Monday, August 20, 2007

Decisions, Decisions.

After a long day of swimming yesterday, both Tom and TJ come home looking a little green. Pool water ingestion. Tom manages to rally and bring Gwen to Jake and Samantha's birthday party, but Thomas tosses his cookies just before leaving (better than in the car, I suppose!).

Suddenly, we are in the middle of the day I have been hoping to avoid. The ominous "SICK DAY."

There is more to know about diabetes than any other subject I can imagine. Every time I open the binder I started at Children's or the care book that has become my bible, I stumble upon a "rule" I had totally forgotten even existed. BUT, not for a minute have I forgotten all the warnings we were given about "sick day management." Of course, the rules are extensive, so instead of sitting in the bathroom with my child who might toss more than cookies, I find myself simultaneously rubbing his back on the couch (while he holds his head over a pan) and frantically trying to discern the most complex insulin dosing chart I have ever seen in my life.

The first part is easy, I already know it without a cheat sheet. NO DINNER, NO FAST ACTING INSULIN. Decision 1 - Check.

But that only gets us until 7:30. Bedtime. Time for his Long Acting Insulin. Now my mind is racing. Does he skip it? Can he have it without food? Should I be putting a call in to the endo on call? Is that my child sleeping with his head in a pan? - Better figure it out fast.

I call Tom to come home and continue reading frantically. (Surely "frantically" is not the method to use for optimal comprehension, but its all I've got, so I stick with it.) OK. He can't skip the insulin, for threat of DKA. He can't have the insulin without food. I have already tested him three times in the past hour, but I test him again to determine his dose. 121. He needs 30% less insulin than his regular dose. Math. Possibly my least favorite part of diabetes care. If only someone would have told me, I would have at least tried to do my algebra homework.

I can do this...I am smart...I can figure simple math! Let's see. 2.5 times .6 is... Where is that calculator again? Well...2/3rds of 3 is 2, so 2/3rds of 2.5 must be a little less than 2. Isn't that scientific. Luckily Tom comes home in time to draw the dose. Decision 2 - Check.

So now we have a TOTALLY comatose child, who needs insulin (sleeps right through it) and Gatorade (won't wake up for it). After 20 minutes of prodding, the Gatorade is gone, his BG is 96 (too low for bed, but the insulin was reduced so I'll let him sleep for a while), and he is in bed. PHEW. Oh yeah, and Gwen - the forgotten one. Sometimes I see the point of all her "you love Thomas more than me sulking." I suppose I'll tuck her in, too.

9:00. Back to work on my Literature Review. I had promised myself to only spend until 3PM on it, but somehow it has taken over the whole day, and is clearly going to consume the night, too.

12:30. After FINALLY finishing my "Literature Review" and submitting it by the midnight deadline, I head to bed, testing kit in hand. 160. Not that high for TJ. More Gatorade. This time it goes down a little easier. Decision 3 - Check.

I set my alarm for 2:30.

3:30. One hour of pressing snooze later, I decide to make Tom check his BG. I am expecting high. Even with full loads of insulin and carefully calculated meals we often find ourselves giving correction doses in the middle of the night. But not tonight. 66. Tom comes back with more Gatorade. I start to protest (not sure it is 'fast acting' enough) but decide that I should be less of a control freak. Decision 4 - Check.

3:45. Tom is back to sleep - snoring. I read a short story and then I go back to test Thomas. Tom thinks I am being overly worried. 60. 'Well There - you were totally wrong with the Gatorade', I think. Of course my worry is now overtaking my ability to gloat. Usually Gatorade sends him sky high. Why is he still dropping???

4:00. Downstairs for raisins. Plus he needs a "carb/protien snack" if his next meal is an hour or more away (another "rule" I forgot - I had to get out the binder.) He eats the raisins. Half asleep he is totally cuddly and adorable. Decision 5 - Check.

4:20. I have given up on sleep. I read another story, go back to test again. 104. PHEW. I wake him up again to have a drinkable yogurt. He actually thanks me. "Thank you mama. I love you mama. Can I go back to bed now?" I tuck him in for the 5th time, rub his back. "See you in the morning" he mutters. Even in the middle of the night, wide awake, drips of yogurt on my shirt, I am the luckiest mother in the world.

Decision 6 - Check.

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