I expected more from you Glucagon...

June 29th I was awoken at 2:30am by Alivia climbing into my bed. I didn't think much of it, she ends up in our bed about once a week. Next thing I knew I heard something that sounded like someone pouring something, still half asleep I wondered if she spilled a cup of water...then I noticed my back felt wet a warm, I rolled to see her throwing up again and again and again. I woke up my husband and he changed the bedding and started the laundry while Liv and I took a quick shower. I set her up on the couch and did a quick sugar and ketone check, 96 and trace ketones. Hubby make a quick trip for some 7up and she was able to keep it all down, I thought for sure it was something she ate.

A few hours later she requested breakfast, still a little worried about her tummy but knowing she needed insulin for the ketones I gave her some toast and a banana and only after she kept it down for a while and her blood sugar started rising I bolused her for it. She said she felt good and was up playing and acting normal. Lunch time rolled around and she wanted to eat what everyone else was eating and she did, bolused her for all of it after she was done eating and she was off and running.

An hour and a half later she climbed into my bed and fell asleep...this was very odd for her, she stopped taking naps years ago. Quick sugar check showed her at 57 with over 2 units active insulin still working to bring her sugar down even more, 4oz of 7up sipped slowly, tummy ache and she wanted to lay on the couch and watch iCarly. On her way down the hallway she started throwing up again, I ran to the kitchen to get her "bucket" and she continued to walk down the hallway and into the living room all while still throwing up, leaving a trail behind her. PANIC was starting to set in, I called my husband who just left for work asking for him to return home. I was alone with 6 kids, puke all over my floors which Addy kept trying to get! And a child whose sugar was dropping QUICKLY!!! I hung up with him (he came, cleaned up the mess and left again) and called our endo clinic, I LOVE our team but I HATE the way they take their calls. You call the main number and before you hear any options you have to listen to this message that takes forever! (Or so it feels while you're panicking!!!) "Blah blah blah, we follow the Portland schools, if they are closed so are we, if they have 2 hour late start we will open at 10am, blah blah blah, our fax number is blah blah blah, for scheduling press one, diabetes management press two", I press 2," if your child is newly dx or sick press one", I press 1, "you have reached the priority line please leave your name, number, childs date of birth and 1-3 days of blood sugar number" I try my best to hold back the tears as I leave the details requested and letting them know it is urgent! While on the phone I was collecting the little red box and a few insulin syringes.

A few minutes pass since I left the message, I mix up the Glucagon, I draw up 5 units, my phone rings and she tells me to do exactly what I had just done and to remove her pump, I gave the shot while she's still on the phone. She tells he that it takes a little longer to take effect and to recheck in 20 minutes, if she's not above 80 repeat, if she's still not above 80 come straight to the emergency room.

20 minutes pass and I recheck...59! Crap!!! Why aren't you working Glucagon!!! Another 5 units given, timer set for another 20 minutes.

Recheck after only 15 minutes showed 115, thank you Glucagon! Glad you could make it!!

Timer went off 5 minutes later, recheck showed she'd dropped to 81. By this time she had no IOB and no reason to drop any more. I thought for sure Glucagon was still working and she'd start heading up soon!

Called the clinic again to give them an update and to request a new Rx for zofran, the pharmacy we use is 30 minutes away and does not have a drive through, I wanted it sent to our local pharmacy just down the street that does have a drive though but does not accept our insurance. $75 is a small price to pay to get it now and not have to drag all 6 kids (1 very sick and weak) through Target. The Rx is sent and she advises me to call before I load everyone up.

I call and am told they do not have it in stock but can order it, ummm I need it NOW! She tells me she will call around to the other Walgreen's and see who has it in stock. She calls back letting me know that the closest place is in the same town as the pharmacy we normally use 30 minutes away! Ugh, if i have to drive all the way out there i might as well save my $75 and run into Target, I tell them to never mind. I call Target and ask them to fill the Rx already on hand, I ask if they keep it in stock and told YES! Do they double check? NO! They tell me to give them 45 minutes and it will be ready.

I'm supposed to have the extra kids overnight so I swing by their house to grab their bag on the way to Target. Alivia has been in and out of it on the short ride to their house so I check her...55! Seriously Glucagon you could of stayed a bit longer!!! I grabbed a 20oz Sprite out of their fridge and passed it to her and placed the "bucket" on her lap, hopeful that even if she did throw up some of the sugar would be absorbed. I called the extra kids Mom on the way to the hospital and had her to meet me along my path to get her kids from me.

