One a.m.

The Things We Have Now

The chirping alarm clock wakes her. Promptly the comforter stirs, legs skimming across the mattress. A shadow lifts out of the gloom as she pulls herself from the bed. She passes like a spirit through the room and stoops outside the door. Seconds later blue-white light fills the hall as she stands upright holding the flashlight that sits plugged into the wall socket. She points the beam ahead of her and enters the other room, where there lies a tiny figure asleep in the bed, bundled deep beneath the covers.

She stands over the child and listens for breath, watches for the shoulders to rise and fall. She sits at the edge of the bed. At this hour the house is quiet and still, there’s no sound save that of the weary resting. Some nights you feel you could sit there forever, just you and the dark and all that unparalleled quiet, if not for this darling small child.

On the beside table lies the slim black kit where she placed it the evening before. She reaches for it and pulls on the zipper and spreads the contents open on her lap: the meter, the test strip and lancet. When she is ready she reaches for the child’s hand, but the air in the room is chilly, the covers warm and snug. The arm extends only after some struggle. Then she arranges the fingers before her, holding them steady while adjusting the light and in the washed out, colorlessness of it all, the blood, when she draws it looks black. It forms a dark bead on the surface. Carefully she aims the tip of the strip at the tiny droplet and an instant later the meter beeps. Seconds pass. The beep sounds once more and she reads the number on the display.

She packs up the kit and zips it closed. She rises and turns to look back at the child. The arm has already withdrawn, tucked safely beneath the covers. She brushes the hair away from the small round face, tucks the sheets firmly about her shoulders and kisses her softly on the cheek.

The beam of light precedes her into the hall and she secures it to the  charger on the wall and moves as a shadow once more through the doorway.

The comforter lifts. The legs slip over the mattress. The stillness returns.

It’s one a.m and all’s well.

10 thoughts on “One a.m.

  1. This was very well written and like others before have posted, reminiscent of my family’s own early hour activities. Like you, we were told that we could let our son go through the night, but the mother hen in me (and my wife) won’t let us. Thank you for sharing this and I look forward to reading through your other blogs.

  2. We didn’t routinely check my little boy at night when he was on MDIs unless there was something funky going on. Something like him being sick or wacky numbers that day or me simply waking up (God’s way of nudging me to check him). Now that he has been on a pump for almost a year I find myself checking him every single night. I set an alarm for 2 am and it is scary how many lows I have treated. On Lantus he had to be so high to get him through the night that he hardly ever went low, but the pump allows us such tighter control that there isn’t that buffer. While I love that the control is tighter and the A1C is down, I hate disturbing his sleep. He rarely if ever wakes, but I do wonder if it messes with his sleep rhythm. So hard on such a little guy. Thanks so much for posting about this and in such an eloquent way!

  3. Hi Steve

    Thank you for this. I am also touched by the droplets of blood stains on the sheets — we have this too…

    We test most nights, but not always for the reasons you outline. Your educators said 2 or 3 am, and this is indeed for fasting level — becauses the body’s natural rhythms are at its low blood sugar level at that time of night. So you are wanting to test at the body’s lowest point, which is 2 or 3am.

    We test at that sort of time when my son’s night levels have been a little unpredictable: he goes to sleep on a good number, but wakes up high, for instance. Or the opposite. This helps us determine how to adjust his nighttime levels on his pump, and sometimes tells us about what he has eaten, or his exercise in the day and how we can adjust things accordingly.

    We test at night usually though in order to ‘see through’ an insulin dose, or a correction, or a snack. In other words, to make sure he is relatively stable and not likely to drop more. So we test 2.5 hours after he’s eaten something and taken insulin for it. We also test if he was a little low before bed, and has eaten a snack to get through the night — we want to see the effect of the snack. We also test if he has exercised in the day — again, to make sure he’s not hypo.

    I’m sorry to say that we have caught *many* a low this way. He does not wake up when low, and we have also caught actual hypos by testing at our regular times and according to our rules in the night. The same applies to the morning: we always test him first thing, then every two hours until he’s up. (A teenager!)

    And yes, most of the time it’s okay. I do hate doing it sometimes though. His poor fingers. Bring on the nighttime artificial pancreas.

  4. It did help, so thank you. We are on a different regime and so it isn’t strictly necessary to test at night. I would love to do it more often but as Frank was only two when the diagnosis meteor hit us and is three and a half now, and with many years of bleeding fingers ahead, I try to give his tiny fingers a rest whenever possible.
    I imagine it will be hard to back away. Peace of mind is elusive with this condition.

  5. Great question, Jules, and duly noted.

    It was suggested by our Diabetes Educator when we first came home from the hospital that we do a fasting blood test in the middle of the night until we were certain we had her basal dose correct. They had suggested 2 or 3 a.m. but we are early risers and getting up at 3:00 didn’t allow enough time to fall back asleep before the alarm goes off at 4:30 🙁

    As a scheduled follow up, we had an appt today with the educator and she suggested that we could back off the middle of the night checks if Lia hadn’t been low during the day 🙂
    (may be easier said than done, we’ll see)

    She said we should only occasionally have to test fasting glucose levels, but when we do it should be taken 3 times a day: once at bedtime (at least 3 hours after eating or dosing humalog), once in the middle of the night and once more when she wakes. If all three readings are in alignment, that is, close in number, then the basal insulin dosage we’re using is accurate.

    Hope that helps.


  6. So moving (again) and I smiled to myself when you mentioned Lia’s arm only staying out of the covers after a brief struggle. We get the same problem. I cry when I think of Frank’s courage and am pleased he puts up struggles sometimes. He will need all the spirit he can summon up and often.
    Can you tell me why you test at one am? We haven’t been told to do it and are curious. Maybe we should start? More information would always be good.
    I hereby volunteer my lovely hubby Andrew for the job!

  7. Steve: Wow. Thank you for sharing this incredibly well-written story about the nightly testing routine in your house. You are amazing with words, and it’s so very nice to read your writing. Aside from that, I’m very happy that these “all good” moments do happen. Hopefully, more often than not.

  8. Thank you for this post Steve. Eloquent.
    I am reminded of these 2 am checks at our house when I change my daughter’s sheets on her bed. There, about 8 inches down from the top of the sheet, are little tiny specks of blood stains, reminding me of the night time checks and her fingers, tucked back into her covers.
    No matter what I do, they do not come out of her sheets. They are here to stay, much like diabetes.

  9. This made me cry, how poetic you are…….so beautiful. Last night was one of those nights filled with high numbers and worry. My son’s BG would just not come down…………….I think he’s starting to get sick. I know he will be fine but I look at him all snugly in his bed sometimes and Diabetes just makes me mad.
    We are such a positive family with a positive outlook……………D will never defeat us and our passion for life. But sometimes I must cry till I can’t cry anymore.
    My adorable 5 year old son loves karate, lego’s, pizza, Disneyland and playing hard with his good friends…..oh yes and he is a Type 1 diabetic for 9 months now.
    BTW- he told me last night at dinner that he wants to be an astronaut and visit the moon and that he wants to take me with.
    thanks for blogging Steve

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