Ketones with a Side of Caffeine

My alarm goes off regularly at 4:30am, earlier if I am doing some insane workout that requires travel time in addition to workout time. I like it though. I like to be up earlier than anyone else, especially the little people in my house. I need to work it out before I am an M-O-M. It makes me a better M-O-M.

Today started out as any other day.... Alarm goes off. Hit snooze 3 or 4 times, knowing my clocks all run 8 minutes faster than anyone else's. After all, my house number is 8 and there are 8 of us in our family, so it only makes sense. Today was a run day-my favorite day of all to get up. I would run every day if my body would allow it. Doesn't have to be fast, doesn't have to be hot or cold out, but outside, with company, and with some music. Hands down, the best way for me to start my day. The plan was for a quick 7 miles. A very enjoyable route with a few gals.

I won't usually eat before a run, but for 7 miles I like to munch a few shot bloks for a small caffeine boost and some calories. Because they have caffeine at it's 5am in the morning by the time I get out of the house, I make sure I'm going to run and those that said they were running....are. Today, I ended up driving behind Kerry and knew she was on her way to meet up. I downed those suckers--3 shot bloks, I LOVE them!

As soon as I pulled into the parking lot, my phone rang. It was Betsey.

I thought she dialed me on accident in her sleep. 5am call from Betsey??

She needed an insulin cartridge. She felt "OK."

I peeled out of the parking lot, hoping to make it home with time to change her cartridge, something she can do on her own, but I didn't think at that point, why is she calling me when she can do this herself? and race back to the meet up, or at least catch the gals as they ran past my house.

Well, turns out Betsey was high. She was pushing 500 mg/dl!! She didn't want me to go. She felt "OK" but felt better if I stayed. And of course I would stay with her. It wasn't a question of me staying with her. But by now, my shot bloks had started kicking in and I was wide awake. They must really perk you up if you eat them and then don't burn off energy and USE the caffeine in them. Oh yea.... they certainly do.

Wide awake. With no running legs.

Bets, when did you start going high? Look through your pump at your sensor.

Umm, the sensor ended yesterday, I have no signal.

Allllrighty. Well, what did you tell me your number was last night before bed?

I didn't test before bed.

This conversation got me a little squirmy. Was it the shot bloks or was it my frustration about the lackadaisical answer? Those two missing tidbits didn't help me to determine how much insulin to give her for a correction based on how long she'd been high and if she had gone to bed high -- because her sensor ended and she didn't restart it as she knows she should do-just a touch of 3 buttons-and she didn't test before bed---the most important test of the day.

Hmmm...........

I gave her a double correction via syringe, put a temporary rate to double up her basals on her pump and we headed upstairs. Those shot bloks had me skipping up the stairs. I couldn't get up them fast enough. I thought, heck, if I won't be running today, I'll skip up the steps. Secretly, I wanted to do the steps again..... with my ipod on. Anyone need anything downstairs?? I'll get it!

I sat on Betsey's white fluffy rug next to her bed as she rocked back and forth, breathing in this almost chant-like thing she does, trying not to think about having to throw up. Her breathing changes as she realizes those nasty little ketones are getting the best of her.

Hayley's alarm goes off, and in my shot blok-ed state, it was downright comical to witness her starting her day. At almost 16, it's not something I am privy to often. She tossed the pink and white and black zebra covers off of her, threw her legs over the side of the bed, and in 4 very quick, very rehearsed steps, narrowly missing Betsey legs on the trundle beneath her, she made a dash to silence the annoying buzz that was calling her out of her slumber half way across the room. This happened 2 more times before Betsey and I made our way to the bathroom.

I had to pull Betsey off the bed. Her body almost seizes up. It's too painful for her to move when she knows she has to visit the throne. We just made it to the bathroom.

It takes everything out of her. Everything.

The day pretty much went downhill from there. I drove her to school after getting her down to about 230 mg/dl thinking she was on the down slope. Lunch time call from the nurse let me know she was well over 400 again and I was out and about and said I was coming to get her.

Basically, we spent the day testing every hour, putting on temporary rates to double her insulin basal rates, and I injected her with double corrections - all day long! She probably got quadruple the amount of insulin she gets on a regular basis.

3 site changes, 3 reservoir cartridge changes, a call to Yale and to Minimed to check the pump for malfunctioning, and she was finally a decent 131 at dinner.

Wow.

I plan to be up every 2 hours checking her because inevitably, she'll be low all night from all the insulin catching up with her.

Betsey is 12 years old. She has a lifelong condition that requires monitoring and attention 24 hours a day, 7 days a week. No break. EVER. If you slip, it can be tough to get back on track. If you slip and slide, it can make you sick. Today, Betsey slipped and slid.

She wants so much for me to be off her back, letting her do her thing, stop hovering her.... But she isn't responsible enough, nor should she be or should I expect her to be, nor is she knowledgeable enough to be able to make the decisions she wants to....alone. There is such a fine line with this crap and I honestly don't know where it is.

Do I step back, allow her to make these decisions, and then watch in the shadows the morning after a violent trip to the toilet because she didn't replace her cartridge before bed even though the pump alerted her three times to do so... and watch her cry, throw up, fall asleep from the exhaustion, slowly work herself back to "normal" and hope she understands and gets it? Or do I try and help prevent it..... always do it for her for now... Deal with her hating me always in her face. Deal with the snide comments, the looks, the mumbling under her breath...

Which is worse? It's the lesser or two evils really. And I don't know what I'm supposed to be doing. Where is the balance? Where is the handbook on how to deal with a 12 year old beautiful, smart, funny, independent, diabetic Betsey?

Hello? I didn't get my copy.

I am at a point in the care of Betsey and her diabetes where I don't know what I'm doing.

There. I said it.

I don't know what I'm doing.

I hope tomorrow is better. It has to be, right?

I'd like to have 3 shot bloks in the early morning hours, get some use out of that caffeine, and Betsey to have decent numbers all day! Please.