Not an area code.
Not an address number.
Not the amount of money in my paycheck.
519. That was the number on the Accu-check meter the day after Valentines day. The day after an insulin absorption issue that was followed by a pump application issue, and followed by another insulin absorption issue.
519. A rather high number. In fact, it was so high the pump didn't know what to do with it.
Let me back up here and explain.
He was fighting off an illness. We assume. His blood sugar was high that day, he had a slightly elevated temperature. Not high enough to register as a low grade fever, but elevated for him. I expected the temperature to go even higher.
It was Valentine's Day. He had candy and cookies at school. We inputted insulin orders for the pump for that candy and cookies. We guessed on the carbs. We could have guessed wrong, but I think he was fighting an illness.
It was pump day. We began changing the pump right after school in case the high blood sugars was pump problems. We put the new pump on and almost right away, the site started bleeding. It's not supposed to bleed like that. We removed the new pump and put another new pump on. His blood sugar was now 350 to 400 range. We corrected and prayed.
He remained fairly high all evening and throughout the night, despite corrections every 2 hours.
The next morning I called him in sick from school. He had breakfast. His pre-breakfast number was around 180. Then.... then the numbers started really climbing. 250. 290. 300. 325. 369. 399. HIGH. Once his numbers reach 400, the Dexcom CGM only reads "HIGH". I corrected when he was 399, so we waited before getting out the Accu-check. Insulin takes an hour to be effective in his system, so there is little point to check his numbers until it's been an hour, at least, from correction time. Unfortunately, he could be ANYTHING over 400. He could be 400, 401, 700 for all I know.
I finally said, enough is enough. Let's finger prick and let the pump calculate how much I was going to administer via syringe. Why syringe? Because it was obvious the pump was not working. Why ask the pump to calculate? Because we had given him insulin and could not know how much he actually received or was still active in his body. The pump has algebraic computation capability to calculate how much is still left of what we have given him. From there, I could make a gut call on if it was going to work. I've gotten good at those gut calls.
Finger pricked. Sample collected with meter strip. BEEEP. 519. Deep breath..... plug number into pump...... What?! I can't input a number over 500? I gave up and called the Endocrinologist's office's urgent line for help.
Mind you, this whole time, he had not had ketones. However, 500 is not something to laugh at. This was the first time since diagnosis a year and a half ago that he crossed the 500 line. To put it into perspective for you, his blood sugar at hospital admission time was 599. The only thing keeping me remotely sane during this problem, was that he had no ketones.
I placed the call to the endo's urgent line as I was walking out of Daniel's room. I maintained composure when explaining the situation to the message secretary who was going to page the endo's line and someone would call me back. I calmly explained the situation and what I needed from them was the how much to give. I already knew I was changing the pump site and giving via syringe, just didn't know how much because of possible insulin on board, if I could count any at all.
As I expected, the endo's nurse said to put a new pump site on .. again.. and to give meal time and blood sugar correction insulin via syringe every 2-3 hours. We were told to allow the pump to run his background insulin as normal. Upon removing the pump, we could tell that the pump was occluded by a bend in the cannula. There are times when this happens and the pump doesn't register there is a problem to alert us to it. At least we knew that the pump wasn't working and that is why his number was so high, in addition to the illness issues.
He had his first syringe injection that day. And his second. With the clearance of the endo's office, his dinner insulin was given through the pump because he was in range at dinner time. By the grace of God, he was in range.
What a day. It was not over yet, though. The calculations for each syringe dose was done by the endo nurse. They told me the calculations they were doing, but I was so happy for dinner to be through pump, that I did not adjust the calculations it was going to do and he went high again. Not 519, though, and correcting over night did what it was supposed to. The next few days we did an override programming to help keep him in check as he was showing insulin resistance common with fighting illness.
We made it through, though. With lots of prayer and breathing and keeping calm, we made it.
Glad I called him in sick from school that day.
519. Not an area code
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