Our First Week Pumping

Well, our first full week pumping has been kind of a mixed bag. The pump itself has been all good, and I can tell you that the past several days would have been much more challenging without the pump.

Thursday night, T-Bear was pretty high at bedtime (335) and I didn’t know why. That can mean a pump problem, and when I checked the cannula there seemed to be a tiny bit of blood around the insertion site. Okay, I figured, looks like maybe the Pod got knocked while the kids were horsing around on the trampoline, and maybe the cannula isn’t sitting quite right. So, I corrected and retested about an hour later, and he was fine (116) so I knew he was getting insulin. Just for the heck of it, I checked again at about 4:00 am, and he was high again (241). Whaaa? No food, and his BG goes up in his sleep? Could be a pump problem, but maybe not. I correct and retest in an hour. Down a bit (217). Correct and recheck in two hours, and he’s up again (253). At 8:00 am we change out the Pod, and two hours later he’s still a little bit high, but by lunch he’s fine. And, BooBoo Bear is sick. So, either the Pod was knocked and T-Bear wasn’t getting the full insulin dose I was programming, or he was getting sick, which always pushes his BG up.

Turns out he was getting sick. The kids all got sick with a respiratory virus that’s been holding on like a dickens since Friday. I, in my infinite wisdom, waited until Sunday, Mother’s Day, to get sick. And Papa Bear was working that day. Joy. At least the kids were feeling better and occupying themselves by then, so I could spend most of the day in bed. Reading. Heehee.

So, how has the OmniPod made our sick days better? Viruses usually mean higher BG for T-Bear. Before the pump, that meant either more frequent injections, or leaving him high for longer periods, depending on how miserable he was at the time (really, who wants to be stabbed in the butt when you’ve got burning sinuses and hacking cough?). With the pump, we can give him more frequent corrections, keeping his BG from getting out of hand, with no additional discomfort

Also, the correction doses are more precise (as little as .05 U at a time, rather than .5 U eyeballed in a syringe) so we’re not having the lows following corrections that we were having with injections (low + fever = bad juju).

Oh, and the BG reminder is pretty cool. As part of the testing and dosing procedure, the PDM will ask me whether or not I want to schedule a BG reminder, and how far out I want the reminder to remind me (usually 2 to 2.5 hours, depending on whether or not he’s eating). No more fiddling with reseting the timer on my watch. And, unlike my watch, the PDM will keep on reminding me every five minutes until I shut it off. No more missed reminders because I slept through the two alarms, or watching a loud movie, or in my house with three wild monkeys making all kinds of noise. You get the picture.

But, really, I just can’t overemphasize the importance of the convenience factor, especially when Mama Bear gets sick. With injections, we had the Diabetes Counter in the kitchen with everything we needed to test, calculate, log and dose. It pretty much had to be done in the kitchen, or I’d be running up and down stairs for all the little gizmos I’d forgotten. So, if I had to test T-Bear in the middle of the night, it was downstairs to get the test kit and log sheet, upstairs to test him, oh shit he’s high need to do a correction. Back downstairs to get write down the BG because I forgot to bring a pen the first time, get the calculator to figure out the correction dose, write it down, draw the dose. Oh shit I just dropped another vial and shattered it on the tile floor, so get another vial from the fridge, which is going to be COLD going in, and cause more discomfort than necessary. Draw the dose, back upstairs to inject. Back downstairs because I forgot the alcohol wipe, and back upstairs. Oh shit, forgot the blasted rocket, so back downstairs for the rocket, back upstairs to deliver the dose to a grumpy kid. Can I go back to bed now before I pass out? Oh, but I’ve got to get up and check him again in two hours in case I gave a slight overdose and he’s going low…

Now, everything I need to test and dose in the middle of the night I can hold in one hand, AND, I don’t have to do any math (what a blessing that is when you’re sick and exhausted). T-Bear’s SPIBelt holds the lancet, alcohol wipes, test strips and back-up meter (plus emergency glucose tablets...yummy). The PDM sits in the palm of my hand, and I bring it with me back to bed so I can hear the alarm, so I don’t have to either depend on T-Bear waking to the alarm or set a 2nd alarm for myself. Five minutes, start to finish, and I can go back to bed. I almost don’t even mind getting up again in two hours to do it again. Almost.

So, now that we’re all just about back on our collective feet, I expect the next couple of weeks to be much smoother. It will definitely be easier to spot trends and patterns without the added complication of virus-spiked highs, so we'll know whether or not his programming needs to be adjusted. My Mommy Sense says it's all programmed just fine and it's going to be smooth sailing for a bit. Wouldn't that be nice?
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Our First 48 Hours

It’s been about 48 hours since T-Bear started pumping, and it’s going really, really well. Our first night, there were no real problems overnight (we were checking BG every two hours). We did a couple of ½ corrections early on, and a glass of milk around 4:00 am to bring him up a little. By the time T-Bear and I finished our breakfast burritos in bed, I was ready for a nap. We hung out at home, laid low most of the day, and did frequent BG checks. Had dinner with neighbors to celebrate Cindo de Mayo, during which T-Bear mostly grazed and I stacked insulin to keep up…a little too easy with the pump, I have to admit.

