Changes

The endocrinologist made a few changes to Lu's regimen because her hemoglobin A1C had gone up .2 since our last quarter visit.  Yesterday was the first day of the dose change and also her 3 hour cheer practice.  I was a little nervous to give her the higher doses with breakfast, but didn't want her to spike before the 10:30 practice time.  Her Lantus was increased from 9 units, to 10 units and her Novolog rate was increased from 1 unit for every 20 grams of carbohydrates, to 1 unit for every 15 grams of carbohydrates.  I gave her the updated dose with breakfast at 7:30 and on the way to practice, checked her blood glucose levels.  258 at 10:15.....we are back to those post breakfast spikes where the insulin is taking a little longer to kick in.  Practice immediately started with warm-up and practicing jumps.  After about 20 minutes of that, they started tumbling and that lasted about 30 minutes.  At 11:30, we did a recheck of her bg's and she was at 115.  She had a snack, apple slices, peanut butter crackers and low-calorie Gatorade.  They practiced their competition routine and around 1:00, she gave me 'the look', which I knew meant that she didn't feel good.  Re-check, bg's 62.  Quick juice and a snack and the timing was good because the team decided to take a break.  10 minutes later,she perked right back up and finished practice with energy left over.

I thought I had it together.....ugh

So, today was our quarterly visit with the pediatric endocrinologist.  Interesting morning, to say the least.  To start things off, I didn't sleep well last night, so when the alarm rang this morning, I didn't want to get up.  Thinking maybe I shouldn't have....  We did Alyssa's normal morning regimen and she asked if she could have a little coffee this morning. So, since she was up earlier than she had been in a few weeks I thought a little 'children's coffee' might help her get going.  I measured the milk, sugar free creamer and mixed them with a little coffee.  I accounted for that with her Novolog dose and we hit the road to drop her brother off at his first day of driver's ed and then on the see the doctor.

When the nurse called us back, she wanted to check Alyssa's blood glucose levels and I thought for sure it was going to be within range.  At this time it had been 2 hours since she had eaten....but a reading of 405.  I was floored!  She hasn't had a reading like that is such a long time.  Re-check...305...better, but what the heck??  I felt terrible.... I mean, I carefully measured her food, counted the carbohydrates, and calculated the insulin dose.... all of a sudden I felt like the worst mom in the world.  I mean, I know realistically that things like this happen and diabetes is a very tricky disease.  Sometimes bg's fluctuate for reasons out of our control like stress or excitement.  I know Alyssa and I both were excited to discuss the insulin pump with the endo.  Another blow, her A1C was 8.2, up from the last visit.  Ideally, they would like to see it 8 or less.  Ugh!

Well, on a happier note we did discuss the pump.  We are scheduled for an insulin pump class on Tuesday evening.  After we pick out the pump we want, the next step will be to contact the insulin pump company to start the purchasing process and see what pump and how much our insurance company will pay for.  I'll go into more detail in another post about the process of getting Alyssa started on the pump and the steps we'll take in the near future.

Pump talk

As I've mentioned before, I've been hoping to talk Alyssa into getting the pump. I know it seems to be an easy decision because she would go from 4 injections of insulin a day to changing the pump site every couple of days. However, I also know the idea can be quite scary and she already has to deal with so much. That is why I've never really pushed it, I just hoped she would show me when she was ready. This morning we went out for breakfast and the topic of getting a pump came up again. She showed a little more interest in the pump this time and said she would try it :). Fortunately, tomorrow is our appointment with the endocrinologist; so, we'll see how it goes!! There are several steps before we can start using the pump, but I'm excited we are on the way!!

Summer Schedule

I remember when I was a kid, the thing I looked forward to most during summer vacation was staying up late and not having to get up early in the morning. But when you have diabetes, its important to stay on a schedule. I have to admit, over the past several weeks we have slept a little later each morning so that now we get up between 7:30-8 as apposed to the 6:00 am alarm when school was in. And Alyssa is going to bed around 10:30-11 pm, when her school year bed time is 8:30-9... well she usually falls asleep somewhere around that time and we put her in her bed :)

I knew last night Alyssa had stayed up later than usual watching a movie. I woke up at 7:40 this morning, pricked her finger (she slept through it) blood glucose level was 147. I made her breakfast (3 little pancakes, sugar free syrup & a cup of milk is exactly 60 grams of carbohydrates), walked her sleepily into the kitchen and she started eating as I made her injections. I gave her her Lantus and Novolog and then proceeded with making coffee and cleaning up the kitchen. When I turned around, I noticed that Alyssa wasn't at the breakfast bar, so I went looking for her and this is where I found her.......