Checks and balances

First, the reality check. Of course, once I unloaded the stress in my brain into words on screen, I had room to think better thoughts and a beautiful day reminding me (again) how lucky, lucky, lucky I am. Almost everything that’s hard in my life can be improved if I make it so – that’s a powerful place to be, even if sometimes I do find myself worn out and wishing  I could curl up and let someone else solve all the problems for a change. (I should post signs around my life reminding me, “Balance is possible. Don’t freak out.”)

Well, mostly possible. Another kind of check, the blood glucose ones, take more than just a mental shift to solve when the results show levels gone awry. I thought we’d solved the problem of the nighttime highs, but for the past seven hours, Nick’s blood sugar hasn’t dropped below 270. He’d been 390 at 9:30 p.m., then 360 an hour later, then 320, then 280 by 11:30 p.m. Not dropping as quickly or to as nice a number as we’d like, but on a downward trend, so I figured I could go to bed. But he came downstairs at 4 a.m., glucose level up to 400.

Much as low blood sugar makes a person not himself, hyperglycemia triggers irrational behavior and poor decision-making. We should have done an injection of insulin at this point, given the failure of the pump-based boluses to bring his blood sugar down appropriately or changed his set to see if that was the problem. But he did another correction through the pump before I could draw a shot and rejected the idea of a set change. It’s probably not the set; the pattern suggests a need to up his nighttime basal rate, and whether shot or pump, another check needs to happens at 5 a.m. to see where we are. Which is why I’m here, chronicling the night in my artless way. The conflict between us arose over shot vs. pump. The internal conflict remains respecting his need to make his own decisions vs. the sometimes greater need to ensure that he’s safe. High blood sugars don’t carry the immediate threat of low ones – slipping into a coma would take days, maybe weeks, instead of unconsciousness and death within hours – but over time, regular hyperglycemia can lead to all sorts of other serious health problems having to do with one’s  heart, eyes, nerves, kidneys.

Almost time to re-check.

Another check – the surf one I’d planned for this morning – is hopefully still on, even I’m too exhausted to do more than paddle out and look around. No time to drive out yesterday, but today’s forecast and the current buoy readings suggest redemption awaits. If I don’t fall asleep. Fingers crossed that the window appearing open truly is and stays that way.

Result: 276. A good sign. Whew. But I’m keeping him home from school, at least part of the day. He needs rest and recovery after a night like this. We go to UCSF on Monday for an overdue appointment. I’m worried about the car – with all the checks I’ve been writing to pay off prior medical bils, ongoing lessons and the ever-rising utilities, my bank balance confirms that this will not be the week in which we haul it over to the mechanic for that much-needed tune-up. But if I can just stay patient, stay on track, be attentive, we’ll get there. In all ways. We have to.

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