On the bright side, combating hyperglycemia through insomnia

3:30 a.m. I spent about five minutes resisting the urge to get up and check Nick’s blood sugar, wishing I could just go back to sleep. He was probably fine, had gone to bed at 11 p.m. with a glucose result of 250 and a little active insulin. Then guilt pushed me out from under the covers. Of course I should check. Of course I would check. Clambered up the stairs, flicked on the light, hoped it wouldn’t wake his sister.

I sprung the lancet into his middle finger, lower than usual because the callouses on his oft-pricked fingers have lately made squeezing enough blood out difficult. I’m already sticking him with a needle. I don’t need to also spend five minutes pressing hard on the sides of his finger, incurring even more pain in trying to get enough blood to test his glucose level accurately. No problem this time – blood puddled out so quickly that I not only had enough to absorb onto the test strip, but I needed to use three of my own fingers to wipe away the excess.

379.

Good thing I checked. He was awake enough at this point to press the buttons on his pump, bolusing the correction. I’ll need to check again soon, make sure it’s come down. But why so high? Miscalculation of carbs? Did he forget to bolus? Teenager, hanging out with a friend, inhaling food as teenagers do. Air bubble in his pump? Hard to say. Even well-managed diabetes can inflict highs and lows upon a person. These days I worry more about how late to let him stay out, about other teenagers driving him and his friends around, about all the usual things the mother of a teenage boy would find racing through her mind in the middle of the night. Or the middle of the afternoon. We debate the appropriateness of certain behaviors often. I often find myself caught between nagging him into constructive action (“Do your chores!”/Check  your blood sugar!”/”Eat some salad!”) and trying to treat him like the grown-up he’ll be someday: “I got this, Mom,” he likes to respond, even when it’s clear to me, his mother, that all he has, in fact, is a smart-ass attitude.

I love him so much. I love all of them so much. Worry dizzies me. I tamp it down, but it rises easily, the cracks in my optimism frequent and wide. He’s had several results in the 200-400 range lately. But some lows, too. How concerned should I be? Is irreparable damage occurring to his kidneys right now? In my attempt to roll with the punches of parenting, am I being too blasé about the ups and downs of his diabetes? I miss his old doctor, the one who was there when we arrived via medical flight and ambulance. She moved on from UCSF and I haven’t felt as connected since. Hard when we’re five hours away. I email with one of the nurses frequently, but I need to figure out a way to check in more often – or rather, make sure we check in more often. It’s so much to handle without support. (Side note: speaking of handling without support, one of the results of finally having insurance after years of Medi-Cal means we’re paying so much more for his health care. Ironic?)

OK, time to check again. And then wonder if I should bother going back to bed.

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