Super Bolus, I Fear You No More
I just couldn't take it anymore. I'd count the carbs perfectly, pre-bolus at exactly the right time and still there are certain foods that require another bolus an hour later. On the surface you would think that I wasn't administering enough insulin but that couldn't be because every once and a while the bolus would work - but not usually.
Example: Movie theater
Arden is a nacho and popcorn lover at a movie, and we see our fair share of movies. Most times, I measure, count carbs and bolus only to watch her DexCom G4 point it's arrows to the sky before the second act is over. Then I spend the rest of the afternoon dropping random measurements of insulin on the number in an effort to get things back to a desired level without going too low. Sounds like a bad Price Is Right game, doesn't it?
Then it just hit me a few weeks ago, we have a CGM, why am I erring on the side of caution and chasing highs when I could be living on the edge of glory with Arden's DexCom G4. Suddenly, I felt stupid. All of this time I was playing scared when I know that's how you get hurt. Time to put my head down and run through a few wood be tacklers. (Sorry, my metaphors are all over the place today)
So I looked at that food on Arden's lap, counted carbs and then added every drop of extra insulin that I ended up given her at the last movie. My new thought, "What's the worst that could happen... she starts to get low, the DexCom catches it and we throw back a fast juice box and catch the fall".
That's exactly what happened
We watched Star Trek, Arden munched on her snacks and about an hour into the movie Arden's DexCom line had never wavered, her BG was 118 and steady. This was either going to be the perfect amount of insulin or too much. About fifteen minutes later, "Beep, Beep, Beep", 92 one arrow straight down. No big deal I thought - then I leaned over and said, "Here Arden, drink this juice". Twenty minutes later the CGM line was steady at 88, Arden was able to graze her remaining popcorn without worrying about bolusing and her BG never fluctuated, even hours after the movie had ended.
All of these fancy diabetes gadgets and I was using them to chase numbers instead of staving them off. I know that this sounds scary to many of you and I know that it takes time to find your comfort level, but please believe that on the day that you gain that level of comfort... this is all going to seem so much easier. Sadly, you can't rush that day to come, but it's so worth getting to and it makes me incredibly happy to know that you will all be there one day with me - kicking type I diabetes in it's annoying ass.
Arden's Hands are Growing
Yesterday morning I entered Arden's room about an hour before her alarm was scheduled to sound. Her DexCom G4 was asking to be calibrated and so I put a test strip into the OmniPod PDM, turned the MultiClix to a new lance and took my daughter's hand in mine.
As I was choosing a finger to strike a hole into, I noticed that her hand felt heavier then it did the last time that I held it to test. I was certain that it hadn't grown bigger since the day before, but yet it felt unmistakably heavier. I sat on her bedside as the machine did it's job and found myself feeling lucky that I have these moments with my sleeping girl. Not too many people get to do this I thought. I get to hold Arden's hand almost every evening after she has fallen to sleep and those moments give me a different perspective on her growth and allow me precious time to gaze at her growing face.
So if you are in need of a silver lining today, maybe this thought could be one for you. We get to hold our kid's hands while they sleep.
Health Canada Approves DexCom G4
DexCom announced yesterday at their May 1, 2013 Earnings Conference Call that...
"On the international front, we are pleased to report that we have received approval from Health Canada to begin marketing the G4 system in Canada. Our initial approval is for adults only. However, we expect to file supplements seeking pediatric approval later this quarter. Our distributor in Canada expects to commence a limited launch at the beginning of Q3 with the full launch commencing before the end of Q3"
Congratulations to my Canadian friends who have been patiently waiting to use DexCom's G4 system!
This Picture Makes Me Smile
Do you see Arden in the middle of the purple glowing smoke, the one wearing the hat. Arden danced the night away on Saturday during her first Bar Mitzvah without a care in the world. I just wanted to take a second to tell everyone how grateful my family is for the technology that makes moments like this better. Without Arden's DexCom G4 I would have interrupted her fun countless times during the evening. Each time taking her from the moment and drawing attention to her diabetes. Instead, we were able to monitor her post meal BGs from across the room and when she did require a bolus of insulin, I never took her OmniPod PDM out of my pocket.
Wireless. Tubleless. Goodness.
