I was modestly pleased with my highly normal blood sugar reading today since my mother keeps warning me how if I stay fat I'm going to get type 2 diabetes and die young. [Expository story deleted by Rachel.]
Rachel received the good news less than enthusiastically. "It wouldn't kill you to take her advice anyway!"
"It nearly did! When I started exercising I ended up spending a month in a shoulder brace!"
Rachel and her mom started suggesting exercise less likely to get me hurt. "You should try swimming." Boring. "Running." My father and my brother have already had arthroscopic surgery; I don't want to be next. "Walking." Boring.
"Water aerobics," she joked. No. But water-skiing? I think we're on to something!
Rachel thought for a second. "Your problem," she said, "is that your idea of exercise is ten years younger than you are."
Showing posts with label diabetes. Show all posts
Showing posts with label diabetes. Show all posts
Wednesday, August 27, 2008
Poke poke
Isaac's NP scheduled an appointment for us at 2:00 with the hospital Diabetes Instructor. Under the impression that someone would know where the instructor was, I showed up at 1:55, to find out that I was mistaken. The only thing anyone could tell us was that she was on the third floor.
The third floor is BIG.
I was a man on a mission, so when the first person I asked for directions had no idea where to look and disappeared, I left Rachel (who didn't want to appear rude by leaving before she got back) and found someone who did. Instructor located, I went and found Rachel and we got started.
I took my blood sugar with the lancet. (112.) It took me 3 tries of increasing lance depth to get enough blood. Turns out the sides of the fingers have less nerves, which was news to me. I will have to let those clowns at the Red Cross know about that next time; they always jab the center for their tests when you donate blood.
Then we learned how to give insulin shots, practicing on an orange first. Then I gave Rachel one in the back of her arm, and she returned the favor. Surprisingly, puncturing skin does feel like puncturing an orange -- a little resistance at first, then it slides in smoothly. The needles are tiny, much smaller than the ones you'd use for your immunization shots. Feels like a bee sting, only it fades away faster of course. Rachel almost wondered why Isaac makes such a big deal out of it, but he doesn't have nearly as much fat as we do which probably makes things more painful.
So this was Step One towards getting Isaac home. Nobody is willing to make a prediction yet, only repeating that he can go home "when he's stable." But this is a Very Good Sign. Just in time, too; having to choose which of her kids to be with is really taking a toll on Rachel.
On the "hospitals make you count your blessings" note: as I left, I saw a little girl Melissa's age zipping along in her walker, minus her left leg. I tried not to stare, but when she and her dad had passed, I turned and watched for a minute.
The third floor is BIG.
I was a man on a mission, so when the first person I asked for directions had no idea where to look and disappeared, I left Rachel (who didn't want to appear rude by leaving before she got back) and found someone who did. Instructor located, I went and found Rachel and we got started.
I took my blood sugar with the lancet. (112.) It took me 3 tries of increasing lance depth to get enough blood. Turns out the sides of the fingers have less nerves, which was news to me. I will have to let those clowns at the Red Cross know about that next time; they always jab the center for their tests when you donate blood.
Then we learned how to give insulin shots, practicing on an orange first. Then I gave Rachel one in the back of her arm, and she returned the favor. Surprisingly, puncturing skin does feel like puncturing an orange -- a little resistance at first, then it slides in smoothly. The needles are tiny, much smaller than the ones you'd use for your immunization shots. Feels like a bee sting, only it fades away faster of course. Rachel almost wondered why Isaac makes such a big deal out of it, but he doesn't have nearly as much fat as we do which probably makes things more painful.
So this was Step One towards getting Isaac home. Nobody is willing to make a prediction yet, only repeating that he can go home "when he's stable." But this is a Very Good Sign. Just in time, too; having to choose which of her kids to be with is really taking a toll on Rachel.
On the "hospitals make you count your blessings" note: as I left, I saw a little girl Melissa's age zipping along in her walker, minus her left leg. I tried not to stare, but when she and her dad had passed, I turned and watched for a minute.
Friday, August 22, 2008
Two Weeks Old
Hard to believe, it seems so much longer...
Glucose levels are all over the place ranging from the mid 200s to over 500. A normal baby's glucose ranges from 50-100. The doctors are trying get it around 100-200. Going to start the long acting insulin Lantus again, which seemed to work pretty well. One of the docs said he's going through insulin like water. On the bright side they now have a pre-diluted solution of insulin upstairs that the nurses can draw from rather than waiting for the pharmacy. So much faster! They've bumped up the sulfonylureas (glyburide) to the maximum dose today...so far nothing. Sigh.
He had a head ultrasound yesterday to rule out very rare Bad Things sometimes associated with NDM (I didn't ask and I didn't want to know). I asked about the radiologists report during rounds today. Dr. Z said reassuringly that it looked perfectly normal. Dr. C, with a gleam in his eye deadpanned, "Well, normal for your family anyways." Wasn't expecting that one, so I didn't have a good retort at the tip of my tongue. I just shook my head while everyone else had a good chuckle.
Isaac graduated to a crib since he doesn't need a warmer. He still eats very well, downing 3 to 4+ ounces at a time or however much he nurses. For once having an overabundant supply of milk is a blessing. The refrigerator and freezer at the hospital are well supplied for Isaac.
