Wednesday, May 10, 2017

Until the Cure

"Why Planes Crash", a documentary, makes the assertion that there often isn't one mistake that causes the crash. Many times there are a series of events that aren't caught, aren't stopped, that result in the catastrophe. The mechanic, the pilot, the plane, may be worthy and experienced but small mistakes on the part of even one can result in failure.

This blog post is starting as a big gray nasty cloud because I'm going to tell you the dark side of Type 1 Diabetes. BUT, it is meant for support for "newbies" if you will stick with me. William (my T1D) and I are very good "pilots" of his T1D. Excellent, in fact. Over the past year and a half, he has maintained an A1C of 5.9 (with one 6.3) in a body undergoing rapid change and puberty. This is no easy feat. I am bragging a bit to emphasize that we know what we are doing most days. Most days, I get posts like this:

Two nights ago was a different story. Just before bedtime, his BG was falling gently from 150, his insulin pod expired at the same time his Dexcom needed to be restarted. Sigh. I suggested that he replace the two week old sensor, but I always leave that decision to him. (It turns out I should have pushed to replace it.) I set my phone alarm for two hours to test his BG for restarting Dexcom. A weekend night, he was going to stay up late and play video games anyway so I wasn't worried about a low (mistake #2).

Two hours later, I found he'd gone to bed and his finger sticks showed he was low 50s probably due to exercise earlier in the day. I turned off all insulin and over the next hours, tried vainly to raise his BG. No amount of juice or chocolate milk, our usual treatments, would raise him. Finally, around 3 a.m., hormones started helping and I saw a rise. The Dexcom CGM cut in and out, too old to be reliable. Yet, at BG 115, past experience showed that he would likely stay steady.

At 4:30 a.m., I woke to find him over 200. I corrected but should have checked the pod (#3). Tired, I reasoned that it was due to a two hour suspended insulin and also pod change. By 6:30, nothing had changed, still over 200. Then, exhausted, I found myself waking at 9:30 (#4) and oh, no! He was over 300 and had 2.2 ketones, a level we've never seen. 3.0 means go to the hospital. The Dexcom had cut out altogether and no alarms warned me. We quickly corrected with a needle and changed the pod, which had a bent cannula. Although inserted the night before, the fact that it wasn't working was masked because for the first four hours he was going low.

I made a series of mistakes, including not better coordinating when his devices should be restarted. Some of it is due to constantly trying to figure out his changing diet and exercise. Some of it, I should have known better. So why am I flaying myself here and telling you all of this?

Each challenge we have seems to have something to teach us. I was raised to think that hard study in school prevents failure. Type 1 has carried the message for me that sometimes, no matter how hard you study and work, no matter what you do, mistakes can be made and circumstances can line up to near disaster - and we have to forgive ourselves for them. Each "crash", each hard night is another chance to learn. Even veterans of this disease make mistakes or have hard nights. Many posts on T1D forums are from moms that label themselves "failures" or "mommy fail", feeling guilty for missing something or making the wrong decision. Shit will happen. It will happen again. But, you, you will learn and grow and be able to shake it off, stand up and move forward. You are not a failure! You are a warrior in an unfair battle and there are many of us beside you - until there is a cure.