Many Hypo Returns by Oliver Double
Tom turned 14 yesterday and was keen to show how mature he’s getting. On Friday night, we asked him if he was getting excited. ‘Not really,’ he said. ‘At school today I forgot it was my birthday four times.’ Of course, the fact he’d noticed that showed us just how excited he was.
Another clear sign that he’s still prone to birthday excitement was the fact that his blood sugars started to drop. Admittedly, he’d had double PE on Friday and youth theatre after school, but even taking that into account it was obvious that his blood sugars had gone a bit wonky. Jacqui was the first to pick up on it.
‘That’ll be excitement,’ she said, knowingly. ‘If you remember, he always tends to go a bit hypo on his birthday.’ I hadn’t remembered that fact, but then again, I’m used to playing the uninitiated Luke to Jacqui’s wise Yoda.
Apparently excitement and stress more typically lead to hyperglycaemia, but they’re more likely to make Tom’s blood sugars plummet. He was low in the evening, and when I checked him before I went to bed, he was barely above a hypo. I set a temporary basal rate of zero for an hour on his insulin pump to let his glucose gently rise, but even so he was hypo when he woke up the next morning.
We treated the hypo and got on with the business of Tom’s birthday. As he tore away wrapping paper to reveal the exciting stuff it had been hiding, I noticed his hands were shaking. One of my fondest memories of Joe and Tom being tiny was the way they would literally shake with excitement while opening presents. I was touched that even at the age of 14, Tom was still capable of getting so carried away just by unwrapping stuff, and I subtly pointed out Tom’s shaking hands to Jacqui, hoping it would trigger the same warm memories in her.
‘Mm,’ she said, distractedly.
It took me a moment to realise why she wasn’t giving me a warm, fuzzy reaction. ‘Oh, do you think he’s hypo again?’ I said, quietly.
‘Mm,’ she nodded. I know she wanted to get him to test his blood glucose, but didn’t want to interrupt his unwrapping. However, as soon as an appropriate moment arrived, he tested himself, and sure enough, he was hypo again.
In honour of Tom’s birthday, Jacqui made us American pancakes for breakfast and put out various toppings for us to choose from – maple syrup, chocolate syrup, ice cream, and even little packets of Maltesers. Tom chose all of them at once, and assembled a truly ridiculous pancake, which he proceeded to chow down with unseemly haste. On any normal day, eating such a carb-rich monstrosity would send his blood sugars into the stratosphere, but his birthday excitement meant that when he tested himself an hour or so after demolishing the Pancake of Doom, his BG level was pretty much exactly the same as he was beforehand.
A bit later we went out to Chatham dry ski slope to try out their toboggan run as a birthday treat. Unlike Joe, Tom’s not a danger hound, and tends to shy away from rides that are designed to get the adrenalin pumping. A few years ago we took the kids to the Gröna Lund amusement park in Stockholm, and while Joe tried to persuade us to let him go on the 80-metre drop tower, Tom had to be coaxed into braving the pink elephants merry-go-round.
At the age of 14 he’s prepared to push himself a bit more, but as we queued up for the toboggan run, he went really quiet. Now he wasn’t just excited because it was his birthday, he was also nervous about just how terrifying this toboggan run might be. Excited and nervous – a bad combination. We got him to check his blood sugars, and this time it was a really nasty hypo. He was on 2.3 mmol/L. After swigging down half a bottle of Lucozade, the only thing for it was for Jacqui and Tom to give up their place in the queue and go and get some lunch in the café.
Inevitably, having treated hypo after hypo, all that Lucozade – not to mention the nachos he’d wolfed down for lunch – caught up with Tom, and his blood sugars rose up into the teens. Now the challenge was to give him enough insulin so that his glucose would come down to a normal level before the evening so that he could tackle his birthday cake, but not so much that he’d go hypo again.
What all of this goes to show is that type 1 diabetes never, ever takes a day off. It works evenings, weekend and bank holidays. It’s there for us every Christmas and every birthday. And of course, what that means for us as a family is that we’re never fully off-duty. That’s why the best present Tom could ever get would be a cure – so that we never had to worry about insulin pumps and blood glucose testing kits and all those bloody hypos ever again.
Still, until that happens, there’s nothing to stop us enjoying a truly ridiculous pancake every now and then.