Glucose levels are all over the place ranging from the mid 200s to over 500. A normal baby's glucose ranges from 50-100. The doctors are trying get it around 100-200. Going to start the long acting insulin Lantus again, which seemed to work pretty well. One of the docs said he's going through insulin like water. On the bright side they now have a pre-diluted solution of insulin upstairs that the nurses can draw from rather than waiting for the pharmacy. So much faster! They've bumped up the sulfonylureas (glyburide) to the maximum dose today...so far nothing. Sigh.
He had a head ultrasound yesterday to rule out very rare Bad Things sometimes associated with NDM (I didn't ask and I didn't want to know). I asked about the radiologists report during rounds today. Dr. Z said reassuringly that it looked perfectly normal. Dr. C, with a gleam in his eye deadpanned, "Well, normal for your family anyways." Wasn't expecting that one, so I didn't have a good retort at the tip of my tongue. I just shook my head while everyone else had a good chuckle.
Isaac graduated to a crib since he doesn't need a warmer. He still eats very well, downing 3 to 4+ ounces at a time or however much he nurses. For once having an overabundant supply of milk is a blessing. The refrigerator and freezer at the hospital are well supplied for Isaac.
Saturday, August 16, 2008
The Good, the Bad, and the Terrific
And a view from the NICU...
And actually he's looking much better than he was.
First the terrific:
Isaac's blood sugar continued to yo-yo through the night. This morning they tried taking him off of the insulin again to see how he'd respond. 25 minutes after eating his sugar was 135! An hour and 10 minutes it was 165. He hasn't had such low numbers after eating while off of insulin. His sodium and potassium levels were likewise good. His blood sugar went up again to the 200s several hours later, but for a brief time he didn't need the insulin. They are now going to try shots of insulin to see if they are able to control his sugar that way. He doesn't have much in the way of fat to disperse the insulin so it's an iffy proposition. All those blood draws leads into....
The Bad:
Even though they draw tiny amounts of blood, he's a small fellow to begin with and can't spare a whole lot of blood. The phlebotomist (she tests the blood) ran a hematocrit. He's a bit anemic and somewhat dehydrated. The doctor recommended either more saline or a blood transfusion, while strongly recommending a transfusion. Eek! I truly wish I could give him blood (he only needs a few teaspoons and we share the same blood type), but there's a delay with screening it, plus they probably wouldn't let me since I gave birth so recently. In all the times I have given blood, I never thought it was something one of my children would need. It's kind of a mixed feeling; I'm grateful, and I'm a little leery. I went ahead and authorized it though, because I do think it is something he needs. Since he has a low RBC his oxygen levels have been on the low side, so they've put him back on oxygen. Darn.
The Good:
Isaac is a very good eater. When I'm not there they do bottle feed him the expressed milk, but he still knows how to nurse well. I asked if they could cup feed, but apparently that isn't something the nurses at Primary's are trained in and they aren't comfortable with it. The only other option is tube feedings, and I can't imagine Isaac being happy with another tube down his body. Plus, he seems to relish eating and I don't want to take that pleasure away from him.
Since he is eating so well now, they removed his artery line that ran through his umbilical stump. I guess there is a higher risk of infection and complications with leaving the line in place now that he's eating regularly. Instead the line is now through his wrist (not pictured because this was taken earlier). This way he doesn't have to be poked in the heel every time they want some blood from him. He's also much, much more alert. I got to hold him for about an hour while he looked around, gazed at the lights, me, anything that moved... I think he is feeling a little better.
And actually he's looking much better than he was.First the terrific:
Isaac's blood sugar continued to yo-yo through the night. This morning they tried taking him off of the insulin again to see how he'd respond. 25 minutes after eating his sugar was 135! An hour and 10 minutes it was 165. He hasn't had such low numbers after eating while off of insulin. His sodium and potassium levels were likewise good. His blood sugar went up again to the 200s several hours later, but for a brief time he didn't need the insulin. They are now going to try shots of insulin to see if they are able to control his sugar that way. He doesn't have much in the way of fat to disperse the insulin so it's an iffy proposition. All those blood draws leads into....
The Bad:
Even though they draw tiny amounts of blood, he's a small fellow to begin with and can't spare a whole lot of blood. The phlebotomist (she tests the blood) ran a hematocrit. He's a bit anemic and somewhat dehydrated. The doctor recommended either more saline or a blood transfusion, while strongly recommending a transfusion. Eek! I truly wish I could give him blood (he only needs a few teaspoons and we share the same blood type), but there's a delay with screening it, plus they probably wouldn't let me since I gave birth so recently. In all the times I have given blood, I never thought it was something one of my children would need. It's kind of a mixed feeling; I'm grateful, and I'm a little leery. I went ahead and authorized it though, because I do think it is something he needs. Since he has a low RBC his oxygen levels have been on the low side, so they've put him back on oxygen. Darn.
The Good:
Isaac is a very good eater. When I'm not there they do bottle feed him the expressed milk, but he still knows how to nurse well. I asked if they could cup feed, but apparently that isn't something the nurses at Primary's are trained in and they aren't comfortable with it. The only other option is tube feedings, and I can't imagine Isaac being happy with another tube down his body. Plus, he seems to relish eating and I don't want to take that pleasure away from him.
Since he is eating so well now, they removed his artery line that ran through his umbilical stump. I guess there is a higher risk of infection and complications with leaving the line in place now that he's eating regularly. Instead the line is now through his wrist (not pictured because this was taken earlier). This way he doesn't have to be poked in the heel every time they want some blood from him. He's also much, much more alert. I got to hold him for about an hour while he looked around, gazed at the lights, me, anything that moved... I think he is feeling a little better.
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