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Reyna over at Beta Buddies started the Naked Pancreas Challenge and I wanted to weigh in. I haven't blogged in weeks so I figured this was a quick, easy one to do!
1. What kind of insulin management mode do you use?
Taylar has been using the OmniPod since May 10th of this year...the day after her 8th birthday. Some present, huh?
2. How often do you inject/change pump sites?
We change the pod every 2-3 days. Usually we go a full 3.
3. What type (s) of insulin do you use?
Novolog
4. What are your basal settings?
It took forever to figure them out and there is still tweaking that goes on, but for the moment she's at:
12am - 5am - .45 u/hr
5am-10am - .40
10am - 8pm - .35
8pm - 10pm - .65
10pm - 12am - .60
It has taken quite a while and a lot of sleepless nights to get her overnight rates to where they should be. She was constantly in the 200s at midnight check but this has taken care of it....for now.
5. What are your correction factors ?
During the day 1:80
At night 1:140 - This was changed a little while ago from 1:90 because after the corrected highs at midnight, she was dropping too low at 3am check. The 1:140 is working better. Ah, the joys of it all, huh?
6. What are your meal ratios ?
She starts and ends the day with the same ratios...
12am - 11:30am - 1:15 Breakfast & morning snack
11:30am - 1:30pm - 1:30 Lunch
1:30 - 4:00pm - 1:25 After school snack (if she has one)
4pm - 12am - 1:15 Dinner and bedtime snack
7. What do you do for activity and/or PE?
This past summer was the biggest challenge with just starting on the OmniPod and all that summer swimming! Taylar could basically eat what she wanted on the days we were at the lake and in the water constantly. Then at night she would always drop low when I checked her at 11pm or 12am though. After 2 nights of that we did a -15% temp basal for 5 hours overnight and it worked perfectly. The "lag effect" is definitely something we deal with a lot. A couple of preset temp basals we have are:
Bike rides: -30% for duration of the ride
Dance: -20% for one hour
Soccer Practice: -25% for one hour
Soccer Games: - 20% for one hour
Swimming (and bounce house/maze craze type places): -50% for duration
Taylar has PE at 9am this year so she usually tests after it. Where it is so early in the day and so close to eating breakfast we haven't had any problems with lows which is a good thing. Plus, her morning snack time is at 10:45, about one hour after PE ends.
8. How do you manage Pizza, Macaroni and Cheese, or any other "difficult to manage" foods?
Pizza, pizza, oh how we love thee. Taylar loves pizza. Who doesn't? I remember reading about pizza when she was first diagnosed and wondering what they heck the big deal was. Well, I sure found out first hand. Now that I get it, we use the extended bolus feature on her pump. Bolus 35g carbs (depending) per slice giving her 50% now and extending 50% over 4 hours. We just did this the other day when she had pizza at a party for lunch and she was 90 before bed! Yipee! If we have pizza for dinner, however, I add a unit to the calculated bolus from the pump and then continue with the 50/50 extended.
Pizza is the worst, but we also extend on ice cream. Usually 50/50 over 2 hours takes care of it.
9. How do you prefer to manage your logs/data?
Well, I have an on again, off again, relationship with Taylar's "frog log". I'm sure you know what I mean right? I have about 4 of them from the hospital and I do prefer to do it the old fashioned way and just write things down. We also download her pump to the computer and can look at it that way as well.
And that's Taylar's naked pancreas!
I've pretty much had it with diabetes this week. Last week we were battling high numbers that were driving me crazy! As if trying to figure out a reason for the numbers wasn't bad enough, I have to deal with the thoughts of what it does to Taylar's body. She did get a flu shot which her nurse said could bump her numbers for a couple of days but it went on for a little longer than I was comfortable with so I called the nurse... again. We changed some basal rates around and adjusted her daytime correction factor. Bam! It worked all right. Too much in fact. Low, low, low. Instead of seeing 250 & 300 now we've got a 56, 65, and a wonderful 42. What the heck!? That's not to mention two of her morning numbers being 70 and finding a 65 at 2am which scares the you-know-what out of me. Thank goodness I pulled myself out of bed that night.
Sometimes it seems like we just can't win. I don't understand how we can go on doing the same things every day but get different results. She eats basically the same things, at the same times of day, exercises at the same times of day yet with different results every time. It's enough to drive a person crazy. We changed some basal rates back to what they were before this latest change so we'll see what happens tomorrow.
