Tuesday, January 13, 2009

A New Pattern

Kacey's CDE called today and I was able to speak with her about the 48 mg/dl she had the other day. She was just as stumped as to why she dropped but she said not to be alarmed because we test often enough and we would of caught it before it got too low. How low is too low? I thought anything below 80 was low so what is too low? She reassured me that Kacey is fine and not to be alarmed when we see those 40's. It is something we're going to see on a regular basis. (yikes!) So she went on to tell me that Kacey was definately through her honeymoon. Made me want to cry but at the same time be happy. Reason being...we were told no pump until she was through the honeymoon so this means we have a green light for the pump but at the same time it means her pancrease is completely broke :( It's not spitting out anymore insulin and now she's completely dependent on the shots (not that she wasn't before...but its more final now) So...I'd call it a "bitter-sweet" moment. I did express (for the thousandth time) how we were really pushing for the pump and I told her about Kacey asking Santa for one. We had an "awwwww" moment and she told me that when we go to see Dr. R next week, to let him know Kacey was more than ready for the pump and since Santa couldn't give it to her for Christmas then maybe Dr. R could give her a great birthday present ;) (her bday is Mar 8th) She said we were doing an excellent job testing through the day and the more she tests the better they can adjust her dose. That really made me feel good! She did have one concern though. It's a concern that I brought up before but then was quick not to "make excuses" for the highs. Her concern was this... when Kacey was home for those 2 weeks for Christmas break, her blood sugars were nearly perfect! We had nothing over 200 with the exception of Christmas Eve and New Years Eve (totally understandable) but when she started back to school last week her blood sugars went wacky again and she's been bopping around in the 200's and then at dinner time she drops drastically. For instance, yesterday she went from a 269 @ 3pm (2hrs after lunch) to a 68 @ 5pm and so I threw a mini pizza in the oven and while waiting for it to cook she said she felt REALLY low and she dropped to a 60 in 10min. So she asked me... Is Kacey anxious at school? Is she under a lot of stress at school? Maybe changing classes is something that is making her feel anxious and stressed and she just doesnt know it? Can you think of anything that would make her bounce in the 200's through the day with absolutely no change in her regular diet? My reply....No. Her teacher had mentioned back when we did the 504 Plan that Kacey seemed to get a headache or tummyache when it was time to leave class. Mrs. M thought maybe it was because she was feeling insecure. As I mentioned before, Mrs. M's husband is Type 2 and Kacey feels very secure with her. It's like she knows Mrs. M is going to be able to take care of her if something happens because she knows what diabetes is and how to handle highs/lows. She told me that with lots of positive encouragement, Kacey finally started to leave the room without "feeling bad". She hasn't mentioned anymore about it so I assume that she hasn't had anymore problems with it. I really never thought about stress making blood sugars go up. I knew I had read it but I think I just automatically associated stress with adults. Shame on me! I guess I never considered Kacey to be stressed over anything. When I asked her if she was feeling ok this afternoon, she said she had a great day and so I asked her if she had anymore issues with feeling bad when she changed classes and she told me no. So what do I do? She doesn't appear to be stressed and she loves school. She actually cried the day they left for Christmas break because she thought it was the end of the school year. Sad huh? LOL! My question is this...those of you with kids...do their blood sugars run higher at school than when they are home? Back to the high and drastic drop....for the last 3 days, she will run high in mid-high 200's 2hrs after lunch and then make that drastic fall to the 60's. Her lunch ratio is 1:10 and we have to keep it at that to keep her from spiking at 3pm. So I made a suggestion to the CDE... at 3:30pm when I pick her up from school, should I give her a snack and then do dinner about 6:30pm instead of coming home and doing dinner at 5pm? I'm trying to figure out a schedule that would work best for Kacey. She said to keep the same schedule for the next week and see if she drops every single day at dinner. If she does, then I can switch the meal times up and play with it til I get the timing right.

Today is a good day :) The reason...because I feel like I do have control of Kacey's diabetes, despite the highs and lows she is having. I feel like I understand things so much more and I've certainly come a long way and learned ALOT in 6 months. I am thankful to have one CDE call me every week (God I hate change!) I used to get frustrated when we had 3 different ones calling and none of them really knew us. I've built a nice relationship with our CDE and it was actually nice to sit and talk with her for 15 min on the phone today. I didn't feel rushed and she was really open to my ideas. When she told me I was doing a good job managing things I felt a beam of sunlight :) Thats a great feeling! LOL I giggled and told her the true test would be that "report card" we get next Thurs! She reminded me that we were only 6 months into this and not to expect to have that 6.0 and I said anything lower than the 10.5 she had in the hospital would be great with me ;)

Tomorrow is a big day for me. I will be substitute teaching all day for my internship. I am shadowing a great 1st grade teacher :) I've already popped in to tell her I was going to be in the class with her and she was thrilled to know the name on the email she got was me. (Can you say....confidence boost!) I'm really excited!


Cara said...

I had a 46 this evening. Didn't even feel it. Thank goodness for CGMS to catch it! Yikes!
Good luck tomorrow! I'm so excited for you. :)

Penny said...

Last year Riley's sugars didn't really fluctuate much at school. This year he's had a terrible time with highs. His endo mentioned stress too. I talked to his teacher who says Riley acts fine and gets along with everyone in his class. I've talked to Riley who says he likes school. So, we don't really know what's going on either.

I've been adjusting basals and have finally gotten him about where I want him (except he had 2 lows at school yesterday). But, it's crazy how much more insulin he needs on a school day compared to non-school days.

We've had a hard time with is this year, but I think it's easier to adjust with the pump. I look forward to hear more about your quest for the pump.

Wendy said...

Addy has had HORRIBLE numbers at school...I'm talking 400's +!!!! Yet she's PERFECT at home and I spent most of her break chasing lows away. This week things have been better, but school totally stresses my little girl out. When I asked her about it, she told me that she's afraid no one will believe her if she says she's low :(

This week has been MUCH better -- only over 200 once.

Small victories...one day at a time...