Monday, March 29, 2010

Let's Talk Turkey

There is a sequence of events that is played out on average of 10 times a day—every day, in our house. The blood sugar check. The lancet clicks, piercing Jenna’s little finger tip. I squeeze her finger, summoning the glistening red bead of blood to form and await the test strip. I close in on the jewel of sticky-scarlet tissue with the meter and allow the strip to absorb the drop. The meter beeps its confirmation of receiving the sample. A moment later, another beep and the number appears precipitating an emotional reaction within me that ranges anywhere from calming satisfaction to considerable anxiety and frustration.

The only results that afford my mind respite from the worry are the ones within range, obviously—the five’s, six’s, seven’s, even the eight’s. Anything below four triggers my heart to beat faster and my protective instincts to kick in while I set out to locate carb tabs in earnest. Numbers in the mid teens or above elicit within me both physical and emotional responses of sympathetic nausea, guilt and sadness knowing my little girl is likely functioning at less than peak physical condition. To be more to the point, she’s feeling like crap.

But things really suck when she has repeated high readings in spite of correcting. Her temper shortens and her appetite for water increases dramatically. Consequent trips to the washroom become more frequent as her body attempts to rid itself of the excess glucose circulating in her blood. When this happens I’m left feeling desperately frustrated and wondering why. And often that question is difficult to answer with any amount of certainty. I can sometimes attribute it to what she ate or the onset of illness. But when the obvious culprits are ruled out and I have nothing more than my own creative devices to work out the “why”, my rationalizations can reveal my desperation to make sense of such a seemingly senseless disease. I’ve been known to ponder if the earth’s position in relation to the sun or perhaps a polar shift has caused an inexplicable high! Especially when I read that other people in the type 1 diabetes blogosphere are experiencing the same phenomenon at the same time.

But occasionally it's the wacky explanation that could very well be the cause.

Jenna had a pasta meal on Friday night—a meal that is notorious for causing a delayed climb in her blood sugar long after her meal bolus has played out. We employ a combo bolus to deal with these poky carbs but we must still get up at least once, usually twice in the night to ensure she is in the good range. More often than not and in spite of the combo bolus, Jenna requires a correction for a high reading in the night in order for her to wake up with a good number. This night, however, she stayed hovering around 9—slightly high but not too outrageous. Jenna’s waking number on Saturday morning was 8. Not too shabby, all things considered! And we were pleasantly surprised that our combo bolus worked so well.  Her blood sugar didn't stray too far from its target all morning.

Mid afternoon found us at a petting farm where Jenna sustained a bite to her right hand when she attempted to pet a turkey (it is a petting farm, after all). Her initial shock was quickly followed by a minute or so of solid crying. No blood was drawn but there certainly was evidence that this turkey inflicted quite a pinch on Jenna’s hand.

Over the course of the next five hours blood sugar readings rang in at 19 and 20 respectively, even though corrections were given for each high reading. I began preparing for the likelihood that a site change would be necessary. And as I was contemplating why this high occurred the thought crossed my mind that the turkey bite experience may have caused the spike. At first I called myself crazy for thinking it. But the longer I ruminated over it the more it made sense.

I mean, why not? It was a sudden, upsetting experience that likely caused a release of adrenalin thus triggering a subsequent discharge of glucose reserves from the liver—the classic fight-or-flight response. The high hung around for the remainder of the day and by bedtime we had to perform a site change just to rule out a bad site. We checked her blood for ketones and miraculously found none. I also dialled up a 20% increase in her basals for four hours. We were up twice in the night to check her and each time her reading was lower than the last. All of this seemed to do the trick. By morning she was 6.3—nice.

I don’t know if it was the unfortunate incident with that cranky turkey that caused this sudden, prolonged blood sugar spike. My gut tells me it’s well within the realm of possibilities. But one thing’s for certain: in spite of my tireless efforts to keep Jenna’s blood sugars on the straight and narrow, I am no pancreas. I can’t possibly know what is happening inside her body at any given moment or how each life experience is going to affect her. I must accept that I will never be able to fill her pancreas’ shoes perfectly, even though I so desperately want to. But my close attention to the subtle nuances of Jenna’s diabetes just might help me anticipate its next move from time to time and that’s what keeps me going.

And as for that turkey—well, there’s a saying I’m rather partial to in situations like this: what goes around comes around. See you next Thanksgiving, bird.

1 comment:

Prudie said...

I just started following your blog after reading your guest post on Kerri's site.
I was diagnosed with Type 1 diabetes at age 2 like your Jenna. I am now 35 years old and have beautiful 3 year old daughter who is the light of my life.
Long explanation to say that I totally agree with you about the turkey bite. Not everyone realizes the effect stress has on our sugar levels.
Case in point; when I was pregnant with my daughter I had problems with my eyes. The specialist I saw told me that I would have to have MANY laser treatments that would hurt A LOT. He also told me that if I had come to him in my state 5 years prior he would have told me to get an abortion!!!! He also took a personal call while I cried in his chair!
When I had to go for a follow up appointment I had the same breakfast I have every morning and my same amount of insulin. I had no other causes to have the blood sugar level of 20 that I did!!
Needless to say I found another eye specialist whom I had a very good relationship with!
You, your blog and your daughters are all beautiful and inspiring!