The Things That Keep Her Alive
Caitlin wears an Omnipod. A self-contained insulin pump that holds and delivers her insulin. It's small, lightweight, tubing free, and auto inserts with an introducer needle, at the push of a button. But you have to have a lot of faith in technology to put your child's life in its hands. The Omnipod holds 2ml of insulin. It doesn't sound like much but at 100 units per ml, that's 200 units of insulin. She uses a little less than 40 units per day, so it holds about a 5 day's supply. It would drive a person to crazy to think about what would happen if the pump malfunctioned and delivered a massive amount of insulin. So I don't. Because if I think like that I will likely push myself over the edge.
She also wears a Continuous Glucose Montor (CGM). This small transmitter (top photo) has a filament which is introduced, again with a needle, into her subq tissue. The filament reads the glucose level in her interstitial fluid every five minutes and transmits the data to her receiver (bottom photo). The data is transmitted via Bluetooth to my iPhone. Instead of the static data you get from glucose readings taken hours apart, you're able to see data for the entire day and recognize trends and problem areas to treat highs and lows more aggressively and even avoid them before they become a problem.
As wonderful as technology is, it sometimes fails us. Her Dexcom started alarming at 2am. Extreme low blood sugar. Swedish fish (fast acting sugar for a quick bump) and thin mint cookies (a little fat to slow the absorption) and we were back on track. Until 5:30am when it alarmed once again for extreme high blood sugar. I heard the high pitched screech as I approached her room. Her pod failed and stopped delivering insulin at some point in the night. Without the basal insulin her pump delivers her blood sugar immediately starts to rise. Even just a few hours without insulin will send her blood sugar soaring over 600. Lacking insulin to unlock her cells her glucose has no where to go. Isn't able to bind with her cells to provide the energy her body needs. Her body then turns to burning fat for energy. The by-product of this, ketones, become toxic to the body at high levels. Left untreated she'll progress to Diabetic Ketoacidosis (DKA), a medical emergency.
But thanks to technology, her CGM, I caught this before her blood sugar was dangerously high and was able to head off ketones. And while I stumbled around the house, checking her blood sugar, feeding her, filling and inserting a new pod, everyone else was happily snuggled in their beds. Including Caitlin who never woke for finger sticks, munching on swedish fish and cookies, a screeching pod I had to log roll her and half undress her to get off, and finally a new pod site. Big fat introducer needle and all. She'll wake this morning feeling rested and well, wonder why her shirt is half off, why her pod site moved, why she has cookies stuck in her teeth. But best of all, she'll wake this morning.
Just another night in the life of a child with T1D.
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