What Did I Miss?

Today, we'll look back 2 years to a pool party for all girl scouts from our area.  As troop leader, I was there, in charge of feeding and keeping track of my group of fifth grade girls. 

This was our first pool visit of the season.  My daughter disconnected her pump and got in with her friends.  They then got out and opened a couple of bags of chips.  "Can I?"  "Just a few."  We'd delivered  a correction bolus for a 200-ish number on the way to the pool.  With the exercise, I figured a couple of chips couldn't be too bad.  Plus, to be honest, it seemed like such a 'normal kid' thing to sit on a circle on beach towels with your 11 year old friends, talking, braiding each other's hair, and muching on chips.

After another swim, the pizza arrived.  I did (to my credit) remind her to plug her pump back in and check.  230.  I juggled the meter-remote, paper plates for all the girls, opening the grapes and watermelon, pointing out the drink cooler and providing napkins.  I bolused for pizza and watermelon.  I might have added the bg.

She ate, unplugged, and headed for the water slide.  An hour later they came back for dessert.  A cupcake and 2 mini girl scout cookies.  She was already partway through the cupcake when I realized she hadn't checked again.  She was reading the box for the cookies (reclaiming a bit of good will).  "4 each, mom."  I had made the cupcakes, so had a number in my head for those.  Still juggling dessert requests and napkins, I bolused.   I glanced over.  She had no pump attached.  She plugged in and we bolused again.

Half an hour later, she found me talking with a mom on the other side of the pool.  A friend's sister's troop and given our troop mini fire cracker pops.  Could she eat hers (which she was holding, open, in her hand)?  From the cobwebs of my brain came the knowledge that these were 'only' 9 carbs.  I gave the o.k.  She was standing there with her friends, on the way to the shuffleboard court.  She bolused for it when she got back to the table.

Once we'd packed up and gotten in the car, her blood sugar was around the 250 mark.  She corrected and had some water when she got home.  An hour later, still 250.   Obviously, the whole evening was riddled with diabetes mis-steps.  Chips with no insulin (probably more than a few), not accounting for missed insulin in the pool, a dinner diet of pizza, chips, watermelon, cupcakes, cookies and popsicles. Everything was bolused for on the fly, often after the food was partially consumed.

Yet, you diabetes detectives out there, there's one more big reason that high number didn't come down. 

Anybody guess it?

I had bolused for dessert while the pump was detached.  Then again when it was.  The pump included all of that insulin in the insulin on board total.  So when we went to correct the 250 after the party, it gave very little, assuming a whole extra cupcake and 2 cookie's worth of insulin was still hanging around.

Any 'party by the pool' event is a challenge, diabetes-wise.  The level of difficulty rises exponentially if I'm in charge of more people than my own kid.  In the end, it was a fun evening and the 250 came down quickly once I'd realized the error of my ways.  But keeping track of diabetes at this kind of event is a full-time job.

Birthday Day and Other Heavy Eating Occasions

My daughter's friend had a birthday last week.  It was on the same day as mine.  The kids have found a way to skirt the school nutrition policy of 'no outside food for celebrations' by bringing in treats to share at lunch. So lunch that day included oreos, hershey kisses, doritos and munchkins.  To her credit, she ate the sandwich and grapes I packed first, but she sampled the rest as well.

For dinner we went to a Thai restaurant and she had an uncountable portion of pineapple fried rice. We came home and had mini cupcakes and cannolis for dessert.

Our household diabetes philosophy (yours may vary) allows sweets, and even junk food.  Birthdays include cake.  S'mores over the fire pit or a trip for italian ice are part of summer fun.  A little bag of chips for the walk home is o.k.  Most days include cookies or a non-dairy frozen treat before bed. Taken one at a time, or even two in one day, we're o.k. with both the questionable nutrition of it and with the diabetes challenges.

'Everything in moderation' is the general idea. But on days when moderation goes out the window, I'm left feeling torn.  Should we ever let her eat this way?

