The Not So Great but VERY Powerful Bolus
Saturday, March 16, 2013 at 11:56PM 
Arden's CGM vibrated on my leg. Earlier during the previews I asked Arden to give me her G4 so that I could monitor her BGs while we watched 'Oz The Great and Powerful'. The vibrations that her CGM sent through me were too intense to ignore and moments later I was greeted rudely by the message on it's small glowing screen.
Arden's CGM indicated that her BG was 94 and the number's accompanying arrow was pointing straight down. You can see on the chart below that's not good news.
Prior to the movie we stopped for a light meal, Arden had a salad and one baked potato skin. I pre-bolsed for twenty carbs, ten minutes prior to the waiter arriving with our food, she ate as I expected. A little over an hour later we settled into our theater seats (about thirty minutes before the movie was scheduled to begin). Arden was holding a box of Bunch-a-Crunch, a small popcorn and she was talking about sharing a few gummy candies with her friend who was joining us. I pre-bolused for forty carbs at this time. We donned our 3-D glassed and the movie began.
95, one arrow straight down
A CGM reading of 95 doesn't phase me, and one arrow down doesn't really cause me to become alarmed anymore, "Just missed with the bolus", I thought. Then I looked at the time on the OmniPod PDM and became a bit more concerned. This was all happening only one hour into the movie, I had more than "just missed" - I significantly over estimated how much Arden was going to eat. I shook the candy box, reached into the popcorn bag and discovered that she really hadn't eaten any of the treats that we initially believed she would. I reached into the gummy candies, put five in her hand and whispered, "Eat these please, your CGM says 95, one arrow down - I think I gave you too much insulin".
Arden ate the candy quickly but three more alarms were already shaking my leg
Now her CGM was reporting a BG of 84 with one arrow down, seconds later it was 76 and then the arrows doubled. 76, two arrows down. Arden's BG was running away from me. I had already opened the juice box by the time the double arrows hit, Arden knocked it back like a shot as I tested to autenticate the numbers on her CGM. Her BG was 56 on the meter and the arrows were staring back at me as if they were awaiting an answer to the question, "What are you going to do Scott?".
I recounted the carbs in my head based on what I now knew she had eaten and then added the new carbs that she just wolfed down to that total. I was okay, I knew that the numbers matched. I told myself, "Just wait, don't over treat" but no sooner than I was able to talk myself into that response...
BEEP, BEEP, BEEP, BEEP - "LOW, two arrows down"
I could feel my adrenaline surge when the beeps angrily blared out. I started looking around to see which way out of the aisle was less blocked, thought about where the snack stands were located and considered sending our son Cole for a cup of regular Coke. Then I looked at Arden, she was sitting next to her friend who came along with us for the movie and I just didn't want her to have to rush around like the world was coming to an end in front of her pal. So I quietly slipped Arden a glucose tab (We never use glucose tabs), I asked her to chew it up quickly and swish the powder around in her mouth.
She did so dutifully, then leaned over to me and whispered in my ear, "am I going to be okay?"
Those words broke my heart and brought a tear to my eye but I answered without hesitation, "absolutely, Daddy has it all under control, go back to watching the movie", but I wasn't sure. The CGM still said "Low", though now it was reporting only one arrow down - so I tested again and this time Arden was 68. I could breath again, she was going to be fine.
I asked Arden how she felt and she responded, "A little dizzy but I'm okay". I told her that we caught the fall and that she should go back to watching the movie. Her friend never saw a thing, I did however miss the flying baboons... I heard they were fierce though, Arden told me later in the car. She knew because she never had to take her eyes off of the screen, mission accomplished.
The DexCom CGM is an indispensable tool in our day with type I diabetes. I genuinely never imagined that Arden wouldn't eat the amount of food that we bolused for. This was a complete anomaly, movie theater food always needs a strong bolus, this never happens - until it did. CGM technology is the best. Who knows how this all goes with out the Dex, maybe Arden would have gotten dizzy and told me that she didn't feel well, maybe the movie would have held her attention to the point that she didn't notice. I'm thankful that we didn't have to find out.
I gave her way too much insulin, that happens. The DexCom CGM makes that eventuality feel less scary.
Scott Benner
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Reader Comments (4)
Hi Scott,
Thank you for sharing. A CGM really is indispensable, even with the potential error margin.
Cheers,
Gil
Thanks so much for sharing this, we are just 7 months into our diabetes journey with my 4 year old daughter and we are thinking about a Dexcom. It's stories like this that really show me the value in it.
I wish that everyone had a CGM. Thank you both for your comments!
Katie - please let me know when you get one.
Best,
Scott
Had a terrifying moment at the movies ourselves the other week when I accidentally miscalculated the carbs in my son's popcorn. Thankfully, my husband and I realized it quickly and a quick dash to the concession stand for Junior Mints and Reese Cups saved the day. I think only our kid would respond, "I have to eat them all?" after being instructed to eat 20 mints and a Reese Cup! Grateful that he never felt a thing in terms of being low, but movie theater boluses now give me the heebie jeebies.