keeping with the crazy weather–one day summer and six days of late fall. We have days of extreme activity followed by days of xBox and Dukes of Hazard movies. Add to that sites that are usually left a day or two longer than they should be and you can see blood glucose anarchy quickly developing.

Last night I expected highs.  He had a totally lazy day so when I looked at the blood on his finger as I tested, I predicted that it was of the “high” consistency.  Wrong! It was of the “crap, which way is it going to go” consistency.  He was perfect. He was 5.2(94).  It was 3 am.  What was he going to do for the rest of the night? Would he go up? Would he stay the same? Would he drop? Perfection is rarely achieved. What was I to do?

At 3 am, I hedge my bets that he will drop and feed him two glucose tablets.  I stumble back to bed hoping that I haven’t sent him nice and high for his first full day of summer vacation.

When I woke up the next morning, I got up and tested him again. I was positive that I would see a 9(160). I was sure that I had driven him up. Wrong again! He was low.  I went out to get him some juice but of course we only had Crystal Lite.  Okay, I will add sugar to it! A few big spoons full of sugar and off I went to wake him up and get him to drink. I don’t normally wake him but its morning and I was up so he could be also!

After a glass of sugary juice and he only went up to 3.5 (65ish).  Next stop was tablets.  I fed him at least another four.  As he was eating, in his sleep, I couldn’t help but think “Rockets–the breakfast of champions!”   I so need a life!

As you can see its been a fun filled start to summer vacation. He will be heading off to his father’s for a few weeks soon so I had better get things a bit more in control by then. Wish me luck!!!

Restraint in the face of…parenting a teen with diabetes!

Let me preface this post by saying that I am very proud of me.  I have not had a complete meltdown. I have not screamed, threatened or inflicted bodily harm to anyone or thing.  I have not cried. I have not bounced my head off of the nearest wall. I have quietly resigned myself to the fact that the next A1c will in no way look as good as the last one and worked hard on continuing to breathe.

The Easter holidays brings great things–in that I get to have all of my guys together under one roof.  It also brings a few days of me not having to test because my sons head back to spend time with their father.  That should be a nice vacation for me but as I have said time and time again, its a period of quiet stress. I know that diabetes care is not the same when Mom is not around. I know that reminder text messages are often ignored. I know that testing is something to be done when bored and not when required.

Having all of this knowledge and not wanting to ruin my son’s time away is the reason why I waited a few days after his safe return before I turned on his meter.  I could feel my blood pressure rise as I looked at few tests, some really high readings, and then some good ones to soothe me slightly.  I calmly asked what happened to some of the readings.  There were readings at 4am but they were because he was still up and then there were no readings for eight to twelve hours while he slept.  I won’t even touch on the “where was the adult who should be overseeing the care?”.  I simply asked what was going on?

“I know I tested more than that.  I tested a lot Mom really! Those readings must have been on the other meter. The one at Dad’s”

“Would that be the green meter?”

“Yeah, that one!”

“The one that you told me yesterday was dead, had no battery and no strips? Is that the meter that you were using when you didn’t test on this meter?”

There was no comment. He swore that there had to be more testing. I just left the room with the reminder that that was not the way to maintain a great A1c.

This was last week and I have not brought it up since.  I have been checking his meter from school.  I have been pleased to see him carry his new AccuChek Mobile when we were rushing off to check on the cabin.  He is making some progress but there is such a long way to go (like the difference between “carrying the meter” and actually using it).

Last night, after I checked him and got a slightly high reading, I corrected and decided to check his pump.  I hadn’t seen him get insulin from the fridge to fill his pump in a bit.  I also don’t remember a site change happening this week.  The last site change I remembered was when he came back from his father’s–after leaving the site in for a week, after the previous one week old site named “Timmy”.  I was sure I would see that he had missed a site change…again.

I scrolled through the alarm history and sure enough…site change reminder: May 5th.  Crap! When will this kid learn???!!!??? Breathe, go to bed.  Deal with him in the morning.  I went to bed with visions of taking over his care and doing all of his sites in his butt where he has refused to ever inject or insert.  I wanted to do something to kick him into remembering. I really wanted that pump with the electrodes that worked like a cattle prod whenever its alarms went off.

I had asked people to build one for years.  My son completely ignores all alarms on his pump.  I am not sure why I bother to set them. For my own peace of mind I guess because he ignores them. Its now time to wake him up and remind him about the site change.  He will tell me he will do it after breakfast. I will threaten to insert it in his tush.  He will tell me that he will put it in his leg right after he is done eating. He probably will get it done because his cartridge is getting low.  Then again, he has been known to change a cartridge and leave a site.  He will tell me that he hasn’t changed this site (insert the latest name here) because this site is working so well. I will remind him that he was high last night.  He will come up with an excuse like the fact we had pizza for supper. I will remind him that it was homemade and he doesn’t have issues with my pizza.  He will mutter and shuffle off to his room. 