"Yes!  You can eat anything except poison...or cookies made with poison..." is one side of the coin. But she really can't eat anything and maintain the same kind of blood sugar numbers she does when she eats healthy, countable things.  Twenty carbs of oreos and doritos is not the same as twenty grapes. Half a restaurant portion of pineapple fried rice and a bakery cupcake simply can't be counted and dosed for as accurately as portions prepared, weighed and measured at home. Add the 'one more dorito because everyone else is still eating,' or the picking all the pineapple out of the fried rice despite bringing home 'half,' and the challenge increases.

Still, I lean towards letting her learn from her mistakes over outright forbidding her from eating like this. She'll encounter days with heavy eating potential for the rest of her life, so perhaps helping her develop a healthy sense of how to handle them is the answer.  Last week's birthday day was an example of how not to handle it.  And she knew it.  She was upset that her blood sugar was high for hours.  Between that lengthy high and the general junk food overload, she had some lingering indigestion into the next day.

Sometimes she makes better choices.  Last weekend, she said no to lunch out with a friend before an evening birthday party because it would consist of too much uncountable food in one day.  She's come home from parties and told us she was the only one who ate the proffered grapes or salad to balance out the junk. She will report with alarm how many cookies or cupcakes some kids consume in one sitting.

I guess it's like all things diabetes, really.  We do our best.  We try to fit the diabetes stuff into what we consider a normal, healthy lifestyle.  We try not to let it ruin our fun.  We learn from our mistakes.  And we're never quite sure we're doing it right.

Prepared

I spent some time emptying and organizing my purse before we traveled last month.  Apparently it the project was overdue.

In my purse, I was carrying:

2 juice boxes

3 boxes of nerds

2 spare vials of test strips

a bag of goldfish crackers

3 rolls of smarties

an empty glucose tab container

approximately 20 used test strips and

a glucagon kit.

I believe in being prepared with supplies for my child.  But this was a little too much.  Especially since as she's getting older she brings her own bag for day-trips and bigger adventures. The stuff in my purse is now just for quick local excursions, or as back-up to what she's packed.

But if I ever get stuck in an elevator, I'll be in good shape.

Two - Many Favorites

Yesterday was the day for 'Continuing Connections' to conclude Diabetes Blog Week.  My delay is two fold:

Yesterday got away from me- it was a gorgeous Sunday packed with activities.

Secondly, and more to the point, I always have a hard time with this d-blog week topic.  I'm never able to read everything and therefore fear that my REAL favorite is still lurking somewhere on a link list waiting to be read.  I also don't want to leave anyone out who I've discovered or particularly enjoyed this week. Narrowing it down is difficult.

But narrow it down I will, to my two favorites from the Diabetes Personified category.  Both are from blogs I hadn't seen before.

From Bustin' Diabetes For Justin, Justin's own picture of diabetes was excellent.  And I love that his mom shared Justin's own words to go with it.  Diabetes is, indeed, "a poop head evil jerk."

Sweet and Sour- The Type 1 Diabetes Roller Coaster compares her diabetes to Moaning Myrtle of Harry Potter fame.   I like the thought that despite all of  Myrtle's faults, there are things we learn to like about her.

To see other bloggers' favorites, click HERE for the link list!

A Big Deal?

This Diabetes thing is a really big deal. 

Please don't make a really big deal about it.

These sentences are from a post I wrote about meeting with the nurse and teachers before my child started fourth grade.  These words were an attempt to sum up what I was trying to impress upon the school staff about having my child in their classrooms.  

I wanted them to be worried enough that they'd keep an eye on her.  I wanted to make sure they wouldn't let her forget her emergency bag for fire drills.  I wanted to be alerted when there was a change in schedule or a class party.  I wanted diabetes to be in the back of their minds always, just like it's in the back of my mind at all times.

Yet at the same time I wanted her to be just like every other kid in that classroom.  I wanted her diabetes to be as invisible as possible.  I wanted her to participate in every aspect of school life just like the other kids.  I wanted her to go through her day without being constantly asked if she was o.k. or given any special attention.

Ditto for the rest of her life.  This quote pretty much sums up our household's diabetes philosophy.

This Diabetes thing is a really big deal. 

Please don't make a really big deal about it.

