Monday, February 23, 2009

When the planets align…

There’s no such thing as “controlling” Type 1 Diabetes. That’s like saying you can “control” a wild animal which you’ve been training and domesticating (sad case in point, Travis the chimp!). Despite all your good efforts, one day, it’s just gonna turn on ya. Diabetes is like that; the best you can do is manage it day to day, and try to keep it on a tight leash.

Well, we were able to keep diabetes on a very tight leash for a whole single day last week. It was February 18th 2009. I’ve got it imprinted in my memory, because it was so very very sweet. It was like the planets aligning. Everything fell into perfect balance.

Maybe that doesn’t sound like a big deal. But really, it is. Since Alex switched to MDI (multiple daily injections) in November, her numbers have been all over the place -- lows of 2.5 (45) and highs of 24.3 (437). Keep in mind, a person without diabetes is about 5.5 (100) maybe up to about 8.0 (140) after eating. But, that day, February 18th 2009… ahh. Alexandra was 100% in her range (4.0 to 8.0).


6.7 (120) at 1:04 a.m.

6.3 (113) at 6:00 a.m.

Injection of 2 units of Humalog at 6:40 a.m.

5.2 (97) at 9:30 a.m.

7.7 (139) at 11:30 a.m.

Injection of 2 units of Humalog at 11:34 a.m.

6.9 (124) at 3:00 p.m.

Injection of 2 units of Humalog at 3:05 p.m.
Injection of 8 units of Lantus at 3:06 p.m.

5.3 (95) at 5:30 p.m.

Injection of 2 units of Humalog at 5:38 p.m.

8.0 (144) at 7:34 p.m.


If only every day could be like that!

Saturday, February 7, 2009

“Looks like we’ve just had our first glitch for this mission.”

The start of Alex’s 8th year probably isn’t what she expected. On Monday, February 2nd, my little Ground Hog baby celebrated her 8th birthday. She has been anticipating and making plans for this day for weeks, if not months… every sentence starts out with, “When I am 8…”

Monday she goes off to school as usual. She has PE for first class, and is supposed to check her sugar before and after. No problem. She is also supposed to check her sugar at break time, which coincides with the after PE program, so again no problem. She is also supposed to check her sugar at lunch time. Problem. She ran out of strips. Evelyn, the librarian, calls and I come scampering to the school, in my cleaning-the-house skanky clothes, and pull her out of class to check her sugar. She’d already eaten lunch, but surprisingly her after lunch number is a 3.5 (63). Maybe an after-PE crash. Whatever. I crank her up with 2 glucose tabs, and promise to return later with her birthday goody bags.

Once I’m home and cleaned up, Sly and I start on the goody bags – juice, corn puffs, Milo cubes and erasers – and bring them to her class. Alex is happy, even though the bags are a bit on the lame-o side.

When she gets home from school, I have her help me make fairy cakes from a mix. Like any normal kid, she wants to lick the spoon and I figure, go for it. I’ll bolus her later. After dinner of soft tacos with rice and black beans, we all have cake and ice cream. Even with all this, Alex’s numbers stay pretty lovely and all is well with the world, or at least this small part of it.

Until 10:30 that is. Alex wakes up crying. Her teeth are hurting and she can’t sleep. She wants to go in the living room because it hurts to lie flat. So I hustle her in there before she wakes up Sly, and check her sugar. She’s running a bit high now – 13.5 (265) – probably from all that friggin’ sugar-escalating, tooth-achin’ ice cream that she consumed earlier. I give her Tylenol and a correction unit, and by 1:00 pm she’s just about in range and willing to go back to sleep.

Now, while I thoroughly enjoy (and desperately and definitely need) my beauty sleep, I have to admit it wasn’t all that terrible to sit up and watch TV at midnight, because I got to watch CSI Las Vegas, which I haven’t seen in years. Make the most of what you’re handed, that’s what I say.

When the morning comes, I tell Sly that Alex has to go to the dentist today. No ifs, ands or buts about it (‘cause we’ve been putting off a dental check-up for her for months). So we ride with the boys to school and then head into Accra to find a dentist. The good thing about living in Ghana is that you don’t have to worry about appointments for things like doctors or dentists or beauticians. They still work in the old-fashioned "Walk-ins Welcome" kid of way. So we walk in at 8:45 and we’re seen by the dentist at 9:15. Not too bad. In the states, even with an appointment, we’d probably be waiting longer.

The dentist looks at Alex’s mouth and spots a lot of trouble. Her baby teeth are wiggly, but they’re crumbling faster than they’re falling out. She’s lost a filling in one tooth, and she’s got a couple of cracks in two others. He fills what he needs to fill, and shows Sly a tooth that he’s just going to ignore because it’s too crumbled to fill and he figures it will fall out before it starts causing pain. (I certainly hope so.) Sly is a little bit green around the gills, because he’s never been to a dentist in his life and being this close to one is a little disconcerting. Sly has beautiful white perfect teeth. Oh, and his mother of 88 still has all of her beautiful white perfect teeth.

The dentist made us chuckle when he tells us that he’s glad that Alex’s teeth problems aren’t too bad and didn’t require any anesthesia, because he’d hate to have to give her a needle (Novacaine) as he doesn’t want children to have a fear of needles. We told him that needle-phobia was the least of our concerns; Alex deals with needles at least 10 times a day!

By the time we get back home it’s too late to send Alex to school, so she gets a freebie on this one. The rest of the day and that night is a non-event. That’s good. It’s lets us store energy for what’s to come.

About 4:30 am, I happen to brush against Alex and find that she’s burning up. What now?! Her sugar is in range, but her temperature is 99.7. An hour later, her sugar is still good, but she’s up to 100.2. There is no way she can go to school with a fever, so here goes another non-school day.

Another hour goes by and she’s at 101 and she’s awake enough now to tell me her “neck” is hurting – she means the inside of her neck, not the outside. Her sugar is still good, but I check her ketones and they’re at .5. Not terrible, but not giving me the warm and fuzzies, ya know? Fever is never a good thing for a child with diabetes, so today we’re off to the doctor.

Doc orders a blood count to check for malaria and a swab for strep throat, because her throat is red. The lab technician gives us another chuckle when he pulls a new lancet out of the box and tells Alex that this won’t hurt. Hah! Good luck finding an unpricked, uncalloused finger, I tell him.

The lab results come in and they’re positive for malaria parasites, and negative for strep. Oh well, can’t win ‘em all.

She’s on malaria medication, and antibiotics anyway, and Tylenol to keep the fever down which absolutely refuses to give up the ghost even as of today. The real problem is she’s got no appetite, and I hate that she’s not eating, so I give her lots of juice.

Now, when I mentioned to the local clinic doctor about giving her juice, he kind of fought me on that. He says I should give her only water, because the juice is high in sugar. To that I think, “d’oh!” “But,” I tell him, “if she’s not eating, and she’s on insulin and showing trace ketones then I’ve got to give her carbs and insulin to knock out the ketones and cover her basal.” He doesn’t really get this, but I know what I’m talking about. He suggests I call our regular doctor afterward. Good suggestion. Sly is leaning toward this doctor’s suggestion about the water drinking issue, and that’s kind of pissing me off. I keep repeating myself, “Yeah the water is fine if she’s eating, but she’s not eating and she’s got to have carbs!!”

Sly also wants me to call the doctor and see what she says. Dr. Renner agrees with me. Give her liquids with carbs if she’s not eating. I win. Good thing, because I’m a helluva sore loser.