Fast Forward


The end of the school year chaos sneaks up on me every year.  Hence the lack of blog content this week.  At some point every May, weeks become a blur of school, softball games, day trips, school parties, after school parties, pool parties, field days, recitals, concerts, carnivals, field trips, impromptu after dinner walks, backyard games, gardening and so much more.  It feels as though the fast forward button has been pressed.

Life takes on a regular rhythm during the school year and then a different, but similarly predictable pattern in the summer. We're not opposed to the occasional early dinner or spur-of-the-moment scooter ride, but there remains a comforting regularity to our days.  A loose schedule of meals and activity is helpful.  In the absence of schedule we must keep a closer eye on diabetes. If we don't, it can easily get lost in the shuffle or stage an untimely outburst, derailing our plans.

Each of  these spring days requires a different game plan, both logistics-wise, and diabetes-wise.  Some mornings, I can look at the calendar and map out an approach.  On other days, spontaneity wins.

On the day of the 9 a.m. class party, we'll negotiate a lighter breakfast and lunch attempting to account for the carb-heavy treats in between.

Before the day-long field trip, we'll try to find out the lunch schedule, but will be aware it's not set in stone.  I'll send plenty of test strips and glucose tabs and sound like a broken record with reminders to check often throughout the day.

 Then there will be days like this: 'PLEASE can we go to the carnival today?  EVERYONE is going this afternoon!!!"  Suddenly, there will be unplanned walking, ride-induced adrenaline, and a bag of powdered-sugar covered zeppoles will appear 'for everyone to share.' 

Or we'll decide to take a walk to the park in the afternoon, run into a friend, and dinner time will arrive with nothing on the table.

It's all fun, don't get me wrong.  I love the longer evenings.  It feels good to come out of hibernation and become reacquainted with nature and neighbors.  The concerts, softball games, parties and carnivals are all the stuff that makes childhood particularly wonderful.

So we do it all, the best we can, while all the time dragging diabetes behind us like a disagreeable toddler, determined not to let it have its way.


Thoughts From The Middle Of The Night

ALTERNATE TITLE:  MY NEW BIRD LISTENING HOBBY

2 a.m. on a night in May:

Alarm.

Wow...it's really hot in here.

Is it still raining?

I'll crack the window before I go check her.

Do I hear birds?

Flashlight, meter, lancet, where are the test strips...here they are.

Wow...it's hot in here too.

Ugh.  302???   New pasta brand?  The heat?  Please don't be getting sick.  Correct.

I'll crack her window too.

I need to reset my alarm and make sure she goes down.

Those birds are really loud.  What are they doing up at 2 a.m.?  I think I hear more than one kind.  Maybe there's an owl.

I can't fall back to sleep.  Those birds are noisy.  Are there some kind of nocturnal birds?  I don't remember ever hearing about that.  Or is it just somehow close enough to day that they're getting up?

It's been 45 minutes...I guess I'll just go check again.  230 with plenty on board.  Good enough for me.  Her room feels much cooler.  Why isn't mine cooling off?  I'll shut off the alarm.

Owl calls.  I know I've heard them, but I can't be sure any of these are owls.  Maybe I'll have learn more about owls...

In the light of day, I decided to find out more about night singers.  Audobon informs me that mockingbirds sing at night during mating season.  They're also known for mimicking a variety of bird sounds as well as other noises, so that would account for the diversity in last night's concert program.   I continued on to listen to some owl calls here but I can't be sure.  We do have a patch of woods within a block of our house, and from local nature center visits and a recent family birding walk, I know there are owls in the area.  Working on my owl identification skills will lend new excitement to 2 a.m. blood sugar checks.   It's good to have things to look forward to.

Meter Problem


We'd finished breakfast and were in the kitchen packing lunch.

"Mommy, did my pump just beep?"

"I don't think so, but check."

The pump seemed fine.  The beeps had come from elsewhere.  A scavenger hunt ensued.

Turns out it was coming from the glucometer.

It was still on the dining room table, all by itself.  It had suddenly decided it wasn't feeling right and needed to alert us.

"Meter problem.  Call customer service," it read, with a code.

Since she doesn't take the meter remote to school anyway, we just left it there and continued the mad morning rush out the door.

Once I'd gotten home and settled for the afternoon, I picked up the phone and called customer service.

I explained the chain of events to the representative and was put on hold.  She returned.

"Did it alarm when she was testing?"

"No."