We do our fair share of worrying. We are prepared with all of the supplies and information we need to keep my child healthy.  We remain aware of what her blood sugar numbers are, and how the next activity might change them.  When she's easily flustered, or lethargic, or absurdly giddy we ask her to check her blood sugar to determine whether she's low, high, or simply 13. When there's a diabetes issue we stop and take care of it. But all of this stuff remains, as much as possible, in the background of an otherwise full and normal life.

She goes to school and does her homework.  She sings, acts and plays two instruments.  She participates in sports.  She stops to buy a snack with her friends on the way home from school. She hikes and swims and kayaks.  She goes to friends' houses, birthday parties and sleepovers.  She eats out and travels.

It would be easy to let anxiety about all of the what-ifs of this disease slow us down.  It would be easy to say no to so many of these things.  

But we'd rather not make a really big deal of it.

Today's Diabetes Blog Week topic asks us to share a favorite sentence or post we've written, or to share why we started the blog in the first place.  Find the rest of these posts HERE!

Today's Menu

Breakfast

              

This is one of our protein-containing, 5+ grams of fiber cereal choices which somewhat diminish the post-breakfast blood sugar spike.  

More excitingly, I bought a whole pint (well, several pints actually) of blueberries for less than one million dollars this week!!!

Lunch

Sunflower butter to protect her peanut-free friends at lunch, with great grandma's homemade spiced pear jam, which she makes special with less sugar just for my daughter.  With an occasional substitution of pretzels or sun chips, this is lunch every day.   

Snack

Snack varies every day.  Sometimes it's more substantial, like a smoothie or peanut butter crackers.  But today she's saving room for Grandpa's birthday dinner.

Dinner

I'll smash up half a sleeve of townhouse (ritz, etc. are all fine) and mix them with 3-4 tbs. of melted butter.  I might remember to squeeze in some lemon juice and add some pepper.  The fish goes in a greased (or better yet, buttered) glass baking dish.  The cracker mixture is spread on top.  Bake at 400 for 10-15 min. until it's flaky.  Yum!

We've nicknamed this rice blend 'crazy rice,' at our house.  It's got tons of flavor and a variety of textures.  Much more fun than regular brown rice.

Grandpa's Birthday Cake

I know- all kinds of problems with this.  Its's processed beyond belief.  It contains artificial everything.  The glycemic index is off the charts.

But it's Grandpa's favorite, and a family tradition.  So we'll indulge!

Food is one of my favorite topics to read, think and talk about.  So I, for one, am looking forward to reading the rest of today's Diabetes Blog Week posts which can be found HERE!

Did These Things Really Happen?

I feel like much of what I write about here involves changes related to growing up and gaining independence. So instead of today's regularly scheduled change-related topic, I went with a wild card choice for today's Diabetes Blog Week Post.  The prompt asks me to share the top 3 craziest stories I have about living with diabetes.  It goes on to say, "If you can't think of three, don't worry. We're just as happy with one or two..." That was not my problem.  Dozens of stories came to mind. So I created 3 categories and picked one from each:

Craziest Medical Experience:

This category has some solid runners-up.  There was the time the pharmacist suggested I have my daughter's humalog diluted by my veterinarian, and the time the lab tech slowly and cheerfully explained every detail of the blood draw.  But the winner goes to diagnosis day.  We'd been at our local hospital for a few hours.  We knew my daughter's blood sugar was 'very high,' but while several doctors and countless nurses had assessed her, there was (alarmingly, in retrospect) no diagnosis or treatment yet.  We were about to be loaded into a helicopter for transport to the children's hospital.  As I stood next to the transport EMT she turned to the doctor in charge and told him she would not put my child in the helicopter until he ordered an insulin drip.  I'm convinced to this day that after hours in the emergency room it was an EMT who first recognized that my child needed to be treated for diabetes.

