Gym Win


Out of all the anticipated diabetes challenges of high school, gym has been the biggest thus far.

Marching band's 14 hour days, including an outdoor week in the August heat? We handled it.

New nurse? She's great.

An intense and stressful academic schedule? Intense and stressful, but managed.

Gym? A disaster since day one.

I wrote about it in the fall. Gym is always in the morning but that's where the predictability ends.

Gym class happens three out of every four days. At 8 or 9 or 10 a.m. Some days are 'fitness days' with sprinting or other heavy cardio. Some days they play volleyball which my kid enjoys playing at a moderate pace. Some days feature floor hockey, during which the senior boys apparently dominate the puck and give nobody else a chance to play. Some days gym is preempted by 'peer leadership,' which can involve either active or sedentary group bonding activities. All we can be certain of is that the whole thing is totally unpredictable. Therefore, adjusting basal rates didn't help. And changing the breakfast bolus was useless. Our next best hope was this:


Squeezy Applesauce!
Toddler applesauce has greatly reduced trips to the high school nurse's office. It's fifteen carbs provide slightly more nutritional value than a straight juice box. It's easier to consume while changing into one's gym clothes than a clementine or a handful of grapes. It's even sort-of fun? And, most importantly, it's working.

She makes the decision whether to consume a pouch before gym based on three factors: what her blood sugar currently is (usually based on the Dexcom, inclusive of arrows), what the day's anticipated activity is, and what time it is (she's more likely to drop fast if there's still a bunch of breakfast insulin on board). There are occasional problems, like when an anticipated floor hockey day becomes an unannounced outdoor running day due to good weather, or when she's had an unusual breakfast and the 'insulin on board' factor is harder to predict. But overall, this tactic is (thus far...knock on wood...fingers crossed) a winner.

Also a plus? We won't be running out of squeezy-sauce anytime soon due to today's 5/$9 sale at the grocery store. She's not sure about the new 'applegrape' flavor, but if you're sucking it down in three gulps, how much does flavor really matter?






Advocacy


I've shared with you my first New Years plan: spending more time with my fellow 'diabetes people.'  The second plan is much less fun, but in my opinion, unavoidable. I plan to spend more time advocating for people with diabetes. Phone calls, emails, tweets and more appear to be a necessary evil for the coming year.

I started today, thanking my representatives who support the parts of the Affordable Care Act which are important to me, and contacting some who do not. The ACA is not a perfect law, but eliminating it without a reasoned replacement would be a setback not just for people with diabetes but for those with all kinds of chronic and expensive diagnoses. Repeal of the ACA will not only impact people who've been able to buy insurance because of it, but also the greater majority of us with employer-sponsored insurance who've seen new benefits and protections through the law. This article explains those parts of the law in greater detail, including coverage regardless of preexisting conditions, coverage for preventative care and the elimination of annual and lifetime maximums.

My daughter is at the age where she's considering career choices. The existence of protections for her as someone with a pre-existing condition and who has high annual healthcare costs is important to us. We'd rather she not have to choose a career, and a job within that career, based primarily on whether she can obtain quality health insurance and be assured that her coverage will never lapse.

Are you concerned too? Here's an easy way to get in touch with your representatives:

http://diabetespac.org/

I'm certain this is only the beginning of my advocacy this year. At the rate insurance companies and prescription benefit managers are picking and choosing what's covered, it's likely I'll be in touch with them. We're fortunate to be in a great school district, but small conversations still need to be had from time to time.  Other political issues may arise locally or nationally which I feel require my voice- not just for my own child's benefit but for that of the whole diabetes community and beyond.

Diabetes People

We were very fortunate to find a parent support group shortly after my daughter's diabetes diagnosis. People in that group were also involved with the local JDRF chapter and I got involved there too. Once we got our heads above water with the help and support of both of those organizations I found myself able to turn around and help others. I encouraged the next round of newly-diagnosed families at the support group meetings. I got involved in planning and running a local JDRF walk. In the three years after diagnosis, personal contact with other 'diabetes people' was a big part of my life.

Then, because of a lay-off and a subsequent job opportunity, we moved back to the area where I grew up. We continued to participate in JDRF walks, and I did help with walks at the elementary school, but my contact with our local chapter was minimal. There was not a parent support group in the area. We were fortunate to know a couple of nearby families with T1D and so had, and continue to have, an informal network of information and support. I found the diabetes online community, and there found both personal support and a way to be supportive of others by starting this blog. For a while that was enough.

Now, though, I'm feeling a pull.

I'm still incredibly grateful for those moms and dads I met during the first months after diagnosis. Having those conversations provided a framework for how we still live with diabetes today. There's nothing like sharing stories, laughs, information or tears with people who have faced the same challenges.

In lieu of New Years Resolutions, I tend to think of something I'd like give some extra energy to over the course of the year.  Some years it's practical, like learning new recipes or starting a vegetable garden. Some years it's more social, like sending thank-you notes for even the littlest of gestures. This year?

I'll be looking for ways to spend more time with other 'diabetes people.'


 

A Bittersweet Week


Christmas is coming. The carols are playing...everywhere. We're making cookies. There are pageants and parties and concerts. The stockings are hung by the chimney with care. We'll gather with family this weekend. We'll attend a candlelight service. Santa will come. Gifts will be exchanged.

We'll enjoy all of those moments, but with a unique perspective.

