Today.
I'll start at 2am, when Liv's continuous glucose monitor gave its warning that Liv's sugars were high. We checked her sugar, she was hovering around/above 300, so we had her treat the high with her pump's calculations. At 7am, she was still above 300. She treated again, the pump gave her 2 units of insulin, which should have brought her sugars back into normal range. Before breakfast, I changed her infusion set, to rule out occluded lines or insufficient insulin delivery. Her blood glucose continued to hover between 250 and 300. So just to cover all possibilities, I had her check her urine for ketones. For what is the first time since the night of her diagnosis at 2 years old, she was positive for moderate ketones.
Two phones calls later with her endocrine office, we had to decide whether or not to send her to school. The nurse said we shouldn't, the diabetic educator thought it was probably ok, but we still hadn't spoken with Liv's pediatric endocrinologist, who was soon to call us back. Liv was anxious about missing class, her first period is math and she didn't want to miss. The school nurse was there today, her one day per week at Liv's school was miraculously today. I spoke with her, our plan was to have Liv meet with her as soon as 1st period was over. Liv's endocrinologist was good with this.
Dustin and I both watched Liv's sugars continue to climb during math class (thank you Medtronic, the mini med uploader is a gift to parents). Halfway through class, I called the school office to have them pull her for a ketone check and blood sugar check, because what Dustin and I saw was Liv's sugars climbing over 300 and still elevating. The nurse had her check her ketones, which were now moderate to large. Per Liv's doctor, we brought her home. Now she was in my care, and I cannot explain how much better I felt just being able to watch her.
Another phone call with her endocrinologist (3rd call with her directly at this point), she calculated a treatment dose for Liv's ketones. Much to Liv's disappointment, we had to deliver 4 units of insulin via syringe. It's been a very long time since we've used syringes (November 2013).
Her sugars hardly budged from 270-300 range. We changed her infusion set again, this time using a new vial of insulin. We treated again, another 2 units. An hour later, Liv was 249. Another hour later, we rechecked her ketones, and she was negative. Her blood glucose continued to fall, slowly, and since this afternoon she's been in the normal range (~100). We're continuing to check her hourly, but she is definitely back to her usual pace, outside shooting hoops with the court lit up with porch lights after 9pm, sugars hovering around 80. It's been a numbers game today.
Debating whether I should sleep next to her tonight, to watch her, to listen for her monitor beeping warnings of deviant blood sugars, to know that all is well. It wouldn't be atypical, though, I don't know any parent of a type 1 who doesn't watch their child sleep through the night, checking sugars and pump graphs, breathing patterns, restlessness.
Tonight will be better.
I'll start at 2am, when Liv's continuous glucose monitor gave its warning that Liv's sugars were high. We checked her sugar, she was hovering around/above 300, so we had her treat the high with her pump's calculations. At 7am, she was still above 300. She treated again, the pump gave her 2 units of insulin, which should have brought her sugars back into normal range. Before breakfast, I changed her infusion set, to rule out occluded lines or insufficient insulin delivery. Her blood glucose continued to hover between 250 and 300. So just to cover all possibilities, I had her check her urine for ketones. For what is the first time since the night of her diagnosis at 2 years old, she was positive for moderate ketones.
Two phones calls later with her endocrine office, we had to decide whether or not to send her to school. The nurse said we shouldn't, the diabetic educator thought it was probably ok, but we still hadn't spoken with Liv's pediatric endocrinologist, who was soon to call us back. Liv was anxious about missing class, her first period is math and she didn't want to miss. The school nurse was there today, her one day per week at Liv's school was miraculously today. I spoke with her, our plan was to have Liv meet with her as soon as 1st period was over. Liv's endocrinologist was good with this.
Dustin and I both watched Liv's sugars continue to climb during math class (thank you Medtronic, the mini med uploader is a gift to parents). Halfway through class, I called the school office to have them pull her for a ketone check and blood sugar check, because what Dustin and I saw was Liv's sugars climbing over 300 and still elevating. The nurse had her check her ketones, which were now moderate to large. Per Liv's doctor, we brought her home. Now she was in my care, and I cannot explain how much better I felt just being able to watch her.
Another phone call with her endocrinologist (3rd call with her directly at this point), she calculated a treatment dose for Liv's ketones. Much to Liv's disappointment, we had to deliver 4 units of insulin via syringe. It's been a very long time since we've used syringes (November 2013).
Her sugars hardly budged from 270-300 range. We changed her infusion set again, this time using a new vial of insulin. We treated again, another 2 units. An hour later, Liv was 249. Another hour later, we rechecked her ketones, and she was negative. Her blood glucose continued to fall, slowly, and since this afternoon she's been in the normal range (~100). We're continuing to check her hourly, but she is definitely back to her usual pace, outside shooting hoops with the court lit up with porch lights after 9pm, sugars hovering around 80. It's been a numbers game today.
Debating whether I should sleep next to her tonight, to watch her, to listen for her monitor beeping warnings of deviant blood sugars, to know that all is well. It wouldn't be atypical, though, I don't know any parent of a type 1 who doesn't watch their child sleep through the night, checking sugars and pump graphs, breathing patterns, restlessness.
Tonight will be better.
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