11th bday party

Earlier today, as we were getting the house ready for tonight's sleepover to celebrate L's 11th birthday, she mentioned that she needed a site change. I was all, "Since we put the last one in on Wednesday night, it can wait until tomorrow morning." Then I had the following thought: "It's a good thing we don't have to change it tonight, since it's her birthday party and what would be worse than having to get a site change in the middle of a slumber party ha ha."

Well, here's what: 429 + large ketones in the middle of a slumber party ha fucking ha.

Perspective: She was 474 at diagnosis with small/medium ketones and since she was discharged from the hospital over a year ago she has never had anything more than trace ketones.

As we were sitting down to dinner tonight she tested at 429. I thought she was high due to all of the excitement (we had just returned from a local amusement center where she and her friends had played one round of glow-in-the-dark mini-golf and two games of laser tag). Plus, she usually goes high during and immediately following exercising, and I expected her to drop pretty quickly. In fact, we agreed that she should only give herself a half correction for her BG, due to previous experiences we've had with post-activity low-tastrophes.

After dinner, it was penguin cupcake time and if it was any other day I would think twice about letting her have one when she's so high but come on people, it's her freaking birthday party. A few minutes later she goes to the bathroom and I remind her to check for ketones. I knew something was wrong when she took so long. Finally she came out and said she needed help deciding if it was (I thought she was going to say negative or trace but no) medium or large. Fucking large.

I could tell L was freaked out but I thought it was because she was afraid her friends would notice she'd been gone a while. I said, "What are you worried about?" And she said, "Am I gonna get DKA? Do I have to go to the hospital?" I hugged her tight and said, "Oh no no no, sweetie, I think we caught it before it got to that point, we just have to look in the book to see what our next step is."

Except when we looked in our manual, we realized the flowchart and calculation sheets were for MDI. We haven't been on MDI since March! WHAT THE HELL ARE WE SUPPOSED TO DO. I call Children's, John's googling "ketone treatment with pump" and L's chugging water. Luckily her pals were entertaining themselves and having second helpings of penguin cupcakes.

John finds the proper flowchart right before the doctor on call gets on the line and we confirm that she needs 15% of her daily basal total delivered by injection (plus the other half of the correction for her BG we thought she wouldn't need) and we need to pull her old site and give her a new one. Now she's upset about having to get a shot, since it's been so long since she had one, and hey, looks like she's gonna get a site change in the middle of her slumber party after all.

I tell her I'll distract her friends so they won't see her going upstairs. I ask her what she wants me to tell them and she says she doesn't know. I tell her, "I won't mention anything about diabetes" and she suddenly looks so relieved. She says, "Oh good, because if you said it was about that I know they'd all worry and I don't want them to." I squeeze her close and start to cry, but only for a moment because I have to perpetrate some subterfuge on the three 11-year-old girls in the other room.

So I ask everyone to join me in the dining room as L and John go upstairs. He gets her out of her head by letting her play Angry Birds while he readies the syringe and new infusion set.

(Real time editor's note: John just checked her again because she said she felt low and she was 240, and 'relieved' doesn't begin to describe it. This is me letting out the breath I've been holding since all this started. Perhaps the rest of this post will reflect my improved state of mind.)

Here's something funny: The on-call doctor wanted to be sure I understood that it was important that I monitor L's BG very closely, so she told me I needed to check her every (half hour, I thought she would say)...three hours. If I hadn't been in the throes of SWEET CHRIST WHAT NEXT, I would have been all, "Guuuurl, whatchoo think I do every day of my life? Every three hours is S.O.P. up in this bitch!" Instead I just said, "Oh yes, of course!"

So anyway, the girls and I are just hanging out, talking about Candy Spray, as you do, and L comes downstairs and rejoins the party like nothing happened. They head down to the basement and we set up the inflatable mattress and after some deliberation (have you ever tried to get four 11-year-olds to agree on anything?) a movie is chosen (you can't go wrong with Miyazaki).

L's friends want some popcorn but that's so not gonna happen so I suggest that she offer them sugar-free Jell-o and Reddi Wip instead. She presents it in the classic good news/bad news fashion and a cheer rises up from the basement. So as of this moment they're all tucked in downstairs, bellies full of carb-free treats, watching Spirited Away and hopefully getting ready to doze off.

Now that the moment has passed and her BG is headed in the right direction (another real time ed. note: she's down to 150, phew), it's easy to have some perspective and realize it was not the end of the world. And the fact that we're 14 months into it and this is our first ketones "scare"? Well, that's something to be grateful for.

But during the kid's birthday party? Come on, man. I feel like re-writing that recent Cee-lo hit (warning: explicit. Earmuffs for the kids if they're around) from the perspective of a PWD to diabetes. I know there are some talented people out there in the DOC. Wanna get on that?

[edited to add: it's 1:03am and she's 132 and negative for ketones. sigh.]