High/Low for Week of…??? Hello? Anyone home?

I’ve been slacking again.  It’s been a busy couple of weeks around here.  Angelina started pumping on July 17 and things went off (mostly) without a hitch.  Actually, pump training went better than I expected and pretty much consisted of a short demonstration of how to fill her pump reservoir and get the pump all set up and ready to connect to her body.  I got my very own site, applied by Ms. Angelina herself.  I volunteered to be the guinea pig, in truth it was so that when I told her “It won’t hurt you” I wouldn’t be totally lying through my teeth and she’d never trust me again.  Truth is though, it didn’t really hurt.  It did, however, make my arm feel very warm for a good 15 minutes after and reminded me of the sensation I felt when I got my ears pierced.  Which, if you think about it, is pretty much the same thing.

The pump trainer took care of setting all the settings as the dr had prescribed them so all I had to do was calm Angelina down and discuss where we were going to put her site.  I voted for her upper tushie since she has more fatty tissue there and I figured it would hurt less.  However, she surprised us all by picking her belly.  And by surprised I mean REALLY surprised, since when she was on shots I’d only been able to talk her into doing a belly injection less than a handful of times.  While I was doing the schmoozing, David was busy filling the reservoir with insulin.  I wiped her chosen site down with skin prep and he popped the mio on and Voila! 20 seconds later she was officially connected to her pump!  I already posted this photo last week, but here it is again for good measure.  We were all a little in awe of the fact that “that was it?”  Really I was thinking “We waited all this time for this?  I could have done this at home by myself.”

2013-07-17 14.35.24

And really, that was it.  We were at the office for maybe an hour and a half.  Most of it was just talking (not even really training, but just making sure we had watched all the videos and asking if we had any questions, etc.) and discussing what kind of barrier wipes we should use since she has eczema.  How to apply the nifty infusion set IV300 tapes.  A brief demonstration of the sure-T infusion sets that our friend was starting out with.  We chose the mio sets since they are the canulla type that don’t require a separate insertion device (that is the one thing our insurance doesn’t pay for).  I didn’t think Angelina would be willing to try a set that the needle stayed in her with, so the mio won.  Sure- T is one of the needle types, which are good if you have teflon allergy or if you end up with a lot of kinked cannulas.  Anyway, I got the mio put in my arm as part of the demonstration but our friend’s daughter decided she just wanted to do the sure-t set on her brand new Lenny the Lion, who comes complete with areas to do infusion sets!

We left shortly after and headed home.  She did complain about the site burning right after we put it in but by the time we were halfway home she said she couldn’t even feel it anymore.  She did start complaining about the IV3000 later when she was chilling on the sofa, so we ended up taking it off.  She was afraid to go to bed with her pump on and asked if she could suspend it for the night.  Which prompted a very serious discussion about how the pump needed to stay on because otherwise she wouldn’t be getting insulin.  I explained it kind of like the pump is now her lantus.  Before she would get a shot of lantus and it would last all day until the next shot, but now she’s not getting lantus and only getting small amounts of humalog instead through her pump.  She was really confused and says “I’m not getting lantus anymore?”   I guess she thought the lantus would be in the pump too.  We put a tegaderm bandage over the site before she went to bed and she opted to clip her pump onto some PJ bottoms.  Everything was fine and in place in the morning and she hasn’t worried much about sleeping with her pump since.

However, on Friday I told her she absolutely needed to bathe because, well, I didn’t remember the last time I made her take a shower was it had been that long.  Was it Monday?  Maybe?  I just knew it hadn’t been since she got her pump hooked up so it had been too long.  She was terrified her site was going to come out in the shower though, so I decided to do a site change and let her hop in the shower after taking out her current site.  I told her she had to be hooked back up within an hour though.  She showered in the record time of 30 minutes, I was amazed.  When she got out I popped her new site in, hooked her up, ate dinner, and she was doing great.

