It's 2am. The alarm that startles me awake says so, and unfortunately I need to listen.
I take a minute to lay there and squeeze my eyes shut tightly hoping for a moment that this will require very little time (or 'waking') on my part, then suck in a deep breath and swing my legs over the bed. I make my way into Sierras room and she sits up immediately, and in a very unhappy voice lets me know that she's wet through her diaper over the bed.
Cut scene here to one of my not so proud parenting moments. I got frustrated, threw a mini-whine tantrum because I'm pretty sick, really tired, and so not prepared to strip a bed with it's 40 stuffed animals and books hiding under covers. To strip my daughter, her diaper, wipe her down, find clean jammies (which was a task, because being sick removes what little desire I normally have to actually complete a laundry cycle), and re-make the bed - THEN test her.
After trying to reel it in, because my complaining about how I'm sick, and really tired, and so disappointed really isn't going to accomplish anything (and I was rightfully berated by my husband for losing it this morning, I'm the grown up and she couldn't help wetting through her diaper after chugging water before going to bed), finish the task at hand, finally get her tucked back in - and bring out the gear for a poke.
Poke... wait... reading: 321.
Really? REALLY? I sadly explain to her that she's high, so now on top of it all, we need to do a shot. She was remarkably fine with it, and said we had to do arm. I agreed.
Was it the delayed reaction from the mac n' cheese she had for dinner? She was only 72 at bed time so we had to give her a little bit of milk and a couple of animal crackers. It just doesn't seem likely that this pushed her over the proverbial edge. She takes her shot with plenty of grace, cozies down into her now clean and dry bed, and asks for her usual back rub and kiss on the cheek.
I'm by now wide awake (of course), stewing at the number and the whole event in general - disappointed in myself, in needing to give her a shot, in really the whole 2am experience.
I'm by no means perfect. I am not supermom, and when I'm sick I can pull a tantrum with the best of them. I'm not very proud of my reaction last night, but I'm human and I'll move on. Sierra has, I can too. Now it's just a matter of trying to resolve what the heck happened and how to try and face it off ahead of time in the future. That's the real struggle. That's what kept me up until nearly 4:30am before finally getting my brain to shut off long enough to get back to sleep.
I worry about her sleep, and the lack of rest I know she's also dealing with. It's not just myself, or my husband suffering from less sleep because of this disease. While she may be able to fall right back to sleep and not deal with the extra wakefulness that usually follows me, she's still tired. Some days I see it in her more than others, and it bothers me tremendously. Our endocrine (whom I actually adore, I wish the staff wasn't so overrun so they could be more helpful on a day by day deal when needed - but he and another of our team are really wonderful doctors) is urging us to try to find a way to get to a point where we don't need to check her at 2am EVERY single night. His concern isn't just for us, it's actually for her. And he understands why we do it, and he understands that sometimes she's high or a little low and we catch it - but he also understands at her age what lack of sleep and proper REM cycles can do to her over time. Not just diabetic-wise, but just as a little person.
How do I balance where to take a night off and check at 11 instead of 2? How often? When will I ever REALLY be ok with that? When will we come to place where I feel that her sleep is just as important as catching a possible high or a little low? Or a big low?
These are hard questions for any diabetic parent. Part of me strongly believes that sleep is just as important as catching these things, because generally we are careful enough to avoid the dangerous lows. But then there are those nights we find her at 300. Or 60. We can never give up the 2am check completely, but when can we dwindle it to maybe 4-5 nights a week? 3 nights a week with a bed-time check when WE go to bed instead?
I don't know. I really hope we can get there, because I think we honestly could all use the rest at this point, and I know it will effect us all either way we do it.
In October of 2011, our 3 year old daughter Sierra was diagnosed with Type 1 Diabetes and spent three nights at the local PICU. These are our stories, experiences, and our life as a family of four moving forward.
