Saturday, January 15, 2011

Report Card Time

And I don't mean the school ones for the boys.  It was time for Mom's D report card (and why is it only Mom's???  That's another post!).  Every 3 months, I tell Pat that Cale's A1C will be higher than the last time.  And every time, he says, you always say that and if it is, it is only by .1 or .2%.


Back in October, Cale's A1C was 6.9%.  I was pleased with that number.  (Can you guess where I am going???)  So after the weigh in (79.8 pounds) and height measurements (4' 11-3/4"...HE'S 9 YEARS OLD!!!!) and some questions for Cale from our lovely nurse, Molly, the time I dread comes......7.7%.  :(

Now I know that this isn't terribly horrible.  But I don't like it!!  I knew that there were the 3 weeks that included Christmas Break and the first week back to school where Cale's BG's S.U.C.K.E.D. no matter what was done.  Ok, holiday's and your regular daily schedule are whacked.  Both the nurse and our doctor said that is typical.  But then the first week back to school was not pretty either.  He wasn't sick, he never got sick (Ryan did, maybe it was sympathy illness....sympathy for the brother that annoys and hurts you...I don't think so!) and he started right back into our regular routine without the blink of an eye!  No clue....

THEN, the second week back to school, there were lows, lows and more lows!!!  However, there were still the occasional "why are you so high?" moments.  Although, and here comes a bad Mom moment on my part, the nurse called one afternoon,  she rattled off his BG's for the day...2 hours after breakfast he was 61, then at lunch he was 309 and 2 hours after lunch he was 274.  WTF!!!  Since he still had insulin working and the day was ending within 45 minutes, I said give him water and I will test and see how he is as soon as he gets home.  So, he gets home and shows me the little slip of paper that has his BG's and treatments (this is something new we are doing.  Normally, since I am at the school A LOT, I just stop in and review the BG's in her log).  His 61 was treated (and not rechecked after 15 minutes!) with a juice box, his normal snack (which is upwards of 25 grams because he has PE in the morning) AND a popcicle that someone had brought in as a birthday snack!!!  First of all, a popcicle???  It is freaking January in Northern Illinos!!!  It is also 9:15 in the morning!!!  It is also NOT SUGAR FREE!!!!  So let's add up all of these carbs shall we....15 for the juice box, approx. 25 for the snack and (let's use an average) 15 for a popcicle = 55 grams of carbohydrates!!!! CAN YOU SAY OVER TREATMENT!!!!!  No freaking wonder he was 309 before lunch!!  THEN, I look at the insulin he was given for his correction scale and was 1 whole unit less than what it should have been.  Total miscalculation on the sliding scale AND I come to find out when I question it the next day....are you ready for this....she never uses the half unit!! At lunch, his ratio is 1:15.  So if there is no correction needed and his lunch was 67 grams, he was only being given 4 units of insulin, not 4-1/2.  Now a half unit may not sound like a lot....BUT IT IS!!!  Why wasn't I looking at her records more carefully?  How did I not catch this sooner?? Why did she tell him he could have that much at snack time that day??? Why wasn't he rechecked for that low????

Needless to say, I am now double checking everything that has been done during the day, everyday, very carefully and making extra sure that it is being done correctly.

Back to the appointment.  I talk to the doctor and we start tweaking his ratios and decided that at his next appointment, if the A1C isn't lower, we will do a trial CGM for about a week to see his trends (YEAH!). I was so glad that his appointment was coming so soon.  I couldn't think anymore of what to do.  I would look at his log and the numbers would just start melting together.  I was very concerned, because no matter I did, during the night it was either, needs a correction OR I was feeding/giving juice at every check-nothing in between!  It was sad that, lately, I would be relieved at the midnight check that his BG was 225.  I knew that it would come down by the time he woke up to a great number.  But, he shouldn't have to be this high to make it through the night!!  If he was 150 at midnight, I would have popped 1 glucose tab in his mouth and crossed my fingers.  It was weird!!  I was at a loss!!!  So, last night, we did the change of ratios and what not and sent him off to bed.  11:30 check...174.  Ok, let's see how 2:45 is....144...and then 7:00 (when he would normally be waking up, except on weekends, my 9 year old turns into a teenager and will sleep FOREVER if we let him)...109!  I am pleased.  I wouldn't mind a little lower at 11:30 which in turn will lower the others somewhat...but I am thrilled with these compared to those of late.  Let's hope the same happens tonight.   Now that I have said this, come back tomorrow for my "WHY DID I JINX MYSELF?" post!!!!  And, keep in mind that tonight it is girl's night out and the last time I had one of those, a fight ensued between Mom and Dad over D care/carelessness.  But, we won't get into that one now, will we??  Again, that's a whole other post!

(What is the deal with the background color for the text...I CANNOT make it go away!!!)

1 comment:

:) Tracie said...

Wow...sorry to hear Cale's A1C was quite the jump, I know how meticulous you are with his care. Things should be a bit wonky right now....hormones. Jes is going through a hormone thing.....HAS to be it, otherwise her numbers are pretty good. Those occasional highs are what tilt the scale an raise that A1C. (of course we were at an 8.7 up from 8.2.....those 7's don't exist for us...phooey)

BIG fubar on the nurse's part about not giving half units of insulin. What's that about?!

Hopefully Pat will step up to the plate and help out a little more..........yea, that'll happen, he and James are made of the same mold in that aspect! The good thing in that is that they completely trust our care for diabetes, but it does wear and tear on us and a little help would mean the world!

Have a great time out tonight! Blow off some steam!