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Double Arrows Down Then ??? (Going to be a long night)

Discussion in 'Parents of Children with Type 1' started by sszyszkiewicz, Jul 21, 2015.

  1. sszyszkiewicz

    sszyszkiewicz Approved members

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    So DS gets invited to a Phillies game tonight. He goes, has a great time, and comes home with a 380. A hot dog, crab fries, and ice cream are the culprits. He does not remember if he dosed for the ice cream or not. Its hot here and he said he was really busy making sure not to make a mess of it, and besids the Phillies were winning, so he was having fun.

    So he comes home at 10:30PM.

    he had not dosed since at least 8 he said

    he "probably" forgot to dose the ice cream cone.

    Dex said 380 slight arrow up.

    fingerstick said 385.

    Calibrated

    then the correction decision.

    we go for 5.5 units aiming for 125.

    he heads to his room, and 30 minutes later I notice double arrows down on the Dex as he is plummeting through the 300's and then 200's. At 200 I start getting ??? When I say plummeting, I am talking 30-40 points in 5 minutes.

    its only like 11:45. That correction is not even 90 minutes old. Dex has been stuck now for 15 minutes. The last reading on the dex was about 200.

    fingerstick time: 89 (!!!!!)
    20 carbs down the hatch
    Check again at 12:15 88 (phew)



    Dex is back and is guessing 114 steady arrow. I calibrate it as it seems to have leveled off.

    10 carbs for good measure and he is sleeping, but i am wide awake.

    2:30 cannot come soon enough!

    image.jpg

    Update: 1:10AM he starts dropping again, 86 slight arrow down. 12 more carbs. he now has consumed 30 carbs. That should cover 3 of the 5.5 units.
     
    Last edited: Jul 21, 2015
  2. Christopher

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    Wow, big roller coaster drop there. Sounds like a tough night but you are on top of it and doing everything right. I wonder if his pancreas decided to try and deal with the high and combined with the correction caused the drop?
    Oh well, hang in there.
     
  3. nebby3

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    We find adrenalin highs are like this -- sudden dramatic highs but they come down on their own a few hours later. I'd think maybe he was keyed up at the game and then it all just switched off plus that combined with your correction. You couldn't really know that sort of thing up front though esp given the possible missed ice cream bolus.
     
  4. StacyMM

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    Looks similar to our adrenalin highs, too. Steady climb that just keeps going, even with boluses...then a sudden, swift drop. Unfortunately, they are easy to see afterwards but not always predictable when they are they are on the way up. We've learned to expect them at certain times (baseball games, performing in a play, night before vacation) but those random ones usually result in a regular correction, a subsequent temp basal and sometimes some carbs.

    I'm glad he had fun and took care of himself! :) That's awesome!
     
  5. sszyszkiewicz

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    adrenalin!

    He ended the night in the 170's. not my best night but today is a new day.
     
  6. jenm999

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    Scary. Great job.

    I know you are happy MDIers but this is where a pump helps because you can see the history. But I agree with others that adrenalin was probably a factor so knowing IOB may not have helped much.

    Awesome job.

    Editing to add, How did people do this before Dexcom without spending most of their lives sobbing with anxiety in the fetal position?!?
     
  7. Christopher

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    A lot of finger pricks.
     
  8. Lisa - Aidan's mom

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    Whew, crazy night; so sorry!
    Those adrenaline highs are unbelievable. When my DS plays baseball he can easily go into the 400s and shoot down 250+ points in a very short time frame - without any corrections.
    Do you have the Novo Echo pen? It shows when the last dose was given and how much; it's very helpful for us MDI'ers.
     
  9. Lisa - Aidan's mom

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    This was after his all star baseball game:

    drop.jpg.jpg
     
  10. sszyszkiewicz

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    After a night at the game, eating ballpark food, I *never* would have expected that. When we corrected at 1030 i honestly was expecting i was going to have to dose him again at 1230!!
     
  11. caspi

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    Don't you just love those ??? in the middle of a steep decline or increase? It's like the CGM is saying, "I give up - I'm taking a break until you figure out where you're going to stop." :wink: It sounds like he had fun, crazy numbers and all. And that's what's most important. :)
     
  12. sszyszkiewicz

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    No we do not have the Novo Echo, and until last night i couldnt imagine why we would ever need one. I am now a believer!!!

    We have been purposely avoiding the pump, but DS has been asking about it, so we signed up for the "Pumps 101" class at CHOP. The class was yesterday. After trying a set, DS is asking for a tslim and already he is asking "when will it be here?".

    I have to admit that I so wanted him NOT to go on the pump. that is the subject of another post.
     
  13. jenm999

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    I'd actually be interested in this discussion if you want to start a new thread.
     
  14. Lisa - Aidan's mom

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    So did you manage to squeeze in Pat's cheese steaks in between CHOP and the Phillies game? :)
    I would follow his lead regarding his interest in a pump; good luck!
     
  15. Christopher

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    Slight derail (but you started it) ;-)

    I was in Philly several years ago and I really wanted to try a cheese steak. I had heard of the "war" between Pat's and Geno's. And of course 50% of the online reviews said Pat's was the best and 50% said Geno's was. So it was a toss up. I chose Geno's and it was NOT good. I wish I would have picked Pat's!!
     
  16. jenm999

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    I shudder at the mental gymnastics required to dose for THAT!
     
  17. Christopher

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    I know! Luckily it was for work so I was there alone.
     
  18. rgcainmd

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    I am also curious as to why you don't want your son to pump. My daughter starting pumping as soon as I could get her stubborn endo to sign the orders and I have never regretted my decision to have her pump. Adjusting basals whenever needed, using temp. basals, not having to figure out IOB, always knowing whether she actually bolused or not, more hassle-free corrections during the night and during school, etc., etc. have given us the ability to keep tight control and keep A1Cs in the mid-5s to mid-6s (even during puberty [so far, knock wood]).
     
  19. StacyMM

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    We've done both. With my daughter, we waited on a pump. With my son, we started as soon as he was diagnosed. There is no one path that everyone needs to follow and there are advantages to both systems. All that matters is that the insulin is getting there...not how it's administered :)

    As a parent that was in no hurry, here is my story...
    DD was diagnosed at 2. We rocked MDI and felt like we had everything under control and felt confident. When she was 4, we decided to try a pump and got started with Medtronic and then never put a single set on her. Changed our minds at the training class. At 5, we tried again. It worked well enough but DD tired of it eventually and we agreed that she could go back to shots if she still didn't like it at her next birthday (which was 8). Birthday rolled around and she was done. Back to MDI we went. This time, giving up the pump was scary and the idea of MDI was overwhelming! Again, it was that sense of starting over and giving up on something that worked. However, she thrived on MDI and all was well. And then her brother was diagnosed and immediately requested a pump. She saw the demos and held the pumps and the idea of him having something cooler than her was just too much and back to pumping she went. This time it was even more fun because we had two starting at the same time - one honeymooning, one not; one in puberty, one not; one experienced, one not. Now that they are pumping, I think I'd cry (on the inside) if either asked to go to MDI. It's not that one system is better or worse than another...it's that sense of losing whatever control you've managed to convince yourself that you have over diabetes :) We'd do it - the kids are old enough to make that call, after all - but it would cause me some anxiety. So as someone who has made the change multiple times, I can say that you aren't the first parent to resist pumping and he isn't the first kid to want it. Just figure out what works for you both and it will work itself out.

    And if you do switch to pumping, the T:Slim is a great choice, IMO. I love that pump!
     

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