Thankful

Yes, it's after Thanksgiving, but that doesn't mean thankfulness has to end.  Diabetes-wise, I am of course thankful for insulin, technology, good medical care, health insurance, and living in a country where these things are accessible to me.  On a daily basis, though, I tend to think smaller.  Below are a few little diabetes things which have made me happy this month:

My daughter got a cute postcard from the World Diabetes Day Postcard Exchange.

We discovered an awful looking site which must have just gone bad.  Seeing the problem early on allowed us to better manage the ensuing blood sugar spike.

Despite some highs and lows during the day, my daughter has been waking up in the low 100's pretty consistently of late.  Starting the day there provides hope for the subsequent hours.

A great technician drew my daughter's blood at the lab 2 weeks ago. He was friendly and kind. He was also efficient and incredibly skilled at finding a vein.

Texting pictures of plates of food was very successful.  As a bonus, it's fun to consider the bizarre museum display we could create with them some day.

The green pump still surprises me with its lack of pinkness.

We had the knowledge and the equipment to allow my daughter to enjoy everything on the table on Thanksgiving day.

Diabetes often leaves us little to be thankful for.  People with diabetes and their families have a lot on their plates.  Worry, exhaustion, physical discomfort in many forms, financial burdens, frustration and much more come into play on a daily basis.  It's a worthwhile survival tactic to rejoice in the little bits of diabetes happiness which come our way.


Text Me A Picture

Today we're trying a new tactic in diabetes management.

There's a Thanksgiving feast at school today.  In elementary school, I always volunteered at these things.  I do enjoy being around kids, and probably would have helped at many events anyway, but the need to monitor what my daughter was eating made my attendance essential if she were to participate.  By 4th grade, she was able to handle some simple carb counting on her own, like a slice of pizza or a packaged snack.  Anything without a set portion size was, and still is, too much.

Middle school is a new world, though.  Parents are not invited in to help with class parties.  The kids are on their own.  We had to come up with a plan which would allow my daughter to participate in this event without me hovering over her.  The school nurse is a great help with many things, but can't be expected to know how to eyeball a buffet plate and pronounce the number of grams of carbohydrate on it.

Enter modern technology.  The school nurse will text me a picture of my daughter's plate.  My daughter will then call me and we will work together to tally the carbs.  I'm not sure how clear the photo will be.  Will I be able to tell if there are marshmallows in the sweet potatoes or how deep the pile of stuffing is?  The element of taste will be gone on my part too.  I'll sometimes have a bite of a pie or cranberry sauce and realize it's significantly sweeter or denser than I'd estimated.

We'll see how it all turns out.  I don't expect her to come home with a blood sugar of 130.  What I do expect is for her to come home happy.  She'll have enjoyed trying foods from other families' Thanksgiving traditions.  She'll have had a few bites of the cranberry sauce she helped prepare.  She'll have taken another small step towards diabetes independence.

Math or Guess? Some of Each.

Thanksgiving is fast approaching and a string of celebrations will follow.  It's time to dust off those carb counting books, or reacquaint yourself with your favorite nutrition info website, or download a new app.  Or probably all of the above.

While it's particularly true for this time of year, each season brings a unique set of foods which must be counted.  Every summer, I brush up on popsicles, ice cream cones and the crusty bread I like to serve with salads.  Late spring brings the start of picnic season, with its hamburger buns, pasta salads, and watermelon slices. This week, I'll be refreshing my memory on stuffing, winter squash, pumpkin pie, and cranberry bread.

I'll turn to my trusted resources - mostly Calorie King - in paper and electronic forms.  I'll read the labels on packaged items, and review the backs of my recipe cards with their penciled-in math problems from previous years.  That homework will provide the base of knowledge needed for the weeks to come.

Yet once faced with a plate of food which includes a 'spoonful' of this and a 'slice' of that, it gets complicated.  Unless the pie slices are measured with a protractor, variables have been introduced.  Unless I know what my hostess means by the 'splash of maple syrup' she added to the butternut squash, I'll need to improvise.  The unforeseen appearance of cornbread could have me suspected of inappropriate phone etiquette at the holiday table.

About a year after my daughter's diagnosis, I met with the nutritionist at our endocrinology office.  I explained that I had gotten pretty good at reading labels and was learning to do the math on favorite family recipes.  "But how will I ever figure out how many carbs are in the scoop of mashed potatoes Grandma serves her, or in the dish of ice cream that comes with her kids' meal?"

The nutritionist gave me a sheet which had to do with eyeballing portion sizes.  Specific measurements were equated with 'half a baseball' or a 'deck of cards.'  She then explained that while this might be sort of helpful, eventually I would just know.  By consistently using measuring cups and food scales at home, I would come to be able imagine how a pile of rice would fit into a measuring cup, or how the size of the diner's french fries compared to the frozen ones at home.

I have to say I doubted her,  But she was right.  Granted, sometimes the 'splash' of maple syrup turns out to be a half a cup.  Sometimes I misjudge the amount of frosting on the cupcake.  Usually, though, a combination of scientific knowledge about carbohydrates, practice with portion sizes, and intuition gives me enough information.

It allows me to make a pretty good guess.

