Movin' along.

We're continuing on here in D-land at a jagged, but somewhat steady, pace as usual. I think the difference of late is that I feel more adept and accustomed to changing things based on completely random elements like whether it's raining, if she had a few lows the night before, or if someone randomly sneezed in China. That sort of thing. I'm getting better at 'on the fly' ratio adapting. For those unfamiliar - I mean insulin to carb ratios (how much insulin she gets per grams of carbs). This has been a helpful adaptation, I think, because I feel a little less stressed about the unknown in regard to food situations and the like.

April has been a very surprisingly busy month both professionally and here at home with the kids, so I apologize for the lack of updates lately. I can't say that there have been any major telling swings here in our world, but I did put the paperwork through to get an Animas Ping pump lined up for our little diabetic hopefully upon our return from Maui the first week of May! This is exciting, I feel like we finally are moving forward with something we've painstakingly gone back and forth over for a good 3-4 months (rightfully, but still, it's tough to make that kind of decision). Ultimately I know that pump therapy is going to be another big crazy shift for us - and that it's the right move to make for Sierra and our family as a whole. I know there is a world of benefit that's going to come with this new curve ball, but at least I'm the one that threw it (more or less) by pulling the trigger and getting it all in motion. It feels good to have a 'plan' - thus far I feel like I've been in reaction mode. Ok, so technically you're ALWAYS in reaction mode where diabetes is concerned, I just mean in response to how we're dealing with it. Going to a pump is an educated guess WE made - and it feels good. It feels right.

We've also decided to contact the local Dexcom rep. We're going to start the process to hopefully get a 'CGM' (continuous glucose monitor). I could probably spend an hour trying to thoroughly explain what that is, and it may be interesting to .01% of you in that kind of detail, but suffice to say it's essentially another tool to give you an idea at a glance of a diabetics current blood sugar level. Sadly, these aren't 100% accurate and are typically running from what I understand anywhere from 10-20 minutes behind their current levels, do have false alarms, and need to be frequently calibrated (and doesn't replace the need to finger prick as often as we do already for the most accurate information) but those reasons aren't why we decided to go for it anyway. Trends. It shows you *trends*. Is she probably going up? Or is she coming down? Staying even stephens? GREAT! This information on trends is so important to us, especially considering how often we run into hypoglycemia (low blood sugar) in the middle of the night for random unexplained reasons all too frequently in my mind.

I can't say I've been super happy with Sierra's numbers lately, but we HAVE (typically on a larger scale) had fewer bad lows. We've also had more highs, but apparently we need to avoid the lows more at this point. An interesting thing about Sierra is watching her numbers on her school days. Maybe those of you with young diabetics can tell me if this sort of thing ever happens to you guys:

For a while, we noticed Sierra had MUCH higher numbers (despite the same or slightly MORE aggressive insulin amounts on school days - administered by the teacher after my training). We thought food might be the culprit so for the last few weeks I've been feeding her breakfast, sending her with lunch (with dosing info/carbs listed on the food etc). Her mornings have been better/normal - but now every single school day after lunch/nap - she wakes up pretty high. Like 350-450 high. What's interesting is that her insulin dose is almost to the point of being *doubled* for lunch on school days vs home days - yet she's still coming out high.

Then, inevitably at dinner she needs additional insulin (called a correction - insulin added to the measured for carbs insulin) to help bring her back into range - and then she ends up low all night. It's difficult because she does need some sort of correction, and her correction scale is very very scaled back - very low dose already, so I'm not sure what's up with the all night lows.

Last night I decided to go for it and stay up until midnight working, do Sierra's night check, then ahhh blissfully fall into slumber for an entire 6.5 hours STRAIGHT. That's right. UNINTERRUPTED 6.5 hours of sleep. Heavenly, right? I was foaming at the mouth at the idea, so I stayed awake and forced myself to work. She went to bed at a perfectly respectable range of something like 150-200, I can't remember the exact number and I'm not looking at that excel spreadsheet again today thank you very much. Anyway, I go in at 12:30, soooo ready for sleep and proud of myself for making it so long despite being a sleep deprived zombie mom, give her a poke - and am alarmed to read a glaring and somewhat scary 39 staring back at me. I fill her with a box of juice, a 4g glucose tablet (which usually in itself brings her up 40-50 points on her blood sugar reading - quickly) and two low sugar special fruictose sweetened cookies made for diabetics. Anyway, probably somewhere around 24g of carbs - which is no small amount for Sierra, but I wasn't risking anything less if I planned on sleeping at all that night.

I waited, she was up to 120 and finishing her cookies 20 minutes later so I felt that it was safe to let her go back to sleep and finally crawl into bed myself. Sadly, the dream I had about that whole 6 hours straight stuff was clearly smashed to smithereens. No, I set my alarm instead for 4am (it was 1am at this point). When I got up at 1am, stumbled pathetically into her room and ran another finger poke test, I was pleased to see a shiny happy 178. I felt she was safe to go until 7:30/8am when it was time to get up.

When I did get her up for breakfast around 8ish, she was 59.

*sigh*.

Her numbers have been fantastic today, last night was way over my head, as is this whole randomly high-post-school-lunch (no she doesn't swipe other kids foods, and she goes into circle time then straight down for a nap one lunch is over... whaat??) It's pretty much a giant mystery and a pretty frustrating one. Do I keep increasing her lunch time school day insulin? Or is that causing her to go low all night (unlikely but it's an interesting trend none the less)?

I hate these kind of diabetes mysteries. Its the same food she has here, more insulin, and theoretically she's MORE active at school (which typically LOWERS blood sugar)... so.... what the hell?

My brain hurts just thinking about it.

Sorry for the novel like entry, it's been a frustrating trend I can't seem to break.

Tonight I'm staying up again until probably midnight. Wish me luck, I sincerely hope to find her in a better range.

From the mouth of babes...

A little tidbit from Sierra... apparently Eggs make her low ;)

Sorry for the quality.... My Canon 5DmkII + youtube/blog sizing isn't very complimentary :) You can check the genuine video in HD from this link if you want :)

http://www.youtube.com/watch?v=BA8pNtoMCew&feature=youtu.be