So they maxed out my ratios across the board. 3:1 all day. Wow. And increased my basal rates - all of them and upped my correction on the Wizard. So yeah... the doc wants to see me again on Thursday to see how everything went. I hope this will help.
I was pretty frustrated even when I left the endo's office. I can't believe I've already reached max. I have another 2 months to go. The doc did say that up until 32 or 34 weeks things will continue to be kindda crazy then it will stay the same - crazy but consistent at least. My pump won't even go past 3:1 ratio... my diab. nurse said I'll have to tell the pump I'm having 30g when I'm only having 15g to trick it. That is such a limitation... and the maximum insulin delivery is pretty crazy too - only 25 units. At this rate I will have to cut back on carbs because every 60g of carbs meals will max out the amount that I can take and then I'll have to remember when it finishes delivering to give myself the difference. Really?! For another 2 months?
So the crazy thing was - I left the doc's office frustrated, called hubby and we met for lunch. Not wanting to mess up on day one with the new ratios I opted for chicken caesar salad with a water and a wedge of garlic bread. So at about 1pm I was 9.6 (not a happy pre-lunch number!) so I put that into the pump and bolused for 35g of carbs (which is pretty high for a slice of garlic bread but again I didn't want to mess it up). The pump spit out 15.3 units (11.6 u for the food and 4.5u for the correction). That ought to do it, I thought. As it turns out I didn't even eat half of the garlic bread but did finish my chicken ceasar and water.
Still bummed out I left Noah at grandparents a little longer while I went home to take a nap... only to wake up around 4:30 with a 14.7! What the monkey is that about? I was about to cry when I decided I will call hubby and he will calm me down. We talked and I decided I should change my site just in case. So I filled up the pump with new insulin, changed the site and fired up the pump. Correction - 10.2 units! WOW. If that doesn't do it I don't know what will. But GUESS WHAT! It didn't do it! At 7pm just before a late dinner (mind you I had not TOUCHED food since 1 pm! ) I was 10.4. WHY?! Someone please explain it to me - because I don't get what I'm doing wrong. How can there be that many changes in a matter of days?? And how can all these new adjustments not work! I was honestly LOOKING FORWARD TO A LOW. Really! I don't have a sensor in now. It ended this morning - the transmittor is charging and I will put it back in the next 30 min or so. Hopefully then I'll be able to see the trends.
With Noah it wasn't like this. I'm wondering if it's because it's the second pregnancy... is that right? Does it get harder? Does each subsequent placenta get more and more stubborn?
I'm frustrated. I wanna keep this kid safe.
That's my No. 1 concern for No. 2
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I hear your frustration. I do. The numbers during pregnancy are enough to make any hormonal pregnant diabetic cry. Hang in there. You only have two more months until you can go back to normal.
ReplyDeleteI don't know if each subsequent pregnancy is harder as a diabetic. My first pregnancy seemed so easy. Then I learned more with my second pregnancy. I was much more insulin and carb resistant the second time around but I was ok with it. My last trimester was in the summer when I wasn't craving heavy carbs anyway.
My third pregnancy was the easiest and the hardest. It was physically the easiest. I had to remind myself I was pregnant! But diabetically it was the hardest. The more I learned the more stressed I got and the more convinced I was that I was causing irreversible damage to my baby. I struggled the whole 9 months with my blood sugar.
She was my biggest baby outweighing her brothers at birth by 3 lbs. She was also very tall and perinatologists told me my diabetes management had nothing to do with her size. I don't know. She was born healthy as could be despite red flags seen in ultrasounds that she may have Down Syndrome or other chromosomal abnormalities.
I know what a mind game it is to exceed the pump's max settings. Just know it's not forever. You can do anything for a few months. Your lucky you have an endo you like and trust. Remember that you're not doing anything wrong. Pregnancy just sucks! Hang in there. There is light at the end of the tunnel.
Your max is 1:3? Hm. I've got my morning ratio at 1:2.9, and I'm sure it's going to keep going (since I'm only 12 weeks right now). I've never heard of an endo maxing a ratio.
ReplyDeleteOr is it a setting on your pump? (I dont have a pump)
Thanks so much for all the encouraging comments! I finally got it down to 6.4 but it is after midnight. Kindda ridiculous but finally down in range! I hope the rest of the week will be okay. I feel a little relived that I will get to see the endo later on in the week so whether the new settings work or not he'll be there to take a look at it (BIG PICTURE) and fix it.
ReplyDeleteAgain thanks, that really helps. It's good to read that others have gone through it before and they were fine too. Noah was born 9lbs 9oz and my endo also told me that it had nothing to do with my management since my A1C hovered around 5.6 for most of the pregnancy.
Alyssa, it is a limitation of the pump. It's not really designed with pregnancy as the main concern. I don't like it and I wish that limitation was not there ( I don't really understand the reason for it) nor do I understand why 25 units of insulin is the max you can deliver at once... I am almost ready to give Medtronic a call and ask to speak to someone that can tell me WHY these limitations are in place. I'm sure there's a reason. Anyways, for now I'll have to reduce carbs slightly and focus on my correction factor - making sure that it gets adjusted as soon as it's not working.
"Be joyful always; pray continually; give thanks in all circumstances, for this is God's will for you in Christ Jesus." 1 Thessalonians 5:16-18
ReplyDeleteOh sweetie, that IS frustrating. I'm glad you got down into the 6s. That must've felt like such a relief. That limitation on your pump sucks. I do understand why it's in place, but for pregnancy, it would seem to me that you should be able to customise it to better suit your needs.
ReplyDeleteYour no. 1 concern for no. 2 is so lovely. That's why you're such a great mom :)
That's a real shame the pump is putting that limitation on you. Is the 25 unit maximum maybe a safety measure or something? But the extra diabetes-math you have to do - whoa! I'm sure your endo will be able to help you out :) Best wishes!
ReplyDeleteI'm so sorry to hear your numbers have been so challenging. I love my daughter's pump, but HATE that it imposes limitations.
ReplyDeleteI am so inspired at the raw emotion you shared. Thank you reminding me that I'm not alone when I feel like I just can't make sense of this disease.
I love how you turned to your husband. What an amazing gift our husbands are :)
Keep us posted and sending you lots of hugs and prayers from Arizona!
you guys are too sweet! You know hubby was amazing. He said "Do you want me to leave now? I can be home in 5 min? I will help you change your site." I was so touched by his love! So it totally helped. I thanked him for his very kind offer but bravely declined his offer. I didn't want him to leave the job site unless it was crucial.
ReplyDeleteI'm happy to announce today number are glorious!! 4.6 and 5.7 :)
Thanks sweethearts!!!
AND HI MOM! (mom's first comment - she's a newbie to blogs hehe)
Hey! You said it was a limitation of the pump and it can only deliver 25 units at once. Can you split your dose? Like if you need 40 units, can you deliver 25 and then a minute later do 15 more? Or does it restrict how often you can do give the bolus (is that what it's called?)
ReplyDeleteI'm interested to hear what Medtronic said; can you upgrade to a newer pump that doesn't have the 25 unit restrictions? (I also second what Alyssa said--split the doses). I also used to take my boluses by injection sometimes so that I wouldn't empty the pump when the boluses were so high.
ReplyDeleteAlso, not to be nit picky--but you ate caesar dressing? Doesn't that have raw egg in it?