The closest hospital is 20 minutes from us but they know NOTHING about children with diabetes, we went there at Dx and they had her transferred to a children's hospital. I chose to skip the middle man and go straight for the children's hospital 45 minutes away, our endo team was there and I felt she would be best cared for there. The drive was stressful, she kept falling asleep and I was worried she might not wake up when we got there and yet I didn't want to pull over... I just wanted to get there. As we pull up to the ER parking I notice that Alivia didn't have shoes!!! How was i supposed to carry Addison and my 60 pound 4 year old?!?! One of the lot attendants came to my rescue and carried Addison for me so I could carry Liv :) We checked in just as the hubby showed up from work and they put us in a room right away. Blood sugar was up to 180 (thank you 20oz soda!) but she still had ketones. Our endo wanted her pump back on but no correction. They loaded her up on the Zofran I hadn't been able to get my hands on all day. The nurse brought her a drink and some jello, if she kept it down she could avoid the IV, if not they'd start one. The snack stayed down and a few hours later she reached the 300's! Tiny correction ordered and they sent us on our way with actual Zofran, not just a slip of paper that said we could have it if anyone ever chose to keep it in stock!! On our way home we stopped by the Target pharmacy to pick up the original Rx that had been waiting for us only to find out they couldn't find the Rx and they didn't have it in stock anyways!!!!!!

They next few days were vomit free but she still had ketones for days and was completely unable to get any insulin other than her basal with out going low for almost a week! But all is back to normal, thank goodness!!!

I'm thankful that we made it this long with out this happening but at the same time I think I had the wrong idea about Glucagon this entire time, I always thought the mini dose was as magical as the half dose she would get in a emergency. But as I learned I shouldn't rely on it in cases like this, I shouldn't expect for it to work quickly and keep her stable... and zofran will always remain in my diabetes cabinet not as a Rx sitting at the pharmacy waiting for me to need it!

Look whoo turned ONE!!!

(Opening gifts at her 1st birthday party)

Can you believe it's been a whole year since baby Addison joined our family?!?!

It feels like just yesterday when we were all sitting around tossing around possible names for Baby "A"

Well it's been an awesome year, she fits perfectly into our family! She is very laid back and doesn't mind waiting a few minutes for her meal while we measure out Alivia's food or treat a low.

She is incredibly fascinated by that little black bag that holds the meter, poker and bottle of test strips. That bag must be kept zipped at all times! She loves to pull the cap off the poker, slobber on the meter and hide bottles of test strips under the stove.

She also LOVES LOVES LOVES wrapping her little fingers around Sissys tubing and giving it a good YANK!

She's also been a great sleeper (unless she's teething!) The girls share a room and she's totally unaware of us sneaking into their room at night, she doesn't even budge when the meter beeps or the pump alarms.

She's also learning at a young age that it's completely "normal" for her Momma to occasionally check her blood sugar, sometimes she scoots over to me while I'm checking Sissy and gives me her hand :)

We're still not in the clear yet with her kidney issues, we just went in for her follow up ultrasound and Dr visit and the kidney is still swollen. It did not go away on it's own like we had hoped for but at this time it's not causing her any problems and it may never cause a problem. Surgery however will be required if it starts acting up.

She's still not walking or crawling yet. I know she knows how to crawl but chooses not to and has very little interest in walking. BUT she does do this super cute butt scoot!

 In a way I'm sad that my last and final baby is growing so quickly, I'll never again be the mother of an infant and yet at the same time I'm a little excited for the next stage of motherhood, raising my children. I'm super excited to be able to just hop in the car with out having to leave my bum hanging out of the backseat in the pouring rain to buckle carseats :)

Everythings changing...

And by everything I mean E.V.E.R.Y.T.H.I.N.G!!!

When we were discharged from the hospital 2 years ago Alivia was on a set insulin dose due to the NPH but when we switched over she was at a 1:15 ratio, for you non-d peeps that means for every 15 carbs she eats i would have to inject her with 1 unit of insulin. They warned us that as she grew her insulin needs would greatly increase...but they never did! Up until a few weeks ago she was still on a 1:15 ratio even though she's grown quite a few inches and gained about 25+ pounds! Of course her "Honeymoon Period" was a huge exception but that didn't last long at all! And sure there were times when we'd start to see a pattern of higher numbers and we'd bump it up a tad only to be greeted with constant lows, and so we changed it back to her "normal" ratio. Same thing with the Lantus and now her basal rates, we started her on an insulin pump over a year ago we spent only a few days tweaking her basal rate and what do you know it was the same rate of .250, 24 hours a day 7 days a week and has stayed that way every day since!

Even her ISF (insulin sensitivity factor) has stayed the EXACT same since day one! 1:200, once again for you non-d peeps :)  1 unit of insulin lowers her blood sugar 200 points, for example blood sugar of 400 would require 1.5 units of insulin to bring her blood sugar back into her target range.

It was pretty smooth sailing, hardly any lows under 60 and only highs due to Mommy mess-ups and bad sites, and she hasn't had ketones since dx. Life went on and diabetes sorta faded into the background.

