RIDDLE: What works better when you don’t leave it in a bag?

I feel fine. Can we play Minecraft?

Bubs date w friend. Pizza dinner, then swim, then sleepover. In tent. In living room. Mid-swim: 83. 9PM 107. 11PM 104. Bigfoot, Bigfoot Spouse decide OK sleep, convinced more worried delayed pizza high than delayed swimming low. Not vigorous swimming. More just stand in water, shoot hoops. Also creepy if hover around children in tent. Sorry if sound defensive.

7AM. Mom! Can you make Peter and me some pancakes? (Sure. Did you test?) Rumble rumble down stairs. Rumble rumble back up. I’m 322! And I don’t have my pump on and it’s not in the tent!
Possible scenarios:
  • The tent sleepover was so exciting he sort of sleepwalked out of his pump and sleepwalk-placed it somewhere weird
  • The pump IS attached and this is one fucker of a delayed pizza high
  • The friend is not actually a friend but a follower of Abu Nazir, and needed the pump to make a bomb
  • B somehow wiggled out of the Spibelt and it’s at the bottom of his sleeping bag and he just didn’t search very thoroughly

Then realize: pump still in swim bag. Blood drain from head, gather in gut. Bigfoot not give back after swim. No insulin since 7:15PM. 12 hours. Amazing only 322? Consider for moment, maybe would be dangerously low if did wear pump overnight? Then exit Pollyanna town, test ketones.

LARGE.

Call endo answering service. “She will get back to you within the hour.” Meanwhile, BSpouse syringe 3u, water bottle. Bubs feel fine, Minecraft with friend. Endo call back within 5 minutes. Bigfoot explain no pump since about 7PM. Endo prescribe 3u more. Water. Warn, “He’s probably going to start to feel very sick.” Bigfoot ask OK eat normal breakfast? Answer: yes, and don’t worry about covering the carbs with more insulin.  Ask: even if pancakes? “We can deal with his blood sugar later–for now we just want to clear those ketones.” Bigfoot ask: So, no basketball at 10 o’clock? Answer

  • check with the blood ketone meter at 9:30 and call me back
  • Maybe they’ll be clear
  • I’m surprised that he doesn’t feel sick; that shows us that he hasn’t had them in his bloodstream for very long
  • Maybe he’ll be able to play

Check out the gleam of the un-weighed, liberally poured maple syrup remaining on the (also un-weighed) plate.

Okay. Make pancakes, ignore batter label Bigfoot make for self last night: 12g CHO per 5″ cake. Make all sizes, teeny tiny, big as face. Freedom. Any size pancake. Also not weigh syrup. Probably eat 60g CHO. 6u insulin inject for ketone can multi-task also handle carbs? Or insulin power used up on eradicate ketones? Would use >6u for 60g CHO, anyway. Because I:C ratio for breakfast lately 1:8. Really think need more insulin. This crazy.

Call endo back, rambling message high carb breakfast…would need even more than 6 units just to cover the carbs…feel weird not giving more insulin…

Call right back. Turn out insulin work ketone/carb same time (huzzah!) but wait more insulin because risk too fast drop, not want “bottom out.” Also turn out, even though endo hear Bigfoot say pancake breakfast, endo not believe Bubs really eat. Because assume will begin sick. That so nice endo explain why wrong dose. Say “I’ll make a note in his chart that he doesn’t necessarily feel nauseated with large ketones.” If trace or negative, can play basketball. If moderate/large: no. Even if he feels fine? Yeah, no, we don’t like kids running around with moderate to large ketones. Call in one hour w. blood ketone meter result, BG#.

Ho hum.

Meanwhile, Bubs begin feel sick. But sick in way ask for more food. Confuse nausea w hunger? Tell Bubs wait eat until after next endo call. Lie on floor w Lego. Ask: do you think you’ll want to go to basketball? Answer: No.

BIGFOOT: Well, if you’re sure we’re not going, then I’m going to start baking that cake

BUBS: What cake?

BIGFOOT: The applesauce bundt cake

BUBS: (Jumps up, smiling) Because of my ketones?

BIGFOOT: No, because we’re going to the _____  house for dinner and I said I would bring it

BUBS: They have a pellet gun! They let me shoot it at their metal chickens!

Not seem sick.

I can’t believe we go away with our biggest eff up to date. (That title previously held by Joe, for telling the Sunday school teacher to give B. hypo-earmarked Skittles at snack time.)

9:30AM 400. Ketones: LO. Call endo. Instruction: correct for high BG as usual, just keep careful eye on BG rest of day…ketones can make insulin resistant…etc. Endo end instructions with you guys did a great job. You know, with a pump, these things happen; it can get disconnected, and unfortunately that can happen, but you guys were great–you caught it before he got really sick. Consider tell endo: not random disconnect. It Bigfoot leave in swim bag. Decide not confess, because why put endo awkward position absolve parent guilt? That what blog for.

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27 responses to “RIDDLE: What works better when you don’t leave it in a bag?

  1. Ee-GADS!! Scary!! My own blood drained as I read. And amazing! 12 hrs only 322, not too sick – all amazing. So glad Bubs is OK! Pink had a site pull out at night a couple months back and had large ketones w/in 4 hours. She also feels sick at moderate ketones. I’ve wondered how long they could go w/out insulin (sick and morbid, I know). Everyone is so different. I hope you are OK too. We ALL eff up!

