What did I do wrong??

[CarlyesHope]

Aside from the fact that the entire meal was wrong, I wondered if you could offer some advice.

The background: Carlye had an ortho appointment, they did some major work on her upper teeth and her mouth was very sore. At 5:30 we were still on the road home, stuck in traffic and she was hungry and miserable. We decided that she could probably eat some soft breadstick - 0r at least she wanted to try.

Pizza Hut it was where she managed, nicely, 5 breadstick at 20 grams of Carbs each - remember she is 11.5, she needs the carbs and brain food, also the docs want her to regain the 30 #'s she had lost when diagnosed.

Next we proceed home when my girls see the Cold Stone Creamery. Carlye is allowed 1 extravagence per month (didn't take hers in May - and the Doc's say this is Okay, just don't make it a habit) and her teeth were still hurting pretty bad and we were still 25 - 35 minutes from home - depending on traffic. Added to the fact that I wanted to reward Carlye for all of her hard work in school, she has excelled academically and stayed there even while being diagnosed - she has received multiple academic achievement awards this year, and we are very proud - - so, I stopped. :eek:

Carlye got an ice cream (a normal one) and added 2 oreo. total carbs 80 for the ice cream and 17 for the cookies.

Before she ate the ice cream I told her we should give her insulin - we added the total carbs. 177 which at 1:15 would = 11.8 add one for her BG which was 165 and you get 12.8 we rounded up to 13, gave the injection and she happily ate - - - - - 4 bites of her ice cream and said she was full! UGH KIDS!!

Usually, we wait 'till she is done eating, then count carbs then give shot, for whatever stupid reason I felt because she was having Ice cream (lots of sugar) that I should give her shot first and let it work with the food, not after she ingests it.

Anyway, she was given 13 units, (6.5) for the ice cream she only ate 4 bites of. I really worried about her going into a serious hypo, so when we finally got home 25 minutes later I tried to find a drink that could take the place of the ice cream - just to counter act all the insulin I gave her.

So, I gave her a coke (not diet) at 39 carbs - no where near the 97 of the ice cream. I thought we would still have to watch her carefully for a hypo but two hours after her injection she was 317, I was shocked - she took 7 units of Novolog and tested two hours or so (forgot to check the clock) after that and was still 289.

I don't understand.....Other than the obvious fact that I made some very poor meal choices today (well, it was yesterday).

Thanks for your help,

Kelly

[gettingby]

Kelly,
After 20+ years of dealing with the big "D", I still make mistakes. Just live and learn from the mistakes and you should be ok.

[Belinda]

Yep live and learn. One thing that I did learn was that with foods like ice cream and bread...and pasta, rice and a few others. I need to dual wave bolus. Which means I take some of the insulin up front and over a course of usually 1 1/2 to 2 hours I take the rest. Not sure how I would do this if I still did MDI but with the pump it is very convenient. Lesson learned.....next time you have a meal like this one..you may want to divide up meds and take two shots or do just like you did and correct it as you check the bs more frequently.

[archimeech]

Yes, you seem to be beating yourself up all the time over not knowing how to treat this disease. Even with all the new fangled gadgets and stuff we have now, it's still a mistery to all of us. You do your best and hope that the worst won't happen( or at least won't happen too soon). It's a day to day roll of the dice and you're got to figure it out for Carlye. Relax a little on berating yourself, but not on the level of care you're giving your daughter. You're a great mom, we can see that by your posts, but also, she seems to be a great kid that will learn, and falter, through the years. Go learn together, and make sure to put as much of the responsibility of her health into her hands. Not because you don't want to or shouldn't do it for her, but because she's going to grow up way to quickly and then she's left to her own devices. She needs the tools now so she can begin to build a lifestyle that will help her cope with all the adversities of Diabetes.

[duck]

What did you do at the ortho? If it was invasive/enough to make you tense and agitated, your body releases stress hormones that inject glucose into your sytem for "fight or flight".

When in doubt, check yo' shugga...It's more important than shooting up, IMHO.

[CarlyesHope]

Carlye had a new shorter wire put on the top teeth that is going to rapidly pull all of her upper teeth together - Until now they have been purposly seperating them to give them space to come in, now they are all there and they want to close the gaps - ouch!

