Yikes! 28.7 (517)! That was the call from Latchkey at 9am this morning as I was in the middle of a conference call with a customer and our plant (not to mention the pesky sales guy that was motioning to me through the window because he needed something for another client). My first thought: #*@&!, another kink. My second thought: Latchkey can pump - go for it and call me back in an hour!
10:10 Latchkey: "He's 7.7 (139)." Me: "Did he have his snack yet?" Latchkey: "Yes, at 9:30. We're going outside to play now." Me: "Ok, that's a much better number."...... After I hung up the phone my math thingy started working.... 28.7-7.7=21.... 21/1hour.... #*@&!..... Wuife IMs me: "You probably should have had them test again to confirm the high.".... #*@&! And in the car we go.......
I get to the school at 10:20 (it's only about a 15 minute drive from the office). I test him again - 7.4.... Phew! I pull out his pump to double check settings (I did a quick-draw battery change this morning right after breakfast). All is as it should be. Then I notice at about a palm-width outside the reservoir there is an air bubble about 1 1/4" long. #*@&! Then I look along the line and see about a half dozen ones along the way.... #*@&! #*@&! #*@&! So now I wonder if it was a bad reading or he wasn't getting insulin... I give my head a shake and look at the math again 21 / 1hour.... Bad reading. I disconnect, pull the reservoir, tap the air that wasn't there a day and a half ago out of the reservoir, rewind, prime out the air, reconnect.... stopping short of a fixed prime... Phew!
I put him all back together and make my notes. It's only been about 15 minutes, but I test him again... 6.9. OK, he's pretty much flattened out, no need to give carbs. I ask them to test again at 11 and call me. On my way back to the office I call the clinic to let them know what happened and get caught up on their feedback from the weekend and yesterday. Mary suggests to me to give him a little something. I take that beautiful and correct piece of advice and stick it in the back of my head thinking if he goes south again at 11:00 (just 15 minutes away now) that I'll do that, but I've fallen for this trick again and bounced him right back up. We chat for a while, schedule the pump changeover for Friday, and ponder the mechanics of the body of a child and how insulin works - thinking of the steep drop and then trailing out into the low 7's high 6's.
I get back to the office and a few minutes later the phone rings... 6.7. Booyah! Great number and the nurse will be there in 45 minutes.
11:50 - Phone rings. Nurse: "Hi, he's 2.8 (50)." #*@&! "We gave him a pack of fruit gushers, what would you like us to do?" Huh? Do? Read the orders! Me: "Ok, give him his lunch and bolus after based on the BG of 2.8 and his 34g of carbs." Admittedly, this is the first low she's had to deal with on the pump. So he spent the rest of the day in the mid to high teens. He came down into the 11's (~200) as we sat for dinner.
I started into my eggs hoping that the glucoaster ride was over for now and pondering the funny BG curve between 9 and noon. Then it hit me like a ton of helium tanks on the head.... That little streak of great numbers at 10-11... Snack carbs!!!! The animal crackers made a brief appearance to save the day, but they just weren't enough for a bolus that probably should never have been.... Sheer, dumb luck!
My little trip to school today was educational:
1) Odd-ball high? Retest (I got an F)
2) Steep crash, give extra carbs? Yes (trick question, the temporary "good" numbers brought me to a D+)
3) You only need to check for air bubbles when you set up the line? False (I must have slept in that day, C)
4) And the bonus question: When in doubt, carb? Yes (over thought that one way to hard, B-)
Result: Do not pass go, do not collect $200, if you ever want to make it to Boardwalk, remember whatyou learned on Mediterranean Avenue.