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    • I was thinking of the news reporter who died last week–they said it was a pump malfunction–I don’t think people can live for very long at all without insulin. I wonder too.

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  2. The second bullet point about the delayed pizza high made me laugh out loud. I f’d up the other day and didn’t dose her for gelato…2 servings worth. Her blood sugar was “HIGH” – it happens. All’s well that ends well. My endo doesn’t even worry about ketones unless they’re vomiting. I once called him with 2.2 blood ketones in the middle of the night and he told me if she wasn’t vomiting to give insulin and go back to sleep. Okey dokey then. I think they scare the crap out of us about ketones when the kids are first diagnosed.

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  3. julia

    I think you were right…. may have gone low if pump not disconnected. The swimming saved him I think. Because he should have been much higher than 322. I would guess a lot higher (our DD would be in the 300s within two hours of disconnection). This happens. And if it happens overnight when you are asleep and don’t catch it, you can have big problems. Some angel was watching over you and Bubs last night. Glad he’s okay. You’re human. A tired human more forgetful. Forgive yourself.

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  4. Eileen

    Ugh. Hate when I do stuff like that but being a pancreas is tough work. The other day I suspended pump to download, resumed, clipped it on his waist. Just didn’t reconnect. Realized at 2am check with an ugly #. Glad B is ok. Hey, at least you avoided those lows. :)

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  5. How terrifying. I’m so glad he’s ok. I never knew large ketones were that bad. I’d always get them bad when I had hyperemesis, but they always said it didn’t matter.

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    • I think ketones are only bad for diabetic people–I mean, I know nonD people on the Atkins Diet’s GOAL is to have ketones. You’re making me realize I have no idea why. It must be that insulin keeps the ketones from becoming toxic.

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      • Exactly. My parents LOVE the low carb thing, their goal is to go into ketosis NOT ketoacidosis (because they HAVE insulin their body can still process their fuel leaving them with ketones but not toxic levels)
        :) You got it girl!

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  6. Sounds like the beta cells are still doing some work! Does sound like you avoided a low, and we’ve had similar forehead-smacking moments. :)

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  7. Nicolep

    Absolved. Big time.

    Over 10 years, I have left my pump behind after 1) showering 2) working out 3) swimming 4) intimacy 5) blacksmithing.

    It happens. Usually it makes you more vigilant once it happens. Then it happens in a different setting later – and so on.

    Glad you did an amazing job handling, though I know it was scary.

    ox

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  8. Eeek, I was gasping out loud and made my boyfriend come in to read the post too! I used it to re-enforce that we ALL forget these things sometimes ( I am not on the pump and have a tendency to forget my long lasting dose of Lantus in the evening… even with an alarm set). Good recovery though! I can’t imagine what it would have been like to have been a childhood diabetic (I wasn’t diagnosed until I was 25), I was a SUPER active child. Great job!

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    • There are so many things to forget! I was thinking it would be safer to just go back to Lantus, not remembering: we might forget that too.

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      • It is certainly a battle. I have not used the pump purely because I don’t have health insurance so the initial cost plus the maintenance and supplies are just WAY out of my reach. That being said the longer I use syringes the more comfortable I am with it and the more I wonder if I would even WANT to switch…

        I guess these are just the things we have to deal with (boo), too many decisions and not enough information (or at least consistent information). All we can do is try!

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  9. Would you believe that I’ve forgotten to pump my pump back on myself after a shower? Or once I almost forgot it at the basketball court? These things happen. You guys did great.

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    • Do you notice it’s missing when you start to feel sick, or when you reach for your next bolus, or do you notice because you get a “something’s missing” feeling, as if you forgot to wear underpants. (I was going to say a bra, but didn’t think that would ring a bell.)

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      • Nicolep

        Scott and Katy – I’ll tell you a story about the boxing gym! Took the pump off to work out at noon on a Saturday, worked out hard, forgot to put pump in gym bag. Leave gym, sweaty like mad, still go to have something to eat because my sugar is a little on the lowish side and I tend to get an “exercise low tail.” Finish eating, head home, go to unplug for shower. DOH! No pump. Call the gym. They are CLOSED because it’s 2 pm on Saturday. Frantic. Then remember, gym is open 24 hours if you have a pass code. Sit stalker-like by the door until I see someone approaching to go in. Get in. Pump NOT where it WAS. Stalk behind the counter of the gym, rifle through several drawers. Then realize there is a big pink sign on top of the gym cubbies… It says “MEDICAL DEVICE??? Please call if you know who this belongs to!” Breath giant sigh of relief as I plug back in – almost five hours later. Wasted Saturday. Sort of… Man things do happen!

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  10. like others have said, these things happen. try not to be too hard on yourself. which i know is easier said than done. believe me, i know.

    i get mad enough at myself when i make mistakes regarding my diabetes care. i can’t even imagine having to be responsible for someone else’s diabetes. just thinking about that makes me start to hyperventilate.

    i stand in awe of you and all the D parents out there. you all are amazing!

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  11. that what blog for!

    when i read the 322 i knew there was no way it had been left off overnight because his BG should have been way way way way WAY HIGHER. but that’s what it was holy cow! amazing. glad everything went as smooth as it possibly could in such a sitch. lol @ joe’s number one diabetes mistake title!

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