I really just don't understand what happened, I was so sure we were still going to battle a hypo and instead we were way high and stayed that way even after adding more insulin. She got way more insulin than she did carbs ???

I do understand that these things happen, but i would really like to minimize the effects, if can get an idea from you guys what may have been going on yesterday than the next time i can have a better plan so she doesn't go as high or too low - I am not looking for perfection, just better control and I guess a basic understanding - right now I'm at a loss as to what happened yesterday.

[duck]

Stress.

Also, I avoid Pizza the Hut because of all the pizzas out there, they hose me the most. I know you got breadsticks, and I can't help because I avoid those carb-centric foods if I can, but as they say, the apple does not fall far from the tree.

[Cinnabon]

Stop giving yourself such a hard time. I do it all the time and then realize it later. My daughter has started calling me "Weberly Worry" :eek: lol
You did the best you could, especially thinking of your drive home. You were just being a MOM (darn good one) and like most moms, you wanted to reward your her.

[Amanda_Jo22]

Kelly,

Uh, the ortho! I hated having braces! It's possible that the stress from the ortho work could have contributed to the high. Like everyone has said, no need to stress. Highs (and lows) happen and are out of our control at times. You are doing a fantastic job!!

[JasonSmithMT]

Everyone has given wonderful advice. Only thing I would add is my experience with ice cream. I find that I have to pump slowly over about 2 hours or more to cover it correctly. My guess is the high fat content. If I pumped it before hand as a straight bolus I would be fighting a hypo 30 minutes later. Not exactly on topic but I would love to hear other people's experience with ice cream.

Jason

[Clint]

One thing about this disease is there is no rhyme or reason sometimes as to why we go hi or low... I would get so frustrated at times becuase of this 'phenomenon' and it would really get me down...

As each person is different, the best way (or at least IMO) to see how things affect us is to track what we do, what we eat, our sugars, insulin intake, etc and then you can start to see a pattern and learn from it.

As others have said, relax and dont beat yourself up so much. We are all still learning... even those of us that have had the 'D' for years...

[Mick]

Who knows why...? What works, what doesn't--it changes year to year, month to month, week to week, day to day, even hour to hour! As long as we sincerely try our best, do everything we can to maintain control, give ourselves the occasional break, and keep on testing, counting, estimating, correcting, etc--there are way too many variables to really ever know exactly what will happen, or why. We have many tools today, and we use them to get as close to normal glucose levels for as much of the time as we can manage. Other than that, at least we're able to see that we've gone wrong somewhere (if not alwys knowing why), and to correct those errors as quickly as safely possible. That what it's about--it's not a science, its an art, a bit of voodoo and black magic thrown in, with a healthy helping of just dumb luck and experience for getting it right. And still we goof up--and often never know why. After 40 years, I have somewhat of a handle on this most of the time, and that's as good as I can tell ya--"somewhat of a handle on this most of the time". That's pretty good, as close as I'm ever gonna come, and I guess good enough--cuz they told me 40 years ago I might live 20 years with this, so guess what...?! HA! Maybe "good enough", but well short of perferct, is... well, good enough indeed!

Love,
Michael

[Eri's mom]

Hi Kelly...
Everyone gives such awesome advice :)
You are a GREAT mom!!!...I beat myself up over this a lot when Eri's all out of whack, but now I am just realizing(after 5 yrs+) that it is a total learning experience every minute of every day. (especially w/ this puberty stage....UGH!!!)...Yesterday was my dad's bday, and my husband got him a small carvel cake, and I cut the pieces, so I made sure he AND Eri both got tiny pieces(I had ravioli's and sauce ...homemade...for dinner for him....Eri had only one ravioli and mostly sauce(she's a sauce fiend)...and I even gave her an extra 4 units of humalog w/ her meal to cover everything...she went from 482(she is always so high after school) to 104 about 70 minutes later...(she worked at the restaurant after that...so good exercise)...bad thing, my husband ordered in the ice cream cooler...so now not only do we deal w/ the carbs from pizza(she doesn't eat that anyway...not a pizza lover)...we have the ice cream....the little scimmer showed her dad the 104 reading, she cleaned some more to earn the "screwball"...but her sugar went to 185 a while later. I said no to the "screwball" but she went to good ol' dad...not TOO bad, considering how high she has run recently, but I wasn't very pleased...and then she got her nighttime 14 units of NPH w/ an extra 2 of humalog and she just went into the 200's again...it drives me batty...but, eventually, we will get a hold on this(I believe once puberty is over, things will be a LITTLE easier!!!)
Oh...and as for the ortho...when Eri had her braces, she always ran a bit high after each visit...especially when they took out the expander(she had an underbite...this expander was starting to grow into the roof of her mouth...she heals/progresses quickly...the ortho was amazed at how quickly it worked)...anyhow, her readings were crazy after the ortho visits...

