Halloween Night Scare

After a fun night of trick-or-treating,

Batgirl Josie, Ellie the witch, and friends.

we let the girls have some of their candy which resulted in a high blood sugar for Josie, a 416. I expected it and gave her a 1 unit correction (enough to lower her approximately 250-300 points to put her in a safe range for sleeping.) 30 minutes later, her CGM alarms that her blood sugar is falling. I go to check and am horrified to see a 46 pop up on the meter. She still has enough insulin active in her system to lower her blood sugar at least 200 more points. She is not safe under 80 and so a 46 minus an additional 200 points would, to put it bluntly, end her life. Just as I’m grabbing juice boxes to start counteracting all the insulin and low blood sugar and to save my daughter’s LIFE, I notice Ellie (who was still awake from all the candy and was jumping around on the bed) lying flat on her back and making this weird gurgling sound. I quickly realize that she can’t BREATHE and I have no clue what happened! I start yelling for Eric because I already have an emergency with Josie and now something is wrong with Ellie. He comes running in, she starts hyperventilating and screaming that she thinks she broke her back. He quickly accesses her, she is able to move her toes, fingers etc, while I coax Josie, who is getting worse by the second, to please keep drinking her juice...

This is what 7 units of insulin looks like.

7 units (making a droplet about the size of Abraham Lincoln's head on a penny) is currently the total amount of insulin Josie needs to stay alive over the course of 24 hours. This is what her pancreas (before her very own body starting attacking it for unknown reasons) would have put out, as needed, all on its own- with no thought from anyone else. Now, in order for our little girl to survive, it has become my job, using my own brain (along with some mathematical formulas given by her doctor) to decide exactly how this tiny amount gets distributed into her body throughout the day. She needs some of it, given in 1/20th of a unit increments (or that drop divided 140 times!) injected under her skin every few minutes with an insulin pump. The rest is divided up and given by me (either with a shot or through her pump) with each meal and whenever her blood sugar is too high. I have to decide how much to give, each time, based on what she eats, her past and predicted activity levels, whether she's sick, going through a growth spurt, or is even just stressed or excited at that moment. If I'm wrong, she can experience very dangerous low or high blood sugars. We have to prick her fingers and test her blood every few hours to try and catch these. 7 units of insulin, just a tiny droplet on a penny, is life saving to our little girl. However, if this tiny droplet were unknowingly injected into her all at once, she would die within a few hours of a severe low blood sugar. If it were withheld from her body for 24 hours, her body would become so toxic with ketones that she also would not survive. She depends on me to get it right for her. This is the balancing act we face, each and every day, for the life of our four year old daughter.