Overall, the diabetes management continues to run smoothly. But underneath that general “doing fine” are dozens of individual stressors, glitches and unexpected challenges.

After several weeks without high highs or low lows, Nick went from over 240 (target range during the day is 80 to 150; at night, 125 to 200) at bedtime to 78 when I checked him Sunday night (or “morning” depending on your perspective). After arriving home from a 14-hour deadline at 12:30 a.m., I went upstairs to check him. Poked his finger while he slept, hoping the blood pooling on his finger wouldn’t smear on his blankets.

78? Too low for nighttime. That’s close to emergency sugar low. I sped back downstairs for some applesauce, then back up where I propped Nick into a sitting position – “Wake up, honey, just enough to eat” – and spoon-fed him like he was a baby once more. He barely stayed awake enough to swallow. Despite my efforts, I banged the spoon into his teeth repeatedly. I slept on the floor of his room so I’d remember to check him an hour later. All good by then, thankfully, but the lack of sleep takes a toll. I worry the day will come when I won’t have the energy, when my eyes will close and by the time I wake up, something will have gone wrong that it’s too late to fix.

He was angry at himself yesterday for forgetting to bring syringes to school. Without a shot to deliver the insulin, his choice is between not eating or eating and then exercising all of the carbs off. Going hungry is bad and potentially dangerous; his blood sugar could drop. Eating and exercising are good if you can figure out the specifics, but we’re not quite there. Fortunately, Nick had extras at school; his principal had to drive them up to Redwood Park where the kids were having a field trip. Nick felt bad. I hope the column I wrote for the Eye this week conveys my gratitude to the SBMS staff for their support throughout all of this.

Last night he said he was hungry. I hadn’t finished constructing the enchiladas yet, so I told him to snack on something; dinner’d be ready soon. He ate too many grapes, sending his blood sugar over 300 when we tested for dinner an hour later. Again, he grew angry. High blood sugar is what sent him to the hospital – he’s afraid of getting sick again, but the fear comes out in crankiness and frustration. We dosed him with the appropriate amount of insulin, but I kept him up late so I could make sure he didn’t ricoshet into a low place. He was tired. He’s tired of being tired, I think.

While reading Bel Canto (by Ann Patchett) aloud – it’s our book of the moment – I stopped, scanning ahead. I forgot (minor spoiler here) that one of the secondary characters dies from a diabetic coma. I didn’t want to read that part, but everyone quickly became impatient – “What are you doing?! Read!” – and I couldn’t think fast enough how to skip over it. But I hated reading that part, was afraid of how Nick would feel, hurt because suddenly that fictional situation hit close to home in a very real way. Apparently I was the only one reacting that way. Our reading digressed into a brief discussion of how accurate the author’s portrayal of diabetes was. And really, how likely is it that Nick will end up taken hostage at a Central/South American dinner party?