Thursday, February 26, 2009

Why do the doctors always seem so less worried than me???

Well, Elijah had his first followup visit with his endocrinologist since he was released from the hospital. It went well. We had his A1C checked first which was 8.3, down from the 10.8 at diagnosis. A1C is basically the amount of sugar attached to the red blood cells and correlates with the average blood sugar level...the smaller the better and around 5 or 6 is normal.

The fact that his A1C came down over 2 points is GREAT...means we have brought his average blood sugar levels way down...yay for us!! We also got to meet with the social worker who was a little bit worried about our family with the extra stress of dealing with a diabetic child, but seemed to be satisfied that we had a support system and counselors on standby :D.

We met with the doc for a while and it was interesting. I dont know what other parents experiences have been with pedi endos, but ours is very laid back and basically asks ME what I think we need to change. I realize I went to medical school and all, but I do not know the best way to treat a 3 year old diabetic!!! He asks me what I am worried about and I tell him I am worried that he stays in the 300 and 400s for days and then drops down in the 50s etc and it does not seem to phase him ???? Why does the number 400 freak me out and the doctor thinks it is great! Ahhhh, I hate that. He seems so out of control to me but yet seems fine to the doctor...I guess it is the curse of being a mommy...that horrible emotional attachment to the patient and all :)

He wants to put Elijah on the insulin pump which I am kind of nervous about and we will probably try to start that process in the summer. It is the best way to keep his sugar levels down but they are very high maintenance and require alot of extra work...and pain with implanting the catheters under the skin. I guess we will see how it goes.

He is a nice guy but I still have not gotten a feel of his skill. From what I have learned from the other parents I have met is that it is really up to US to make sure our babies are being treated the way that will keep them the healthiest and protect them from the horrible longterm effects of this disease...or at least hold off those effects for as long as possible. Diabetes is definitely a time intensive disease and keeps me on my toes...500 one hour then 60 the next...???!!!

For those of you who may be is our current schedule for Elijah

7:30-rise and shine, check blood sugar, eat breakfast-he only gets 30 minutes (difficult when you are a grazing toddler :)
while he eats I figure carbs and do my calculations for his correction and carbs
.5 unit novolog for every 30g of carbs plus .5 unit for every 100 blood sugar over 150...making sure to record his sugar, carbs and units on his clipboard
8:00-prepare his insulin and drag him out from underneath the table to give him his shot (sometimes he is cooperative but not always)
8-10:00-he plays, we watch him for any signs of lows or highs, looking for sluggishness, hunger, thirst, etc.
10:00-snack time, check blood sugar, eat snack in 15 minutes while I figure the carb count and correction based on his blood sugar
10:15-prepare insulin and give him his shot, make sure to record all his numbers again.
12:00-blood sugar check, try to decide what he will eat with carbs in it, ear lunch in 30 minutes, calculate insulin dose
12:30-insulin, record all of his numbers, get ready for nap time
2:00-blood sugar check, to make sure his insulin bolus is working
3:00-blood sugar check, snack, calculate
3:15-insulin, record numbers, start dinner
5:30-check blood sugar, eat dinner (sometimes not), calculate carbs
6:00-this time of the day i usually have to chase him down for his shot, record his numbers
8:00-blood sugar check, bedtime snack, calculate carbs, give allergy meds
8:15-he gets 2 shots at bedtime...lantus and his novolog for correction if needed and to cover his carbs...if his blood sugar is over 200 he goes to bed at this time, if not he stays up
8:15 to bedtime-blood sugar checks and snacks until he is over 200...if he goes to bed less than that he could become hypoglycemic and have a seizure at night
10:00-blood sugar check
12:00-blood sugar check, treat with a shot if necessary
2:00-3:00-blood sugar check, if he is decent (200-300) then we go to bed, if low or high we treat and recheck throughout the night.

some nights are looooong:( some nights are fabulous:)we make changes to his insulin every day. In between blood sugar checks we are constantly monitoring for signs of illness, hypoglycemia of hyperglycemia...and if he is acting out of sorts, the first thing we do is check his blood sugar. It always makes me sad when I look at his little fingers and arms and see all those bruises :( sometimes he is so brave and strong and other times he cryies like a pitiful little baby saying "mommy it hurts" through the sobs...this always makes me lose it.

It has certainly been an adventure and we are so proud of Elijah for how he has adjusted and taken it all on stride, even helping out with his own care. We thanks God everyday for keeping Elijah safe and getting his diagnosis before any permanent damage could occur. What an awesome God we serve!!!


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