I had noticed she was running a little on the high side since we hooked up to the pump, but we had been told to expect that since they usually liked to set her basal rates a little lower to avoid low blood sugar episodes.  We had just been doing correction boluses as needed (which was pretty much anytime we checked her blood sugar).  We decided to make chocolate covered bananas from a recipe that I saw posted on another D-Mama’s blog: Raising Colorado.  So we ran out to the store for chocolate chips and bananas at 10pm.  Angelina helped by melting the chocolate and kept asking if she could lick the spoon.  Then she says “Mom, I’m shaking.  I think I might be low.”  So we stopped our deliciousness making and checked BG: 60.  So she slurped down a quick juice and was up to 114 just in time to indulge in some seriously sinful desserts.

When I checked her at 2am her bg was a lovely 165.  Of course, in the middle of the night she moved herself out to couch and when I checked on her in the morning she was all wrapped up in her tubing and her site looked like it had pulled out, but her BG was hanging out in the high 100’s until later that afternoon so I figured she was fine.  She was responding to boluses so we just left it alone.  Sunday morning however, she went from 208 at 7:30, to 227 at 11:30, to 335 at 2:30, even after correction at the earlier checks and it wasn’t food related since the 335 was right before lunch.  So we decided to pull the site since we were on the way to spend the evening at Six Flags.  Of course, we were already on our way there when that happened because she had refused to change the site at home before we left just in case the site was fine.  We got her hooked up, bolused for lunch and went.  At 4:30 she was still hanging around 330, which meant that the site was working, at least, but she wasn’t coming down.  She was 316 at 6pm and we decided to head home.  She was really cranky and it was hot and very busy at the park.  WE have season passes and live only an hour away so it wasn’t a huge loss.  We went on one ride in the two hours we were there.

She did start coming down and was in the mid 200’s by the time we got home and 195 at bedtime a few hours later.  Then her numbers just kind of bounced around in the 200’s and 300’s for the next couple of days, even after a slight basal increase on Monday.  The correction boluses that we were doing just didn’t seem to bring her down much, just slightly prevented her from going up higher.  Tuesday she had a couple excursions into the mid 400’s.  Throughout all of this she was constantly complaining of being hungry and she was just very cranky and difficult to deal with.  Thankfully no ketones, so I knew she was getting at least SOME insulin, just very obviously not ENOUGH insulin.

Wednesday she was mostly in the mid 200’s again.  We did site change, again with no issues.  That was the first site that actually made it to 3 days.  There was no rash or irritation, although I did hurt her a little taking it out because it was REALLY stuck and I accidentally pulled the canulla out sideways when I was trying to lift the adhesive with a unisolve wipe so I didn’t rip her skin off.

We saw her endo yesterday (Thursday, July 25th) and explained that she had just been running way too high so she cranked her basal rates up and adjusted her sensitivity (correction factor) as well.  She was actually back in the 100’s last night and overnight, and I was really happy.  Then she managed to spike a 406 this afternoon, but I think the culprit was a sugary nescafe latte mix that she just had to have a couple hours before.  We did a correction and she was down to 250 within an hour and 95 an hour after that (and some play time at the park).   I guess we’ll have to wait and see if we get nice numbers again tonight.  Her 3 overnight checks last night were her first in-range numbers since that 114 last Friday night, that was actually a recovery from a low.

Oh, and there was this:

Ang Pump BG's

One of the things that was the most frustrating is I just felt like we were on our own.  I had gotten the impression that we were supposed to contact our pump trainer for adjustments but every time I reached out it seemed like she didn’t return my calls, or if she did she didn’t really DO anything.  It didn’t even occur to me to email the endo, and I knew she was only in the office where we see her on Thursdays.  Since Angelina started pumping on a Wednesday and that Thursday was okay and the following Thursday was her appointment I didn’t see the point of calling the office.  I think I learned my lesson though.  But I also learned that the dr gave the pump trainer the okay to make adjustments because she joined us at Angelina’s appointment.  Things are so far, so good though.  Fingers crossed.

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