We only checked every four hours last night, and he stayed pretty much on target. I faxed numbers to the Endo and chatted with one of the CDE’s; no changes to his settings at this point. Another quiet day at home, and T-Bear handled his own BG check and bolus for lunch (with me looking over his shoulder). Wasn’t THAT a cool moment?!?

We’ve got friends coming to hang out this afternoon, and Papa Bear returns home tonight. Tomorrow will be our first "pumped outing” – a birthday party at a mini-golf place. With PDM in hand and Pod on butt, it’s gonna be a comparative breeze…

More Detail

Now that T-Bear has decided he wants an insulin pump, our record-keeping has been taken up a notch. I’m on the Endocrinologist’s list for Pump Information Night and Pump Orientation, and I’ve got some homework to do in preparation.

First, I’m keeping a more detailed log of T-Bear’s BS and insulin. Instead of just writing down what his BS is and how much Humalog (fast acting) he’s getting with each meal, I’m recording the time, BS, how many carbs he is eating, how much Humalog he’s getting to cover his meal, and how much to adjust for a high or low BS. This detailed record keeping will become critical when T-Bear gets set up with a pump, since the data will be used to program the pump and refine its dosing over a period of time. Also, the insurance company will want to see two months of logs before they consider approving the pump, to be sure we are serious about managing T-Bear’s T1, and are capable of doing so.

Second, I’m writing down all of my carb counting. Every meal, every snack, every day for a week. Since I usually cook two meals a day (that’s cook, not warm up in the microwave), I’m basically writing down each recipe as I make it (I often make it up as I go along) with each ingredient’s carb count, total up all the ingredients, and then decide what portion of the pot T-Bear is eating. A little more work up front, but I’m finding it can actually be handy to have that stuff written down. I can go back and look it up later when I make the dish again, or when we’re having left-overs. Til now, I’ve been kind of eye-balling portions, but I may take it up a notch and start weighing the pot versus how much T-Bear serves himself, so I have a more accurate count. Regardless, I’ll have my homework done by the time I get to class. I'm still a Teacher's Pet after all these years...

Snow Day!

I stepped out onto the front porch in my slippers and listened to the sound of snow. Not snow falling (which is an amazingly peaceful sound), because there was no snow falling. Not the crunch of stepping onto snow that’s been sitting out all night ice-ing (although I did hear that). Just the sound of Snow “being”. In the magnolia tree. On the lawn. On the lawn ornaments. Quietly chatting with itself while it moved through the transformation that sunrise and the day will bring to it. Quietly preparing to melt, just a wee bit, when the sun kisses it. I suspect Snow will linger today and through the night, since the temperature is predicted to remain very low…in the 20’s, and dropping into the 10’s tonight. I can’t wait to chat with the Last Remains of Snow again tomorrow morning.

So, I called a homeschool “snow day”. No chores, and no studies. Woohoo! Everyone was stoked, including Mama Bear, because I actually got to spend a little time blogging and posting photos. Just hung out, played Wii, watched Mythbusters, hit the Y, and took Brother Bear to his Orthodontic appointment (more on that later).

But, there was a downside. T-Bear had an appointment scheduled with our pediatric endocrinologist today, but the office called and said they were cancelling all appointments for the day…we’d have to call back on Monday to reschedule. Most kids would be thrilled to hear their doctor's appointment had been cancelled, but T-Bear had decided earlier this week that he was going to ask Dr. A to approve an insulin pump today. He’s really excited and impatient to get an OmniPod – even wearing his taped-on dummy Pod for the last three days – so he was genuinely disappointed when I told him his appointment was cancelled. Drat. Hopefully we’ll get in to see Dr. A next week….

So, here are the pix, starting with “before the kids are up”…

Stepping out onto the front porch.

The front walk...revisited.

Bird...revisited...with detail.

Magnolia in the Morning.

Magnolia, too.

Magnolia, tree.

Anxious chicken, in the morning.

Umbrella, dusted.

Umbrella...detail.

What do you see?

Art?

First one out!

My little Snow Elf.

Yes, I made the scarf....can't you tell?

Hunting for snow.

Found it!

Snow Angel #1.

Did I call HIM an angel?!?

Snow Angel #2.

Yep, I guess I did....

Brother Bear's gloves.

An icicle...sort of.