To explain the high - a lot of times what happens with fatty foods like pizza and mac & cheese - you give an appropriate dose, but since the high fat food takes longer to digest, the insulin hits it before the fat has digested...so you end up with a low. THEN, later once the fat starts digesting, there is no insulin left and you end up with a high (plus the bedtime snack for the low earlier). That's likely what happened. But, then again, you never know with diabetes! When you have a pump, you'll be able to better combat high fat meals by extending boluses - when we give Adam pizza, we will plug in the total amount of carbs, but only have the pump give him like 60 or 70% up front, then the rest will be delivered later to combat the fat digesting later. Sometimes it works well....sometimes it doesn't. :)
ReplyDeleteI will tell you that when Adam is having a string of good numbers, we don't check at 2am all the time. I'm sure some will be appalled to hear that, but it's true. If he hasn't had a high fat food for dinner, and I know his basals are correct and his 8pm and 11pm checks are similar....I don't check him at 2am. Plus, we have the extra comfort of the Dexcom to alert us to any impending lows.
Thank you for the really helpful post Steph! That completely makes sense and definitely increases my desire to get the pump program in motion. One more week until class then all bets are off, I'm going to push push push. It's such a bummer that it's hard to head off with MDI... I mean I guess we could wait to give her a dinner shot until after she's finished eating to extend the life by about 45 minutes (she takes that long most of the time) but I don't know if that would even help. I think eventually we'll have a similar approach to the 2am thing... not just for us but her. And hey - thank you for keeping up on my blog, I really love to know there are moms following and willing to listen and share stories and advice!
DeleteAbsolutely! I'm glad I could help. :) Sometimes I feel like I don't know that much about diabetes....but then when I write it out, I realize, "hey....I kinda DO know what I'm doing...at least some of the time, LOL!" The pump doesn't make everything "perfect" by any means, but it certainly does help. I'll be crossing my fingers for you guys that you can get "hooked up" soon!
DeleteI agree with Stephanie about the high. Emerson doesn't eat mac & cheese (I know...not a normal kid, right), but if she eats pasta, pizza or rice we have to extend her bolus because they cause her to go high later than other foods. I think you will love this feature of the pump.
ReplyDeleteI feel your pain on the middle of the night checks. When on MDI, we checked every night at 2 a.m., but once we switched to the pump, our diabetes team suggested that we check two times per night. We often struggle with night time BG, so we have been checking her two times per night (since June) and sometimes more often with highs and lows. We are hoping that one of these days we can get back to one nightly check and get approved for a CGM. All of us D-Mommas (and dads too) need a little sleep!
Ahh yes, can't wait to pump for that extended bolus!! That does sound at least helpful. I've heard whole wheat pastas can sometimes help a little bit - have you tried whole grain pizza crust? I wonder if there's anything to the rumors ;)
DeleteOof - twice a night? I'm so sorry! That makes my 2am feel wimpy. You're a huge trooper for sticking with that so long... does Emerson just have really fluctuating #s? For a while we really had Sierra's night time numbers under great control, but it's definitely shifting lately.
I haven't tried the whole wheat pasta, but I should. Even with the pump, Emerson still has fluctuating numbers. We have better control, but she typically runs high overnight.
DeleteYou're definitely not a wimp...I don't think any D-Momma can be considered a wimp...we all fight hard for our children. Keep up the great work.
Hi, my 4 year old was diagnosed last June so we are pretty new at this as well. The only thing that has helped us all get more rest is when we started her on a cgm (Dexcom). We set it up on her nightstand, right next to a baby monitor, and (as long as it has been reading her pretty accurately lately) sleep much more soundly- knowing that it will alert to any problems. Now, it doesn’t make for a full nights sleep, unfortunately. I still wake up naturally around 2 (I think it just gets engrained in you!) and always go in and at least peak at the cgm. Believe me, it’s much easier to fall back asleep when you see a nice, safe number with a steady arrow looking back at you. I only do a finger prick when it is a number or arrow that I am uncomfortable with. On the nights that I’m totally exhausted, I nudge my husband and have him check and report the number- or we just bring her into bed with us and keep an eye on the receiver that way. The exhaustion is still there, just not quite as profound… In the early days, there was no going back to sleep after the adrenalin surge of seeing a low number pop up on the meter and having no idea how long she’s been that way or how long it will take for her to come back up. The cgm has been a saving grace for all of us in that sense.
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