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!

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!

3 month Endo appt...

Well the time has come for yet another check up for Alivia with the Pediatric Endo. Leading up to the appt I was looking through her log book and although most of her numbers were in range  they were pretty much on the higher end, it wasn't until a few weeks before the appt that her numbers were coming down into the range I preferred. Current 14 day average on the meter...139, 90 day average...214! I figured were were looking at an A1c of 8.1 and was really surprised when it came back at 7.5! I thought for sure all the time it took us to get adjusted to the pump and getting the basals set would of done a number on her A1c but I guess when you check and correct every 2 hours around the clock it doesn't do much damage.

The Dr. looked over her numbers and decided not to change much except the target range and to up her basal just a tad. He said we have great control but if we wanted to could even get it a little better. I'm all up for better!

We changed her target from 150 to 130 during the day and from 150-200 to 130-150 during the night. Already her numbers have been great! We chatted a little bit about her weight again, she's now up to 50 pounds and is following the growth curve but just above it. He's not too concerned about it yet. After our appt we took the advanced pumpers class and learned about cool features of the pump like combo bolus!!! We tried it out on our Saturday morning Starbucks hot chocolate and it worked great! Such a cool feature!

-Enjoying a S'more with no high blood sugar spike!-

On our appt/class days Tony takes the day off and we try to make the day special for Alivia, all our attention is on her and we let her pick where we have lunch, This time she picked the hospital cafeteria of all places! Silly kid!

After lunch we met up with a fellow D-mom Amy and her kids at Cafe Sip-n-Play (best invention ever!). We got to sit and chat while the kiddos played, it was so amazing to talk with another D-mom face to face. I long for the day when I can chat with all you guys face to face too!!!

-Holding baby Addison-

-Giving baby sister a bottle-

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!!!

Alivia's 3rd Birthday!

Oh my gosh...I can not believe my baby is 3!!!

Seriously though this year has gone by SO fast!

I swear the older I get the faster my kids grow up!

Well this year Alivia chose a "Princess Party", it was mostly family but she had a few friends there. We had all "free" foods to eat and cake of course! I timed it so we would eat the cake at her afternoon snack time so that she'd actually be able to have some, and that she did! She was actually low when we checked her before the cake so we even let her have a little of the frosting.

(Daddy helping Aunt Christy check her blood sugar)

Alivia opening her presents...

And of course every birthday brings the well child visit. It was actually the 1st time seeing her pediatrician since before being dx. She apologized for the advice nurse not putting together all the symptoms I had mentioned during my many many calls to the clinic in the days leading up to the dx and explained to me how really rare it is to see diabetes in a 2 year old, Alivia was the youngest both the pediatrician and the on-call Dr we saw that day had seen with it.

Alivia was right on target for all her developmental goals, except for staying dry through the night. Alivia has been potty trained both day and night since 15 months old, we had to put her in pull-ups at night a few months before being dx and we haven't been able to get her to stay dry at night since! Is this a normal diabetes thing or just a stubborn child?

Well the bid shocker of the day was that she was 40 pounds!!! She was 27 pounds only 4 months ago! She also grew 2 inches since then. This put her in the 50% for height and over the 95% for weight! The Dr was a tiny bit concerned and wants me to talk with her endo about meeting with the nutritionist again.

The Dr was really impressed with how quickly Alivia has adjusted to the whole thing! And how well she just does what needs to be done without any kind of reward other than a verbal praise. She picks what finger she wants poked, actually pushes the button on the lancet to poke herself and picks where she wants her shot (usually one of her arms unless I tell her is the Lantus then it goes in her tummy). She was also amazed that her A1c went down from 14.1% to 7.7% in just 2 months!