Hannah's diabetes appt went good today. It was good to finally sit down and talk with someone who understands what's going on, and can help me. We saw a CNP, today and not her endocrinologist, which was fine. I liked her too. Found out her A1C is still high, 8.0% last time-- 8.5% this time. Goal is 6.5-7.0%. It just means her overall average blood sugar in 3 months is still in the mid 200's. Although the meter results indicated her average was 186, I forgot to bring the school meter, which had alot of high's on it as well and would have brought that average up some.
Each time I get a print out of about 6 pages, showing her levels for a month, the averages, the number of highs, normals, lows, percentages of each, and weight and height growth, etc. Alot of information.
She is 52.6 lbs, and 50 1/8 inches. She has grown so much in a year. Last December when she was diagnosed she was 42 lbs, and about 48 1/2 inches. She is in the 75th percentile for height and 25th percentile for weight.
Tall and thin--where does she get that from?? Emery's I guess-- he he.
We talked at length about doses, carbs and her daily routine and changed a few things. Mostly the at school stuff, and then the bedtime routine is changed a bit. She is most likely out of the "honeymoon" phase now, and is no longer producing any insulin. She said where as in the beginning we could get away with giving her a few extra carbs or a snack because her body was still producing a little insulin....now we have to watch the carbs more and give her insulin accordingly. She said we are doing a good job though.
At school she was being tested before PE at like 9am or so, and sometimes the nurse was giving her carbs if she was 200 or below, for the exercise. ( which with the limited exercise of 2nd grade PE she was probably getting too high with the extra carbs already) and then at snack time at 10am was getting milk and snack which is about 20-25 grams, and no insulin.
So now she wont be tested before PE and instead at 10am snack time, which will then be an accurate test, where as before PE is was not.
( tests are not considered accurate, if tested before 3 hrs because the insulin is still working in her body for up to 3 hrs.)
I am not really worried about her getting too low in PE, and we need to worry more about covering her carbs at snack, so she is not so high at lunch. The nurse won't have to test her at lunch then, ( since it's only 2 hrs after snack time)-- but will just cover her lunch with insulin and I will test her when she comes home from school to see how it all works.
Her doses stayed the same, from what I changed them too over the last hectic month, so I guess I did pretty good there. May have to change the lunch dose a bit if the morning routine, still brings her after school levels still too high.
Things have been looking better the last week or so, but still gets quite a
few 200's or higher, so I knew there was still something else we needed to do.
Then at bedtime, she always wants a snack that we hardly ever give her insulin for, unless she is pretty high already and wants a snack. Then I test her at 12-1am, which isn't fun to wake up and wake her up.
So now, we'll give her whatever she wants for a snack at about 7pm, give her insulin for it and I will wake her to test her at about 10pm for awhile to see how that works. After we pretty much know how her body will handle the snack and insulin dose, she should be good all night then, as the Lantus dose is working for now at keeping her morning levels always pretty good. It'll be a little playing around with doses again and frequent testing.
Basiclly we just need to change things up a bit in our routine, so that everything she eats is covered with insulin. We've been a little lax, I think, with giving her extra carbs.
So hopefully this will get a little easier after getting into a new routine. Once we get this figured out (hopefully soon) then this winter I think we'll be doing the pump, and seemingly starting all over.
Her next appt is January 14, at 9am, with her endocrinologist, and they will do annual blood tests-- thyroid, kidney function, etc, which they did in the hospital in December last year.
We are getting through, one day at a time, I just wish...... well you know.
I am thankful, that even though insulin is not a cure, that it is keeping her alive and well. I thank God for her.
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