When I was learning about diabetes and how to care for my son in hospital after his diagnosis I noticed that the nurses would always get another nurse to double check their dosage of insulin before administering it. They told me it was a good habit for me to get into too so that if I had drawn up the wrong amount of insulin, the other person checking it would be there to pick up on it. I did that for quite awhile, back in the early days when I was still pushing a syringe into a vial of insulin. Now we have the pens to administer insulin, which is easier and more convenient, not to mention less painful for my son as it has a shorter needle on it than a syringe.
Jason has three different insulin to get him through each day. He has two needles in the morning, one being Novorapid and the other Protophane. The Lantus is given at night which continuously works to help improve his blood sugar control over a 24 hour period as well as another dose of Novorapid to cover the evening meal and snacks. Novorapid is a short-acting insulin. It works fast, within 20-30 minutes of injecting it. It is given just before a meal to control the increasing blood sugar levels after eating. Protophane is an intermediate-acting insulin which covers him for about half the day. However, when we swapped from syringes to pens, I had a few incidents where I got the different insulin pens mixed up and hence, ended up giving him the wrong amount. You may wonder how I managed to do that! It's not hard to do if you've had lack of sleep, you're in a hurry, stressed out and not concentrating. It was probably the worst fear and panic I have ever felt, when you suddenly realise that you've injected your son with double the amount of fast-acting insulin, knowing full well that his blood sugars are going to come crashing down. You then spend the next three hours or so closely monitoring him, armed with obscene amounts of sugar and carbohydrates on hand to prevent this drop from hitting dangerously rock bottom. After a few of these unsettling mistakes, I sat down with a diabetes educator and came up with a solution. We put the Novorapid into a red coloured pen case because I could easily associate red with fast. The Protophane went into a blue pen case and Lantus, silver. This works a treat. No more mistakes.
Then, it was over the Christmas break one day that Bailey alerted to a low blood sugar. I treated the low, rewarded him and got on with things. Bailey kept on alerting and became agitated. Normally he will signal and then maybe repeat it again a few times and then settle when he sees me treating the low or high. But on this day he bugged me repeatedly. After fifteen minutes, he was still offering the low alert and Jason said that he still felt low. When I retested Jason's BGL's, he was still low. I gave him more sugar to bring him up and then when his BGL's were stable, more carbohydrates as a back up. Half an hour later, Bailey was still alerting and when I tested Jason's BGL's again, he was hypoing again. This was an unusual situation and I had no idea what was going on. He wasn't feeling unwell, so I checked the end of the pen which shows how much insulin was dialled up and it showed the correct units. It appeared that he'd had the right amount of insulin that morning, and he'd had his usual meals and snacks. Eventually after quite a bit of sugar and carbs, Jason's BGL's stabilized.
It wasn't until just before breakfast the next day that I discovered the reason for his severe hypo the day before. As I was about to inject Jason with his Protophane, I just so happened to glance down at the pen. The middle of the pen is open so that you can see the clear refill of insulin inside. You can also see the name of the insulin printed on the refill. You don't tend to take much notice of this once the refill is in the pen but I happened to look down at it, only to discover that the Protophane wasn't cloudy as it should be, it was clear! The Novorapid had been put into the Protophane pen! Now in our household, I think I am accurate in saying that almost all of Jason's care is administered by me. It is different for every family but for us, this works. So when I went to my partner to tell him about the mix up, he told me how he'd refilled the insulin pen a couple of nights before. He had been tired and had accidently put the Novorapid into the Protophane pen which means that Jason had received triple the amount of fast-acting insulin that morning! The changing of insulin is also something I would always do but I was busy at the time and didn't even know that it had been refilled which is why I didn't pick up on the mix up in the first place! I am grateful that this occurred on the holidays and not when Jason was at school or the consequences would have been disastrous!
