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I have noticed that M is balancing her diabetes care pretty well over the last few months.

Don't get me wrong. She still has plenty of bad habits.

She leaves bloody test strips in her meter case. Sharps from her infusion set are frequently left in the open, or on the floor, even.

But there is one thing that she seems to be doing more and more frequently these days, and it concerns me. She is waiting until the last minute to change her infusion set. And by "last minute", I mean that she waits until there is no insulin left in the cartridge.

You see, the insulin pump looks like a pager. In the "pager" part, is a little reservoir cartridge which holds insulin; usually enough for a few days. There is tubing that leads from the pump to the cannula, which is the little straw thing that is inserted under M's skin and distributes the insulin that the pump sends from the reservoir.

"Are you sure that she knows that she is low on insulin?" you might ask.

Oh my, yes!

Pump manufacturers are geniuses, you know. They have all kinds of user error prevention going on in that little device. There is a "low reservoir" alarm which lets M know, through a noisy and rigorous vibrating, that she has a couple of hours of insulin left, and that she had better get all of her medical stuff together so that she won't run out.

Up until recently, when the alarm sounded M would go immediately to the medicine cabinet to get a new infusion set, and go the fridge to get another bottle of insulin.

But friends happen.

The first time I remember M waiting until she had run out of insulin, we ended up staying very late into the night until her blood glucose reading returned to under 200. That night, she knew that she would run out of insulin during a play at her high school, but she didn't want to keep her friends waiting while she changed her infusion set.

Then she ate a Reese's Peanut Butter Cup.

Then chaos ensued.

It was an unplanned, exhausting, and clear lesson in "doing what you have to do when you have to do it."

But only part of the lesson was learned, it seems. After all, she will still choose not to respond to her alarm in a timely fashion.

Now when she does it though, it seems to be more calculated. She figures out how much insulin she will need to get her through the night, and if she thinks it's going to be close, she'll simply go to bed, ignore the infernal buzzing of the pump's alarm system, wake up the next morning with a somewhat high bg reading, and then change her infusion set.

Not recommended, by the way. Those alarms are there for a reason, missy!

Maybe she is trying to save herself time and effort. Maybe she is trying to save our family from higher-than-necessary medical bills. I am not sure what motivates her to wait, but it makes me nervous.

As M is often the child that needs to learn things through experience, we may just have to hope that her calculations and time estimates are always correct.

In the meantime, I will apply the usual dose of nagging.