Don't Let Your Guard Down

Lately, we've been in a comfortable diabetes rhythm.  Jess and Sean have been doing great.  We've been at this quite awhile now with Jess.  The emotional burden has lessoned.  We are used to Jess hating diabetes at times.  We are used to the daily impact it has on our life.  It is always there, but at a level that most days is on the back burner.

And, we let our guard down.

Jess was high last night.  Not crazy high, but in the high 200's despite multiple boluses.  I was on call and so my energy was focused on the patients I was caring for.  There was nothing major going on with Jess and so I didn't focus on it.

We all slept in and got up barely in time for the girls to go to brunch with my parents.  I don't even remember what Jess was before she left.  But, it couldn't have been too high or she would have said something and I would have noticed.

After brunch she was in the high 300s.  Not terribly abnormal for Sean or Jess on occasion to run that high after an all you can eat brunch.  Not ideal, but we so rarely do all you can eat buffets that it is not alarming.  We usually correct and move on.

Jess was due for a site change and that was done.

Throughout the day she stayed in the 300's despite repeat boluses.

Then this evening.  Pow.  High 500s.

We should have pulled the site and given a shot.

But, there is a sense of pride.  And pride can sometimes breed stupidity.  You see, she hasn't had a shot since getting the pump over 3 years ago.  Giving a shot has turned into a bigger and bigger deal the longer we have gone without doing it.  Stupid, really.

We bolused one more time.  Thirty minutes later---critical high.  Above 600.  Haven't seen that since diagnosis night.  Small ketones.  Didn't have those diagnosis night.

We realize our mistake and the acuity of the situation.  We pull the site which is kinked- no surprise there.  We have turned into one of those nightmare patients that they present to you before you get your pump.  You know, the ones that demonstrate how things can go so badly so quickly on a pump.  The ones that as they present them to you, you sit there and think "That will never be us.  We would never let something that stupid happen."

I draw up the insulin into a syringe.  I haven't done this for over 3 years.  I am surprised when it feels normal, comfortable, and in some sick way I don't have time to explore, like a long lost friend.

Jess freaks when she sees the needle.  But, we get it done.  I am likewise surprised how comfortable it feels to give her a shot.  As I write, I realize that I gave so many that first year that it must be like riding a bike.

I am surprised by how I feel no guilt.  We screwed up.  And, that is all it has to be.  She's back to the 300s now, and will be back to normal before I go to bed.  I remember when much less than this would lead to me blaming myself and filled with guilt.  I don't know if it is good or bad that I feel none.  Diabetes is a monster.  You can't let your guard down.  But, we are not perfect.  Most days we nail it.  But, we can't do it every day.

And, this will even sound worse.  As the crisis passed I realize I am glad in some small way it happened.  We gave a shot.  We won't hesitate now to do that again.  We corrected a blood sugar in the 600s with ketones with no help but our own.  Jess learned how quickly problems can happen, but how quickly they can also be fixed.

And, we all were reminded that we cannot let our guard down.