Fast forward 2 years to present day and then go back 3-4 weeks and we've got highs after highs after highs! Corrections are only working half ass and as soon as she eats she sky rockets AGAIN! Frustrated beyond belief I changed her site 10 times in 5 days, I opened 2 new bottles of insulin, it HAD to be one of those 2 things we've never had it any other way! After 5 very long and frustrating days had passed I finally gave in and started making changes, changes and more changes. Just 3 days later we were finally seeing numbers starting with a 1!!! We finally landed with an insulin to carb ratio of 1:10, basal rates of .500u/hour and an ISF of 1:150. All was right with the world and her numbers were "in range" every single time. Whew, that was rough but we all made it through alive and well (except for that A1c which will be sky high I'm sure!) End of story or so I thought...

Only a week after the return of the "in-range" numbers she was crashing hard and fast all the time. Lows only an hour after meals, corrections during the night bringing her into the 40's and 50's, and lows for no good reason! I very quickly pulled back hard on everything thinking she was just going through a growth spurt and now it's over. Everything was promptly returned back to "normal" and so did her numbers...for 4 days!

The last 2 weeks have been a nightmare! Everything only works for a few days before needing to be increased, a few days later decreased again, then increased, then...well you get the picture! I never know what number will pop up when I poke her little finger. She over reacts to every little thing and I never know if it's because she's high, low or just 4 going on 16!

In a way I feel like we're back at the starting line only the beginning of the last race was all down hill and this time it's up hill! I know so many of you have been going though this from the beginning but for us this is all new and very frustrating!

I do not like change! Or diabetes!

Pump Start!!!

Monday Alivia got a delivery from the UPS guy…

it was her Pink Ping pump!

She was so excited to open it up! 

She loved looking at it and was very excited to try it out.

It was hard for her to pack it up and wait until the next day when we met with the trainer.

Tuesday the trainer arrived at our house around 1pm and spent a good 2 hours going over the basic setup of the pump and showed us how to put a site on Alivia. Alivia did great! We used the numbing cream and she didn’t feel a thing! We didn’t actually fill the pump with insulin but the trainer wanted her to keep it on as long as possible so she could get a feel for it and she wanted Tony and I to play around with the pump and remote as much as possible.

1st site

 I drew the circle to show where I had put the magic cream...Daddy was a little off target.

As you can see she was very excited to start using her Hello Kitty pump pack...

Unfortunately her 1st site only lasted 6 hours. That evening we had gone to Old Navy and while looking at sunglasses she got the tiny amount of tubing that was showing stuck on a hook and didn’t notice so when she walked away the site got ripped out. She handled it very well! I did not have another set with me so I figured we’d just let her be for the night and try again the next morning, which we did. That day was a real test of how she would handle wearing it! We spent a good 6 hours playing and running around at the Children’s Museum and another few hours playing at the park. Every meal and snack I would use the pump and practice giving her insulin the whole time wishing I could use it for real! She did have a lot if trouble being able to lift the pack over her site to be able to pull her pants down to potty without rubbing it against it and by the end of the day a small corner of the adhesive was starting to peel up. Her only complaint all day was that the pack itched her, so that night I sewed a few pouches onto the front of her tank tops.

She loved these! Unfortunately I’m not the best at sewing and the weight of the pump eventually took it’s toll on the stitching. I do think that the tank tops work best for her right now so I plan on taking the rest of the fabric and the other tank tops to a professional to have done right, I’m sure they can make them to last.

Thursday morning we lost the 2nd site, the corner that had started peeling up the day before got stuck to the inside of her tank top and when she went to take off the tank top the site came with it. We chose not to waste another set and let her have one last day with nothing stuck to her body. We did however learn a very important lesson…IV prep is a MUST!!!

Finally Friday arrived and so did the trainer! It was a very quick lesson, actually more like a quiz, she had us do the site all on our own (we used the IV prep this time!) and re-set a few of the targets, my idea of Alivia’s target and her Drs were a bit off, I like her in the 70-150 range during the day and 150-250 at night and he wanted it more like 100-250 during the day and 150-300 at night. We settled on 100-200 during the day because all it really means is that if she was below 100 the pump wouldn’t have me cover much if any of a snack and it wouldn’t have me correct her until she hit 201. And 150-250 at night. She reminded me that they weren't set in stone and I could always change them when we got everything fine tuned.

She answered a few of my questions, wished us luck and was off! Just in time for lunch!

That 1st meal shot free was priceless!!!

