Apidra, again.

A few weeks ago I decided to give Apidra a try for Princess.  We have had huge success with Lovebug using it and I thought maybe it would be easier to have them on the same insulin  I know that sounds like a bit of an oxymoron because they are on different pumps so I am not confused.  I am not a big fan of accidentally filling the wrong pump with the wrong insulin.  Just don't need that headache.  I have to make enough changes to basal and bolus amounts as it is!  I really don't need to make MORE work for myself.

The first week, I was seriously ready to pull my hair out.  Princess kept going low an hour after she would eat and she hadn't done that with Novolog.  I raised I:C ratios, and kept raising them. To no avail, that was not working.  So I lowered them back down and started using the Square Bolus and evening her bolus out over an 1.5 hours.  That didn't seem to work at first.  It just prolonged the low.  But I kept with it for a few days and it started to work!  A little victory, at last.

Then  we started seeing higher numbers over all.  I raised her basal rates and we are still raising them. Maybe I should say tweaking them.  I think they are as high as they need to be, (i could be wrong though) I just really need to figure out how to balance the day out with what she needs.

Take for example, over night (for us that is 8pm to 8am right now) She typically goes to bed in range and then spikes up about 200 points with in and hour after she falls asleep.  (dusk phenomenon)  We still can't get that spike to go away.  I did, for a while, but then she was waking up too low in the morning.  So needless to say we are still working on that one.  Plus we have this weird pattern that has been happening after breakfast.

I have been giving her a normal bolus and she will spike and come back down in range within 1.5 hours and then a half hour later is going straight back up again!! (double arrows up on Mini)  And has been high at lunch.   (around 200)  I raised basal for the morning but it doesn't seem to be helping. Might need another basal tweak there too.  All those tweaks just never end!

Now three, (almost 4) weeks in I am happy with Apidra for Princess and very hopeful we will be sticking with it!

Catching-Up

I can't believe I haven't blogged in a week!  To my defense last week was a bit of a crazy week for me.

I ended Napblopomo with a whimper as I missed a few days but life is life and it happens.  We had an endo appointment.  Princess pump had a "malfuntion" and we had to get a new pump. We got a new addition to our house.  We celebrated diabetes by eating ice cream.  We had a family reunion.   We got the design all set for our JDRF Walk T-shirts. And last but not least, I broke my big toe.

This week isn't much better in the busyness department, but I promise to try to blog a bit more!  :)  Unfortunately diabetes doesn't go away just because you are busy and diabetes has been....let's just say NOT on it's best behavior.  (and that is putting it nicely)

So, I guess I will start with our endo appointment last week.  It went pretty good.  Lovebug's A1C was up from 6.6 to 7.0 but that's not too bad. Although it was at 6.2 just 6 short months ago.  I would personally like it a bit lower but as I said earlier, diabetes hasn't been on it's best behavior lately (then again when is it ever?! ) That and I did have another child diagnosed since Lovebug's last endo appointment so despite all that, I am just happy it didn't go up more!

It was nice to get a "pat on the back" from the endo and our CDE though. Love it when the endo looks at Lovebug's pump download and says that he can't see any way to make her numbers any better so no changes.  That was nice!

We ended up taking the whole family because my hubby wanted to go to the appointment.  That was interesting!  Peanut (our non-d kid) had never been to an endo appointment so she got to see what her sisters go though at each appointment.  Then Princess finally got to meet the doctor.  Because he was full when she was diagnosed we haven't been able to get her in for her first official endo appointment yet.  (it will just be 4 months this week) She has been in for her pump start and such but we had to see one of the other doctors so we could get started earlier.  (her first actual endo appointment is the end of this month) She seems to like him just as much as Lovebug.  He is pretty easy going guy that really knows his stuff.   My hubby and I really like him.

While we were there we signed up for a research study that will tract the girls at least until they are 18. They collect information (from our endo visits)  and track the girls "progress" as well as let us know of clinical trials or studies that come up that they could be eligible for.  We are "excited" about it and what information they may be able to gleam from the girls.