Every day we all play a role in the management of Jason's diabetes care and for the most part, everything runs along smoothly. However we're only human and mistakes are sometimes going to happen. Bailey's alerting is proving to be a constant, even a year on. He picks up when things are not running smoothly and makes us aware of it. He continues to prove what a valuable resource in him helping us in the day-to-day management of our son's disease.
Jason has three different insulin to get him through each day. He has two needles in the morning, one being Novorapid and the other Protophane. The Lantus is given at night which continuously works to help improve his blood sugar control over a 24 hour period as well as another dose of Novorapid to cover the evening meal and snacks. Novorapid is a short-acting insulin. It works fast, within 20-30 minutes of injecting it. It is given just before a meal to control the increasing blood sugar levels after eating. Protophane is an intermediate-acting insulin which covers him for about half the day. However, when we swapped from syringes to pens, I had a few incidents where I got the different insulin pens mixed up and hence, ended up giving him the wrong amount. You may wonder how I managed to do that! It's not hard to do if you've had lack of sleep, you're in a hurry, stressed out and not concentrating. It was probably the worst fear and panic I have ever felt, when you suddenly realise that you've injected your son with double the amount of fast-acting insulin, knowing full well that his blood sugars are going to come crashing down. You then spend the next three hours or so closely monitoring him, armed with obscene amounts of sugar and carbohydrates on hand to prevent this drop from hitting dangerously rock bottom. After a few of these unsettling mistakes, I sat down with a diabetes educator and came up with a solution. We put the Novorapid into a red coloured pen case because I could easily associate red with fast. The Protophane went into a blue pen case and Lantus, silver. This works a treat. No more mistakes.
Then, it was over the Christmas break one day that Bailey alerted to a low blood sugar. I treated the low, rewarded him and got on with things. Bailey kept on alerting and became agitated. Normally he will signal and then maybe repeat it again a few times and then settle when he sees me treating the low or high. But on this day he bugged me repeatedly. After fifteen minutes, he was still offering the low alert and Jason said that he still felt low. When I retested Jason's BGL's, he was still low. I gave him more sugar to bring him up and then when his BGL's were stable, more carbohydrates as a back up. Half an hour later, Bailey was still alerting and when I tested Jason's BGL's again, he was hypoing again. This was an unusual situation and I had no idea what was going on. He wasn't feeling unwell, so I checked the end of the pen which shows how much insulin was dialled up and it showed the correct units. It appeared that he'd had the right amount of insulin that morning, and he'd had his usual meals and snacks. Eventually after quite a bit of sugar and carbs, Jason's BGL's stabilized.
It wasn't until just before breakfast the next day that I discovered the reason for his severe hypo the day before. As I was about to inject Jason with his Protophane, I just so happened to glance down at the pen. The middle of the pen is open so that you can see the clear refill of insulin inside. You can also see the name of the insulin printed on the refill. You don't tend to take much notice of this once the refill is in the pen but I happened to look down at it, only to discover that the Protophane wasn't cloudy as it should be, it was clear! The Novorapid had been put into the Protophane pen! Now in our household, I think I am accurate in saying that almost all of Jason's care is administered by me. It is different for every family but for us, this works. So when I went to my partner to tell him about the mix up, he told me how he'd refilled the insulin pen a couple of nights before. He had been tired and had accidently put the Novorapid into the Protophane pen which means that Jason had received triple the amount of fast-acting insulin that morning! The changing of insulin is also something I would always do but I was busy at the time and didn't even know that it had been refilled which is why I didn't pick up on the mix up in the first place! I am grateful that this occurred on the holidays and not when Jason was at school or the consequences would have been disastrous!
Every day we all play a role in the management of Jason's diabetes care and for the most part, everything runs along smoothly. However we're only human and mistakes are sometimes going to happen. Bailey's alerting is proving to be a constant, even a year on. He picks up when things are not running smoothly and makes us aware of it. He continues to prove what a valuable resource in him helping us in the day-to-day management of our son's disease.