A good weekend!
Hey all
Feel we have been gone *forever*, but really it was a good break with relatives and NO COOKING etc in Norwich...
E's numbers have actually been pretty darn good, with more hypos but general levels in green -- almost all of them! Considering that we forgot to bring scales and didn't want to make a deal of carb counting with ten people at every meal, things went well.
The extraordinary afternoon highs of last week seem to just be knocked on the head by a simple ratio change, from 1:11 to 1:10 -- incredible the difference. We also raised the late afternoon basal by 0.05u/per hour -- again, this minute shift seems to have made a tangible difference.
All in all, I think I'm right in remembering that he went into every single meal with a bgl that was IN TARGET! Heavens!
We did find that we had to react often to one-off situations, which I guess is natural and to be expected -- but again, this is the HUGE value of the pump as far as I can see:
-- Lots of 'unscheduled' exercise, eg swimming and football in the garden. In two out of three instances we remembered to put him on a 75% temp basal immediately after finishing. This seems like magic for him -- he stayed steady, and it's about the right amount of time. The one time we didn't remember to do the temp basal...see below!
-- Lots of late night, bitty eating. This is the one thing I found stressful about the weekend -- we had to test him every night at 12, sometimes 1 and then 3am -- because he'd had a late bolus for a pudding or whatever. The very first night we were so incredibly relieved we have a system in place for this: the 12am test showed 1.9 mmols 😱. We figured this was the result of a *very* light dinner, and we had overestimated the potatoes... With slug of apple juice, he was 8mmols at 1am, so okay in theory (see below!).
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Problems and lessons
1. When we forgot to switch him to temp basal yesterday after an hour of football: an hour after lunch (at which he had TWO helpings of the difficult to dose strawbs!), he felt bad. 2.2mmols: carton apple juice. Ten minutes later, still felt rotten, tested 1.7 mmols: 2 glucose tabs and immediate switch to 75% temp basal. We were in the car by this point. Began to feel better, but he fought lows almost ALL afternoon, riding just above 4mmols. After two more hours of this, we switched him to 50% basal and he began to properly recover. Throughout, he ate LIKE A HORSE, and we underestimated carb the whole way, free carbing at least another 20 or 25 grams. Eek! Poor guy. Lesson: ALWAYS use temp basal with him with ANY exercise, and be prepared to be flexible in its use.
2. The first night there -- of 1.9mmols rising to 8mmols fame -- he ended up, to our surprise, waking on 3.8. He then spent the first half of the day with a headache and practically flat out on the sofa...Hmm. It was his first day off school, so this would contribute, but still, we ended up coming to the conclusion that despite our efforts he *must* have dropped again, or remained borderline low, for some of the night -- and he had suffered his first nighttime hypo-head. It was pretty miserable for him, though he didn't complain and we're not even sure if he clicked. He just rested. But we felt bad. We realised later that we should have used temp basal just to be certain -- which we did, even after lowering the nighttime basal rate, two nights later. On this night, he tested at 5.8mmols at 12am, but I could *not* wake him for love nor money to have some juice just to be sure (he was shattered). We then tested him at 3am. He was 4.4mmols. He could then be woken, had some juice, and just to be on the safe side, we put in a 75% temp for six hours. Unfortunately he woke on 14 -- but hey, you live and learn. The new nighttime rate is obviously a good one for him. With the juice he would have been fine til morning, no temp basal necessary. Lesson: again, be flexible with temp basal! Use it!
3. This lesson I feel we must all know: Chips are delicious but hellish. So on the way home we stop at the hell that is IKEA and have to eat, so he chooses the hell that is chips, and we decide to try the dual wave thing with them: 50/50 over three hours. Things are looking up at 10pm -- 7mmols, but by 11pm (hour after end of dual wave) he's at 3.8 -- damn. Treat and put on temp basal until 4am. At 3am he's risen to 16mmols! 😡 Chips, chips, I put a curse on you! Anyway, remove temp basal, give 2unit correction (UNDER dosing from wizard, which suggests 2.9units). This morning, good result: 5.7mmols.
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We truly feel almost there, and where we are not there, we feel flexible. We want to be going into bedtime with more security, rather than up testing all the time, so we will try a night basal test I think once we settle down, to see if he remains steady throughout. We feel that we are at risk of 'feeding' the basal rate at night, since him *not* eating particularly well at night seems to risk him going low. We also may need to lower the 9pm-12am basal rate (having raised it earlier in the month!), so that he has a higher chance of being on 7 or 8 mmols at bedtime, rather than the 5-ish of the last few days.
It's obvious to us that some of the difficulty in the last two weeks is down to recovering the rates from France, and some is down to his changing needs. The late evening and night basal levels show this, as does the afternoon change: these changes actually revert him to some original levels of the pump, which *were* sending him into hypo-land...
Oh well. It's clear too that his needs actually *fluctuate*. They don't just increase, they also decrease, and differently in different times of day at different times....
Oh, and it's worth noting that he's not on the same pattern as he was at school: we have adjusted his weekend pump settings for his school holidays!
AND: Harry Potter 6 -- mixed reviews here! 😉
Hope everyone okay. I'll seek out others' threads.
Bev and Adrienne: hope A & J now feeling better? We are sneezy too, but have not gone down with anything...
Mand, Sugarbum: hope there is news on your threads...
xxoo
