Last week started out with an ear and eye infection for Riley. But, instead of running up his sugars he had lows that just would not come up.
He finally went back to school on Thursday. I really didn't want to send him. He still wasn't feeling all that great but there was no reason for him to stay home other than his screwy sugars. Being that he has Type 1 and screwy sugars come with the territory, I sent him.
I wrote a note to his teacher explaining what had been going on and that I needed to be called before Riley got insulin because I was giving him less than what the pump suggested. Also, I let her know that he wasn't really eating all that well.
Instead of being low he ran high all morning. He was 300 at lunch. I thought maybe the lows had passed. The teacher got Riley to give his insulin. Turns out she pre-bolused him and he didn't eat everything. Rather than calling me and asking me what to do she just let it go. So, of course, he was low a few hours later. He got juice and fruit snacks and actually came up this time.
Riley went to school again on Friday. His teacher called me before lunch and said that he didn't want pizza ( which is what he had ordered, Didn't want pizza? He must be sick.) She said she'd gone over the menu with him and he wanted a ham and cheese sandwich instead. She called to ask me the carb amount.
A couple of hours later (right after lunch) I got another call. (I was at a different school on Friday doing vision screenings. My cell would not pick up there so the teacher kept having to call me at the school. I'm sure the people there were wondering what was going on.) She said that Riley had accidentally dropped his pump and his site had come out. She wasn't sure if it happened before or after he'd received his lunch insulin. (The lunch insulin she'd given the full amount of without calling to check first to see how much to decrease it like I had asked.)
I had to leave and go to school to put in another site. When I got there I asked Riley if he dropped his pump before or after he gave his insulin. He said after so I assumed he got his lunch insulin. I found out his sugar was 84 at lunch. The teacher gave him the full amount of insulin (even though I had ask that she call me first). After the site change I checked his sugar. It was 134. I knew that he still had plenty of insulin on board from lunch. Plus, he tends to go low after a site change. So, instead of the usual 60% decrease I decreased his pump 80% and prayed.
At 2:30 I got another call from the teacher. Riley had been low for an hour and a half. He had gotten up to 83 at one point only to drop down in the 60s again. I had finished the vision screenings and was on my way home any way. She said they were having a pep rally and she was going to take Riley to that so I could pick him up in the gym.
On the way to the school I called his endo. She wasn't in the office so I called her cell. When she answered I quickly told her everything that had been transpiring over the last week and told her I was at the end of my rope and didn't know what to do next. I know I sounded like a blubbering idiot the way the words rushed out of my mouth.
She said that she did not know why but sometimes kids would go low like that. I explained to her that it didn't help matters that he had no appetite. She said that if he would not eat to give him sugared fluids. The key was to keep his sugar up enough that we could safely give insulin as to keep away ketones. She said that if his sugar was under 200 not to bolus for any food and if his sugar was over 200 to try only giving half the suggested insulin.
After I hung up I started to panic. I had decreased his basal 80%. Had I caused ketones? I couldn't wait to get to him and test his ketones.
I found him sitting in the gym watching the cheer leaders perform. Friday night at the basketball game was Senior night. So, just as I was arriving they called out all the Senior basketball players and cheerleaders. They called Holden out on the court. I'm not doing too well with all the Senior stuff as it is. I glanced over at Riley and he sat with a huge grin on his face. It should have made me happy, but instead I started to cry.
I started to quickly wipe away the tears hoping no one would see. Between all the low sugars and Holden's 18th birthday and the reminder that my son is a Senior and will be leaving for college next year I just couldn't take anymore.
I wanted to whisk him away so I could test his ketones but he asked to stay for the pep rally. As soon as it was over we left. I tested his ketones and they were negative. I breathed a huge sigh of relief.
Like I said Friday night was Senior night. Holden, Michael, and I walked out on the court while someone announced Holden's achievements and plans for college. I did pretty well. Tears welled up in my eyes when they presented to whole class of 2009, but I never actually cried.
Riley went low again at the ballgame, but not to terribly low. That's the good thing. Even though he's been going low, he's been hanging out in the 62-78 range. At least he's not going into the 40s and 50s and staying there.
After the ballgame we had a surprise birthday party for Holden. Riley's sugar was 73. I knew that he didn't need any insulin so I let him pick out his piece of cake without worrying to eyeball it to figure out how many carbs were in it.
Now, I don't know about you other parents, but when my kid gets to eat cake, he's almost giddy with excitement. He always scarfs it down. I say he does it because he's afraid someone is going to take it away from him.
I looked over and noticed Riley's plate sitting there, the cake only half-eaten. He said he couldn't finish eating it because his tummy hurt. That had become a common complaint, and one that put my mommy sensor on high alert.
Once home his sugar was still on the low end. I had to bribe him to eat something else.
By Saturday we were still celebrating Holden's birthday. We took he and his friends out to eat and to go bowling. We ate at a Japanese steakhouse. Riley loves that place and for the most part ate pretty well. He ate quite a bit of rice. His sugar was around 170 s0 I gave him less than half of the amount of insulin suggested by the pump.
Next we went to the bowling alley. While there Riley went low, 64. I got him to drink a juice and eat a couple of pieces of candy. After the bowling alley we went for ice cream. At the ice cream shop Riley was up to 84.
I let Riley pick out his ice cream and didn't stress at all trying to figure out how many carbs were in it because I knew we wouldn't be bolusing for it anyway. An hour after the ice cream with no bolus he was 124. He stayed pretty much in range for the rest of the night.
It was nice not having to stress about the insulin and carbs, but I kept a nagging feeling in the pit of my stomach. I thought I remembered reading in a blog a while ago that some one's daughter who was Type 1 started having low sugars before being diagnosed with Celiac.
I did what everyone does but shouldn't, I turned to my good friend Google. I found that the symptoms of Celiac include diarrhea (check), decreased appetite (check), irritability (check), abdominal pain (check), and the one that made me catch my breath, in those with Type 1, low blood sugars.
I kept my findings to myself for a while, but finally last night I let my fears spill out onto Michael. I told him that it was one thing that I had feared since Riley was diagnosed with Type 1. Type 1 is bad enough but when you throw another auto-immune disease into the mix that limits what foods can be eaten, it sounds almost unbearable.
So, for now, I continue to monitor Riley. I ask him at least 10 times a day if his stomach hurts. I'm keeping a log of what he eats and what his symptoms are. And, I'm praying really, really hard that this is just the effects of a bad stomach virus.