"Was it when she was bolusing?"

"No...as I said, it was all by itself in the dining room."

I was transferred to a 'meter specialist' (making me sort-of wonder what the first individual's credentials were).

I was asked to go through the chain of events again.  Did it happen before she tested?  No. Was she able to bolus?  Yes. Did it happen when I put a strip in now?  No.  Did it happen when I turned it on with a button press now?  No.  Was there an error code or just a service code?  Just a service code.  Was I sure?  Yes.  Did it work with control solution now?  Seemed to. (The fact that I was able to put my hands on control solution was nothing short of miraculous.)

It became increasingly clear that I'd stumped them.  So a new meter will be on my doorstep this week, at which point I'll send this one back for careful study and analysis.  Maybe it just wanted attention.

Spreading the Love and Laughter

Diabetes Blog Week


As another Diabetes Blog Week draws to a close, let’s reflect on some of the great bloggers we’ve found this week. Give some love to three blog posts you’ve read and loved during Diabetes Blog Week, and tell us why they’re worth reading. Or share three blogs you’ve found this week that are new to you.

I read countless excellent posts this week.  I'm sure I also missed countless excellent posts with which I hope to catch up in the coming week or two. 

In an effort to narrow down my top picks (listed here in no particular order), I've limited it to three of those which made me laugh out loud.

George's petition against Targoglycemia was fantastic and coined a new term for the diabetes dictionary. 

From Rolling in the D, this post about the perfect service animal (a goat) was very clever.

Bigfoot Child Have Diabetes routinely makes me laugh.  Wednesday's post about the memorable details of diagnosis was my favorite this week. 

As an addendum, The Tangerine Diabetic is a blog I'd never heard of before this week, but the name itself tempted me to click over. No specific post to recommend, just good writing with a sense of humor. I'll be checking back from time to time.

What a great week of writing and reading.  So glad to have been able to participate with so many fabulous and fascinating people!

Haiku





Night 

Quiet.  Floor boards creak.
Meter.  Flashlight.  Lancet.  Blood.
Low. Drowsy juice. Kiss.





Diabetes Blog Week

This year Diabetes Art moves up from the Wildcard choices as we all channel our creativity with art in the broadest sense. Do some “traditional” art like drawing, painting, collage or any other craft you enjoy. Or look to the literary arts and perhaps write a d-poem or share and discuss a favorite quote. Groove to some musical arts by sharing a song that inspires you diabetes-wise, reworking some song lyrics with a d-twist, or even writing your own song. Don’t forget dramatic arts too, perhaps you can create a diabetes reality show or play. These are just a starting point today – there are no right or wrong ways to get creative!

Freaky Friday

Diabetes Blog Week

Just like in the movie, today we’re doing a swap. If you could switch chronic diseases, which one would you choose to deal with instead of diabetes? And while we’re considering other chronic conditions, do you think your participation in the DOC has affected how you treat friends and acquaintances with other medical conditions?


When my daughter was diagnosed with diabetes, we were transferred to a major Children's Hospital.  We spent that first week on a unit which was the destination for kids with new diabetes diagnoses, but which also treated kids with many other conditions. 

A day or two after our arrival, I met the mother of a child with Cystic Fibrosis.  This child (and her mother) had spent more days at that hospital that year than they had at home.  Their most recent admission had included a diagnosis of diabetes on top of the usual pulmonary and gastrointestinal issues they dealt with upon every visit. 

Since then we've met families whose children have autism, celiac disease, asthma, complicated lung conditions, cardiac issues, life-threatening allergies and more. Some of them we count among our closest friends. We've watched friends struggle taking a child with autism to get blood taken, an ordeal incomparable to taking my child who is anxious but ultimately able to understand and tolerate the process. We've dined out with friends for whom not knowing what's in a plate of food could be a matter of life or death, not just a long night of blood sugar checks and corrections.

Every chronic condition comes with its own set of daily obstacles and fears. Each has its own learning curve. Each has its own daily tasks to be conquered.

Yet as a parent of a child with a chronic condition, I've found great empathy among parents whose kids have other chronic issues. We all find ourselves in doctor's offices and hospitals.  We all have personal relationships with the school nurse.  We're all desperately trying to raise our children to live full, happy lives while carrying the weight of their diagnoses.

The more I learn from people's first-hand experiences with other chronic diseases, the less inclined I am to want to trade.  From those first days in a hospital full of incredibly ill children, I knew we'd drawn a much, much longer straw than many other families. 

