In the past two days, the Diabetes Shit-Storm has been relentless.
It started at lunchtime on Wednesday, when I (kinda-temporarily) forgot to give Madeline insulin to cover her lunch on Wednesday. Oh-yes-I-did. No excuses, and only one explanation: I’m a moron. Later that evening, a misery-inducing flu virus hit the two of us head-on. This, being our first foray into sick-day-land since diagnosis, triggered a trip to the ER. Both of us, sick and bedraggled, pushed through the night without sleep while Madeline received IV glucose and fluids, and anti-nausea meds. In the absence of more vomiting and ketones, we were sent home around 6:30 am on Thursday morning.
How I was able to drive the 70-minute trip home, sick and exhausted as I was, I will never know. We stumbled into the house and fell into bed around 8. I set my alarm for an hour later to check Maddy’s glucose level; by some miracle, I woke to the alarm, checked her level, and gave her the morning dose of long-acting insulin.
I woke again around 11:30 am with a nagging feeling that something was not right. I checked Maddy’s glucose: 122. She got up to pee, and I checked her ketones. Problem revealed: ketones were moderate. My foggy mind began to panic at the very likely prospect that we would be returning to the hospital, this time for an admission. I called the endo team, and received instructions for intense monitoring and treatment in an effort to clear the ketones. Don’t let her sleep. Give carbs every hour, somehow. Give water, somehow. Check BG. Give insulin. If we can’t clear the ketones by 4, she’s going to be admitted.
So, over the course of the day yesterday, I had to keep her awake so that I could carry out the treatment protocol. We were successful at clearing the ketones within 3 hours, and Madeline began to sit upright and even play, so—again in my state of near-delirium without sleep and feeling utterly miserable—I stupidly thought we were clearing the woods. The kids and I went to bed early. Maddy’s glucose level was 122 at bedtime and I set my iPhone alarm for 11 pm to check her.
The Night of Relentless Lows began to unfold with that first glucose check at 11 pm. She pulled a 60. I gave her juice. An hour later: 64. Now I started to worry: How can she possibly be a 64? I gave her another juice and checked her again in 15 minutes. 110. I set my alarm for an hour and tried to sleep. Up again, testing again; this time, a 60. It made no sense to me, but I stopped trying to figure it out and began to panic about how to get her level up with something other than juice. I decided that I needed to give her something to eat, not drink. I searched the house for something that would give a carb boost but also digest a little more slowly, giving her body something to “chew on” for a little while. Like, a tablespoon of something. What was that something? This was a problem: we don’t keep junk sugar sources in our house (another post for another day).
I settled on peanut butter crackers, which Maddy ate while crying because her belly hurt and she did not want to eat!anything!Mommy! I waited 30 minutes, then tested her blood again: 151. I finally breathed, left her to sleep, and set my alarm for 2 hours. I didn’t sleep, of course, trying to figure out what this all meant. She’d never been persistently low like this at night. We’ve treated lows at night, yes, but they’ve been isolated events and juice has always done the trick. I mulled, albeit lacking much sense and reason, for the next two hours. When I tested Maddy again, she was up to 188. Somehow, I thought this was a good thing, and promptly fell asleep under the influence of false relief and exhaustion.
Never mind the fact that I completely didn’t get it that duh! she has diabetes! Duh! She needs insulin for her body to convert those lovely carbs to fuel! Duh! Give her insulin, dummy! Three hours later, I woke up with a start: I saw that Maddy was still breathing (always the first thing I check). I tested her: 226. Bits of intelligence began to filter into my consciousness, as I realized that I needed to give her some insulin to correct the high and have her consume some carbs.
Safe to say that I am stunned at the complexity of taking care of diabetes in the midst of a virus. And stupefied at how much harder it’s made when the Human Pancreas (that’s me) is reduced to moron-level reasoning ability due to limited sleep and illness. And overwhelmed by the challenge of facing all of these first-time experiences, without any been-there-done-that experience to draw upon. I think we’ve banked quite a bit of learning this week.