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Help with a teenager that's on his own.

Discussion in 'Parents of Teens' started by truck2ff, Sep 3, 2010.

  1. truck2ff

    truck2ff Approved members

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    I agree, I don't know alot about NPH, but when he told me those were the orders his doctor sent him home with from the hospital I was shocked. I think the doctor that's seen him since he was released is a clinic doctor that pulled his records from the hospital stay and just wrote a script for the insulin based on that.

    I'm questioning how often he's actually taking it. I think it's hit or miss from day to day right now. I need to set down with him and have an honest conversation about how often he's skipping his injections. I'm thinking I might try to get ahold of him today while I'm on shift. I'd like him to bring what he has for supplies with him when he comes to our enginehouse for his ride along this week. Maybe then I can see what he has and what he needs to get set up so that we can start logging some data and get this regimen adjusted to something that makes more sense.
     
  2. truck2ff

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    One other thing, are Novolog and humalog interchangable? I've always understood that they are, but did I read that novolog is a little faster? I guess it could still be mixed with Humilin-N just like Humalog?
     
  3. wilf

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    Novolog and Humalog are interchangeable 1:1 and both can be mixed with NPH. I'm not familiar with any particular difference in how fast they act. Apidra is much faster.
     
  4. wilf

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    Actually, not taking all of what he's been prescribed would be an understandable response to the regimen he was prescribed.. :rolleyes:

    I think your plan for how to proceed is a good one.. :cwds:
     
  5. truck2ff

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    Thanks for the info on the Novolog/Humalog. I thought it could, but I have lots of novolog prefilled pens from when our son was DX. It might be easier to use these initally till we get him into some sort of routine with his care. I always thought they were more convienent and our 8yo was much happier with them than the vials and syringes they sent us home from the hospital with.

    Your conclusion on his regimen makes sense now that I think about it.
     
  6. wilf

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    Only problem with Novolog pens is that using his current insulins, he should be mixing the Novolog with the NPH at both breakfast and supper. To do that you need to draw both insulins into a syringe.

    But you can remove the pen vials from the pens, and then go from there.. :)
     
  7. truck2ff

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    We have two types of novolog pens. The Novopen jr. that we still use occasionally to do a correction if we get a bad site uses the removable cartridges and I've even filled our sons pump resevoir with them. We also have some of the prefilled novolog pens that are throw aways. I thought we drew insulin out of those into a syringe to dose 1/2 units before we got the Novopen Jr. (which will dose 1/2 units). He could probably do that couldn't he?

    I have extra cartridges too, but I'd like to use the pens up as well and he could carry one around for corrections if need be. I've always hated wasting any of these supplies, even more so now that I realize how hard it is for some people to get it.
     
  8. wilf

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    The pens with removeable cartridges are easy to use to draw insulin into syringes - you just remove the cartridges and those are your insulin vials. But even the throwaway pens can be used - you just use a hacksaw to cut the ends of the pens and you end up with something about the size of the pen cartridges, that you can draw insulin vials.

    Great that you have all these supplies! :)
     
  9. truck2ff

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    Great, I wondered if you could get them apart. We've ended up with a lot of different stuff and our insurance provider hasn't batted an eye when DS endo or CDE wanted to try something a little different.

    The Children's hospital on the east coast where we were vacationing when he got dx last summer had their idea of what they wanted us to use, then when we got him back home and seeing the local endo he had a different idea. Followed by some suggestions by the CDE which seemed appropriate. Then in June this summer we started pumping. So we've kinda ran the gambit in a short period of time and ended up with alot of things in the process. The lantus is the only thing I don't think we'll use much. Maybe when he's untethered for swimming, but we didn't see big problems with that as long as we watched the time and maybe set a little temp basal once he hooked back up. We're still learning though....:)
     
  10. truck2ff

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    Well, I met with the him before lunch this morning. He had taken his insulin at about 8:30, but hadn't eaten yet (it's now 10:30 ugh) 40u humolog and 40u novolin-N according to his previous orders after hospitalization. His BGL at 8:30 was 208. We drove to the college he's taking his EMT class at and at 11:00 am he was 122. Grabbed Subway with him and worked on a little carb counting with the calorie king book and then went over an inventory of what he had for supplies and what I had brought with me. Then we went over the new regimen for his insulin and carbs/meals. I got him set up with a kit to keep in his pack similar to my DS, with glucose tabs, juice, lancets, test strips, a spare mini one-touch, carb king book, log sheets and a small note book with his regimen and quick tips on treating lows, highs and sick day care. He already had syringes and insulin (old, but he was going to take care of that after class).

    I'm glad that he's testing and taking his insulin, but we came to the conclusion that the insulin he has been using in the last week is probably old (2 months??) which may explain why 40u/40u this morning without eating didn't leave him on the floor. It's still working some, but obviously not like it should. He has a script from a local clinic that will subsidize his insulin at a certain pharmacy here in town and its very cheap.

