Olly is having a LIE-IN. This is my Easter miracle!

Olly is one of those intolerably thin people who do everything with lots and lots of energy. He eats energetically; he relaxes energetically. So he usually finds lying in bed and staying still so as to fall asleep incredibly difficult. Some nights he will lie there, utterly still, without moving a muscle even though I can tell he is wide awake, simply waiting for sleep to come as if it rewards patience. No such luck.

Full nights of insomnia are rare for Olly, but hard for me to comprehend as I am from a family of easy sleepers. My dad, who was a fireman for many years, perfected the art of catching forty winks whenever he needed them, even when I was a young child and he was in his early thirties. If we had been driving to visit family - setting out incredibly early to make the most of the day on the pre-proper roads into North Wales - Dad would stop at a particular park en route. We kids would spill from the car and run for the ‘witches hat’ or dangerously tall, giraffe-thin slide; mum would go to the not-so-filthy public loos and change which ever sibling was a baby at the time, and dad would recline his drivers seat and be snoring - and I mean full-throated, deep-chested, rumbling male snores - before we had gotten onto the grass.

So it is a particular irony that Olly, he of our pairing who finds it hardest to sleep in the first place, should also be the one who finds broken nights and losing sleep so very difficult to deal with. Having a long, bank holiday weekend at this point in the pump start has been of great value to us therefore. I haven’t had to try and pressure Olly to take the time off work when his busy timetable just won’t allow it. We’ve all had the luxury of staying in our pyjamas for late mornings instead of having to rush up and out of the house. And we haven’t had to go to bed outrageously early to cope with the night time testing, so still having adult down time together when the kids have first gone to bed.

But I cannot tell you how amazed I was when, this morning, after what can only be described as a particularly difficult night, Olly said he was going to stay in bed for a bit. Lying in only works if you find lying still and sleeping relaxing. Olly may well be lying in bed and reading - I haven’t checked - but he never volunteers to stay in bed when the sun is up and his eyes have opened. He must be completely shattered. I didn’t even suggest it, he did!

I am pretty sure our problems last night stemmed from the fact we have got this bank holiday weekend because it is Easter. So pump start and bank holiday good, from a sleep point of view. But pump start and Easter not so good, from a sleep point of view!

In many ways yesterday was about as good as Easters get in our house. The boys were allowed to have chocolate first thing in the morning. They usually have half their breakfast as choc and half of their normal cereal. This is mainly to avoid being sick as they are neither of them used to excessive amounts of fatty sweet stuff. However, they are getting older and we are trying to let them have some more freedom to learn these things for themselves. So Tom portioned himself out 91grams of carbohydrate made up solely of easter egg for his breakfast. He woke on 6.8 mmol but was on 20mmol by 11am! Oh joy! At least with a pump you can give a correction easily!

Before lunch he was back down to 6.9mmol, which is pretty cool. Olly made us a lovely Sunday dinner - veggie nut roast, sweet and white potato mash, roast pots and snips, home-made gravy, with carrots and broccoli on the side - which was as filling as a Christmas Day extravaganza. However, the boys still managed to want chocolate by the end of it. I let them bolus for it separately in the hope it would help hold down any of the sugar and fat, and that they might be rather more realistic with their tummies already chock full. No such luck.

In all Tom had about 130grams of carbohydrate in chocolate alone. Joe wasn’t behind him, having 135grams carbohydrate in chocolate as well. I feel slightly ill even thinking about that, though I may well have matched them if I actually sat down and measured my own intake. Who knows. I only know what they have because I am looking.

Amazing as it may seem this amount of extra food wasn’t too much of a problem for either Joe or Tom’s levels during the day. However, they were allowed a final supper of a little bit of chocolate an hour before they went to bed, and it was this final parting Easter shot that did all the damage. Joe was on 10mmol before our dinner. BY 10pm he was on 11.9mmol - not too bad I hear you say - but by 11pm he was on 16.7mmol. We corrected him down to what should have been 10mmol and settled to wait the obligatory hour to see if the correction had worked. You have to look to see if they have dropped at all since giving the correction. This is the best rule of thumb for using pumps and avoiding complications if the infusion site is not working or something is wrong with the tubing etc. Waiting that hour, checking the level again and comparing to the one before then sets in motion a chain of events you must follow. If the BM is higher than the one before, you have to change the infusion set and give some novorapid by injection.

This is because the pump has only fast acting insulin in it. You don’t have the back up of knowing that there is some other type of insulin - the levemir of lantus - in there as well doing some extra work. If the fast acting insulin isn’t going in properly and doing its work, things can go wrong within hours, allowing the sugars to build up dangerously fast and Diabetic Ketoacidosis to develop if you are not very careful. We’ve seen DKA close up and personal. It nearly killed Tom was he was diagnosed. So a set change if they are still rising after an hour is not too much to ask to avoid so nasty and terrible a complication.

So Joe, who had only had his set changed before dinner, then got another change at 12am. Olly gave him 2 units of novorapid by injection whilst I did the reservoir and hooked the system up again. Then Joe did his own insertion by his own insistence. Half an hour later he was on 15.3mmol having been at 17.9mmol. By 2.30am he was on 9.9mmol, by 4.30am 6.2mmol and at 7am he woke on 5.3mmol. Hurrah. In total that was 4 wake-ups through the night to deal with Joe and his levels, including a period of getting very awake and then finding it very hard to go back to sleep.

Tom was on 14.4 before his dinner. He was on 14.6 by 10pm. This was a dilemma. His numbers had gone up, but there had been eating in between as well so we were in a quandary at this point as to what to do. He then had a correction down to 10mmol at 10pm and was re-tested at 11pm to check if this was falling. He was on 14.4mmol by 11pm, a small drop but a drop nevertheless. However, by 11.30 he had gone up to 16.8mmol. Sigh. We had to deal with Joe first, which took about forty minutes all told, then we -retested Tom ready to do a set change at 12.41am. He had now dropped by 0.4mmol. Another dilemma. We waited a half hour, and tested again at 1.15am. By this time Tom had come down to 11.7mmol. He then went to 9.4mmol by 2.30am, 8.8mmol by 4.30am, 8.4mmol by 5.30am and 7.7mmol when he woke at 7am.

Looking at these numbers you can sort of see how the correction finally caught up with Tom, and it may be that Joe would have had the same had we waited and checked again and again instead of doing the set change. There wasn’t a kink in his set, or any bubbles in the reservoir when we took it out. But we had to follow the protocol. It was only because of the time lapse dealing with one child’s diabetes needs that we saw the drop start in Tom. So, with Tom  we add in an extra 2 wake-ups on top of Joe’s 4.

So , you can see why Olly is having a lie-in. And I am sure you will sympathise when I say I am banning chocolate from today’s diet. Anyway, I’ve eaten all mine…