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Post Of Shame

Discussion in 'Parents of Children with Type 1' started by DavidN, Jun 29, 2013.

  1. DavidN

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    Yesterday we're driving 7 hours to our vacation destination. We take two cars because it's an extended vacation.

    5:30pm - BG is 160 so wife gives 0.5u
    Now we switch cars and I'm with the boys
    6:30pm - BG is 210 so I give additional 0.8u (we use CF of 90)

    She had been running him at +30% temp basal so I up it to 60% because it seemed the +30 was not high enough and during previous drives we'd run him at +50 to +60%.

    The back story: we recently had what I judged to be a horrible A1C, he'd been above 200 all day two days ago, and I really struggled to get him down. So with the inactivity for 7 hours, the recent stubborn highs, I thought to myself, "I am not going to let him creep into the mid to high 200s again", hence the additional correction and increased basal rate.

    We are close to our destination and stop for pizza.

    8:40pm - BG 101 (no arrow)

    He eats a 10 inch thin crust pizza. Wife and I estimate 80 carbs and bolus 30% up front and extend 70% over 1.5 hours.

    9:25 pm - CGM reads 80, finger stick reads 78 flat arrow
    I cancel the extended bolus.
    9:35 pm - CGM reads 72 flat arrow, but he feels low and I give 10g of juice.
    9:45 pm - CGM bumps up to 74
    9:47pm - "DAD, I FEEL REALLY LOW"
    9:48pm - Finger stick - 34

    DEFCON 1 in our house. Juice and tabs. Son is very shaky.

    10:02pm - BG 82
    10:18pm - BG 99
    11:00pm - BG 249

    I clearly gave him too much insulin. The increased basal and correction hit him fast and furious when I thought I'd again me met with more resistance. I always thought his first sub 40 number would be due to extreme exercise, but no, it happened right under my nose with him in the car with me.

    11:05pm - Son says to me in bed, "I hate my life. I hate Diabetes".
    11:06pm - Dad feels good. Real good. :(
     
  2. ecs1516

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    That is so hard when they are riding in a car they go up and hard to guess how much to give in additional. Did you pump take off for the 1st correction when you gave the second one because of IOB?
     
  3. DavidN

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    Yes, I think the calculation was 1.2u but the PDM then subtracted .4u of IOB for a final bolus suggestion of 0.8u.
     
  4. virgo39

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    I'm so sorry that happened and especially that you son was feeling so bad about things.

    If you had to do things over again, yes, you might do them differently based on this experience, but it seems like you were doing your best based on past experience--and that's nothing to be ashamed about.
     
  5. Jaredsmom

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    We are all human and being human we are not perfect we have all made mistakes and will continue too make them. As long as we learn from our mistakes that is what really matters. I personally have overbolused Jared when I felt a high wasn't coming down fast enough. I have also over treated lows to the point that his bg was over 400. It happens. As long as you are diligent about testing they will survive I can promise you that. :)
     
  6. Sarah Maddie's Mom

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    It happens. We've ALL done the same, or worse. Let it go and carry on.
     
  7. ecs1516

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    David I also wanted to add that my older son has said the exact same thing.:(
     
  8. DavidN

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    Son now has a temp of 101. Maybe him getting sick compounded the problem?
     
  9. ecs1516

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    Oh yes, I would agree
     
  10. greenpalm

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    Yes, I'm sure him getting sick would contribute to the problem.

    At a weekend orientation for Camp Sweeney diabetes camp, Ernie Fernandez, M.D. the endocrinologist that presides over the camp pointed something out to us in the parent session. He said in a survey of parents of kids with type one, they asked, "Would you rather your child be at 180 or 60?" Most of the parents picked 180, and his point was that 180, is at least 30 points above target range, while 60 is only 10 points below target range, and that we probably ought to worry as much or more about hovering around 180 as we do hovering around 60. It ought to be JUST as urgent to bring them down.

    My husband's endocrinologist says "hyperglycemia will kill you slow, hypoglycemia will kill you fast? pick your poison."

    So, no "Post of Shame," you were doing the right thing, and you were doing your best. This isn't easy.
     
  11. LoveMyHounds

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    I know, I know.... but I still would pick 60 :rolleyes:
     
  12. Sarah Maddie's Mom

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    To each their own, but I take little away from that comment. And find the notion of framing highs and lows as a "poison" one sides with entirely unhelpful.
     
  13. hawkeyegirl

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    Not to mention that hyperglycemia can actually kill you pretty quickly, and statistically is a lot more likely to do so than hypoglycemia. ;)
     
  14. susanlindstrom16

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    Don't beat yourself up over it. I know that's easier said than done. I have had my instincts be way off when it comes to D stuff, it sucks. There's nothing to be ashamed about.
     
  15. DavidN

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    Thanks, I felt like absolute crap at the time but am more or less over it now. I was just stunned to be so far off. 70, 60 or even 50 I get. But 34 when I was right there with him the whole time?! I guess it happens.
     
  16. Nicole N

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    Your story sounds just like my days. BG is crazy, often cannot be figured out...but we all do the best we can. Let me tell you - my son (who is 9) says the same exact things (often). It breaks my heart. I cannot wait until treatment is better!!!
     
  17. mmgirls

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    You need to make sure that you try to calibrate at the low end whenever you can. And again if you reuse/extend the life past 7 days.


    My kiddo has had more than 1 low when I got to to "rage bolus" side of things. You know that overly aggressive correction or balas change that you where looking to feed if need be, but it all happened too quickly, and all of a sudden whatever insulin resistance there was is now gone. "PUFF", like a cartoon.

    Just tuck this back into your memory for the next time, cause it will happen again.
     
  18. DavidN

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    Not sure what this means. On another thread there was universal agreement that calibrating at low end is a bad idea and I'm warming to that idea due to accuracy. Dex was just late to the party. It eventually showed the low, just 5 -10 minutes after my son alerted me.
     
  19. MomofSweetOne

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    I don't know if you did this, but when I go aggressive with a high, I increase the low alert on the G4 to its highest alarm so that I have a few minutes earlier warning if she's dropping fast.
     
  20. mmgirls

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    can you point me to that thread?

    I am a firm believer that Dex is more accurate when you calibrate in all ranges, I am not talking about calibrating right then when there was the fast drop. But rather when you have lower or higher numbers that have been steady for awhile.
     

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