Monday, July 12, 2010

Insulin Gone Bad?

Just when I think Gee, C's numbers have been really great lately...boom!  Relentless highs.  I mean blood glucose readings in the 200s, 300s, and yes, even 400s. Gobs of insulin corrections weren't making them even budge at times.

These highs began happening as soon as the kids were out of school last month.  But I couldn't figure it out.  It didn't make sense.  We were even more busy, with lots of activities...swimming included.  And swimming always makes C go low.  It was so frustrating.

What was totally insane was that it wasn't just at one or two different times during the day.  It was round-the-clock.  I'd get her down to the mid 100s with jumbo corrections, only to have her test in the 200s or 300s before her next meal.  This continued throughout the nighttime.  I did a couple of our famous middle-of-the-night-site-changes to no avail.

I began changing the site daily...opening another insulin vial, and then another.  Maybe it's gone bad, I thought.  Maybe it's a bad lot.  I just kept pushing forward, checking and correcting overnight, feeling overly exhausted.  You know this kind of tired...when the first thing you think of upon wakening is the bottle of Advil.

And then one day, I B-lined it for the pharmacy.  The insulin must have gone bad, I kept thinking.  Maybe they'll replace these vials that are barely used...I know, wishful thinking.  But, I was tired.  So off I went with C to the pharmacy.  I asked to speak with the guy who's been there the longest, as long as we've been getting insulin for C.  There are really only 2 employees left at our particular pharmacy who  remember me from the beginning...the haggard, emotional mom who needed, yes, 300 test strips a month for her baby.  He's one of them, so I thought for sure he'd see things my way!

"My daughter," I said, "her numbers have been crazy high.  I've opened like 3 new vials of insulin in the last week.  Could the insulin have gone bad?"  I asked.

"Uh, no," Mr. Pharmacist said.  "Let me see the cartons...Hmmm...no, they should be good.  Our shipments go directly in refrigeration.  She's possibly having a growth spurt."

A growth spurt?  That really didn't cross my mind.  Why hadn't it?  I thought for sure the insulin had gone bad.  Her numbers were high across the board.  Usually when we make adjustments and tweek basals in the pump, it's because numbers are creeping up, sneekily...not all at once.

So, with blurry, sleep-deprived eyes, I nodded, "Hmmm," I said.  "thanks."  We headed back home...determined to make adjustments and figure this out.  Over the course of the next few days, with some nurse help over the phone and internet, we adjusted every single basal setting and even added 2 more.  We changed so many things!  It made me nervous.  I'm very much a fan of the scientific method of changing one variable at a time.  But I knew we had to wrangle these numbers in a bigger way.  So, that's what we did.

It seems to always take several days for any type of setting change to really work itself out and show results.  We dug in for the long haul.  I knew this meant lots more testing and lots less sleeping but...oh well.  That's life with diabetes.

And, did the basal changes help?  Boy, did they?! But that's to be continued in another post...
Insulin gone bad?  Well, I know it can.  But not this time.  Now we have 3 newly-opened vials...ug. 
 
Sometimes insulin can go bad.

1 comment:

  1. Firstly, I'd like to commend your pharmacist. I hear so often about the opposite experience - very little understanding of blood sugar fluctuations, so kudos!

    Secondly, I would (I'm a rebel though) put the insulin back in the fridge and pretend like nothing happened.

    Lastly. Oh. My. Goodness. But I have to say, Caleb's numbers have changed overnight like that in several times in the last several months. I know what you mean - it's usually gradual. Is this maybe a precurser to puberty or something? It's like a hot frying pan in the face.


    Looking forward to hearing how it's going. Hopefully swimmingly. :)

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