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Life Is Short, Laundry Is Eternal: Confessions of a Stay-at-Home Dad

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No, not that basil

Day one was really like day .5 because by the time we got home from the insulin start appointment it was 4pm.  The real work began that evening when I did Arden’s first basal test.  


Basal refers to a minimal level that is necessary for health or life. As used by diabetics and health care professionals, it describes a low, continuous dosage of insulin (either as a basal rate from an insulin pump or a slow-acting insulin injection) intended to "cover" the glucose output of the liver.  This works together with a bolus of insulin, which is a dosage of insulin intended to "cover" a meal or to make a large glucose level correction.


When we were injecting insulin Arden would get a dose of a slow acting insulin called Levemer.  It was a time release medication that acted as her basal insulin.  It was decent but sometimes unpredictable, would last an indeterminate length of time and caused a lot of lows.  So I’m glad it’s gone from our lives.  In it’s place Arden’s fast acting insulin (Novolog) is now automatically administered by the pump in tiny increments every hour.  To fine tune those increments I had to test her BG every two hours all night long that first night.  When Friday morning came I was a bit tired but I had a lot of good data that helped us make adjustments to Arden’s basal rates.  


Now truth be told, the rest of that first day I was a bit of a wreck.  Not so much because of the pump but because it felt like I was starting over - which I was.  I had Arden’s routine down to my own little science and it worked most days very well.  Now I’m counting every carbohydrate that she eats and trusting this little piece of plastic to do what I have been doing for the last two and a half years.  Most of the day I felt exactly the way I did in the hospital when Arden was diagnosed - heart in my throat and looking for a window to leap from.  By the time Kelly got home from work I was fried, unsure of myself and emotional to say the least.  


Arden’s BG had been high all day. I realized around 1 pm that her basal rate needed to be increased during the day to a higher dose.  I called Kelly at work to run my theory by her. I wanted to run my thoughts past Kelly first to make sure I didn’t sound like a moron when I called CHOP and so I could get my crying done with Kelly so the poor nurse wouldn’t have to suffer through my weepiness.  In the end I think I was right, I called Cathy at CHOP made the changes - so far I seem to have made the right choice.


On day two (today) I focused on Arden’s insulin to carb ratio (IC).  That number represents how much insulin it takes to combat a certain number of carbs.  We initially had it set to 1 unit per 50g... I moved it this morning to 1 unit per 45g.  Again, so far so good with that change.


Right now it’s just before midnight and Arden’s BG was 208 about 45 minutes ago.  I gave her .2 units with the hopes of getting her into her range (100-150) for overnight.  If the new overnight basal rate we programed is correct, she should wake up in the morning still in that range - which would be nothing short of magical for us.  I’m less stressed today then I was yesterday but still no where near comfortable.  I’m anticipating that by this time next week I’ll have most of the kinks ironed out and I can go back to my baseline, which is being frightened all the time that Arden has type I (but at a much lower intensity level). 

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