Diabetes is SO constant and knowing that it isn't going anywhere, anytime soon can be very overwhelming. I would love to just forget about it all for a while. I'd love to forget about carb counting for a day. I would love to let Taylar's little fingers heal from all those finger pricks too. With all those lows we had to recheck recently, I looked at her PDM. In a 24 hour period I counted 14 blood sugar tests. That's just wrong, poor thing. I would love to just ask her how her day at school was when she gets off the bus without looking at her to see if she looks pale to me or wondering what her blood sugar is knowing she hasn't tested or eaten since lunch time. I'd like to just leave the house without asking my famous question, "Do you have the PDM?" It really is all consuming. I think about diabetes when I'm with her, when I'm not, when I'm in bed, in my car, out with friends, at the gym... all the time. I didn't invite this intruder into my daughter's life and here I am catering to its demands. It is just a constant battle.
So here I sit on the couch at 3:45 am while the rest of the house is asleep. Why? Because diabetes is keeping me up. It has been two weeks since Taylar started using the OmniPod (is that all?) and things have definitely been interesting. Overall her numbers during the day have been pretty good. Actually, no, they've been great. There have been occasional lows which I don't like and am not really used to though. We've handled them he best we could and I'm convinced the change in weather has a lot to do with it.
The first week was a bit overwhelming learning all there is to know about the pump but by now we pretty much have it down. (Except for extended bolusing which I'm very anxious to use especially for when we eat pizza. But I won't get into that now because "Taylar vs Pizza" could be a blog all it's own!) Of course the biggest benefit is not drawing up syringes or dialing up insulin pens. I hardly use the sharps container anymore which has been a good thing.
So part of this whole thing has been checking Taylar overnight at 12am and 3am. Oh yes, that has been a blast, let me tell you. I've tried handling it in different ways. Staying up until 12 to test, trying to sleep before getting up at midnight, attempting a nap during the day. Honestly, it doesn't matter how I do it because in the end it leaves me T I R E D! And, like tonight, sometimes it leaves me A W A K E! Just can't win sometimes I guess.
Before dinner last night we changed her pod site to her back. She never put it there before so I was a little nervous that it might hurt. But like usual, Taylar took a few deep breaths and moved on.
For these two weeks we have been adjusting the basal rate set for 8pm - 12am to bring down her midnight highs. And we're talking 272, 365, 488, and 255 just to name a few numbers from this week. Lovely, huh? It started out at .3 basal rate. Up to .35, up to .40. It doesn't really matter what we changed it to, she's still high at that time. Talk about frustration! Yesterday I called our nurse educator (yet again) and left a message saying I assume I should up it to .45. She called me back laughing saying, "Hey, you don't need me anymore." (Yeah right!) So tonight .45 it is. That sounded like a lot, it should do the trick. Right after changing the pod I made the basal rate change for the night. Blood sugar check was 120 before bed. Her target! Ooh, happy Momma!
So bedtime....I went through the whole bedtime routine and Taylar started complaining that the site hurts. Mind you we just changed it 3 1/2 hours prior. She tried laying in different positions but she really seemed uncomfortable. After about 30 minutes of trying to convince her that it was fine (because yah, I would know how it feels right? Not!) we changed the site. This was a first. It was a new pod and it was now 8:30 (She's usually asleep by 8pm) and Taylar needs her beauty sleep. (I'll just leave out the part that I had planned on grabbing my iPod and going for a nice long walk by myself after she was in bed. Note to self: Never plan something for yourself because chances are it probably won't actually happen.) Let the frustration kick in here. Ugh! The site looked fine but obviously it didn't feel very good, poor kid. We did what we had to do and by 9pm she was back in bed and sound asleep. I pouted as I folded laundry and then had some ice cream with praline sprinkles. (Hmm, probably not the best decision but my emotional eating could be yet another blog all on its own!)
Midnight check at the new, increased again, basal rate was... 273. Waahhhh!?! I gave a correction and rechecked at 3am...201. What the?
So THAT is why I'm sitting here in front of the computer while everyone else is sleeping. The diabetes monster is having its way with me and won't get out of my head. I'll call our nurse educator in the morning to see what in the world we should do again. ::sigh::
Oh my goodness, it's 4:30am and I hear birds chirping outside! Maybe I should try and go back to sleep now. My hubby leaves for work in an hour and my youngest, Carissa will be up about an hour after that though. Maybe I should just stay up.........Actually, maybe I should grab the iPod afterall and take that walk. But sshhhh, don't tell anyone!