One of the great gifts diabetes has given us (really...it can give gifts though it mostly gives us a hard time) is that of relationships.  There are the instant bonds among people who also live with diabetes, but there are also these connections which are so much more easily made and cemented with the glue of shared experience with kids with chronic conditions. 

Wild Animal Kingdom Wildcard

Diabetes Blog Week


What is the ideal diabetes service animal? Think beyond the obvious and be creative in explaining why your choice is a good one. For example, maybe a seal would make a good service animal - it flaps its flippers and barks every time you get a good blood sugar reading!

Hoppy would make an excellent service animal.

He's my daughter's stuffed rabbit.  She has fallen asleep with Hoppy in her arms every night of her life.  As she sees it, Hoppy is a nocturnal rabbit who stays up all night watching over her while she sleeps. 

What could be better than to train Hoppy and his many peers as diabetes service animals?

Imagine the training class.  An educator is surrounded by a circle of teddy bears, stuffed dogs, cats, cows, and frogs.  Perhaps there's an American Girl Doll, or a Barbie.  They spend time discussing signs and symptoms of hypoglycemia in the children they love. They're all schooled in glucometer use, parameters for treatment of high and low blood sugars and how to administer glucagon.

Who could be more suitable for this job?  Except for the rare time he's accidentally thrown on the floor, Hoppy is at my daughter's side all night.  His primary purpose in life is to look out for her while she sleeps.  He has a tough job already, don't get me wrong.  He's responsible for soothing the anxieties of a middle-schooler after a long day.  Further back in his job description, he's been in charge of closet monsters, bad dreams, thunderstorms, the dark, and a myriad of other concerns.

Yet as a best-loved toy, his dedication to his owner knows no bounds.  It's time to set up some training sessions for Hoppy and his peers.


Memories of a Wedding

Diabetes Blog Week


Today we’re going to share our most memorable diabetes day. You can take this anywhere.... your or your loved one's diagnosis, a bad low, a bad high, a big success, any day that you’d like to share.

'Most' memorable day would still be diagnosis, but that's already been covered here, so I've chosen another of many memorable diabetes moments:

My sister-in-law's wedding day was memorable for many reasons.  It was a gorgeous fall day.  The cememony was held outdoors in the gazebo on a quaint New England town green.  My husband and I were both in the bridal party.  My daughter was about to turn three, and looked adorable wearing a wrist corsage especially chosen by the bride.

What makes this a memorable diabetes day is that my daughter started pumping insulin just days before the wedding. 

Until she started pumping, we were giving my daughter shots of NPH insulin twice a day and covering her biggest meals with shots of humalog. There was therefore no wiggle room in a very tight schedule.  If she didn't eat snacks when the NPH peaked, she'd experience  low blood sugars.  If she ate more carbs than 'prescribed,' her blood sugar would be high.  This highly regulated eating routine made every day difficult, but made special occasions a nightmare.

Imagine, if you will, bringing a 2 year old to a party where snacks are out on a table.  People are eating crackers, grapes, cookies and mini hot dogs.  Your child may have 8 grams of carbohydrates at exactly 3 p.m., and nothing else to eat until 'dinner time' at 6.  We had lived this scenario for nearly two years.  This wedding day brought into focus how significantly our lives had just changed with a new pump tucked neatly under that little party dress.

Allowing my daughter to eat a couple of ritz crackers while we waited for our turn with the photographer was life-changing and no, I'm not using that term loosely. 

The main meal was served at 1:30 p.m., which just a week before would have required us to pack a separate lunch for noon.  We then would have spent our mealitme distracting her from the fact that everyone else was eating and all she got was a glass of crystal-light and some celery sticks. 

When her aunt and new uncle cut their cake at 4 p.m., she was first in line for a slice and I calculated my first SWAG bolus.

That October day  represented new beginnings.  It was the start of a new and happy life for my sister-in-law and her husband.   It was also the start of a slightly simpler life for our family; one in which we could participate in social events without the anxiety and discomfort our previous diabetes routine entailed. 

We The Undersigned...

Diabetes Blog Week


Recently various petitions have been circulating the Diabetes Online Community, so today let’s pretend to write our own. Tell us who you would write the petition to – a person, an organization, even an object (animate or inanimate) - get creative!! What are you trying to change and what have you experienced that makes you want this change?