We also talked to the endo about switching Princess from Novolog to Apidra.  I was a little hesitant BUT it would be nice to have them on the same insulin.  I have already almost put the wrong insulin in the wrong pump!  (we do both girls site changes on the same day.)  We did come up with a system of  I change one girls site change and my hubby does the other girls site change.  Anyway, we got a vial to try from the endo.  So far, so good.  But I have to admit that I need to go in a makes a few changes (we had to with Lovebug too).  I haven't seen as big of a change in Princess numbers as I did with Lovebug's when we switched her over last summer.  Another one of those things were you realize that EVERY kid is different and their bodies just work differently.  So, we have had yet  more change but  Princess's numbers have been so high that I thought we needed to make some sort of change.  (the other changes just weren't working they way they should) So hopefully we will start seeing some changes and drops in Princess's numbers!

If you come back tomorrow I will tell you about the new addition to our family! :)

My Pumping Princess

I have been waiting for this day since diagnosis day, six very long weeks ago.

PUMP START DAY!!

I'm pretty sure the excitement started the night before!  When I gave Princess her last shot of Levemir she got estactic, clapping and cheering.  I wish I had a video recorder in my hand at the time to show you. It was PRICELESS! This morning she cheered again after receiving her last "pen shot" as she calls it. She was not the only one cheering at that point.  :)

Last shot of Humalog...a little blurry since Lovbug took the picture! 

She marched into the endo's office yesterday morning like a champ. She knew exactly what to do. She took her shoes and coat off and went over to the scale and then over to check her height.  She even sat right down and put her arm out to get her blood pressure checked.   I could hardly believe that she had gained 2 lbs and grew a half an inch since her diagnosis!  I hadn't even noticed that she had lost weight prior to her diagnosis but apparently she had!  I thought maybe it was from a growth spurt but the endo was pretty sure it was weight gained back.  On the other hand the .5 inch taller is a growth spurt! :)

Just a little arm hug! 

She did pretty good when it came to getting her site changed.  She wanted to sit down for a site in her tummy and she can't do that.  I need her to stand up. There was a bit of a struggle but we made it through.   I am pretty sure she was just being her normal stubborn self. :)  She was pretty happy when it was all done.  I am still amazed that she WANTS belly sites and that she doesn't even flinch when I put the site in!  She sure is one brave little girl!

All hooked up and pumping!!!

They did her A1c and it was higher, like I expected it to be.  It was 7.2 at diagnosis and is now 8.1. (yet another reason I am glad for the pump!)  Not bad for her age and I am okay with it, just I knew it would be up considering the amount of high blood sugars she has had since her diagnosis.  We really couldn't do a whole lot about it though because the smallest dose we could give while she was on MDI was 1/2 unit.

I was surprised when our CDE told us we would be pumping the Novolog instead of Humalog.  I guess that Novolog is a little more stable in insulin pumps then Humalog is.  Interesting....not a big deal to me though, they are both pretty much the same thing just made by different drug companies.  Lovebug pumps with Apidra and I might eventually change Princess over the that but since Apidra works much faster then Novolog I thought we would start out that way and then make the switch later.  When my head is a little clearer then it is now.

It is interesting to see the differences and similarities in the girls when it comes to their diabetes.  They are both similar in that they both have Dusk phenomenon, which happens a lot in younger kids. When it comes to carbs, Lovebug is much more sensitive.  I can't do a 15/15 fix for her to correct a low blood sugar.  I have do what I call a 8/20.  Give her 8 grams of carbs and wait 20 minutes.  Those 8 carbs will easily bump her up 15-20 points.  You give Princess a 15/15 fix and it works just the way it is supposed to. Lovebug started out with just one basal rate when she had her pump start.  Princess is starting out with 4 different basal rates!  Can you say C-R-A-Z-Y!

Since we came home from the endo office she has been high.  Like in the 400's high.  I gave 3 corrections yesterday and she still wouldn't come down lower then 250. Goodness gracious! This has been going on for a few days now. I just thought maybe the pump start would lower her back down.  I am going to give it a few days but I already think her basal rate needs to be bumped up just a bit.  I thought she needed a bit more Levemir before she started the pump too. I just decided to leave it and tweak basal rates instead of messing with the Levemir.

This morning she woke up at a nice 133.  Lovely.  Now here's to hoping she stays under 200 today. (I know, wishful thinking, right?)  I have to admit that I was THRILLED that it only took a few seconds to give her insulin rather then 5 minutes! Good bye hand written logs!!  Good bye pen needles!!  Good bye insulin cartridges!!  Good bye syringes!! (for now anyway!) Good bye 6-8 shots a day!!  Good riddance to you! The pump is SO much easier!!

Hello more free time!!  That is just what this mama of 2 D-kids needs right now. Anything to make it all just a little easier.