World Diabetes Day


World Diabetes Day




Many of you already know that today, November 14th, is World Diabetes Day. 

But aside from wearing your blue and seeing an extra news piece about diabetes, what do you know about this occasion?

Why November 14th? 
It's Frederick Banting's birthday!  Mr. Banting, along with Charles Best, is credited with the discovery of insulin.  We're honoring his work.

Where is it commemorated? 
When we participate in World Diabetes day, we join with over 160 nations and territories.

Who sponsors it? 
The International Diabetes Foundation coordinates worldwide efforts for awareness.

Why the blue circle? 
It was adopted as the day's symbol in 2007 when the United Nations passed its World Diabetes Day Resolution.  The circle represents worldwide unity in the fight against diabetes.  The blue is both the color of the United Nations flag, and also represents the blue sky under which the worldwide diabetes community stands together.

How do people commemorate World Diabetes Day? 
Health fairs are held in places around the world, from Chicago to Ghana; Jordan to Peru. Schools and businesses hold poster contests, walks, and healthy living presentations.  Famous places previously lit in blue include portions of the Great Wall of China, the statue of Christ the Redeemer in Brazil, the CN tower in Toronto, and the statue of the Little Mermaid in Copenhagen. Human blue circles are formed. 

Perhaps most uniquely, there will be a horse jumping competition near Warsaw, Poland called 'together we overcome obstacles.'  Horses dressed in blue and white saddle pads with blue ribboned riders will compete while spectators are offered a wealth of diabetes information as well as free pony rides.  For so many reasons, I wish I could be there.

So What?
For those of us who live with diabetes in our homes, every day is diabetes day, and every day is a good opportunity to raise awareness.  Yet for me, it's encouraging to know that on this day there are people gathered across the globe raising awareness about diabetes.  The diabetes community goes beyond my personal relationships, beyond people I follow online, beyond those I encounter at the doctor's office.  The diabetes community is an enormous worldwide group of people.  We're all in this together.

All of the above information about World Diabetes Day and much more can be found on the International Diabetes Foundation website, including some really great photos blue monuments.







Or Sort-Of Green

If you look back at yesterday's post, you'll see pictures of the unwrapping of my daughter's new pump.  The excitement was akin to Christmas morning, with bubble wrap flying and packaging strewn around the living room.  The shiny new pump, with no scratches or faded buttons was exciting to discover.  Most importantly, it was green!

It's packaging, however...not so much.  Strikingly out of proportion to its contents, it reminded me of a girl scout project our troop did last year in which they each had to bring in an example of excessive packaging. 

Granted, I'll take it all apart, recycle the cardboard, paper, and what plastic our town will collect.  The school librarian just asked for boxes, so I'll send that in for re-use. Yet, as my girl scouts learned, not using the materials at all is even better than recycling them responsibly.

It's part of a lingering concern I have.  The amount of trash diabetes generates in our household is enormous.  Infusion sets and their big plastic inserters, cartridges, tubing, wipes and their wrappers, lancets and their caps, test strips and their containers, insulin bottles, juice boxes, and the packages all of these things come in need to be disposed of.  Very little of this is recyclable, particularly because so much of it is medical waste. 

I hear Omnipod has program to return and recycle old pods, which is great.  I hope other companies will find ways to follow suit.  Until then, there are occasional ways to repurpose things. I've heard of people using their old insulin tubing to tie up their tomato plants.  When my daughter was little and had a play kitchen, we turned test strip vials into spice containers.  Her creations were extremely flavorful. Last spring, she used lancet caps as eyeballs for a school project.  Every package I send goes off in a pump supply box.

Obviously, the value of these supplies to my daughter's health unquestionably outweighs the environmental concern.  Therefore it becomes a matter of finding ways to dispose of them or repurpose them as best we can. Meanwhile, we can ask our supply companies to keep looking for packaging that's a bit...greener.



 

It's Green!













The waranty had expired and it was time to get a new pump.  Sticking with our previous make and model was an easy decision.  Both the features and the service we've gotten with Animas have been outstanding.  The tough choice was the color.  The last one was pink.  Pink again?  Silver? Black? Blue?  In light of the lack of purple or orange, the choice was easy:





 
 
 
 
 
 
 
 
 
 




 

Blue Fridays!






It's Diabetes Awareness month.  One of the simplest things we can do is to wear blue every Friday, and also on World Diabetes Day, November 14th.

You can find out more about this initiative, and upload a picture of yourself wearing your blue, on the Blue Fridays Facebook Page.

Wearing blue creates the opportunity to initiate conversation about the issues diabetes poses in our lives.  It also creates a sense of solidarity. 

Wear your blue this month to show that we're all in this together.

Snow?

As I watch the snow begin to fall on our already beleagured neck of the woods, I'm headed downstairs to dig out the snow shovels and boots.  A crock-pot of stew is bubbling, and we're trying to reconcile our quick transition from hurricane season to snow season.  In case you too are engaged in a sudden search for your sleds and snow pants, I thought I'd reprise a post from last winter:

There's been no sledding yet, but in winters past, it's been our nemesis. The initial experience of being very cold, combined with the thrill of the hill causes an adrenaline rush for my child. Her body is fighting off the chill and the fear. Her blood sugar skyrockets. Then, usually suddenly, her body realizes that she's just spent an hour repeatedly climbing a hill. Were there a life-sized graph of this decline, it would be the best sledding hill ever.

