An action taken to avoid disaster.
Joseph calls with his post-breakfast blood sugar.
"Hi, mom. I'm 228 . . . you know, just a spike. Oh, and we're having the same snack as yesterday-- Cheez-Its."
"Okay, bud. Let's get that bolus on board and not worry about a correction."
".45-- should I go?"
"Love you too, darlin'."
Joseph calls yet again, this time with his pre-lunch blood sugar.
"Mom, " he says between telltale chews.
My heart sinks.
"I'm 67. I'm really, really sorry," he continues, in a voice muffled by the familiar crunching of several large glucose tablets.
"Honey, there's absolutely nothing to be sorry about. You're low. This is gonna happen sometimes. Really bud, it's okay."
"But, mom, you don't understand," then, he says miserably, "I didn't have a snack."
Immediately I'm calculating in my head. No food since 7:00 this morning.
And more insulin.
Almost half a unit is a hell of a lot for this kid to take in with no food. Thank God he was high going into snack.
It should be all right.
Deep breath. Then, with no trace of the panic that has begun to take hold.
"It's okay. But honey, what happened to your snack?"
"I forgot all about it."
"And... well... Mr. S. never gave it out."
Now, along with fear and worry, anger jumps into the fray.
"Honey, I want you to call me back in 15 minutes with your sugar," I say, in as calm a voice as I could muster. "Just stay in the nurse's office, okay?"
I hang up, and immediately punch in the number for the school.
"May I speak with Mr. S, please?"
Dead space of hold.
"Mr. S, here."
"Hi, this is Sandra Miller, Joseph's mom. I'm calling because I just spoke with Joseph. He's having a low blood sugar right now. Apparently, he bolused for the snack, but that snack was never given out."
"Oh, well. You know, we didn't really have enough crackers for the whole class so we didn't hand them out."
A pause, and then in a bit of an awkward tone:
"And . . .well . . . Joe does have peanut butter crackers for those times when he needs them."
"Yes, that's true," I respond, struggling to hold my temper. "But he was told there'd be a school snack. He bolused specifically for those Cheez-Its. Then, when they were never given out, he just forgot. We really need to make sure that he eats something whenever he's given himself insulin for food. I guess I'm just looking for a fail-safe here. I really need to know that someone is watching out for him when he's giving himself his insulin. Making sure that if he forgets, he'll be reminded to eat something or bolus if need be."
I'm so damned combustible right now that if there is even a hint of disagreement, I'm just gonna blow.
"Sandra, I'm so sorry. I guess I need to be more involved with this."
"Yeah, that would be great. Really great."
I get off the phone and just want to cry. But before I have the chance, the phone rings again.
"Mom, I'm 63."
"Okay bud, let's have ya eat three more glucose tabs, and check again. You came down pretty quick from that snack-time sugar, and that extra insulin is just pushing you down further. But it's okay."
"Hi Mom," Joseph says, sounding much more like himself. "I'm 72."
The right direction, just not quite as high as I was hoping.
"Can you go to lunch right now?"
And so he did.
Rebounding hours later into the 300s.
I Hate This Damn Disease.
Thursday, February 09, 2006