Knowing that Arden was safe, carefree and completely unencumbered by diabetes while she danced is a feeling that may be lost on other parents, but I think that every parent of a child with type I will look at his photo and smile along with me. As a father, I found this moment to be completely joyous - nothing beats seeing my kids live without limits.
Have a great week!
Scott
The Not So Great but VERY Powerful Bolus
Arden's CGM vibrated on my leg. Earlier during the previews I asked Arden to give me her G4 so that I could monitor her BGs while we watched 'Oz The Great and Powerful'. The vibrations that her CGM sent through me were too intense to ignore and moments later I was greeted rudely by the message on it's small glowing screen.
Arden's CGM indicated that her BG was 94 and the number's accompanying arrow was pointing straight down. You can see on the chart below that's not good news.
Prior to the movie we stopped for a light meal, Arden had a salad and one baked potato skin. I pre-bolsed for twenty carbs, ten minutes prior to the waiter arriving with our food, she ate as I expected. A little over an hour later we settled into our theater seats (about thirty minutes before the movie was scheduled to begin). Arden was holding a box of Bunch-a-Crunch, a small popcorn and she was talking about sharing a few gummy candies with her friend who was joining us. I pre-bolused for forty carbs at this time. We donned our 3-D glassed and the movie began.
95, one arrow straight down
A CGM reading of 95 doesn't phase me, and one arrow down doesn't really cause me to become alarmed anymore, "Just missed with the bolus", I thought. Then I looked at the time on the OmniPod PDM and became a bit more concerned. This was all happening only one hour into the movie, I had more than "just missed" - I significantly over estimated how much Arden was going to eat. I shook the candy box, reached into the popcorn bag and discovered that she really hadn't eaten any of the treats that we initially believed she would. I reached into the gummy candies, put five in her hand and whispered, "Eat these please, your CGM says 95, one arrow down - I think I gave you too much insulin".
Arden ate the candy quickly but three more alarms were already shaking my leg
Now her CGM was reporting a BG of 84 with one arrow down, seconds later it was 76 and then the arrows doubled. 76, two arrows down. Arden's BG was running away from me. I had already opened the juice box by the time the double arrows hit, Arden knocked it back like a shot as I tested to autenticate the numbers on her CGM. Her BG was 56 on the meter and the arrows were staring back at me as if they were awaiting an answer to the question, "What are you going to do Scott?".
I recounted the carbs in my head based on what I now knew she had eaten and then added the new carbs that she just wolfed down to that total. I was okay, I knew that the numbers matched. I told myself, "Just wait, don't over treat" but no sooner than I was able to talk myself into that response...
BEEP, BEEP, BEEP, BEEP - "LOW, two arrows down"
I could feel my adrenaline surge when the beeps angrily blared out. I started looking around to see which way out of the aisle was less blocked, thought about where the snack stands were located and considered sending our son Cole for a cup of regular Coke. Then I looked at Arden, she was sitting next to her friend who came along with us for the movie and I just didn't want her to have to rush around like the world was coming to an end in front of her pal. So I quietly slipped Arden a glucose tab (We never use glucose tabs), I asked her to chew it up quickly and swish the powder around in her mouth.
She did so dutifully, then leaned over to me and whispered in my ear, "am I going to be okay?"
Those words broke my heart and brought a tear to my eye but I answered without hesitation, "absolutely, Daddy has it all under control, go back to watching the movie", but I wasn't sure. The CGM still said "Low", though now it was reporting only one arrow down - so I tested again and this time Arden was 68. I could breath again, she was going to be fine.
I asked Arden how she felt and she responded, "A little dizzy but I'm okay". I told her that we caught the fall and that she should go back to watching the movie. Her friend never saw a thing, I did however miss the flying baboons... I heard they were fierce though, Arden told me later in the car. She knew because she never had to take her eyes off of the screen, mission accomplished.
The DexCom CGM is an indispensable tool in our day with type I diabetes. I genuinely never imagined that Arden wouldn't eat the amount of food that we bolused for. This was a complete anomaly, movie theater food always needs a strong bolus, this never happens - until it did. CGM technology is the best. Who knows how this all goes with out the Dex, maybe Arden would have gotten dizzy and told me that she didn't feel well, maybe the movie would have held her attention to the point that she didn't notice. I'm thankful that we didn't have to find out.
I gave her way too much insulin, that happens. The DexCom CGM makes that eventuality feel less scary.
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