    He likes his One touch Ultra meter , but strips are expensive and I've been unsuccessful in finding any deals or indigent programs for those strips. Luckily, I had some extras to get him started till we can find a source through another company or program, he has a bayer contour also with a few strips, but I need to do some research on what programs are out there. At this point it would be great to get him to test before meals and at bedtime and logging those, I told him we should do some post meal testng, too. We'll see how he does. Given his previous management, we'll have to walk before we run...
     
  11. sassypantz

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    Both Freestyle and Accucheck have programs to get test strips for no more than $15 (the whole script, not per vial or box of 50). I've got 2 unused Freestyle Flash meter kits if you want one (one came with DD's omnipod, the other came for free when we signed up for the Freestyle Promise program). I also have an Accucheck Aviva meter, but no lancing device for it because that was why we bought the meter! ;-)

    I also have a leftover vial of One Touch strips if you need some to tide you over till you find the right program for him.

    PM me if you'd like any of them and I'll send them to you.
     
  12. truck2ff

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    Thanks so much for the offer. I'll PM you about the specifics. In the mean time I might check to see if the clinic and pharmacy that help him out with his insulin have any programs for strips. I'll check out Freestlye and Accucheck's programs, too.
     
  13. MyBoys'Mom

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    Hi there. I can spare a box of One Touch strips (100 strips) if you'd like me to send them. PM me and let me know if you'd like a box. This may help until you guys get things figured out.

    Thanks!
     
  14. HBMom

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    I could spare 1 vial (25 strips) - let me know where I should send them.
     
  15. bgallini

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    I think that getting him to test 4x a day will be ideal at this point. Certainly you can explain why occasionally testing 2hrs after eating will be goo but, honestly as a mom of a 20 yo, I think that's pushing it.

    I will see if I can get some test strips for you. Alex uses the one touch.

    Again, as a mom of a 20 yo, I really appreciate what you are doing for this young man!!! :cwds:
     
  16. truck2ff

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    Thanks guys, I really appreciate all of the offers!:) I think getting him to test 4 times a day probably will be great at first as you've mentioned. I loaded him up with quite a bit yesterday. He's coming to our rig for a ride along today, so I can hopefully slow down and work through some of the carb countng and eating issues with him. Thanks again for all of your help. I'll try to PM everyone that had strips once I get caught up at work this morning. You guys are great!:)
     
  17. kyles_mom

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    same here, I have extra one touch strips as well.......just pm where to send them. You are doing such a great thing :)
     
  18. Mimi

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    I keep coming back and reading this thread. This is a wonderful thing you are doing for this young man.

    Thank you.
     
  19. truck2ff

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    Thanks. He's been here at the enginehouse since this afternoon. He brought his log and kit with him, which is a start considering he never use to carry anything. He started on the new vials of Novolin and humalog this morning on the new regimen that one of the CWD members came up with and our CDE reviewed.

    He was high this morning pre and post-breakfast (260's BGL) but he had fried food for dinner last night and oatmeal for breakfast so we had several food spikes in play, but one thing at a time.;) Still about the same at lunch but I hadn't worked with him on his correction ratio. He understands that now and I told him we'd stay where we're at dosewise and carb-wise for a few more days and only correct numbers that are over 200 and try to get him in the 140's-180's if we can.

    He was 145 at 3:30pm today and 90 at supper time here and he ate with our crew, a little later than we should have, but his number was OK. Burgers fries and milk (I know, I know:eek:) but at least he counted up his carbs.

    Working on some free foods for snacks and keep tracking his food and BGL's and we'll see how it goes when he checks in with me next week. Thanks for everyone's help, couldn't have helped him much without you all....:)

    PS anyone have a good downloadable log for NPH and Humalog with room to take notes on meal details?? I like the medtronic ones we use for our son that is pumping, but it's not set up for two types of insulin and MDI.
     
  20. truck2ff

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    I just wanted to drop a note to everyone that has offered advice, supplies and moral support and say a big THANK YOU. Your generosity and caring for this young man that you've never met is overwhelming.

    I think that the experience of dealing with diabetes opens your eyes in a way that most people outside of the D world will never understand. Most people wouldn't give this kid a second look and would probably write him off. The little victories he's had in his life would seem like no big deal to most people. Those of us that deal with D everyday appreciate those little victories more than most I imagine.

    I hope he doesn't give up. I figured I'd give him some breathing room for a few days and then try to meet him for lunch again next week to go over logs and see what we need to do next. Fortunately, I think we have a local charity lined up that works with a local clinic and pharmacy that may provide his strips, insulin and syringes almost entirely. We've got some paperwork and issues to deal with, but I'm hoping I can help him with that so that he has a source for everything locally while we still have enough strips, syringes, etc. to continue his care.

    Next is A1c labs and another trip to the Doc. He had orders for an A1c last year and never went because he knew it was bad. I've been trying to get him to let go of that good number-bad number mentality. They're just numbers. Tools in the toolbox of D care, but I know how easy it is to become obsessed with the numbers and not what we learn from them. We'll just keep plugging away.

    Thanks again for everyone's help here at CWD, you've been a wonderful help to this kid.:)
     

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