When I was at the start of my teens, my big sister’s best friend invited me to join her for a week away in the heart of Derbyshire. The description of who would be there, and what we’d be doing was, at best, vague. “There’ll be around 75 of us. We’ll be split into teams. And we’ll do lots of silly games. And there’ll be thought provoking discussions and reflective talks in Chapel. And an evening sing song. Every day.” I weighed up all the information I’d been given. It sounded bonkers. And I’d know no one there apart from my sister’s friend. I faltered. Should I go? Finally, the extrovert in me won out and I agreed.
A couple of months later, I was standing outside a school boarding house, with my case, forcing a smile to show my sister’s friend that I was absolutely fine….. Within the hour, I knew I’d made the right decision. The people I met on that holiday have remained friends. Indeed, I spent many more weeks with them throughout my teenage years, at Easter and Summer, enjoying all the activities and sport the weeks provided.
When Big turned 13, she was invited to join the same holiday party, still with many of the adults who’d organised the parties I had attended, and even though, just like her mother all those years before her, she knew no one going, she agreed, and had the most amazing holiday. Consequently, every Easter and Summer, she too is to be found joining all these friends for a week of silliness and thoughtfulness.
And so, as Pumplette turned 13 just before the summer holidays, her time came to join her sister on holiday. I was so excited for her to be able to experience this very special part of my childhood. I pushed to the back of my mind how challenging the management of her bgs during the week would be. Every young person on the holiday is encouraged to be self sufficient and responsible for themselves. Which is exactly what I encourage all my daughters to aspire to. However, being a Pumplette involves considerably more responsibility than even I, as a supposedly fully fledged adult, am altogether comfortable with.
Always up for a challenge and new adventure, Pumplette could see only positives in this exciting chapter. Indeed, when we were discussing what support she would like, it was she who assured me that the daytime wouldn’t be a problem. And I knew this. She is well versed in temp basals, SWAG (spectacular wild arse guess) bolusing, hypo treating and rage bolusing. She is aware how different forms of exercise will impact upon her bgs, not only at the point of exercise, but also several hours later. Plus, she can confidently handle her pump, cgm and all other equipment she uses to manage her T1. However, at night, Pumplette doesn’t wake up. Not for a hypo. Not for a hyper. Not for a 76 trombone parade marching through her bedroom. Which is a little bit tricksy when I’m expecting her to independently manage T1 for an entire week. Ever resourceful, when Pumplette and I were discussing how we would manage this, Pumplette asked if it would be possible to use the Dexcom G5 whilst she was away. That way, she could hook up to the wifi overnight and I would be able to view her bgs in real time. If there was an issue, and she didn’t text me, I could call or text her at night and we’d trouble shoot together. This sounded like an eminently sensible suggestion and so I made arrangements for her to borrow a G5 transmitter for the holiday. It arrived a couple of weeks before she left, so we tried out some of the functions together and came to an arrangement we were both happy with. It is at this point I should mention the holiday’s policy on mobile phones. It is one I fully support and applaud. Mobile phones aren’t banned, but every teenager is encouraged to leave them well alone for the week and enjoy the “here and now’ element of the parties. This made it slightly tricky when it came to requesting access to the wifi for Pumplette there. But that was mainly because I had failed to adequately brief the adults on the party about the importance of this and how much work it would save them!
Once the day of the party dawned, Pumplette, Big and myself, loaded the cases into the car and headed off on the 3 hour journey to their home for the next week. There was lots of excited chatter and the journey passed by all too quickly. And then we were unloading suitcases, and I was briefing two very understanding, if slightly shellshocked, dorm leaders about the most rudamentory elements of T1 management and assurances that I would be first port of call for any queries at all. Pumplette waved me off very cheerfully and I did the return journey in a somber fashion, with Abba’s “Slipping through my fingers” running through my internal sound system!
Now. Night one was a baptism by fire to say the least. The reason for the importance of Pumplette having access to overnight wifi wasn’t fully understood on night one, so we were relying on somewhat patchy 3G coverage. OK, VERY patchy. At 1am, I was staring at a rather depleted graph that I’d been alerted to by the alarm on my phone. Pumplette’s bgs were a very shaky 2.3mmols (36 to the bilingual reader). I sent my first text. And waited. And waited. And then, for good measure, waited some more. With an unwavering number, and no reply from Pumplette, I sent a second text to tell her I would call her phone in 2 minutes if she didn’t reply. Wait. Call Pumplette. A very bleary Pumplette answered with a whisper ( she was sharing a dorm with 4 other girls) and asked me to message. I hung up and text her. She replied with an OK, then, silence. But what was even worse than the silence, was that, in treating her hypo and then falling back into her default catatonic state, Pumplette had moved her mobile, so there was no longer any signal. At all. Whatsoever. I couldn’t tell whether Pumplette had treated before sleep, or flaked out part way through the hypo treatment. She could, conceivably, have been wallowing in a puddle of Lucozade, bathing in the stuff, rather than ingesting it. It was 5am before she shifted and nudged the phone back into the beam of signal and 3G, when contact was made once more and I could see, by the dizzying 3.7 that was now showing on the graph, that she had, indeed, managed to complete some kind of treatment.
By the second night, everyone in the dorm was tired and Pumplette had been handed the code for the wifi! I won’t say the rest of the holiday was plain sailing. It was, at times, as tough as I can remember it ever being. But, cruicially, that was only my feeling. Pumplette managed amazingly and took some really grim bg fluctuations and levels in her stride and didn’t let it stop her from participating in any part of the week. One factor I’d failed to remember until late in the week was the part tiredness plays in insulin resistance. It was relentless as the week wore on. And the amounts of insulin we were texting each other about seemed to be colossal. But together, and if I’m honest mainly on her own, she managed this crazy burst of bgs. And she managed her mother’s sadness at having brief conversations that were solely about her bgs. Which she knows I hate doing. I would never ordinarily text her to ask her whether she had checked her bgs. Or ask what they were. It is something I just won’t do. It is something that I would not instigate. This is Pumplette’s gig and I will not trespass, unless invited, when she is awake.
Bg art
There will be another post about how I felt watching Pumplette’s bgs during that week, once I’ve worked out how I actually felt about it.
This blog, however, is all about Pumplette’s resilience and refusal to be curtailed by her T1. Because she managed to keep pace with her sister and all the other teenagers for that whole week in the summer. She managed that with style, grace and understatement that I’m unbelievably proud of. And together with her big sister (who had her back for the whole week too), embraced the responsibilities impending adulthood holds for them. Spectacularly.
An excellent holiday had. Girls reunited.
(Footnote: I can’t thank the organisers of the holiday enough for enabling Pumplette to enjoy such a fabulous week, where she never once felt isolated or excluded. Bravo.)
This is us. Completely. I swear a fire engine could drive through her room and she wouldn’t wake up. I’m contemplating similar in a few weeks with a new school and people who don’t know us. Tell me, what effects do tiredness have on insulin resistance? More resistant? So less need for reduced tbrs? This is what I found on PGL last year, and I’m struggling to know how to handle this next one. But I’d assumed she’d need less insulin as the week wore on, not more