looking at the new from the old

my brother, Mr Wogglebug (HM.TE) was here on a visit and left me with a gift.  It seems  like I am looking back from such a long ways off.
A,B,C,D,E,F,G,
who is that looking out at me?
what are the secrets behind her eyes?

where are the hidden lies?

A preview

 

Somebody  wanted Something Zombie.

the clown car effect

Sometimes when I deal with Mr Footless and Insulin shock I seem to switch over to some alternate reality where the furniture seems to be the same but people seem to be operating from the twilight zone.
I was talking to someone about this and called it the clown car effect.  Its as if a car full of clowns pull up in front of your place and pile out and there is no figuring out what will happen next. Here are several of these that stand out in my mind as unforgettable and amazing episodes of Chinese fire drill.

1. The day we found the cat that had fallen down the chimney which involved a cherry picker and four fire guys.
2. The day I came home from work to find a grocery cart in the living room with a cryptic note from a police officer informing me that my produce was in the refrigerator and a missing husband.
3. The epic line up outside the house that involved a city bus, a police car, a fire truck, an ambulance, the mail van, The UPS van and a friend's car.
4. The episode in a coffee shop where the guy concluded that Mr Footless was possessed by demons and began pulling out all the stops including the bible and calling on Jesus to help this poor soul.
5. The time Mr Footless went out in his daughters bathroom and we got the graduated sized fireman and EMT parade all of whom wanted to try fitting themselves into a bathroom the size of a refrigerator carton
6. And then the latest one where Mr Footless collapsed in a restaurant during the five o'clock rush and we had the whole mess happening in a bar on the floor, wherein the Manager after the thing was over offered me two shots of tequila to take the edge off.  

considering all that. it has become very hard to upset me I guess I have been worked over by experts.

When things calm down you can see through the confetti

Mr Footless sat down to examine all the data that we have gathered this past few weeks and what needed to be done about the pump and the incredible time problems that we were looking at.  Somehow it has all come together in our understanding  as to how to deal with the problems with the pump.
 You need to understand that there are real advantages to it.  Mr Footless and I have both known that he really should be injecting two boluses a day to smooth out the lumps in his delivery system.  There was no way in hell that Mr Footless was going to do it. The cruel truth is/was that he is afraid of needles.  Once a day was all he was going to manage and that was that.  Well the pumps delivery system has taken the horror out of injections.  Once the infusion set is in place, getting the insulin on time and properly dosed is a matter of five punches of a button.  One ouch, every three days.  Smooth delivery and minimal issue.
The real problem was what we had no clue about.  Nobody knew and nobody could predict the length of time insulin was lingering in his system.  In the end this is what was causing the crashes and the craziness.
We know now that he can manage the pump, his food, and stabilize the routine because he understands that it isn't all that foreign to his way of managing.  He just has much more accurate knowledge of what is going on and a much more accurate calculation and delivery system.  Hurray.  I think he is riding it, instead of it riding him.

In which I get a vacation whether I want it or not

Let's state the obvious.
the last few weeks have been stressful. very very stressful.  they have included steep learning curves.
finding out just how odd Mr Footless's metabolism is. broken sleep, emergency runs. and Mr Footless after too many insulin shocks where his cognitive ability has slipped.  I have been feeling voiceless and run down. as if I have to make unpopular choices and can't get them across in a way that states that I mean business.  So I have  laryngitis.  I can not make myself heard.  I have been struck dumb.
I rescheduled almost everyone and hunkered down for a day of silence, rest and reading.  All the connective tissue in my head swoll  up and it hurt to put on my glasses. Ah silence.
  the strange thing about it is that I have found a way to communicate with Mr Footless that  he can hear what I want to tell him and he doesn't block it out.  Mr Footless is beginning to understand just why text messages are a really good thing..  I lost my voice so that I could say what I needed to say and as a positive note Mr Footless has partly entered the newer communication age.  He can't send them but he can get them.

Another piece of the puzzle

 The following is the rushes on my making sense out of my last experiences over the weekend.

 Dear Diabetic expert that is the age of my son.

MR. Footless did not respond well to the original parameters of the pump set up.  What could not have been taken into consideration was :

1)      MR. Footless is high blood sugar phobic.  He will not tolerate extended periods of blood sugars running over 180mg/dl

a)      His body responds to extended highs with nausea and vomiting so his refusing to tolerate them is entirely understandable.

b)      His lifetime manner of dealing with this is to refuse to eat, to take bolus insulin and wait until the blood sugar drops.  At present this is making him miserable.

c)     ( He is no bundle of joy to live with either.)

d)     I put the pieces together to figure this out about two weeks ago, and after twenty years of life together.

2)      MR. Foot less's insulin processing is very idiosyncratic. 

a)      This may be due to his extended life as an insulin dependent diabetic. After 70 years his body responses are what they are in part due to the long term and life long habits that have allowed him to survive and in part to thrive while injecting insulin.

b)        they aren’t normal.

c)      Apparently he has an extra long onset time, and a much extended active insulin period. It begins to make sense of the 4 am crash and burns and the wild variations over the years.

3)      The active Insulin period of Humalog is supposed to be four hours.  For MR. Footless it is ten hours.  This is the reason that he has the blood sugar crashes in the wee morning hours and the reason that the night time basal has been dropped to nonexistent.  With the pump calculating for four hours he has been inadvertently been stacking his dosages which all hit at somewhere around 4 AM (lucky Me)

a)      During the latest emergency I was able to get enough information to re-calibrate the information in the pump using the numbers that repeated testing over a ten hour period helped to confirm

4)      The following chart is the recalibration as Mr. Footless’s present numbers have indicated.  It has a much lower basal which may need raising and a much larger carb factor in line with both the blood glucose results and the crash and burn episodes in the early morning.  Todays  blood glucose results do not thrill Mr. White but they seem to be taking into account the long time that insulin is active in his system.  I have some questions.

1.      The pump does not have a ten hour insulin time. eight is as high as it goes.  While this is better than the stacking effect that four hours applied to Mr. Footless, is there shorter acting insulin?

2.      We are pretty sure that there is an hour delay before the insulin begins to show in the system, and we know that it begins to peak after four hours and continues to work for another four hours. How do you plan meals around that?