‘Tis the Season…for Colds and Flu
7am: Sam, my 12 year old wakes up not feeling well this morning and doesn’t want to go to school. He generally enjoys school and he looked fine, but his blood sugars had been high overnight. This sometimes this indicates the onset of a cold. With diabetes it’s hard to separate all the factors. Sometimes, after a night of consistently high blood sugars, he wakes up more cranky than usual. We are able to give insulin through the pump during the night to bring the blood sugar down without waking him, which, of course we did. The body doesn’t feel well when so much sugar is coursing through its veins. Is that why he woke up sluggish and cranky? But, then again, he’s a pre-adolescent boy with a math test today. However, I must bear in mind the other diabetic in our household: When our 6 year old son wakes up from a “high” night, he, too, tends to be extra cranky.
Kids get on the average of 8- 10 colds per year and they are more frequent during the winter season. I didn’t need my MD and specialty in Pediatrics to tell me this. But it’s so much harder when they have other medical issues. With diabetes, anything that sets the body slightly out of whack can affect their blood sugars. This includes growth spurts, viral infections, weather changes, altitude and medications. When my kids get sick, this triggers their asthma which requires them to take more medications so they can breathe well and not get sicker. Also, when the blood sugars are high, it is harder for the body to fight infection. This is because the white blood cells (neutrophils) work more slowly. It is a vicious cycle. It is easier for them to get sick and it is harder and takes longer for them to get better. They feel worse when they are sick because abnormal blood sugars make you feel like CRAP. So that adds more crap on top of your general sick crappiness. It is also hard to predict into what a cold will blossom. One summer his cold at sleepaway camp triggered a full-blown asthma attack which required steroids. His blood sugars were so unstable he went to the ER and stayed home for a week. Thankfully, this is not always the case, but there is the tension of never knowing which way the wind will blow. We can only hope for the best.
7:45 Sam needs to either get out of bed and get dressed for school or stay home for the day. I am hoping for school. He has no fever or worrisome cold signs, perhaps just a little wheezy. He gets out of bed, takes his insulin, inhalers and breakfast and goes to school.
8:45 Sam calls from school to tell me his BG was 354, so he felt high, but he also felt low because the albuterol for asthma makes him feel jittery and low. I tell him to retest and call in 20 minutes.. He does with this report: his blood sugar is even higher and he is starting to cough. No doubt now: Time to go pick him up.
While Sam leaves the room to pack his bag, I am grateful the school nurse hears me out over the phone. “I feel bad for him…it sucks for him to feel like this and I can’t do anything to make him feel better.” She replies, “But I see him every day and he has become so strong, so robust as a person. I see others who suffer more for far less things. Sam is doing fine.”
Her kind words reassure me. Of course, isn’t that what we all want to hear? That our children are able to confront their challenges and master their environments? I’m certainly thankful that he is able to show these strong character traits to the outside world. It makes me proud and it makes me smile. But, my smile is temporary. Reality hits as I approach school and I wonder how bad this cold will be? How will it affect his BGs over the next week? And, finally: how long until we return to a level of “normalcy?”