Friday, October 26, 2012
Growing Up Right
After four plus years of playing the role of pancreas-by-proxy for my daughter Alexandra, I thought I’d seen it all but I was in for a surprise. My friends on Facebook know what I’m talking about; they’ve seen my many laments about insanely crazy overnight high blood sugars that refuse to fall in line despite a quart of insulin. I’d have better luck just saturating the mattress with her Humalog and hoping that osmosis will do the trick. It’s puberty. I guess my baby can’t stay my baby forever.
Other parents with daughters of a certain age I am sure share with me that bittersweet moment when they realize that their baby is growing up. For them I’m sure it’s the first few subtle signs –hair where there used to be none, the newfound need for a size 28AAA bra to cover tiny bumps, the promise of long, lithe limbs which are just now at the awkward, gangly stage. We won’t even go into the attitude adjustment now that Alex is a pre-pubescent tween.
It’s apparently a lot of work to grow up, and the body is a magical thing. I think I would find it much more magical if I weren’t too keenly aware of how hard it is. I want to be awed by the magic, damn it, not exhausted by it.
But parents of daughters (and sons to a slightly lesser extent) with type 1 diabetes who are going through puberty know first hand how hard the body is working to mature our child, to make them ready for adulthood and to eventually procreate (oh God did I just write that?!). We parents of T1 kids see it in elevated blood sugars, a side effect of the growth hormones which makes blood glucose much more resistant to insulin. I’ve had nights where I couldn’t budge Alex’s sugar out of the high 300s and even 10 units of insulin (quite a lot for a 75 lb girl) didn’t ever bring her blood sugars in range.
Only daybreak did. You know that very typical remark about growing kids? Goes something like this, “My goodness! It looks like you’ve shot up over night!” It’s true. It does happen overnight, and it can be overnight for three or four nights in a row. That’s three or four nights when I’m losing sleep and up every three hours re-checking and bolusing and dwelling on how much worse it would be if I didn’t do these things. I can’t even begin to imagine what Alex’s A1C is going to be – I might just forego doing the A1C until she’s 18 or so.
What’s most frustrating is that the first night you get those high numbers you wonder if it couldn’t be food related or perhaps an illness coming on, so you just do your normal thing and hope for the best. Then the second night you think to yourself, okay it must be puberty so maybe what I’ll do tomorrow is run a temp basal. That seems to work for day 3 and you’re content because you’ve been able to keep her sugars down a bit (still not ideal but 180 is way better than 380!) though now you’re up every two hours checking just to be sure. And then on day 4 your 2:00 am check finds a low. Oops and ugh. Guess this growing body is taking a breather.
Then a week or two later it starts all over again.
So let me tell you about our summer. It was wonderful. We went to N.J. for the month of August to see our family, and stayed in a lovely little cabin just near Six Flags. We had bought season passes for a ridiculous amount of money but certainly got our money’s worth since we were there nearly every day for a few hours.
Now, I like amusement parks and in my younger days when Six Flags was just Great Adventure I did all the rides including the roller coasters like Lightening Loops and Rolling Thunder. Well Lightening Loops is long gone though Rolling Thunder still hanging in. But the park’s main attractions are the big boys, Superman – the Ride, Batman the Dark Knight, Bizarro, Nitro, El Toro and of course, the king of all roller coasters in the whole wide world, Kingda Ka.
I am no coward but neither am I a nut.
But I am a parent and before I’d let my 11-year old daughter go on any of these rides I had to “test” them out first. Maybe I am a nut after all. But I wanted to see how they were, and assess whether or not I thought my daughter could handle them. In the end I got up the nerve to ride them all except Nitro (I absolutely must have shoulder harnesses to hold onto!) and Kingda Ka (just no and after I saw the picture of my two sons riding it the answer is still no, and that goes for Alex, too).
The rides can be scary for any kid but the adrenaline rush for a type 1 kid could really mess up a blood sugar – in either direction.
My husband and I tried our hardest to be crazy careful; we checked her blood sugar before she went on a ride, we made her carry glucose tabs in her pocket or the pocket of whomever was with her. There was always a soda or a juice box waiting. But still we made mistakes, all of us.
The first time was when Alex was riding on El Toro with her brothers and cousin; it was night time and they had just been on it once (for the first time ever for Alex and her cousin) when they dashed back to say they were going on again. I pulled Alex over for a quick recheck. She was 50 mg, with some insulin still in her system. Not a number good enough to go on any ride, much less a roller coaster with a 176 foot drop and g-forces of 4.4. No.Friggin.Way.
But Alex was desperate to go again before the park closed in 10 minutes! Here’s how it played out; she gulped down a whole bottle of coke and chewed 2 glucose tabs while her brothers and cousin stood anxiously by (it looked like the four of them were in dire need of a bathroom, they were jiggling so much with impatience). An 80 mg was the best I was going to get if they were going to be on the ride, so off they raced with glucose tabs in one of Sean’s pockets and a juice box in the other. I followed to the picture booth where they take snapshots of all the riders as they take plummet at 70 miles per hour. There was Alex and her crew – screaming wildly and grinning their heads off, with their hands in the air. With their hands in the air?!
Insanity runs in our family apparently.
We had one more run in with a crazy blood sugar at the amusement park and it was not good (I know, are they ever?). We had waited in line to get on Bizarro, another crazy roller coaster with a lot of inversions. I was waiting with my niece Natasha, Alex and Sylvester; the boys were somewhere behind us. Our ride was next, maybe 2 minutes more of waiting when Alex says she doesn’t feel well and Sly offers to take her off while I ride with Tasha. He and Alex head for the exit ramp. I look down then look up again a moment later and Sly is carrying Alex in his arms her head is slumped on his shoulder.
I’m still trembling as I think of this. He said her knees had buckled and she was on the verge of passing out, so he grabbed her and carried her down the 4 flights of metal steps to the ground. I ran behind with Tasha in tow – Sean and Mike had no idea and were still ready to go on the ride. We sat Alex on the ground and I checked her sugar with quaking and shaking hands while she drank the Coke her step-brother Jules had just run for. She was as white as a sheet, but she wasn’t low – a rebound? I don’t know; we had checked her before we got on the ride but we did have to wait a while so maybe the heat of the day and anxiety conspired? I still don’t know. I do know that I never want to see my husband having to carry my daughter in his arms again like that. Ever. But I am also ever so thankful that he did and that he was there with us. In a theme park surrounded by the “heroes” that I grew up with – Superman and Batman – they couldn’t hold a candle to my husband on that day.
Did that episode stop Alex from going on her rides, or me from letting her? Of course not; as we T1 parents always say, our kids can do anything that any other kid can do. And I’d be doing Alex a grave injustice if I treated her differently just because she’s got type 1 diabetes. She’s still a kid, a growing one, but a kid nonetheless and it's my job to make sure she does it right.