More fun!

I feel like we have been sent to the top of the class. We have passed go and collected our £200. No, we haven’t had a full nights sleep - don’t be silly! We have in fact done our first dual wave bolus for dinner!

 It’s this sort of flexibility which makes the pumps so brilliant. We have been having problems with the fact most of our food is low GI and wholegrain. We make our own bread and are veggie (though we eat fish, so rather are ‘fishy’) so have lots of fruit and veg on the menu along with pulses and fresh sauces (and lots of bloody Easter choc which I will throw in the bin soon if it doesn’t get eaten!) Both of the lads have their highest basal rates just after dinner to try and help this. But the dual wave allows you to bolus part of the meal with a shot of there and then insulin, whilst gently trickling out a proportion of the bolus later over a couple of hours and thus boosting the basal rate further. This has the knock on effect of countering the slower release food and has given Joe his best night’s levels yet.

It is hard to keep perspective on what we have achieved already. We have had the boys with insulin in their pumps for only just a week and two days. And yet the highest level the boys have had between them in the last two days has been 14mmol. When you have been used to having blood sugars which range from 20mmol to 2mmol, with seemingly little rhyme or reason, such control so soon into using the pumps is unbelievable. I didn’t see it though, through my sleepless eyes. Becky pointed it out to me - patiently as ever - and pointed out that this is with the dratted chocolate still involved. That outside perspective really helps.

Being back to school has made some radical changes for both boys. Tom has had his basals changed quite a bit. At 7am he is having 0.45U/ hour to cover the huge breakfast he likes and which usually makes him zoom right out of range. However, at 10am he has his basal lowered to 0.10U/hr. This means that he has less than a units worth of basal for the afternoon through until 6pm ready for dinner. Is there any wonder that Tom would hypo so much during the week. He had to have more levemir to try and help the breakfast spike, but needs so very little afterward that we were not able to reduce.

He has had hypos to show us that this is his needed pattern. But he is feeling them mainly when he is in the 3’s rather than the low 2’s as he was before. So he is safer in the margins of tighter control. Also, he has put on 3 lbs since going onto the pump! He has been having chocolate of course, but I think this is because he is mainly keeping the energy from what he is eating, rather than losing so much through the renal threshold being breached. There is so much less rushing to the toilet for him all day. His teachers have noticed that he is at his desk more in the day, and able to concentrate and not be as emotional as he has been wont to be.

Interestingly, Joe is still finding the idea of having freedom around food very difficult to embrace. He doesn’t snack between his meals unless I ask if he wants to. It is like he has no conversations with his own stomach. I am always listening to mine - do I want a cup of coffee? should I just finish that Chelsea bun? - but he has blanked his for so long he doesn’t know how to tune into it again. I’m not pushing him at the moment. It does mean he is actually eating less than his younger brother right now. Tom is away after this two week Whitsun break, on a residential with school (which Olly is going on), so maybe that will be the time when I can let Joe lead us in our eating with his appetite. He may just need some space, and me waiting for him to tell me he is hungry before I put out food for him etc. At least we’ll get some time to concentrate just on him for a change.

I have now used temporary basals, a dual wave bolus, and just love the maths of the bolus wizard. It’s only the sensors to go for now. Joe is ready for his first sensor which he will have put in tonight. Tom has said he will have his on Sunday (an arbitrary date but what the hey?) with the added persuasion of an extra pokemon toy for doing it. This will hopefully let them give their fingers a bit of a rest whilst telling us so much more about the foods and the exercise patterns in their typical week at school and home. Exciting!