We, the undersigned, petition medical professionals to tell us the truth about the level of discomfort we can anticipate when undergoing tests and procedures.

We particularly request the elimination of the following two phrases:

1. 'You'll just feel a little pinch.' 

2. 'This might be a little uncomfortable.' 

Even a savvy three year old can tell you 'just a little pinch' means 'I'm about to stab you with something long and sharp.'  Please give up the phrase.  Nobody believes you.

'This might be a little uncomfortable' is used inaccurately by medical professionals in multiple settings.  Examples of the use of this vast understatement include but are not limited to:

An orthopedist resetting a broken arm.

An orthodontist taking impressions for braces.

A pediatrician taking a sample from the back of the throat for a strep test.

An eye doctor putting in drops for dilation.

We, the undersigned, demand less deception and more respect for our intelligence and common sense.

To Share or Not To Share?


 
Diabetes Blog Week



Today's prompt: Often our health care team only sees us for about 15 minutes several times a year, and they might not have a sense of what our lives are really like. Today, let’s pretend our medical team is reading our blogs. What do you wish they could see about your and/or your loved one's daily life with diabetes? On the other hand, what do you hope they don't see? 

Embedded in this question, I think, is another:  How helpful, kind and realistic is your endocrinology team?

I know plenty of people equate the endo appoitment to a big test, or a performance evaluation. These people try to hide their recent out of range numbers.  If they can't do that, they find themselves cowering in their chairs feeling berated by the discussion of them.

To me, the only way to get the most out of endocrinology appointments is to share as much information as possible.  There's really nothing I 'hope they don't see.'  The more they see, the more they can help. 

Why the 300 the day before yesterday?  Bagel day at school.  She forgot to combo-bolus in the nurse's office, but even when she does she comes out high.  Any ideas, doc? 

"Don't eat bagels?" (Said with a wry smile...we love his sense of humor.) But then he goes on, "I like that it looks like you kept checking and correcting.  In those situations, that's the best you can do and you did it well.  I had a patient the other day tell me she boluses a full 20 minutes before the bagel and sets a temp basal rate when she starts eating it.  You could try something like that next time, maybe.  Basically, bagels are just bad news...but once in a while you're gonna eat one, so keep experimenting."  Not only did we benefit from sharing our bagel disaster, but we also benefitted from someone else doing the same.  We came away feeling empowered, not guilty.

We were fortunate to start out at diagnosis with an endocrinology team who understood that there was more in my daughter's life than diabetes.  When we moved, we did our homework and found a doctor with the same philosophy.  When he moved, we changed practices.  Perhaps the types of professionals we've contracted with for care influences my perspective. 

Our type of endocrinologist is one who would ideally follow my daughter around at all times, looking at her diabetes management and how it intersects with the rest of her life.  He or she would spout out helpful advice along life's diabetes journey.

Alright, maybe being followed by an endocrinologist 'at all times' would get a little creepy.  Yet at the heart of the matter, the idea is the same. Those extra eyes on the quarterly downloaded blood sugars are so much more helpful if they're able to see as much as possible of the person's life those numbers came from.  That's why we share it all.


Bits and Pieces 4

It's been a busy week with a busy upcoming weekend.  My thoughts are scattered and it feels impossible to create an entire post about one topic.  So here are a few bits and pieces of what's on my mind:
 
My daughter had her standardized testing this week, which went better than it has other years, diabetes-wise.   She's tired of peanut butter whole wheat toast every morning, but there was no repeat of the infamous 3rd grade nurse's office workout.  I think we have a test-day breakfast winner.
 
A new favorite product is Gatorade's G2.  We bought it to aid in recovery from a stomach bug, but it's become a must for softball games too.  With something like seven carbs per 12 ounces, it's just the thing for both a sick, dehydrated kid and a budding athlete.
 
Check out the Diabetes Co-Stars Video from Sandofi. It provides 3 snippets of life with diabetes with a focus on who provides support.  As a bonus, after 10,000 views, Sandofi will donate $10,000 to the Diabetes Hands Foundation.

Last but certainly not least, 'who's your diabetes co-star' would be a great question for Diabetes Blog Week next year.  For now, there are great prompts for all seven days next week plus two wildcards to choose from.  I'll be participating and can't wait to read the thoughts of my fellow bloggers.  Stay tuned!
 

Diabetes Blog Week
 




Dining Out


I love to eat out, but the following scenario will give you an idea why we don't often dine out as a family:

We sit down at the table and the negotiations begin.