Craziest Era:

The NPH days were awful.  They lasted for almost 2 years, while my daughter was between the ages of 1 and 3 at which point she started with  a pump.  They coincided with her short but ill-timed picky eating phase.  Here's a snippet of a piece I wrote about those picky months and having to eat when the NPH peaked:  I spent the first two months of 2003 trying, religiously, to stick to the “meal plan” sent home with us by our medical team.  Starch, protein, fruit, milk.  Every day at 1 p.m.  There was screaming and crying.  Yelling and throwing of stuff.   Sometimes she would throw stuff and I would cry.  Sometimes we’d trade.   It was reminiscent of Green Eggs and Ham, without the happy ending.  Would she eat it in her chair?  Would she eat it over there?  Would she eat it if I sing?  No…she won’t eat ANYthing.  We’d inevitably end up sitting on the kitchen floor, covered in yogurt or peanut butter, in an exhausted stalemate. And then there was a low blood sugar at 2 p.m., for which I’d have to squirt cake decorating gel into her mouth because she’d refuse to drink juice.  I eventually sought and received help from our excellent diabetes team.  But if I had to pick a time when diabetes sent me closest to the brink of insanity, this is it.

Craziest Encounter with a Muggle:

When my daughter was 4 years old, we were in line to enter a museum.  The woman behind us in line got my daughter's attention and asked, "Is that a t.v. you have there?"  I can still see my child's blank stare, and how it was mirrored on my husband's face.  "There...on your back?" she persisted.  Aha.  Lacking pockets, my daughter was wearing her pump in a waist pack with a clear window.  I took a deep breath and silently exhaled all of the snarky and sarcastic replies which came to mind.  Instead, as politely as I could, I replied, "No!  It's actually an insulin pump; to treat diabetes."  That stopped the conversation dead in its tracks. "Oh," replied the inquisitive lady.  She clearly thought this a much less logical possibility than that of a 4 year old wearing a television on her back.

Want to read some more crazy stories?  I know I'm looking forward to it.  We'll find the links HERE!

Messy

The bloody tissues are the grossest part.  

There are always used test strips in the bottom despite the designated tic-tac container in which to stash them.  

I'm not sure how long that half roll of smarties has been in there.

But this is a snapshot of the meter case in all its typical glory.

Why does it stay this way?  Why are we keeping all of this trash in here?  Because testing is among the least interesting parts of the day.  Meter, test strip, lancet, blood, tissue, number, go.  It's time to eat, or head to volleyball practice, or go back to whatever was happening before the Dexcom alarmed.

We typically don't clean it out until  the mess diminishes its functionality.  Or until there's an impending risk of dumping test strips all over the floor of a friend's house or a fancy restaurant.

Otherwise, I sort of see this mess as a good thing.  It means we have better things to do than tidy up the meter case.  It means we have better things to do than worry about diabetes for a second longer than we have to.

It's an excellent excuse anyway.

More Diabetes Blog Week posts on the 'Clean It Out' topic can be found HERE!

Anonymous

As you may have noticed, I do not share my daughter's name on this blog.  And I have never posted her photo here.  It makes for some awkwardly phrased sentences, but it's important to me to maintain a sense of anonymity.

I made this decision when I started blogging.  "Why?" my daughter often asks.

"It's for your own good," sounds like such a terribly 'mom' thing to say, but I believe it to be true.

In this age of Google and instant information, I know that once I attach her name to diabetes via this blog, I can never take it back.  I'd rather not have my blog come up as the first item when her name is searched. Today she may not care, but some day somebody's going to google her name when she applies for a job or a learning opportunity. Or when somebody sets her up on a blind date.  I'd rather newspaper articles about academic or extracurricular events pop up instead of my blog posts.  If diabetes is going to come up in that search, I'd rather it be her name as part of an advocacy or a fundraising effort she's been involved in.

I know lots of bloggers share their kids' names, and I can see the other side of the coin.  It makes the stories feel more concrete.  It allows the child to take on a bigger advocacy role within and outside of the blog.  I think that's absolutely great, and consider it another in the long list of ways different things work for different people when it comes to living with diabetes.

For me, maintaining her anonymity and allowing her to choose when and how to disclose her diabetes is what works. I do sort-of wish I'd come up with a pseudonym though.  I've spent way too much time trying to rework those awkward sentences.

This is today's contribution to Diabetes Blog Week.  To read more about things people with diabetes are keeping to themselves, click HERE.

I Can Do So Many Things All By Myself!

