6:00am - The early morning quiet is broken by the sound of a sweet, tiny voice breaking out into song. Bed sheets rustle then two little feet hit the floor. I know the sound of Jenna’s feet versus Jazmine’s. Jenna has a heavier foot with a faster pace. Jazmine is always in stealth mode. This is Jenna marching into my room with the determination of a warrior and the subtlety of a bull. Within moments she is at my bedside, pulling back the covers and nudging her way in beside me. Mornings like these I am thankful for both the early morning snuggle and for not having to lie in bed and wonder if Jenna is okay. She is up. I know she is safe.
6:10am - While I grab my morning shower J gets up to prepare breakfast for the girls. A blood sugar check is done, cereal choices are made, carbs are counted, buttons are pressed on her pump and a bolus is administered.
7:30am - J and I sit and enjoy our morning coffee together while the girls play. Before J says his goodbyes and heads to work for the day a report of the details of Jenna’s breakfast is given--what and how much she ate, the dose of insulin given and what her waking blood sugar was before she ate. This information gives me an idea of when Jenna will need to have a snack. If she didn’t eat all her breakfast I know to watch for a low around 9:00am. But even if she did eat all her breakfast, there’s no guarantee she won’t go low. Diabetes is funny that way. All the rules are subject to change without prior notice and often for seemingly no reason at all.
8:30am- School time. My oldest daughter is in grade one, in a learn-at-home program. I teach her lessons at home weekday mornings. I also plan structured learning activities for Jenna most mornings.
9:30am - Snack time--the highlight of the morning for Jenna. Another blood sugar check before they tuck in to cheese, crackers and apple slices or corn cakes with peanut butter and banana; perhaps a piece of whole wheat toast lightly dusted with cinnamon sugar. Another carb count, more buttons pressed and a bolus is administered.
11:30am - Lunch time. Soup, sandwiches, the usual lunch fare. Another blood sugar check, carb count, buttons pressed and bolus given.
12:30pm - For Jazmine afternoons are spent either in classes at her school, in gymnastics lessons, in swim lessons or art classes depending on the day. Jenna also takes gymnastics, swimming and art classes. I need to pay extra attention to the timing of snacks depending on the scheduled activity of the day. For swimming I like to ensure that Jenna’s snack is no more that one hour prior to her lessons to ensure she doesn’t go low while in the pool away from my watchful eye. The same is true for her hour long art class on Fridays when I leave her at the art studio with her meter in a little backpack and a tube of carb tabs. I often spend this hour at a Starbuck’s writing on my laptop--trying NOT to worry. It’s only an hour but still...
1:30-3:00pm - Afternoon snack time varies. But what never changes is the pre-snack blood sugar check and bolus.
5:00pm - At this point in the day I am usually immersed in the preparation of the day’s last meal. But every three days a site change needs to be done on Jenna and this is often the best time to do that. J and I work together like a well-oiled machine to get the job done; one of us removes her pump while the other loads a new cartridge by drawing up 100 units of insulin. The insertion device is unwrapped from its sterile seal, unwound, cocked and ready for use. Then while J holds Jenna I prep the area and perform the insertion as swiftly as possible to decrease the anxiety Jenna still has regarding infusion site changes. Once this is done it’s a matter of reconnecting her pump to the new site and applying adhesive remover to her old site for easier removal. If I feel a review of Jenna’s numbers is warranted (usually about every two to three site changes) I will take the opportunity to download data from both her pump and her meter to the PC. I then print out two weeks of log data so that I can spot trends and determine the appropriate setting changes required. I usually save data analysis till after supper though, when I can sit with my highlighter and a cup of tea. Tea, for me, is a necessary accompaniment to a variety of life’s activities, not the least of which is effective data analysis and blood sugar trend spotting.
5:30pm - Supper is served after another blood sugar check is performed, carbs are counted, data is entered into the pump and a bolus to cover her supper is administered. This bolus requires more thought, however. It is what will impact her numbers while she sleeps, depending on what she ate and the type of bolus given. A higher fat meal tends to delay it’s full effect on Jenna’s blood sugar, sometimes for up to 10 hours or more! This is when we employ the help of the combo bolus to stretch out the dosing of her insulin to match the delay. It doesn’t always work. I’m getting rather bold though and often ramp up her basal insulin by 20-30% in conjunction with the combo bolus. This helps prevent a horrible, stubborn blood sugar spike. Unfortunately it can work too well and send her into a hypo. I must be extra vigilant.
7:30pm - Bedtime. Teeth are brushed, a final sitting on the potty, faces and hands are washed and stories are read. Of course, another blood sugar check is done and we take note of how much insulin is still on board to determine, in a best-guess sort of way, what kind of night it will be; the kind of night where we can check her one more time at our bedtime and call it a night (a rarity), or the kind of night where we will be up every two or three hours checking and correcting.
10:00pm - A blood sugar check is done while Jenna sleeps. The results will require one of three courses of action: a correction bolus of insulin for a high blood sugar, a carb tab or two for a low (followed by a water chaser to help rinse away the sugar bugs), or a sigh of relief that she is within her target range and all is well.
12:00am - If a correction bolus or a carb tab was required at 10:00pm, another blood sugar check is done at this time to ensure our intervention worked. If further intervention is required at this time we set another alarm for...
2:00am - If a correction bolus or a carb tab was required at 12:00am, another blood sugar check is done at this time...yadda, yadda...
4:00am - If a correction bolus or a...well, you know the drill.
6:00am - We awaken refreshed (pfftt) and ready for another day.
In spite of the broken sleeps and the constant presence of diabetes in our lives I am so thankful for our many blessings. The routine testing, carb counting and bolusing to keep Jenna healthy has become just another part of our daily routine. Oh, sure, sometimes it can be overwhelming. On the days when Jenna gets fed up and cries out in sheer frustration I HATE having diabetes! I wish I didn’t have it! I want to join her in her moment of exasperation and, indeed, sometimes I do.
But most days we just get on with it. We aren’t going to let it slow us down and, knowing Jenna the way I do, she will never let it stop her from doing whatever she decides she wants to do in life.
To look upon her beautiful, sweet face or watch her dance in one of her princess dresses and her “clippy-cloppy” shoes you wouldn’t know that, much like the style of her gait, Jenna is a warrior through and through. Diabetes is the red cape and she is the fierce, charging bull.