You Should Really Call Your Vet

Diagnosed at 13 months old, my daughter started her time with diabetes on tiny doses of insulin.  The NPH was measured in half unit doses, so with the smallest insulin syringe we could measure that dose accurately.  The Humalog dose was often best measured in increments of .25 or less.  It was much safer and easier to prepare those doses with diluted insulin.

The pharmacy at the children's hospital diluted our first batch for us.  We did some research and discovered we had what's called a 'compounding pharmacy' very close to our home.

Per Wikipedia, "Pharmaceutical compounding (done in compounding pharmacies) is the creation of a particular pharmaceutical product to fit the unique needs of a patient. To do this, compounding pharmacists combine or process appropriate ingredients using various tools. This may be done for medically necessary reasons, such as to change the form of the medication from a solid pill to a liquid, to avoid a non-essential ingredient that the patient is allergic to, or to obtain the exact dose(s) needed or deemed best of particular active pharmaceutical ingredient(s)."

Initially, this service was ideal.  We got to know the head pharmacist well, and he took a shine to my daughter.  The pharmacy was also a fabulous gift and card store, and had fun toys to check out while we were there. 

After nearly a year of seamless insulin pick-up, the pharmacist retired.  He explained that other staff members knew how to dilute the insulin and that we should have no problem.

One afternoon, I picked up my insulin and brought it home.  I took it out of the box, and noticed it looked different.  It was full strength Humalog.  If I'd measured 5 units of that on my insulin syringe for my daughter's .5 unit dose, it would have been disastrous.

I took it back.  Someone diluted it.  The next time I checked before I left the store.  It wasn't diluted.  I pointed out the problem to the pharmacist.

"We don't ordinarly dilute insulin.  You should really be having your vet do that for you."

"My vet?"

"Yeah...they do that all the time."

My daughter was next to me, holding my hand. "I've never taken my daughter to a vet before."

A blank stare.

"It's for her," glancing down at my little girl, "not a pet."

"Oh...I'm so sorry, maam." 

At our next appointment, the educator taught me how to dilute my own insulin.  

Everybody's Different

Sometimes I feel as though we're the only family who does not yet use a Continuous Glucose Monitoring System.  Though we're inching closer.

If not, then I'm certaily the only parent of a child with diabetes who has not read and highlighted every one of Gary Schneider's books.

Unless we're battling something significant or dangerous, I don't stay up all night checking blood sugars. If my daughter's number is 200 at 2 a.m., I'll give a small correction and go back to sleep. Shhh.

Does anyone else out there feed their child (gasp!) cereal in the morning?

Are we the only family who's never been to Friends For Life?

I'm guessing I'm not alone.  Everybody's different.  It's what makes the world go 'round, in a general sense for sure.  It's what makes the diabetes blogosphere so great too.  We read eachother's opinions.  Sometimes we find soulmates who are quite like us.  Sometimes we get talked into trying a new tactic, or file an idea away for a particular situation.  Sometimes we're left scratching our heads.  But it's all good because regardless, we're made better by sharing our thoughts and ideas with eachother.

It's 'leave a comment day' in the diabetes blogosphere. If you identify with any of the above, leave a comment and let me know I'm not alone.  If you think I'd be better off for changing my ways, let me know that too.  I know you'll be nice about it.  Or do you have thoughts about how our differences make the blogging world better? Or if that's all too much, just tell me your favorite summer beverage...that's easy, no? Whatever it is, bring it on.  I'm looking forward to reading your thoughts!

An Ice Cream-Free Heat Wave

It's been HOT here for a week and we're reaching the end of our list of coping mechanisms.  The town pool has gone from refreshing to soupy.  The mall was fun once.  We finished the jigsaw puzzle.  We read entire books during our visit to the library. 

Food-wise, we've grilled and crock-potted.  We've enjoyed salads, partly from our little garden, and we've consumed lots of summer fruits.  The slushie magic I picked up at a steep discount as a site change prize incentive has seen a lot of action.

Frozen fruit bars and even mediocre popsicles made from low-carb gatorade have made refreshing treats.  Yet what would really taste good is a nice cone of ice cream. 

