In the back of my mind I think "not lunch time yet, not the nurse calling"
As the phone lights up I wait for the ring again to finally see the ID of the caller, St G_____ School.
SHIT!!
As I hold the phone up to my ear my mind starts listing off possible reasons for this call:
Possibility #1. Cara is sick at school and they want me to pick her up...I sent her to school with a little bit of a cough because she did not want to miss the Terry Fox walk.
Possibility #2. One of the other kids are sick or in trouble...Cody has a really yucky cough and it is only a matter of time until it runs through the entire house (hence why Cara has a cough). Although I have not yet received a phone call from the school because the kids have been in trouble you just never know!!
OR
Possibility #3. There is something up with Cara's blood sugar...
I answered the phone HELLO, with my figures crossed not to be possibility #3!! AND since I'm typing this on the blog you all know that it was...
Hello Cara's mom, I'm calling because Cara's blood level is at 2.8mmols (I hate when people use the wrong terminology...ya I know BITCH. It's just a pet peeve of mine) . She is having a juice now (15 grams).
SHIT (did not say that out loud) OK thanks, can you have someone re-check her bg in 15minutes to make sure it is on the way up?
Sure! the secretary answered, her nurse just walked in...
15minutes later....Phone rings and I know it is Cara's nurse I don't even have to look at the phone.
Cara is 2.6mmols now...HOLY CRAP...wrong way kid!! OK another juice (15grams) let her eat her lunch then call me back please and we will figure out how much insulin I want to give her for lunch.
First thought when I got off the phone...why in the hell does everyone sound so calm?? Do they understand what is going on? Are they trying to "save face" because they are talking to me? What is going through their heads when dealing with these lows? UGH the uncertainty!!
NOW this is where I have a question for all you wonderful people
The nurse called backed after she ate and Cara was 9.2mmols, she had 30 carbs from juice to correct her lows and has now has eaten her lunch, a sandwich (32 carbs) and chips (22 carbs).
I told the nurse to put in her low blood sugar of 2.6 in the pump and the amount of carbs only eaten for her lunch. I left the juices (30g), correction for the lows uncovered. The pump gave us 1.6 units and I shot it down to 1.4 units. I knew she was going to go outside for lunch recess and she is on her own until the nurses comes back to the school at pm snack.
What would you do?
How do you treat a low just before lunch or a meal?
I just hate giving insulin after a low...
I just hate Cara having a low at school without me there to watch her...
I just hate that her nurse is not there for the whole day...
I just hate that she has diabetes...
Update, after 1 hour Cara's blood sugar was 13 mmols. Not bad! 2 hours later (pm snack) she was 20.2mmols.
Oh and btw government of Ontario who believes that they are doing a fabulous job keeping our type 1's safe in school... that would make 7 phone calls in a span of 4 hours either from the school and/or the nurse all trying their best to keep Cara safe. I don't mind the phone calls, I like the phones calls knowing what is going on BUT that is more then a half of day at school when type 1 diabetes did not want to play by the "rules". And we are the "lucky ones" in Ontario that have nurses coming into the schools. Most schools and type 1's are on their own...You think something needs to change?? MAYBE!! YA, I think so!!
TRAINING, SUPPORT& POLICIES for all children with type 1 diabetes in Ontario school.
Here is a link to a wonderful page from the CDA on diabetes related question asked to 3 running parties in the up coming Ontario election. Have a look!
10 comments:
when my son has a low like that, i give the full amount of insulin that the pump suggests... it already deducts insulin for the low. and then we just check again in an hour or two. it's a tough call, but this is what works for us.
*GROAN* that's about all this post made me do. groan for the yuckiness rollercoaster that I know Cara must have experienced. Groan for the number of phone calls, Groan for the crappy politics. Groan.
TOTALLY feeling the same same on this one! I dread those calls, I dread the stubborn school lows, and I never guess right as to what to do. I honestly would have done exactly what you did and just corrected the low after school. The school board policies in Ontario for our d-kids are ridiculous!!
Those lows are scary! I hate when they call and say she is low, not that I like the high calls either...
Is she still wearing the CGM?
If Brianna is low, it usually takes a good 20 minutes before she starts going up. I too would have freaked out if I saw she was going down.
I guess this is what my thoughts would have been.. When she first called she was 50 right? then she was 48. If you figure the error for the meter, she did drop a little but was really holding steady. I would have given the full lunch does, making sure the pump does not subtract any insulin for the low, because I treated it and didn't want it taking more off.
Again can't remember if she is wearing the CGM all the time, but this is where I really reply on the CGM and Brianna to tell me how her numbers are going and what she is feeling.
In all honesty if I gave that many carbs to treat the low as soon as the numbers started going up I probably would have dosed for some of the juice.
Do you typically find that apple juice works to bring her up? I know for Brianna it doesn't really work quickly, it takes forever then I see the high later. We use glucose tabs that seem to work a little quicker but that is a personal preference and you know her best :)
With all that said, school and home are two different places. Home I feel like I can deal with anything diabetes hands me, where at school, I worry.
Either way you know her best, and you and the school have to feel good about your choices. I hate that we have to make these hard choices all the time.
Hope her numbers are better today.
I hate those phone calls! But I'd much rather get them and know what's going on. I guess I hate what they signify. Sigh...
We always treat the low, make sure he rises, then cover the carbs. His recess is about two minutes, so it doesn't affect him much.
thanks everyone for your comments. I think with the info you have all given me I may change up my game plan a little at school.
Kelly no Cara does not wear the CGM all the time we are waiting for Medtronic to have a "special" on CGM's since we need to pay out of pocket. Our D clinic allows us to use their CGMs when numbers are in question.
Oh and btw we do use the tabs because they do work the best with Cara but on this day I DID not have them packed...UGH!! And I did not want the nurse to walk all the way back to the classroom to get them. Kool-aid Jammers work fine for Cara usually too!!
thanks everyone!
Nicole I wish I had advice, we're not there yet, but I am thankful for the above comments knowing others have been there and have great experience to share. Take care - I hope today is smooth sailing!
I never give insulin for the carbs used to cover a low-it'll just drop them back down! I'd have taken off a .2 too. : ) You have to prevent a secondary low! Maybe she did some extra exercise or had lots of extra insulin on board? You never know.
Hope it goes better tonight and tomorrow. She can't be too sick, or she'd probably be high. ; ) Hugs, girl!
Ugh.
Lows at school always shake me to the core.
Seriously, people...I'm all for staying calm and all, but don't be so calm that you underestimate this beast!!!!!
I usually wait until she's over 100, then enter the lowest BG and total amount of carbs. Given the fact that she ate lunch on top of being treated, I would have probably done the same thing, except I would have included the fast acting carbs.
Sometimes I'll skim a little off for stuff like activity...I may have backed off the total suggested dose like you did, but it would depend on the type of activity. If it was a PE day, I would have for sure.
At any rate, YOU DID AWESOME! Live and learn!
You obviously guessed correctly. Each Mom will treat differently based on experience with their own child. Of course, we would never, ever bolus for carbs used to treat a low. If dropping or not coming up from a low, we reduce basals for two or three hours, in addition to treating the low. Yes, as you did, I would not bolus for the full lunch but give some free ExCarbs, particularly since recess is after lunch and she will get exercise. I will usually give 20 free grams just for the exercise following lunch. If worried, I would give even more. P.S. You need to impress upon the school staff the seriousness of these types of lows; don't know how you can get through to them, but I would try, once again.
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