Close Call (d*mn carbohydrates)

I’m sure many parents have gone through this — you have 1 or 2 fabulous babysitters, they “get” the diabetes, pay attention, text or call with questions — then they get to a point in their lives when they are moving on to “real” jobs. That’s where we are and though we’ve been “interviewing” new people, it’s still getting hard to find someone when we need a night out or to go to something as a couple.

Last night I had been invited to read poetry at a local event and it has been a while since I have and I really wanted to go. We tried our regular folks but everyone was busy or away. I had someone I know through work who had offered before – very sincerely – and is someone I really respect and think a lot of. She is older than who we usually have for sitters – probably about 10-15 years older than we are – and that always makes the BHE* a bit nervous given our diabetes experiences with older relatives (a story for another time), but I really thought it would actually mean someone who really understands having a child and taking care of the important things.

I went through my usual spiel** about how to use the meter, the pump, when the bear*** usually eats, the bedtime routine, what to do in reaction to various ranges of numbers, common carb counts, etc. (What I can’t remember now is whether I really went over the serving size info + carb info for things that have a label that I hadn’t gone over… the BHE usually brings that up if I forget, but he wasn’t in the room this time)

When we got home, our new sitter said jokingly, “She’s not dead,” — not too comforting, but ok, just a joke. (I don’t think anyone but other d-parents get how much we actually worry that our child could die – for most parents I think it is their worst fear, but not one that is an actual daily risk) She said something about the timing of when the bear had a “treat” after dinner being off, but when she eats isn’t that important as long as she gets the insulin. Then… then I saw the written notes about the night. 70g carbs for pizza? for the kid who never eats more than one slice with no crust? 74g for 1 caramel and one fruit square? So 144g carbs covered with insulin when it should have been 32g covered? OMFG. Of course, the sitter read the caramel container and saw 37 g (which would have been for 1 caramel) and the same mixup with serving size on the fruit square. I mumbled something about it and that it was WAY too much insulin, and she kept saying, but her number was 244… and I never did figure out what that was supposed to mean (obviously I hadn’t done a very good job of explaining the connections between eating, insulin & bg numbers). I said something about that not really being the point, to which she shrugged and said, “well, she’s not dead anyway.” In my head I was screaming — HOW WOULD YOU KNOW? SHE COULD BE! SHE’S UP IN HER BED, SLEEPING, WITH FOUR TIMES AS MUCH INSULIN IN HER LITTLE BODY AS SHE NEEDS! 

Immediate bg test came back at 55. The bear woke up startled but pretty lucid and I got her to drink two juice boxes (30g), eat 8 (I think) glucose tablets (32g), and drink about 1/4 cup of milk (4g). before she went back to sleep. Tested again in 30 minutes and she was up over 200 (of course), and 3 hours later she was over 300 and needed a correction… So, I probably (definitely) overreacted, and should have checked to see what the actual boluses were considering the IOB (she probably didn’t get a full bolus on 144g CHO given that there would have been some IOB subtracted). The poor kid’s body dropped down to 55, then rocketed up to over 300 — and, boy do I know how that makes me feel.

I feel guilty (why didn’t I make sure the sitter understood the serving size thing? why didn’t I make a list of everything that Amalia *might* eat over the night?), irritated (why didn’t I ask the sitter to text us before she gave insulin so we could do a common-sense check on how many grams of CHO she was thinking of covering?), selfish (why am I leaving my kid with someone new just to read some stupid poetry??). And, yes, I know the answers to all of those things (besides the BHE has made sure I know not to beat myself up over something like this – just learn from it, and we did come up with some good ideas for the future). What I am left with today is just being scared, or the hangover from being scared. We could have come home to find our daughter unconscious, seizing, or dead in her bed. How could I have put her at that kind of risk? What kind of father’s day would today be if we were in the ER or ICU or worse?

I will have to get past this and move on. The bear will spend a huge amount of her life in the care of others — at Kindergarten this fall, after school before we get out of work, at friends’ houses, at school events, and eventually at college, living on her own. I have to figure out how to best prepare other people so that I (and the bear) can trust them to take good care of her, not shrug it off.

Thanks for listening…

Quick Update: Yes, she needs a CGM — at least a “falling” or low alarm would alert someone that something was wrong…

*BHE= Best Husband Ever
**Some places spell it spiel, some shpiel, some schpiel — anyway, you know what I mean
***Bear = our 5-year-old daughter, a T1 like me, dxd at 3 years old

This entry was posted in Getting it Wrong, Living with Diabetes, Others caring for your T1 kid. Bookmark the permalink.

2 Responses to Close Call (d*mn carbohydrates)

  1. Katy says:

    with some sitters, even if you asked them to text before giving insulin, they might think, “oh, i won’t bother her at her poetry reading, this is easy for me.” i think you did everything right.

    and i hate, hate that the sitter joked about bear still being alive.

  2. Pingback: Decompression | Principles of Uncertainty

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