a hard night

One of the frustrations with diabetes is how rapidly Nick’s needs can change. He’s currently in what the doctors call “the honeymoon phase,” which means his pancreas is still producing some insulin, giving the impression he’s “better” — but it’s only temporary, they’ve warned. Regardless, adjustments have had to be made. And after last night, we’re cutting back again.

It was terrifying.

I gave Nick a 1 unit insulin “correction” for a bedtime blood sugar of 281 at 9:11 p.m. Given the regimen changes after having low blood sugar counts at school, we weren’t completely confident in the amount. Would it still be too much? Too little? He worried. I promised him I’d do a test before I went to bed, as the insulin was peaking.

When I checked him at 11:24 p.m., he was extremely low — 34. My heart skipped when I saw the number. I tried to wake him, but he stayed incoherent and barely conscious. I squeezed cake gel into his mouth, wondering if I should be reaching for the emergency Glucagon instead, and tried to keep him as awake as possible. I wanted to hold him, but lacking an easy place to sit down, I stood on a stool next to his loft bed, stroking his hair and murmuring reassurances I wasn’t sure I felt. At 11:35, I rechecked his blood sugar. I knew it was too soon (you’re supposed to wait 15 minutes), but I was so scared. Down to 31. I kept thinking about the Glucagon.

Glucagon is an insulin-stopping hormone. The pharmaceutical version comes in a red plastic box like a pencil case, within which is a syringe, a bottle of liquid, a bottle with a tablet. You have to suck the liquid into the syringe, inject it into the bottle with the tablet, shake that bottle till all is mixed, then draw that back into the syringe, then inject it into the person’s leg or butt. It’s the way to save a diabetic’s life when things go bad. I was afraid of using it if Nick didn’t need it and afraid of not using it if he did.

Very long minutes passed. Nick cried and tossed in pain. At 11:42 p.m., his sugar level was only up to 55 (target goal after a “low” is 100). I gave him 4 ounces of orange juice and feigned calm. He didn’t want me to touch him. I couldn’t keep from trying to rub his back, his legs, anything to maintain some sort of contact.

At 11:59 p.m., he was still only at 78. This had never happened before, these lingering lows. I gave him his choice of more juice or four Starbursts — he chose the candy, through tears — and called the doctor. She sounded worried, but confident that since he was improving, although slowly, he would be OK. She encouraged me to keep on it and follow with a healthier, non-fast-acting-sugar snack once he hit 100.

At 12:14 a.m., I poked his thumb, already spotted with blood, once again. Finally he’d reached 100. After 50 minutes of standing on the stool at bedside, I left him long enough to make him some toast with butter and a spot of jam. He felt better, ready to go back to sleep. I grabbed an extra blanket and curled up on his floor, unable to stop thinking about what would’ve happened if I hadn’t checked him, if he’d crashed without being able to call for help, just left alone in the dark as his body failed him.

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3 thoughts on “a hard night”

  1. Terrifying Jennifer.Are these tests always accurate? Are lows brought on by anything in particular so that you can try to predict them? Did he have enough to eat that day, or does that matter?A friend of mine in high school was diabetic and his arms were covered with the needle scars. He was an excellent athlete, one of our star volleyball players. He collapsed during a game without warning. Came out of it fine and wanted to start playing again, but the coach gave him the day off which was probably smart.How did you discover that Nick was diabetic? How old is he?Someday I’ll have to tell you about my son’s heart murmur. Turns out it’s probably nothing, but my nerves still gnaw at me whenever he’s active and breathing hard.

  2. The tests should always be accurate unless something is wrong with the machine. Lows can be brought on for a number of reasons: not enough food in general, not enough food to compensate for exercise, too much insulin. In this case, Nick’s insulin needs appear to have suddenly lessened (which is common in new patients — the doctors call it the “honeymoon phase”), hence the lows. Understanding doesn’t always make it easier. We found out he was diabetic mid-September. He’d been sick with what I thought was some sort of run-of-the-mill virus. After a few weeks of vague symptoms, none of which were even severe enough to keep him home from school, he had a weekend of throwing up. What had been relatively mild became obviously more serious, although I still figured flu or something similar. I took him to Urgent Care at General. They diagnosed him within five minutes, sent him to the ER at St. Joe’s, and then we were flown down to UCSF, where Nick was kept for a week. He turned 11 last Sunday.We’ve had tons of support and have plans to connect with other diabetic folks, but still – it’s huge. Being helpless in the face of your kid’s pain is the worst. Since I can’t fix this, I’m trying to at least make everything else work.And right now, that means breakfast burritos! Off to the kitchen with me…(And thanks for your concern, Eric. Anytime you want to compare parenting freak-out moments, I’m up for it. I used to do a parenting show on KMUD and thought I’d been through a lot then — that was nothing! Somehow I’d expected it would get easier…)

  3. I’m so sorry. It’s still fresh then.I’m just glad you took him in when you did. And I’m glad they figured it out so quickly.11’s a young age to have to take on something like this, but I’m sure you and he will manage it just fine in the long run.I must have missed all of your parenting shows. I’m sorry I did.

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