Sadly, that's where we've hit a dead end. My daughter's lactose intolerance has chosen now to flare up.

With good reason, I guess.  We were traveling the weekend before last, and didn't put the pieces together until it was too late.  The day started with cereal with regular milk. Lunch was a bowl of new england clam chowder (her favorite). Dinner was pizza.  Despite the little lactaid tablets, this was too much for her system.  It was way more than the one or two small servings per day she was used to.

The dairy binge was followed by several days of feeling decidedly awful and subsequent days worrying about whether the discomfort had gone away for good.

She went at least a week completely dairy free.  She's since had a sprinkle of cheese on a taco and a couple of other negligible bits of dairy products.  Yet she's (understandably) nervous about trying anything more yet.

So we're sampling treats like sorbet in ice cream cones (really, really sticky), and almond milk smoothies ("whatever you put almond milk in, the whole thing just tastes like almond milk").

I'm not much of a complainer, or dweller on negative things.  But a heat wave without an ice cream cone outing is making me a little sad. 

Since I feel compelled to find a bright side, not dealing with ice-cream's all night blood sugar revenge is a huge plus.  While a sweet sorbet will cause a spike, it gets itself out of the way pretty quickly. 

Snippets

 What follows are a few recent every-day moments made possible by diabetes:

I received a voice mail from a diabetes supply company about a bill.  When I returned the call and stated I had not received an invoice for the bill in question, the representative responded by asking me for the invoice number about which I was calling.  This went on for about 3 rounds before we got any further.

I attracted significant attention at a social event by holding an enormous Costco-sized tin of cookies over my head to read the carbohydrate information printed, inconveniently, on the bottom.

My daughter supplied the words for a Mad Lib which described the demise of dinosaurs this way: "Scientists think a giant trophy fell from space, creating a nutty wave of insulin and dust which destroyed these magnificent creatures."  This was followed by a discussion of how the dinosaurs would have slowly all passed out from low blood sugars en route to their demise. Which raised questions regarding whether dinosaurs were naturally insulin-dependent in the first place.

Unisolve saved the day once again.  It's perfect for removing pine pitch from one's fingers.

Those moments when diabetes' presence can amuse, or even assist, are refreshing.

Waterproof

 

 

My daughter took this picture from her kayak last weekend:

 





 

 

The outing was made possible by Ziploc bags.

 

It's unlikely that our kayaks will get swamped or tipped on this calm pond.  More of a threat are the drips from the paddles, and the wet feet going in and out of the boat. 

 

One gallon sized bag holds the meter, glucose tabs, a juice box and a small snack.  It will also hold a small camera.

 

Circling the pond can take a couple of hours, depending on how many frogs, turtles or loons we need to stop and watch, or how long we stop in the shallows to chase polliwogs.

Knowing the diabetes essentials are dry and at the ready allows us to, for the most part, forget about them and enjoy the water.

 

 

 

 

Stealthy

This article appeared in our local paper a week or so ago.  From the Associated Press, it describes Medtronic's 'smart pump' research, with its automatic shut off for low blood sugar.  While a furrowed brow is usually the end result of my reading diabetes articles in the popular press, this one seemed fairly well fact-checked. 

What caught my attention was this sentence related to fear of overnight hypoglycemia:

Parents of children with diabetes often worry so much about this that they sneak into their bedrooms at night to check their child's blood-sugar monitor.

I clearly need to change my modus operandi for 2 a.m. checks. 

My current method involves stepping on several squeaky floorboards on the way in.  I turn on the flashlight.  About half the time I manage not to shine it right in her face.  When I put a strip in the meter, it beeps.  I stab her finger, then squeeze it, sometimes pretty hard, to get blood on the test strip.  The meter beeps again.  A couple of times a month, I have to wake her up to give her juice.  I can't say I never drop something on the floor sometime during the process.

With a CGM midnight finger pricks aren't always necessary, but beeping and waking for juice are still standard parts of the picture.

Clearly I'm doing it all wrong.  I need to get myself a black ski-mask and memorize the squeaky floorboards.  I'll also need a 'diabetes device silencer,' but I'm not sure I have the black market connections to make that happen.  The outstanding question is how to sneakily give a sleeping child juice...