Oh the joys of teens and diabetes care.  I remember when I dealt with all of this stuff myself.  I forgot things but I knew that they were done as well. Letting him fly and fall is a lot more frustrating.  The joys of being a mother of a teen with diabetes…Happy Mother’s Day all!!

My favorite number

Everyone always asks you “what is your favorite number?”  For whatever reason, mine has always been six.  Today I realized how much I truly love that number.

Last night I tested my son at 2:30am.  I had changed his basal rate was I was expecting him to be either in range or high.  I was figuring on the high because we only seem to have readings fall into one category or the other–high or low. I was happy to see that he was 6mmol (100) and headed back to bed with a smile on my face.

This morning I began to think about numbers.  A high (anything over 12 in my world) causes a groan–hormones are raging or we miscalculated a bolus and I am a bad pancreas. A higher high–something over 16 (290) causes a slightly larger reaction–CRAP! What is wrong? Did we forget a bolus? Is the site in? Is the insulin bad? Is there air in the tubing? Will this correction work or should I inject? Crap!

There is also the dreaded non-number.  You know, when the meter simply says “HI” and you know that its not being friendly and wanting to strike up a conversation.  That is the reading that instantly gets the “Oh SH!#” response followed by the injection, ketone meter, jug of water, new site, new insulin and a lot more cursing wondering where I went wrong. I am now a colossal failure as a pancreas and have to get serious FAST.

On the other side of the coin, we have the number 5. I hate a five at night (90 for my American friends).  A five is a number that is close to six but far enough away that it could easily turn into a four…or less.  A five keeps me awake at night. I wonder which way it will go.  Will it make it up to my beloved six or will it tank to an unwanted two?

Fours are much more simplistic.  Add a small amount of sugar.  Its too close to call so I assume we are heading to a low.  Add a tablet or a bit of chocolate milk and rest assured that a crisis has been averted.  Well don’t rest too soundly because I have been wrong before and he could still tank but its a start.

Threes are a two tiered panic.  The first three I see at night, I respond with “crap”! I have to be a bit awake and somehow get glucose into my child.  The second three (or worse) means I am wide awake and cursing the arrival of diabetes into our lives.  I then know that this will be a long night and I will be tortured by its memory long after he has climbed back up to my special number–six.

A two or one? Well they instantly put me in five star, full fledged, try not to panic, but What The…??? freak-out mode.  These numbers have me clambering for glucose and praying I don’t need the glucagon.  These numbers have me watching the clock praying for the next reading to be so much better.

Yes, six is a wonderful number. Its peaceful.  It means I have been a good pancreas.  It has a serene sense to it.  Even a 6 in an A1c is fabulous.  I love six…don’t you?

T-E-E-N is a four letter word!

Today was the day anyone living with diabetes seems to dread…the A1c report card.  The last A1c was Horrible (yes that is horrible with a capital H).  We went up over a full percentage point. I wanted to cry.  There was logic behind the horrific rise.  We were moving.  My son was spending a lot of time away from me and his care was pitiful at best. It still did not look good and I just could not handle any lecture.

Today’s A1c did not have that same excuses.  My child has spent almost all of his time with me.  We did have our earlier fall rebellion with no testing and minimal bolusing that was bound to have an impact on today’s test.  Lately though he has been testing.  He has been bolusing and our readings? Well they are the readings that now make me understand Joe Soloweijczyk’s suggestion to run over your glucometer.  Despite doing all things right, my son’s reading cannot get out of high double digits (we are talking 250+ for my American friends).  I have upped basal rates.  I have adjusted carb to insulin rates.  We have prebolused.  We have changed sites, insulin and even batteries.  Nothing is working.

I walked into our appointment today full of trepidation.  These people do not know us well. They know me by reputation which is not as bad as it sounds but we have only seen this team once before.  What we they think? They will know that I am now officially the worst diabetes mom on the planet. I spent the night wondering if we would soon have to look at adding something like Metformin to his regimen. I was grasping at straws!

This afternoon we pulled up our big people pants and headed into the clinic.  We went to check in and she said “Your appointment was last week and we have you as a no show. Your next appointment is in April.”  What??? I told her we had received three different appointment dates and times.  The last one was via email just before the new year.  It told me to come in on the 11th.  I found the email and told her who sent it.  She said that his doctor was in and she would see what she could do.  She went back and they would fit us in.  No one had a clue how this had happened.

They weighed and measured my child.  He had grown 3cm (over an inch) and gained 13 pounds since the summer! I could tell. Besides the insulin resistance, he was starting to be able to look me in the eye.  His doctor noticed the change in him as well.

We saw the nurse.  We have known each other for years.  She reminded me that puberty was hell and things would only get worse.  The A1c’s of under 7 would be something we could fantasize about but would not see for at least a few years.  I was dying! She said the last A1c was not that bad considering and I told her that this one would not be better.  She looked at his readings and agreed.  He has been high, high and high.  We haven’t seen a low in weeks.  He is getting used to running to high and I am in panic mode.  I told her that I had upped his basals and she said to keep doing what I was doing.  If I needed some help to give her a call.

