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this is why we test at night

Discussion in 'Parents of Teens' started by wilf, Nov 17, 2011.

  1. MomofSweetOne

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    I think I'd be reporting her to her boss. She sounds awful...that's a dangerous expectation to tell parents as well. Does she think all of us night checkers just like being up? If we could have a perfect night even once a week, I'd be thrilled. Last night was highs with ketones. Growth spurt, flu bug, your guess is as good as mine, but the nights have been brutal this week.
     
  2. missmakaliasmomma

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    Great idea to switch.. I had to deal with my daughter's first endo because there were no others around me until last yr. Our first endo critiqued us.. and that's about all she did. I would tell her my findings and I was always wrong in her eyes. I wanted to take my daughter off NPH, they wouldn't. I explained to her that my daughter kept going low because NPH was too unpredicatable and she kept going low because of it. Her response, " you're going to give her brain damage because of all these lows" So change her damn insulin!! Ugh, it makes me mad now to even think about it lol. Changing endos was the BEST decision I ever made. My dd's dr now is wonderful and I wouldn't change. ( The first endo was so bad I actually switched my insurance so I could see the one she has now)

    I wish you luck with the next one you go to! =)
     
  3. wilf

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    Is she clued out because she's just out of nurses' school, or has she learned nothing since then?
     
  4. Michelle'sMom

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    I'm not sure Wilf. She looked very young, but who knows? She definitely lost credibility with me. She'll have to further her D education somewhere else...not with my child.
     
  5. MommaKat

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    NP is indicative of, at a minimum, 4 years of school to earn a BSN, two+ years to become an NP (maybe 18mos if she did an accelerated program, but few exist), and required hours of floor nursing to get into that program. If she holds her CDE certification that's 1000 hours of documented D education or 400 hours (on top of three years RN experience) if she completed the NCBDE mentorship program, plus passing the CDE board exam. To think she made it through all that with that stunning lack of knowledge? Beyond frightening. I'm with MomofSweetOne - that's reportable - at the very least to the endo center, if not the state board of nursing. She won't lose her license, but she'd have to complete more education.

    I still night test, even with dexcom G4. I will never not test at night - except of course when she moves out, on to college, or whatever. My 13 yo had her first seizure a few weeks ago. Scared the pants off of me. Sub 50s in the middle of the night have failed to take a hint and become strangers. Unlike dd's original endo (who insisted on no night testing from Dx on), her new one talked to dd about coming up with a plan for night checks that she can start in HS so it works for her in college. The endo also put 'continue to check BG through night every three to four hours' in her POC orders so that dd's dad and older sis can maybe start getting it. Maybe.

    I was recently in the hospital for a week and a half, and it was dd I worried about most. No one in our family was willing to night test - she spent a week at her bff's and my friend got up twice every night to check bg. (In that sense, we're blessed.) We had dinner at an ADA event last night, and L was telling me how much she and her husband are now learning about diabetes, how the night time numbers and dd's variability throughout the day both surprised and scared them. L and her husband have always been happy to check dd's BG at sleepovers they host, but she said now they understand why we test at night. It's things like that, or re-reading this thread, that validate what we do - sometimes at just the right moment. Don't have time to come here much lately, but it's threads like this that keep it bookmarked in favs.
     
  6. Michelle'sMom

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    I've requested my dd's complete medical file & all dr's notes. I plan to pick them up on my way into the clinic (we drive 6 hrs to the endo). It should be interesting to see what the NP documented about our visit. My response to her was simply that day to day management was up to us & as long as we're responsible for our dd's care, we would decide the testing schedule. I was so taken aback by her comment about the constant 100 overnight that I laughed & asked if she was aware my dd's dx was T1. At that point, I wrote the appt off as a total loss. In hindsight, we should've ended the appt there. Instead, we were subjected to her opinion about our decision to homeschool, which I'm still simmering over 4 months later. She seemed to be as knowledgeable about homeschooling as she was about managing an adolescent with T1.

    I do plan to discuss the visit with the endo next month, but I want to see what's been entered into the record before I do. I'm expecting a big red-lettered label as "non-compliant parent." :cwds:
     
    Last edited: Jun 13, 2013
  7. wilf

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    better to be "non-compliant" with a happy and healthy kid, than to follow poor advice and put them at risk..
     
  8. Helenmomofsporty13yearold

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    OMG, I am so sorry. It is freaking me out that a seizure can still happen on CGMS and with night testing. Was it a night she was active? Do you think she was ovulating at the time or was it just before her period? Did she have a bedtime snack that night? I am asking all these questions because DD had several episodes of needing 175 carbs to bring up nighttime lows during puberty even though we did nothing different than any other sports night, other than perhaps not having a "good bedtime snack" versus e.g. a piece of fruit. She has not had these incidents since she stopped growing. I think every mother of an active daughter needs to test between 1:30 am and 3:30 am.
     
  9. Michelle'sMom

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    I absolutely agree. Hormonal fluctuations during puberty are so totally unpredictable. IMHO, it's dangerous to not warn parents of the unexpected swings that can happen, particularly overnight. We've used the Dexcom for almost 3 yrs, & we still miss lows....from the Dex being off, or from not hearing the alarms. It's just much better for our peace of mind to continue night checks. And it gives us additional opportunities to catch those hormone spikes as well.

