Monday, March 21, 2011

Getting Lost, then Getting Found

I needed a life preserver, honest.
I was so very lost in the land of basals and correction factors and carb ratios.
Ever get lost within it all?
To where, if you look at one more number and try to figure out where it all went bust, you think you are gonna bust.
That's where I was after The Perfect Storm and for the last week.
Great endo appointment. Amazing on many levels for self-realization.
But not so much for getting those basal rates corrected and figuring out Grace's correction factor.
Not able to figure it out.
Not for lack of trying. It was just that trying, you see, was getting me nowhere.
Nowhere, as in mixed up crazy numbers, high then low and not seeing the forest for the trees.

So, off I went to see Gary.
And I literally looked at him and said,
"I need help, I am really lost. I don't understand what's going on and I really would like to understand."
And he helped me understand.

He printed out a month of numbers and we looked at them.
He printed out the graph of her patterns and we analyzed them.
He drew me a line of how basal patterns run in kids her age.
It didn't look like my 'two-peak-like-an-M' line that I had for her, not at all.
He gave me percentages of lows, highs and in-range for each segment of her day.
We said 'Yes!' to some things and 'Wow!' and 'Whoa!' to others.
We fixed, we changed, we altered the schema of basals.
We figured out true correction factors from subtracting ending BGLs from the original high and the correction bolus given.
We changed correction factors, cause really, that wasn't the problem after all.
The basals were tanking her at times, then shooting her high at other times.
We changed I:C ratios based on after meal numbers.

It looked like this when we were done:

Graph of BGLs, with %s of lows, highs and in-range numbers.
New basals underneath and basal tests to do.

Notebook with my simplified notes.
Line graph is a typical 24 hour basal pattern for kids her age.

Ever get lost when you are driving, then all of a sudden you ask someone for directions and instead of just verbally giving them to you, they motion to you and say "Follow me," jump into their car and they lead you out and onto your way again?
It felt like that.


Lorraine of "This is Caleb..." said...

Sounds like a productive visit (understatement).

meanderings said...

I am envious...

Misty said...

Oh man have I ever been lost in the land of the basals, carb ratios and correction factors! And it does take a toll on you. I LOVE it when our endo & staff TEACH me instead of just doing it for me. So glad that you found your way :)

Joanne said...

So cool you have access to such wonderful care... I'm a little jealous!

Heidi / D-Tales said...

Lucky you to have Gary within reach! That's really terrific! :)

Alexis Nicole said...

Thats so awesome that you have a such a kick as CDE!

Unknown said...

Ahhhh....I sooo know of the peaked "M" you speak of. I think I have the same pattern that you went into Gary with. Is there a book that he has based on children's needs for insulin?

P.S. I am so glad that it was a productive meeting Penny!

Hallie Addington said...

Wow! That sounds like a little slice of heaven!! So glad it helped! Now can you help me???

Jules said...

So glad it gave you that support and clarity you needed. I struggle with the numbers and am in awe of your ability. It also goes some way to explaining how you manage those intricate quilts!