[middnite03]

so let me get this stright......

your walking around right now with a pump on your hip, treating yourself like a diabetic, and counting carb, and bolus-ing. why because you get to experience what it will be like for your little one. and you even have a thought as to if your a good mom or not? I dont say much around here, just read whats going on, and sometimes add my 2 cents... but from what I read around here you take one **** of an active approach with this. not to mention stopping at cold stone creamery, (the best ice cream out there, LOL)

from personal experience, bread sticks from pizza hut dont raise my suger like normal bread, it takes about 2 hours then it just fly's up. now looking at them, they dont seem to have too much fat, but the way they reaise my suger it's just like eating pizza for me....

but everyone is completely different in the way that foods effect them...

thats my 2 cents for today :) now i'll head back to the shadows :hypocrite

[gettingby]

thats my 2 cents for today :) now i'll head back to the shadows :hypocrite
Don't head back into the shadows. We all want different opinions on things, so just jump in there and give yours. :D
Sorry Kelly, wasn't trying to hijack the thread, just went a little :topic: there.

[Funnygrl]

My vote is on the stress from the ortho causing it. Also, I know some people need to use more insulin than their normal ratio after a certain amount of carbs. I'm not one of those people, so maybe someone else could expand on this?

Don't beat yourself up over this, just use it to learn.

[ksa01]

As everyone else said -- there are too many unknown infuences to pinpoint exactly went wrong. There are days when I eat something and my bs stays pretty normal, but when I eat the same thing the next day as leftover I get a totally different response. Stress and pain can definately make you bs go up. Mine go high whenever I go to the dentist or when I have a simple headache.

As far as I see it, the important thing to remember is that you can never achieve perfection -- there will always be highs and lows. All you can do is test frequently and make adjustments to insulin and eat as needed.

Also, it's a game of averages of sorts. The occassional highs and even the lows aren't as important as what happens most of the time, in my opinion. Besides, sometimes you need to indulge yourself and give in to cravings and desires. Just do your best and regroup with you next reading. With more time and experience, you learn to make more accurate guesses, but they are still guesses so be gentle with yourself.

[am1977]

I understand how you feel...I really do :o . When I have a situation like yours where I test and I get this unexpected number, I drive myself crazy trying to figure out what happened and what I did wrong. It can be quite frustrating and most of the time there's no way of knowing what was the cause. The best thing to do would be not to agonize over it, but to chalk it up to a once in awhile thing and let it go. You are not a bad mom, we all know that you are doing the best you can and sometimes these things cannot be prevented. So cheer up, k? ;)

[Erin]

I always lose my appetite when my bg is on it's way up (that could have been why Eri didn't want her ice cream?) sooooo... next time she doesn't want to eat something, test, test, test, and don't treat the low until you see it starting to happen. (that said, my mom would have done the EXACT same thing when I was a kid... it's too too hard to wait for your kid to have a low, when you know you can prevent it. It's easier to do as an adult)

I've no idea why she would have been going so high, maybe it was the doctor's appointment, maybe the bread sticks have more carbs than you thought, maybe the rings of Saturn were out of alignment (again). This disease is funky, we all have those fluke numbers, don't beat yourself up over it.

(and I didn't see anything wrong with any of the things you did, or the choices you made)

[duck]

The more I think about it, it was probably Pizza the Hut. Sometime when you guys are feely a little brave, try the breadsticks again (carefully) and test test test.