If I’m lucky, Madeline’s insulin program works effectively for about eight days, nine days tops. About three weeks ago, her BG was in the stratosphere, day in, day out. 356. Correction. 325. Correction. 298. Correction. 313. Correction, infusion set change. 246. Correction. Overnight, it was a horror show, starring Bleary-Eyed-Mommy, Who Tries to Make a Reasonable Decision About How to Dose Insulin on Sleep Gained in 1.5 Hour Increments.
It went on and on. Correction. Correction. Correction. I studied the data incessantly, seeking a pattern, trying to understand the numbers. I made tweaks to the insulin program. Sweeping changes, even, at times.
Finally, a break came. A streak of several days of reasonable BG readings were had. Several nights of reasonably good sleep (read: up testing only twice in the night) were enjoyed. We even had what I call a One Hit Wonder: one day—occurring as frequently as pigs fly—during which all of Madeline’s BG readings were within the target range.
Do not get the impression here that I somehow discovered “what was wrong.” That I somehow figured out “the reason why her numbers were so high.” This is decidedly not the case. No. Instead, it was all the product of guesswork.
We artificial pancreas-types become exceptionally skilled at guessing. Oh sure, there are variables that are considered when trying to figure out what is going on and what to do about it. What kind of carbs did she eat? How much fat did her meal contain? How much activity has she put forth? Is hell freezing over? Was she stressed out when the dog ran off for a two-hour joy-run in the woods? How much water has she had? Is she growing? Is she getting sick? Am I going crazy? But make no mistake: as much as I try to analyze the variables, the bottom line is that my decisions about how to intervene are nothing more than guesses.
And the luck of my recent guesses has worn off, for here we are, in the trenches again. 236. 193. 381. 377. 399. 374. 205. 155. 190. 302. Back to the drawing board.