OK, I'll fess up. I threw together yesterday's post in a mad dash to get one out because in all the insanity of the weekend and getting back to the office after a week of meetings I totally forgot about this project. So I promised myself I'd take a little more time today to be able to put some good thought into it.
I, probably like most people, would love it if there were a one-size-fits-all "how to" book for this thing. We all have some similar tricks and tactics, but at the end of the day everyone is slightly different. As much science as there is behind what we do, a great deal of it is still more of an art. We begin to develop an intuition that guides our actions and can steer us in slightly different directions based one the subtle nuances of the situation.
In basic terms, low and danger are proportional. The lower the low the more dangerous it can be, so the first thing is to be able to recognize a low. Jonathan can be 3 or 23 (54/414) and he does not usually present any symptoms. Once he gets to about 2.5 he starts to show, but I don't like letting him get that far. Since we can't pick up on lows by sight, we vary our test frequency to suit the day. While an average day may entail 5-6 checks, a suspect day might easily be double that if not more.
Once a low is determined, we most often treat with a fast-acting carb. The easiest thing is juice. The drawback to juice though is he loves it and once he has some he will want more. Juice is our night time standard though as he can sip through a straw in his sleep. We have a few cups left over that have the built in straw and I dole out juice and 1/4-1/2c servings depending on the BG#. Apple juice and peach juice seem to work well and he likes them. I prop him up with one arm and put the straw to his mouth while whispering in his ear a steady chant of "juice time, keep going, good job, drink it up…" and with about 20-30 seconds he's done and rolling back into his sheets. The other reason I like this is because I can get a L of juice in a tetra pack that has about a 12 month shelf life and is re-sealable - no sense tossing half a juice box in the garbage. Some of the day time favorites include, arrowroot cookies, fruit, or if on the go a sour crème glazed timbit (if you don't know what a timbit is, you need a weekend in Canada). Of course candy is always an option and is on hand, but we'd prefer something a little healthier.
Thank God, and knock on wood, we've never had to use it, but there is also a tube of cake decoration (see The Kit). If worse comes to worse and we don’t have glucagon on hand, we can put a dollop of cake paste in each cheek and rub it in for a quick sugar boost, but like I said, it's never come to that and hopefully it never will.
At the end of the day, it's whatever will get him back in a safe place. Of course we have our preferred choices, but just about anything will do in a pinch.
After the fact, I try to look back and his numbers and see if there's a pattern - I find a lot of the time that lows follow a high and vice-versa. It's possible that this is just a fluke thing from time to time, but odds are there is a probable cause to be found and a lesson to be learned and it is in that learning that we get better at what we do. There will always be lows (and highs for that matter) no doubt about it, but we can work to minimize them. Everyone is different and some will have more than others, just as unfair as the disease itself is, but sometimes we need to look back to move forward.