"Do you think they have diet root beer?"

"All I see is diet pepsi.  How about iced tea?  Or water?"

"I guess.  Do they have splenda here?"

"I have one in my purse if they don't."

"I can't decide if I want chicken fingers or maybe I'll get a bowl of chowder.  If I get the soup will you share some of your fries with me?"

"If I get fries, I will.  Look...there's a soup and salad thing too."

"But what's in the salad?"

The waitress arrives.  "Can I get you something to drink?"

"Iced tea please...unsweetened."

"Unsweetened...are you sure?"

The table answers in unison:  "Yes."

We return to the previous conversation, "It says a garden salad.  I can't imagine there's anything too weird in it."

"O.k.  I guess I'll get that with the clam chowder."  She begins to chat with the rest of the table or do a children's menu puzzle. I hand over her meter so she can check her blood sugar. The waitress reappears with drinks.

"Have you decided?"

By this time, I've carefully perused the menu options for my daughter.  Depending on the venue, I've managed to choose a wine by the glass or a variety of tea.  There's little chance I've even begun to consider my own food choice.

"I'll go last," I usually say.

"Mom, can I have that splenda?"

"Give me just a minute."  This can be said with varying degrees of kindness.

It comes around to me.  Unless I've been organized enough to preview the menu online before our visit, I order what I usually have there, or the first thing that catches my eye. I get out the splenda and begin considering how many carbs are in the bread which has arrived at the table.

Her salad appears.  It has seven croutons on it.  I bolus for them and the bread.  I take a breath, a sip of my beverage, and a glance around the room, beginning to focus in on any table conversation.  I begin to chat and relax.

Our meal arrives.  "May I taste your chowder?"

With a sigh, "yeah."

Not too many potatoes, but tastes a little starchy.  I estimate the carbs.  "How many fries do you want?"

"I don't know."

"I'll give you ten to start...I need to bolus you for something."

"O.k."

The mental math begins.  If an 8 ounce cup of new england chowder contains x carbs and this dish looks like twelve ounces and it has fewer potatoes than most but tastes thickened by flour or cornstarch and then I add ten fries and the package of oyster crackers, I'll bolus for y carbs for now and if she eats it all or eats some of someone else's dinner, I'll add z carbs later.  I plug the numbers into the meter remote and press 'ok.'

The waitress appears.  "How is everything?"

I've eaten nothing yet, but smile and nod anyway since my plate looks like it contains what I remember ordering.

"I think that's what he told us, isn't it?" My husband is pulling me back into a conversation I haven't been following.  I grab a now-only-warmish fry, and another sip of my drink and try to catch up.  It's time to enjoy my dinner and relax for a bit. 



A Pharmacy Story


I called the pharmacy on Monday to refill prescriptions.  In a rare moment of organization I checked the Lantus we keep for emergencies and noticed that it had expired.  The automated system told me that the prescription itself had expired and I ended up speaking with a pharmacist.  She said they'd call the doctor's office for the Lantus. 

She then informed me that we could only get 4 vials of Novalog instead of the usual 6 for a three month supply.  She attempted to explain the situation.  The conversation became very convoluted and in order to end it I agreed to accept the 4 vials. An endo appointment is in our near future and I figured we'd start fresh with a new prescription then.

On Tuesday I stopped in to pick up my prescriptions.  I gave my daughter's name to the pharmacy tech, who knows me well.  "Are you looking for the Lantus?"

"Lantus and Novalog today," I replied.

"I see they're still waiting for a call back from the doctor for the Lantus.  The Novalog isn't in here at all." 

I smiled broadly and kindly, because what else was there to do, and said, "The Novalog's the one I really need."  She went to the other computer station to submit the refill, and came back over.

"It says you only have two vials left on the prescription."

"Hmm...yesterday I was told it was four." 

"I'm sorry...it looks like only two."

"Fine.  I can get a new prescription in a couple of weeks anyway.  I'll take the two and regroup next time."

So I waited, picking up a few additional items including what I figured was a much deserved Twix bar.

When my name was called, the original tech rang up my items and handed me a pharmacy bag with six (6?) vials of Novalog in it.  I tucked it in with the rest of my items and returned home to restock the butter compartment. 

Today's task is to call the pump supply company to reiterate my daughter's desire for blue sets instead of the pink which mysteriously reappeared in the most recent shipment.  Will the stars align twice in one week?