Thursday, September 16, 2010
Choosing No. 4
I'm working on a chart. The secretaries at Theo's school need a reference page to go by when they check his blood sugar levels.
So yes, when he's 80 or over, go ahead with the lunch insulin. But wait! 78 is close to 80. Maybe I should back that 80 down to 78. Better yet, have a separate line for what to do at 75-80, and 70 to 80 with symptoms, and 70 and above without.
With type 1 diabetes, the numbers really do make a difference. Theo's target blood sugar at this age is 80 to 180, and we'll do everything we can to keep him in that range. We've been given insulin dose ratios as well as education on how and when to adjust them. For example, Theo gets 1 unit of insulin for every 24 grams of carbs he plans to consume. Some parents plan their meals down to the gram, whereas we've been figuring out what he'll eat and rounding up or down according to facts, circumstances, and gut intuition.
Numbers are everything. I've been feeling a bit guilty lately for not packing into my son's lunchbox a meal that is easily divisible by 24.
And then it hit me.
24 is not a magic number.
The doctors and doses, glucometers and CalorieKing are fallible, and we all have to do our best and hope for the best. I'm reminded of the day I asked the nurse about a strange spike in Theo's blood sugar levels despite our perfect counting; in her kind way she said, "Well you know, he does have diabetes." Meaning we've got a manageable yet unpredictable disease on our hands, and to expect the unexpected.
Doing our best despite the circumstances, the circumstances not fitting easily into one category or another. I write on this often, don't I? In the last post, and in my latest essay at Burnside. These thoughts are visited as often as I make attempts to reconcile myself with them.
Earlier today, a researcher caught me up in a phone survey on the health of Michigan residents.
"On a scale of one to five, with one being highly satisfied, two being satisfied, three being somewhat dissatisfied, four being dissatisfied, and five being highly dissatisfied, how would you rate your satisfaction with your life?"
By this point I knew I was not permitted to choose an answer lying somewhere in between his options, such as "4.5," nor was I able to have him elaborate beyond his script (they must have a section in their handbooks called How To Discourage Housewives Starving for Social Outlets).
My mind went to August 2, the day of Theo's diagnosis. To my ability to show up every day at lunch and gym to help with the insulin shot, and get an extra hug; my thankfulness for a flexible schedule, and the little tug and pull from the projects I'm neglecting. Walking my son to a class he's had to miss part of, wondering when all the missing is going to register with him.
In the end, the researcher needed a number, and the insulin pen must be dialed up to the half unit. But life can be lived on the edges of these boundaries, and even just beyond.