Fourteen years ago we spent this week at a children's hospital. We'd been helicoptered there on December 21st with a very sick baby. We spent the night in the ICU and the week at the hospital. We spent the week grateful for life, knowing that our baby had been treated just in the nick of time. We spent the week scared and overwhelmed by the ways our world had changed with the diagnosis of diabetes. We spent the week surrounded by other hospitalized families, some of whom were not expecting as happy an ending as we had been granted.

The experience has forever added a bittersweet thread to our family's Christmas week.

This year's first tears came while I watched my daughter narrate the Christmas pageant on Sunday. I was overwhelmed with gratitude that she was there at all. The specter of what could have happened if we'd waited even hours more to take her to the emergency room lingers a little closer during this season. Hearing her beautiful voice and watching her smile at the little angels scampering down the aisle stood in stark contrast to what might have been.

I'll tear up when we sing 'Away in a Manger' at the candlelight service. I sang it hundreds of times to calm my baby in her hospital crib. I'll skip wearing mascara to the school holiday concert, and take a few deep breaths when I unbox a Christmas decoration we were given in the hospital fourteen years ago. I'll experience a flood of empathy when I encounter or hear about people who are spending this Christmas in a hospital, or in a shelter, or who are grieving or afraid this season.

The thread of Christmas 2002 runs through all of our future Christmases. While it's not a thread I would have chosen to weave into our family's story, it has added a depth of meaning to all of the Christmases that have followed. The thread reminds us that at the core of this season's stories there is light and hope despite the apparent darkness and despair.  As I wrote to conclude the first post I ever wrote for this blog:

My daughter’s second Christmas, when we sat together in the cafeteria of the children’s hospital eating prime rib off of Styrofoam plates, remains one of my favorite Christmases ever.  Despite all that we had lost in the preceding days, we had each other, we had the power of modern medicine, and we had hope. 

Roll Over Beethoven


I heard it from across the crowded room. The unmistakable melody. A terrible electronic version of 'Fur Elise' was coming from my daughter's insulin pump. What, I often wonder, would Beethoven think?

Eye contact confirmed that this wasn't a simple 'Bolus cancelled by user button push' or 'Unable to communicate with pump' Animas Ping alarm. My kid looked both concerned and irritated. I made my way through a few conversation groups.

'I forgot to do a site change before we came. I'm out of insulin. It gave all it was supposed to give to cover what's on my plate but now I'm out.'

We were really enjoying this party. I was reveling in the opportunity to hold an adorable baby whose mom needed a civilized plate of food and adult conversation. My daughter was enjoying helping the little ones at the cookie decorating table. We were having great conversations with friends both new and old. To add atmosphere, it had just begun to snow. This particular festive gathering was exactly what we needed after a whirlwind weekend of holiday shopping and preparations.

We were not, I decided, going to let diabetes win the afternoon. My daughter ate a little less than she'd bolused for, to provide a cushion. We kept an eye on her numbers. She held steady for almost an hour, then her blood sugar started to creep up very slowly. We considered leaving then, but I had to return the baby, and then on the way to get our coats we found other people we wanted to talk to. The rise became more significant about twenty minutes later, and we started our round of goodbyes. But considering the homework that still needed to be done and the football that needed to be watched we wouldn't have stayed much longer no matter the diabetes circumstances.

We got home, replaced the insulin and the site, and bolused for an hour and a half worth of missed basal insulin in addition to the suggested correction for her blood sugar at the time (about 220...not bad at all). The rest of the night was uneventful blood sugar wise.

There were few minor downsides: I needed to heat up some leftovers since she had stopped eating anything but raw vegetables once she ran out of insulin. She missed out on a great spice cake. And the electronic Beethoven theme repeated itself every few minutes- but I'm guessing it probably wasn't audible to anyone but us over the music and conversation.

Looking back, I'm glad we didn't panic. There was no need to. She disconnects her pump at the pool for an hour at a time all summer. At the beach it's often longer. We do the same thing we did last night: make up the insulin once she's hooked back up to the pump. Ideal? No. Medical advice? Absolutely not. But sometimes it's more important not to let diabetes ruin a good time.



Handy

 
Each performer was assigned a number for the two-part high school musical auditions. There were dozens of kids auditioning, and the directors are new to the school so it wasn't just the freshmen they didn't know yet. They needed a system to track everyone.
 
For the singing auditions on the first afternoon, the kids could just hold onto their numbers and report them when they individually entered the audition room.
 
On day two, the audition involved learning a dance routine all together on the stage and then performing it in groups of 8. The numbers had to be attached to the performers. While some kids struggled with tape and others scavenged safety pins, my kid had a built in solution.
 
She fastened her number through the snap of her Dexcom case. It was visible at waist level throughout the audition and was still attached when she arrived home:
 
 
 
 
Love these once in a blue moon moments when having diabetes comes in handy.
 


A Letter From Santa!





What kid wouldn't cherish a personalized letter from Santa?

Mine certainly did. We had the Diabetes Research Institute Foundation help us solicit a special letter from Santa several years in a row. Santa always writes great letters, but with help from DRI's special elves, these were particularly personal and even included a bit about how well my daughter handles her diabetes.

The cute video above illustrates the program well.

If you love a little one who's expecting a letter from the North Pole, you can make it extra special for everyone involved. Here's the link to the page with all the details about how to make a small donation in exchange for a unique handwritten letter this season. I promise you won't be disappointed!