We saw the doctor and she concurred. She suggested that I not be afraid to warm it to the insulin.  The little jumps that I have been making are just frustrating me.  Make bigger leaps (probably during the day when I am more comfortable) and try to find our way out of this.  She agreed that we didn’t want this to go on for long and was open to the possibility of adding in other things if need be but we are not at that stage yet. 

All in all, the highs are not the result of a non-compliant kid.  Despite my grumblings, he has been doing a lot better lately and I made sure that I said it a lot in front of his team members both for his benefit and theirs.  He is just growing and going through puberty.  He eats non-stop but that’s called being a teen. I have lived through that with one son and now we go through it with another. 

I left the house today filled with anxiety.  What would they say? I am a bad mom for allowing this to happen.  My finance reminded me that he was growing and I was doing my best.  You have to truly love that kind of realistic support.  I came home calm, happy that we were done in less than two hours, and feeling ready to tackle that horrible four letter word–TEEN also known as the insulin resistant years of hell.

Hi Hi Hi Merry Christmas?

Hi! Hi! Hi! Merry Christmas??? Well my son says that Christmas will bring changes.  I certainly hope so.  Life was coasting along okay.  Diabetes was just giving us its usual little bumps but all in all we were handling it alright.  Testing remained hit and miss but we had a few more hits than misses.  Diabetes must have realized that Christmas is fast approaching and we don’t really have a lot of time for messing around with other “stuff”.

We started out with a few highs here and there.  Perhaps some basal tweaking was in order.  Once that was done we ran into a new catastrophe–tubing breakage that went unnoticed for a few hours while at school.  He had spare sites at school but instead went through about 100 units of insulin filling tubing and correcting.  He was ketonic by the time he came home of course but quickly changed tubing, insulin and began to guzzle water. I was proud that he handle things on his own and took charge of his care so thoroughly (once he got home).  Thankfully he was a lot better within a few hours.

Next came the night time snack with no bolus to cover. He was high and felt ill during the night but quickly came down with a correction. Finally we just had highs.  Pancakes are evil and lead to highs. Growing also leads to highs.  Pancakes we can extended bolus for.  Growing is going to take a bit more work. The shirt I bought him during the summer on our vacation is now too tight.  The running shoes he had for school no longer fit.  The child I looked down on, now looks me in the eyes. This growth thing is going to take some serious insulin to cope with.

Its funny, when my oldest son would grow I would just hate to see my baby getting so big and my wallet would hate to see me having to buy new clothes so quickly.  With my younger son, again, I can’t believe how quickly he is growing, clothing him is not cheap, but we also have the added grey hairs of trying to guess at basal and bolus rates.

Life can’t be simple when diabetes moves in.  Of course these little quirks in otherwise, decent blood glucose levels are occurring in the month before we go and have another A1c done.  We were going to have this one in a much better range.  I am not as hopeful anymore.  We now have errors, puberty, and Christmas holidays all to mess with life. 

Last night I thought how much simpler things were when I had full control.  I fed him.  I tested him. I bolused for his food. I logged.  It was a lot of work but he didn’t eat around the clock like he does now.  I could keep readings in range.  Life was simple.  Now he does things on his own. He can cook.  He eats enough for six small children and he doesn’t need Mom around at all functions.  He does his own WAG for carb counting (and usually he is pretty good at it). Mom sits in the background as the constant voice of “Test. Bolus. Log.” 

Somehow we will make it through the holidays.  We will survive the results of another diabetes report card (aka the A1c results).  We hopefully will even survive puberty!

May your house be filled with love, laughter and great blood sugar readings this holiday season! And the best present of all? Let’s hope that Diabetes takes a permanent vacation soon from all of our lives! Merry Christmas!

Pizza really is evil

People always discuss the evils of pizza. When we were on NPH years ago we didn’t have that problem….well until his honeymoon ended and then I began to see issues where previously there had been none. I still thought I had pizza pretty well handled. We used an extended bolus and life seemed good…except when in New York and dealing with their pizza. There just seemed to be no bolusing for it.

Well its been years and now I am having a new “pizza” problem. We use the extended bolus with great success for the first four or more hours. Readings are in range. I am a happy camper. Liam is a happy camper. Life is great! Then we hit the 8 hour or so after pizza mark and things begin to get ugly. Eight hours! Who would think!!! Last night he was 6 (108) four hours after pizza. I thought we had things beat. By 10 pm (we ate the pizza for lunch at around 1pm or so) he was up to 24(432). I couldn’t believe it. It wasn’t the other food that he had eaten because that was pretty normal and I am sure the bolus was accurate. By 1am he was down to 21 (378) but this just seemed crazy. I really hate diabetes. A lovely family lunch turned into a Mom meltdown by 2am. Ah the joys!