Another Day

He's 321, and cranky.

I can't really blame him. He's been high all night.

But thank goodness, no ketones.

And at least he's not low. He's had a lot of low blood sugars lately-- and some have been scary.

I twist off his insulin pump cap, pull out a half full cartridge of insulin, then press "Rewind."

Immediately we hear a whirring sound as the pump's threaded piston rod slowly spins down.

We're all very quiet this morning.

Even Evan says nothing as my hands move quickly-- tearing cellophane; puncturing a vial of insulin with a long needle; drawing fresh insulin into a new cartridge.

"Any air bubbles, Mommy?" she asks, lifting her head briefly from her brother's shoulder.

"Oh yes," I tell her as I repeatedly smack the side of the cartridge with a pen, and then quickly remove the needle and plunger from the cartridge, attach one end of a length of tubing to it, then insert a now full container of insulin into the pump.

I press "Load Cartridge."

As the piston rod whirs again-- rising toward the back of the cartridge -- I lift my head, and for a moment, just watch my two kids sitting together.

Joseph looks tired-- and wary.


He doesn't say a word.

Just waits for me to tell him it's time.

This is a ritual we repeat every three days-- sometimes sooner.

Like this morning -- when something is wrong.

When his blood sugar is dangerously high and isn't coming down.

"I'm ready, Bud."

Joseph puts Evan down, then I look to see where I'm going to insert the cannula-- the small (6 mm long) tube, or catheter that will be the entry point for the insulin coming from his pump.

He can do this himself-- has done it himself -- but prefers me to do it.

You see, he does so much of this stuff-- monitoring, figuring out carbs, thinking.

Always, thinking about how he's feeling.

With one hand, I hold the insertion device against the skin of his abdomen; with the other, I rub his back-- and breathe with him.

"Honey, now take a gentle breath in . . . and now a soft breath out. . . that's it . . . and now another breath in . . .

and then softly out . . . "

I squeeze the sides of the device, and with a loud snap, the introducer needle shoots into my son's belly-- he gasps.

Still holding the inserter against his stomach, I count slowly, "One.. two.. three.. four.. five.. " then pull out the long needle.

The cannula is now inside my son's body, and will (hopefully) remain there for another three days.

"Was that okay, Bud?"

"Sure, Mom," he says, but he's still wincing.

Sometimes it stings for a while after.

This is our life now-- or at least one piece of it.

The doctors said in the beginning that this would all become a routine.

"Like brushing your teeth," they told us. Just something we'd do.

Something he would do.

But you know, if we forget to brush our teeth, we don't get sick.

We don't die.