My favorite saying is from an amazing mother of a child with diabetes who years ago told me that "living with diabetes is like driving a car from the backseat, steering with two rubber bands while careening down a winding road." That about describes it! Its just nuts. The ride will leave you in tears of frustration and a reading "in range" can produce a weird happy dance that is understood only by others traveling this road as well.
We deal with lows and picture young minds starving for glucose. We can fear seizures and brain damage. We experience highs and wonder if this one will be the one that starts to shut down those small blood vessels in the eyes or kidneys. We careen down this road wondering about the unknown and praying that our best efforts will be enough.
When I was first put on this Diabetes roller coaster, I quickly learned that there was only one way to maintain my sanity. I had to look at life in four hour blocks. That was a challenge. I was a person who planned for 10 years ahead and now I could only plan for four hours? I realized that if I wanted to stay somewhat sane then four hours it was.
Why four hours? That is the technical duration of our fast acting insulin. That was the time between the breakfast needle and lunch, the lunch needle and supper, and the supper needle and snack. Four hours was what counted. In four hours, I could generally see if the ratios for a meal were set okay. After four hours I could make a decision on basals but four hours was my report card. Did I pass or fail as a pancreas during that time frame?
Times have changed and we are no longer injecting every four hours. My son now uses an insulin pump and we bolus on an hourly basis it seems as he grazes through our kitchen. I still look at life in four hour bites. Its the only way I can handle things as yesterday clearly shows.
Summer is finally thinking about making an appearance here so we are seeing an increase in activity levels. There is now hockey outside and grass that is being mowed. Last night I reduced some basals. He was low in the evenings and when waking up. I knew that this would be the first of many summer adjustments.
Later that evening I heard someone stirring. I got up and found my son in the kitchen getting ready to make some Crystal Lite. My first thought was he had stayed up way past his bedtime to watch the hockey game. My second thought was he was high. I was right on the second one.
"How high are you?"
Grumble, mumble and no clear answer as he heads to his room. He hadn't tested. He just knew he was thirsty.
"If you are high, bring water to your room. Did you change that site that was over due? Do NOT bolus a correction on a dead site that was supposed to be changed DAYS ago! Change that site now! While you are at it, change the cartridge. It will be low by the time you fill the tubing. You need a correction with a syringe. Input the correction in the pump and see what it will suggest." My mind was way too tired to think about math at 1am.
After a bit more muttering, I found out that he was 30 (540). New site, new insulin, injection, bottle of water and he was good to go to bed. I dozed off for about an hour or so when I was woke up yet again. I could hear him in the washroom. I wasn't sure if he was getting sick or just using the facilities. I got up and waited. He just had to use the washroom so thankfully we had most likely dodged the ketone bullet but I began to think that he would be very tired the next morning! I had him retest, correct and by 3am, we were both happy to be heading off to la-la land.
In one day he had gone from the 2 and 3's mmol (36-60 mg/dl) up to 30 (540). His body had been through the Montezuma of roller coaster rides. My nerves had cruised along with him. The four hour blocks were--low when he woke, high when he forgot to bolus his breakfast, good after lunch, low after supper, good later in the evening, and a colossal high during the night. Whew!
I know this roller coaster isn't fun. I like to think about how far the care has come in the few past years and that puts me a little more at ease. Perhaps living in the now is a better option anyway....
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