    MommaKat, I'm so sorry you both had to experience that.
     
  10. shannong

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    My son recently went on the pump and I had to attend the mandatory pump training clinic. I sat in a room full of other parents with kids with Type 1, who groaned when the nurse suggested that after their kids go on the pump they should do a 3am check for the first two weeks. The nurse assured them that the would NOT have to do this after those 2 weeks.

    But here is what boggles my mind: there must be many, many, parents of D-kids who don't test at night (I was in a room full of them). And it seems pretty common for endos and nurses to assure parents that it is not even necessary. So, if this is the case, I am assuming that d-kids bodies must have some pretty amazing abilities to protect themselves against the lows and rebound from them. I'm thinking that rebounds must happen all the time from those kids that are not checked at night. I shudder to think about what the long term health consequences of that might be.

    I believed my son's health team in the beginning that "he would just wake up from a low" and did not night time check for the first month after diagnosis. I remember one night shortly after diagnosis when my husband called me to my son's room because he was drenched in sweat. I mean drenched. The sheets were soaking wet. We stood there wondering what on earth could be going on. We were so clueless, we didn't even think about him having a low. When a doctor assures you that they would wake up if they were having a low, I believed them. I look back on that time now and would bet money that he was having a terrible low. I'm not sure where I learned about night time checking (maybe on this forum), but we are big night time checkers now. I really just wish that endos and nurses would tell parents to night time check! Maybe the body has the ability to rebound from lows, but it sure doesn't mean it's not harmful.
     
  11. Michelle'sMom

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    Not all CWDs rebound & it's certainly not something I would ever want to depend on. I can count on one hand the number of times my dd has woken from a low, including the first time I used glucagon on her.
     
  12. shannong

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    I totally agree and thus, test every single night (usually a few times) because yes, rebounds are not something I would ever depend on.

    In my earlier post, I was simply wondering about all those d-kids who are never tested at night (often on the advice of endos). Clearly there could be dire consequences for a rebound that doesn't happen, but I also think there must be harmful consequences to the body for lows that then rebound and thus go undetected.
     
  13. Michelle'sMom

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    And that's not even considering the missed opportunities to correct those sneaky highs. I often wonder how many of the kids who aren't being checked at night wake with out of range BGs & spend the whole day battling. Those prolonged highs are doing damage as well.

    As for the endo teams & why they won't suggest night checks, the ones I've spoken to seem to think we're all a bunch of parents living in fear of overnight lows, as though they rarely happen or we can have any real control over every single one. I've come to the conclusion that unless they have a CWD themselves, they really have no clue what we deal with.
     
  14. wilf

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    You've got it exactly right.

    Nights offer a great chance to correct highs or lows, and get the next day off to a good start. Nights are our "secret weapon" as we muddle through DD's teens.

    Few medical professionals really get it. The ones that do are worth their weight in gold. :cwds:
     
  15. sugarmonkey

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    At the support group I go to, I'm the only mother who tests at night. None of the others (pumping and MDI) think it is necessary at all. I feel a lot safer testing DS at night, and can't sleep if I don't. I still wake up at his usual test times if he's at his dads. DS comes home from the youth support group meetings telling me 'No one else has to test at night'. I just tell him the same thing I say about family rules, 'What other people do is their business. We'll do what we think we need to do.' I have caught MANY lows testing at night that we would have missed. He has not woken up to them once. Also, as the PP said, lots of highs that would have resulted in a really crappy day if we had left them till morning.
     
  16. ecs1516

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    Yes I don't see how people do it without testing at night or having CGM wake them up. Like tonight, son ran 3 miles and it was site change night. It alarms and he is 67. i give 6 glucose tabs and turn pump off 1 hour. 20 min. Later he is 51. Two more glucose tabs and OJ. Of course he never woke up with alarms.
     
  17. BittysMom

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    I've wondered how they could say night testing isn't necessary when they see cgm data as part of their work. :confused:
     
  18. Sarah Maddie's Mom

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    I test at night but I'm not a slave to it. If she's had an uneventful day and maybe a lower carb dinner I'm more relaxed about it. I might get up to check the cgm that doesn't quite reach to my room, but I think night checking can be something one does based on past experience and an understanding of what has gone on during the day.

    It does't help us to be unnecessarily exhausted or, I think to communicate to our kids that the overnight hours are to be so feared. I just don't see it as so black or white.
     
  19. sugarmonkey

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    We don't have cgm and DS is very unpredictable between 12am and 3am. One night he can be high, the next low, so I never know what he's going to do. And that's without anything different, like extra exercise during the day or something. No matter what I do to basals, we still get this unpredictability. So for me testing sometime during that window is a necessity.
     
  20. wilf

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    Fair enough. I should clarify that we test most nights but not all nights.

    There is the odd evening where it is clear that nothing unusual happened during the day, there is no bolus/correction insulin working, Lantus is set right, and there was no significant exercise that day. On those blessed evenings we turn in early and happily sleep through.. :cwds:
     

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