I periodically dig the meter out of my inside coat pocket, where I've (hopefully) stashed it to prevent the "I'm frozen" error message. We test and correct, or treat with something unfreezable like glucose tabs or smarties, and she's off again.

I can't really figure out a better way to manage this situation. Upping the insulin prior to sledding would, I think, just exacerbate the low later on. Testing more often is always a great diabetes management tool. But testing while sledding is near impossible. The mittens, the snow, the wind, the lack of anywhere to put anything down, the numb fingers and their related bloodlessness all combine for an unpleasant five minute ordeal.

So, if we get any significant snow here, we'll need to pack up the meter and the smarties (along with the sled), and head for the nearest hill. We'll manage the diabetes the best we can. I'll stand at the top of the hill, and each time she appears, I'll say, "feeling ok?" or "need to check?" Eventually, I'll force her to stop. She'll be high and correct about half of it. Twenty minutes later, she'll be low and have smarties. We'll bring enough to share with her friends.

Sledding is a rare treat, and in my opinion, we do the best we can while being practical. If she decides to join the Olympic luge team, we'll need to come up with something better.

When my daughter returns home today from what could turn out to be her only full day of school this week, some hot chocolate will be in order for both of us, I think.  And perhaps tomorrow, she'll sled before it melts into a slushy, muddy mess!

Halloween



No...this post isn't late.  It's only the day after Halloween at our house.  Our sense of time and connection to the rest of the world continues to be altered a bit from the after-effects of Sandy.

Glad for the opportunity to trick or treat, my daughter the witch met up with a blue and green striped monster and a werewolf for a some fun last night.

As is our tradition, we came home and sorted the winnings into four piles:




From left to right, we begin with the dish of candy to keep and enjoy over the next week.  Next is the container of fast-acting carbs like smarties, sweet tarts and nerds.  Third is the container of pretzels and chips, great to throw in the lunch box or to snack on.  Last is the bag from which my husband and I will pull a few favorites before the rest gets donated.

I often get asked if Halloween is hard for my child because of diabetes.  I usually have two answers.  First, I clarify that she can enjoy candy in moderation.  Then I talk about all of the other fun aspects of Halloween like costumes, pumpkins, being a little spooked, enjoying friends, and walking around after dark.  Last night, we walked around a neighborhood which had only had power back for about 24 hours.  People were so happy to have the kids come by and to catch up with their neighbors. Doing something so fun and frivolous after the week we'd had made this Halloween extra special.

 

Go Bag





Sandy is the first storm for which we've packed a full diabetes 'go bag.' 

There is always a plastic shoe box on my daughter's closet shelf with batteries, three of four vials of strips, some syringes, and a couple of site change sets.  It also has a spare meter and some glucose tabs.  It's our travel box for weekends at Grandma and Grandpa's or our starter kit for vacation packing.  I think of it as what we would grab should we need to evacuate.

Yet as I began to contemplate the possibility of an actual emergency, I realized some things needed to be added to tide us over:

A flashlight

Juice boxes

A big jar of glucose tabs

At least 2 weeks of site change supplies, strips, lancets

Alcohol wipes to sterilize things if we had to

Snacks

I also realized that once the hint of an emergency is on its way, we should get this kit out of the closet and put it somewhere handy.  Last week, we put the plastic box into the ironic 'JDRF Walk To Cure Diabetes' bag, adding the aforementioned items.  We also added our every-day insulin and  long-acting back up insulin, as well as the spare supplies we keep in my purse, my daughter's backpack, and elsewhere around the house. 

Once gas is easier to come by and Target doesn't seem like a far-off land, I'll head over to get a larger container so that this discombobulated bag of diabetes paraphernalia can be organized and water-proof.

Meanwhile, I'm grateful that I was able to unpack a few things from it this morning and return it to its shelf.  

Sandy

It's all a blur.

Today's my first day this week back on the internet, catching up on the non-storm related events of the past week. 

Apparently Halloween happened.  I've seen lots of facebook pictures of friends' kids in cute costumes.

It seems the candidates are still campaigning for an election next week.  There are contingencies for me to vote in a national guard truck of some kind, which could be interesting.

There's also the matter of Diabetes Awareness Month beginning yesterday.  I think last year I posted every weekday in November.   Perhaps that will seem more realistic next week.

Meanwhile, we are happy for home and family.  We're relishing the resumption of all of our utilities.  The fact that we still have half a tank of gas and a running refrigerator with food to prepare puts us miles ahead of half our town and most of our surrounding geography.  We're enjoying unusual amounts of company with neighbors taking us up on our offers of heat and electricity. 

Next week we begin anew. Halloween might be on Monday.  Power will continue to be slowly restored and trees removed from our town.  School, work, and blogging will take on relevance for our family once more.

Meanwhile, we'll celebrate all that we have and seek more ways to help those who have lost so much.  It's my hope that you will do the same.