Thursday, February 16, 2012

A Day in the life....

I thought it would be an interesting concept to share with you "A Day in the life... With type 1 diabetes"... I cannot speak from a first person view, because our T1D is Clifford. However I can speak from a parent's point of view to help others that might not be familiar with T1D understand what is involved in a day in the life of a child with type 1 diabetes... So let's start at wake up....

Wake-up: Blood sugar is tested (a tiny little needle is pierced into his lil fingertips, which btw are already so blistered over, blood is collected onto the strip)... Wait 5 seconds for the beep and to reveal the start of our day....

Food is measured, or weighed out to the exact serving size to count all carbohydrates, this includes all food and beverages if any with carbs such as milk for cereal. The total carbs are then divided into his Carb to Insulin ratio. A nice little ratio that tells you how many units of fast acting insulin (Humalog for Clifford) he will get to eat his breakfast. His breakfast ratio is 1:18, this means he gets 1 unit per 18 grams of carbs. As an example this morning 1 cup of captain crunch berries was 35 grams, 13 grams for a cup of milk, and 26 grams for some pudding he wanted to have. Total 74 grams of carbs this equaled out to 4.1 units. However you now have to take into account their blood sugar number. Today Clifford woke a bit high at 265. Now you have the added fun of doing more math in the morning by finding out how much he gets for correction. The correction simply means to help bring his blood sugar into the target area, his target is 100. You take 265-100 and divide by his sensitivity(how much 1 unit of insulin will bring his blood sugar down) Clifford's sensitivity is 120 with this you get 1.4. So you add this to the 4.1 and get a total of 5.5 units of insulin.

After all that math it's time to give him an injection so he can start to eat. Another nice needle (bigger than the lancet this time) jabbed into his skin to deliver life saving medicine (sounds dramatic, but it's the truth).

After all this in 2 to 3 short hours it's time to do it all over again for Lunch.
1.Check blood sugar (more blood)
2..Math time (count carbs(this is the weighing and measuring part), figure out insulin or correction if needed)
3. Injection time (another jab or poke however you want to look at it)

Fast forward 2 to 3 short hours later (granted he didn't feel dizzy, or hungry, or have a headache or tummy ache) all of those could be a sign he is either high or low and would need to test his blood sugar.
Snack time
1.Check blood sugar (again more blood, you get the picture here)
2. Math time (food weighed, measured, carbs counted, figuring out the insulin and correction if needed).
3.Another jab of the needle

2 to 3 hours later
1.Check blood sugar (again more blood,)
2. Math time (food weighed, measured, carbs counted, figuring out the insulin and correction if needed).
3.Another jab of the needle

2 to 3 hours later and it's bedtime. Bedtime is not a fun time for those with T1D.
Now our bedtime routine is slightly different then the previous times above
1.Check blood sugar (again more blood, you get the picture here)
2. Math time (food weighed, measured, carbs counted, figuring out the insulin and correction if needed).
3. Not 1 count them 2 injections (1 to cover carbs (fast acting) and 1 for his 24 hour basal insulin)

I'd love to stop and say our day ends here but that's not the case. For the most part every night at midnight, Clifford gets his blood sugar tested. Here is a few examples of what has gone on during previous midnight testings.

1.Tested blood sugar (LOW, 68)
2.Run downstairs to get a juice box, and pixie sticks just in case
3.If I'm lucky I can wake Clifford up enough he starts drinking the juice box, or there are the other times he will not wake up, that I have to open his mouth and start pouring pixie sticks in it. Sounds easy enough except the opening of his mouth, he fights me in his sleep, I have to basically hold him down, and pry open the side of his mouth, hold it open, hope he doesn't bite me and pour in the sugar.
4. Re test his blood sugar in 15-20 mins (If above target for night time 120) good, go back to sleep for 2-3 hours, if however he is still low, repeat all the above steps every 15 mins until he is back up to target.

Now here is an example of high
1.Test blood sugar (high 325)
2.Go back downstairs, get a syringe, alcohol wipes, prepare the insulin in the syringe, take it back upstairs
3. Turn Clifford over (bum shots for correction during the night work best, ) If I'm lucky he'll sleep through the injection. But then there are other nights he moves like a crazy man and I have to make sure I have a tight hold on him before injecting and try to hold him down with one arm, and legs while injecting (getting kind of difficult with him being 8 and 4ft tall , only 14 inches shorter than mom)...
4. Go back to sleep retest in an hour to make sure he is coming down good, but not too much.

2:30-3am (this is when Lantus (24 hour basal insulin) likes to peak, so it's best to check to make sure he didn't drop low. If all goes well he's in rang and I can go back to sleep till 5:30-7ish depending on when I decide to get up. However if we are low again, well we repeat that fun low process.

After all this it's back to wake up time and to start all over. This does not include those days when we get crazy lows out of no where because that is usually 3-5 more times testing blood sugar during the day.

Welcome to the life of T1D, blood, needles, sometimes tears, cranky behavior from highs, annoying behavior from lows, fear of overnight lows they won't wake up from, lack of sleep, caffeine fueled.

In all it's not that bad :) Clifford is alive and we do the best we can to keep it that way along with healthy to avoid any complications as he gets older, and in the process teach him along the way of how to care for his diabetes responsibly.

Now this is just the life with T1D and injections.... This will all change soon when we're on the pump, and I plan on writing in the life of T1D and pumping for you all to see.


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