We’ve had pretty good numbers the last few days except for a few near disasters the pump caught and we were able to avoid…Thank Goodness for the IOB feature! Going to bed at 90 with almost 3 units on board would have been really really bad! I loved that I could play around with the carb amounts on the meter and know exactly how many carbs she would need to cover the IOB…a whopping 40 grams! I never would of given her that many carbs with out covering before but I trusted the pump and it worked out PERFECTLY 168 ALL NIGHT LONG! I called the Blood Glucose Management Team the next morning to figure out why she had so much IOB in the 1st place and she said it can take the Lantus a few days to completely leave her system. It happened again the next night but not again since! Overall I’m very happy with our choice!!!

Thanks for all your guys help and support!!!

Keep your eye out for my next post… “Help us name Baby “A”

3 month Endo appt and PUMP CLASS!!!

Endo Appt... I guess I'll start with the Endo appt because it just happened to be first up today...

This was only our 3rd appt and it was the first one that I didn't worry myself sick over the A1c. I knew the last A1c of 6.8 would be history and I was truly ok with that. August- October was so easy...too easy! November-January have been much much harder, I knew I tried my best but the D Monster put up a darn good fight, no matter how much I adjusted she had random highs everyday and random lows once or twice a week, there was never a pattern! I was actually a bit surprised that it was 7.5 (her current 30day average on the meter was 219...yikes!). Her Dr was pretty happy with that, he agrees that she's definitely coming out of her honeymoon period and expected the rise in her A1c because of that. He looked over our log book and couldn't find a pattern for her crazy highs either and didn't want to make any changes. He did offer up a few suggestions for us to try out on our little guinea pig to see if we could fix the problem. Well give them a try, hopefully it won't lead to lows!

If you've been reading my blog for awhile you'd know that we were all getting pretty concerned about her weight, at dx in May she was 27 pounds just 4 months later in September she was 40 pounds and only a month later at our last appt she was up to 45 pounds!!! I was so excited today when he told us she was 46 pounds, she's still off the chart for weigh but at least the gaining is slowing down!

And best of all he went ahead and gave us the green light for the PUMP!!!

PUMP CLASS!!!!!...
Can you tell I'm excited about this part????
As much as I liked meeting the reps during the in home hands on demos, I really felt like they were just trying to sell their product, mostly because they were!!!

It was SO nice to have an impartial person going over each and every pro and con for each of the pumps. In the end we just had to pick, there wasn't "the perfect" pump (someone needs to make it!!!!).

I wanted the good remote,
I wanted the linked CGM,
I wanted the tubeless feature...but which one did I want more???
I wanted the Ping, yes it has tubing, no I can't have a linked CGM, yes it will take a few more steps to deliver insulin, but it is waterproof, it can deliver the smallest amount of insulin which Alivia will need, it has the good remote, I can give insulin directly from the pump if needed, it keeps track of IOB and most importantly it comes in pink! We meet with the rep tomorrow to start the paperwork!!!
Honestly though if Medtronic had the good remote (they currently only have a tiny one with 3 buttons, no screen) I would of gone with them. With an active 3 year old I felt like we needed the remote, at least until she does it on her own.

If everything goes well with the insurance we should be pumping in a month!!!

Picking a Pump...

Well 1 week from today is our pump class! They will quiz us on insulin adjustment among other thing and if we pass (I think I'll let the Hubby copy off my paper) we'll get to choose our pump!!! The only problem is that I'm so torn in which one I want. My 3 choices; OmniPod, One Touch Ping and MiniMed Paradigm.
OmniPod got the boot, apparently it doesn't keep track of insulin on board other than correction. in my 1st thoughts I didn't care about that because I couldn't keep track of it with shots anyways so it didn't really matter, but the more I thought about it, it hit me that why even bother switching to the pump if I'm not going to let technology help me gain better control of her numbers (we have enough lows with out over dosing her with insulin)! So I figured for now I'll skip on the awesome tube-less feature to keep my daughter safer, maybe when she can actually tell me she feels low we'll revisit the OmniPod.
So with that I'm only left with the One Touch Ping and MiniMed Paradigm...I can't choose!!! I LOVED the MiniMed one but only because it had the pump, CGM and test meter that were linked together. The only thing I didn't like was that it didn't have a good remote and we'd need to actually have her pump in our hands to do what we needed to do. Most of you guys with young children know getting a 3 year old to stand still while you fiddle around with the pump imputing number and what not is next to impossible!
I haven't actually gotten to see the Ping one yet, the company has yet to call me back after my 3 e-mails about setting up a hands on demo. I've heard tons of good things about it! Those of you that have it, is there anything about it that you don't like or wish you could change? And does it come with good support? The MiniMed one came with a nurse for the first few weeks, you e-mailed over your numbers everyday and they'd help you make changes and once everything was good they'd turn you back over to your endo office, I really liked knowing I wasn't just turned loose with it.


I know there has been a ton of talk about pumps lately but if you're not too burned out on it please, please leave me a comment with any info you think I'll need to make this choice! Thanks!!!