Ladies and Gentlemen, it's time again to gather round to watch the ever entertaining...
Most Surprising Moment: Grace grew an inch in three months!
May explain some of her wacky numbers. Growth hormones interfere with insulin absorption. And we finally have proof that our peanut of a girl actually grows!
Most Anticipated Announcement: She's out of her honeymoon!
Grace is now using about the average amount of insulin per day that a 9 year old of her size uses. She's out of her honeymoon, so her pancreas has finally crapped out.
Most Laughable Moment: Grace's A1c is 6.6!
Thus proving that a number is just a number. She's had so many highs, and this number just shows that she's had a lot of lows that we haven't caught. An A1c is basically an average of her blood sugar numbers for 3 months. With all the highs we've seen, they must be balanced out with a ton of lows to have such a low A1c. So even though it's a low number, it doesn't mean squat. (Well, it actually means that we've done a piss-poor job catching lows.)
Biggest Stab in the Dark: Our Pump Adjustments!
Where, exactly, do you start when every single number, at every hour of the day, is out of whack? 10am one day she's 89, the next day at 10am she 396. Multiply that by the entire summer, and you see the conundrum that my CDE was in. We're starting slow - lower her daytime basal to get rid of those unsightly lows, and raise her Insulin Sensitivity Factor so when we do correct a high it's more effective. (In the past, when we correct a high she doesn't come down right away. She needs more insulin to bring her down.) Next week I'll email her Grace's numbers and we'll make more adjustments. To be followed the NEXT week by school starting, which brings us back to square one.
Best New Technology: The Insulin Pen!
Yes, ladies and gentlemen, we are insulin pen virgins. Never had one, never been offered one, never knew how to use one. Now, we left the endo with a prescription for 5 pens - one being designated for school. Seems kinda cool. Love me some new gadgets.
Most Exciting Prospect on the Horizon: The Masked CGM Program!
Joslin has a program where Grace can wear a Continuous Glucose Monitor for 3 days. We don't see the numbers, and treat her as we normally would. After the three days, we send the monitor back to Joslin, where the data is extrapolated. From that we can see if how we're treating her is effective, and where areas may be which we can alter our plan. Such as, should we bolus her right before dinner or 20 minutes before? How long does insulin stay active in her body? How the hell do I bolus for french fries?
Best, by far, Moment of the Day: Meeting a Wicked Sweet Reader!
Yes, a real, live reader! Sitting in the play room at Joslin, a beautiful woman came up to me and asked me if I wrote a diabetes blog. "Excuse me?" was all I could think of to say. "Do you write a diabetes blog? Is that Grace?" This wonderful mom recognised my daughter from this very blog. Unfortunately, at that moment, Grace was called back for her blood work and vitals, after which I was immediately ushered in to meet with my CDE. When I came back to the playroom she was gone. So, to the lovely woman in the Joslin playroom... thank you for reading my blog! Please contact me so we can talk. I'd love to get to know you and possibly get together!
Thank you, one and all, for attending this year's Endo Awards! I hope you've had as much fun as we've had. See you again in three months!
The apache wars by paul hutton
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