When my daughter was between the ages of one and four, we participated in a program called Kindermusik. It was a weekly parent-child music class where over the years she progressed from teething on maracas to dancing around the room with scarves.  One of the songs, which has now been stuck in my head for a week thanks to this prompt began, "I can do so many things all by myself!"

The song included call and response verses sung with great toddler pride: "Can you brush your hair?"  "I can brush my hair!"  Or, "Can you wash your hands?" "I can wash my hands!"

Over the years, my daughter has added a long list accomplishments to the list of things she can do:

She can wash her hands before a fingerstick all by herself.

She can read her blood sugar numbers all by herself.

She can unpack boxes of supplies all by herself.

She can check her blood sugar all by herself.

She can go to school all by herself.

She can tell if she's low all by herself.

She can treat a low all by herself.

She can read a nutrition label all by herself.

She can count her carbs all by herself.

She can go to a birthday party all by herself.

She can go out for lunch all by herself.

She can disconnect and reconnect her pump to swim all by herself.

She can have a sleepover all by herself.

She can manage her diabetes on stage all by herself.

She can go out to a buffet brunch all by herself.

She can change her site all by herself.

When she was two, I couldn't imagine leaving her to play in a different room from me.  When she was five, I couldn't imagine leaving her at a birthday party.  When she was eight, I couldn't imagine a sleepover. When she was ten, I couldn't imagine sending her to a restaurant without me.  But the independence has come, slowly and steadily.

While it's hard to imagine now, the day will come when she can go on an overnight trip all by herself.  In the blink of an eye, she'll be going off to college all by herself.

With the same instinct a toddler has to want to do as much as possible 'all by herself,'  my daughter continues to strive for independence in her diabetes care.  It's a delicate balance between keeping her safe and giving her wings. There are mis-steps and stumbling blocks along the way, but each success is cause for celebration, just like when she learned to brush her hair.

Today is the first day of Diabetes Blog Week.  Click HERE for more information about the event. Click HERE for a link to a list of participants in today's prompt of 'I can!'

It's Nurses Week

This is week is Nurses Week and tomorrow, Wednesday, May 6th, is National Nurses Day.

If you have a school aged child with diabetes who is fortunate enough to have a nurse available at school, this is a good time to say 'thank you.'

Whether you love your school nurse like family, are simply grateful for her presence in case of emergency, or even if you sometimes have trouble seeing eye to eye, a little act of kindness is in order this week.

We've always given flowers.  Sometimes a few from our own garden, sometimes a bouquet from the grocery store, and to one nurse with a green thumb, we gave a pack of seedlings to plant in her patio pots. The flowers are always accompanied by a short note from our family, thanking the nurse for being there for our child.

It doesn't really matter what you do. I know other families who give a box of tea, a coffee gift card in a token amount, or a pleasantly scented bottle of hand sanitizer.  Maybe you're crafty, or maybe you and your child will bake something.  Maybe all your nurse wants or needs is your child's artwork to decorate her office with.

Whatever you choose, a little 'thank you' can go a long way when you have as thankless a job as many school nurses do.

The Airport

We arrived at the airport two and a half hours before our flight to Las Vegas.  When we received our boarding passes, they indicated we were headed to the TSA prescreened line.  I do not know how this happened, perhaps it had to do with having a child and a senior citizen in our traveling group, but I'm very happy about it.  The line was short, we kept our shoes on and we didn't have to remove our quart sized ziplocs from our bags.

I informed the person at the head of the line that my child was wearing an insulin pump and that the backpack I had placed on the belt to go through the x-ray machine had diabetes supplies in it including juice boxes.

Danger!  Danger!

We've flown twice before with diabetes, and every time my daughter and her pump have been thoroughly examined for explosives while the backpack full of juice boxes and sharp objects has glided through security without a second glance.

When the insulin pump had been visually examined but not swabbed for explosives, and my daughter had not been subjected to a wanding or a pat down, I thought this was going to go down as our easiest TSA experience yet. Until the backpack was taken aside for inspection.

"There are juice boxes in there for diabetes management," I quickly repeated in hopes of quelling any concerns.  "I mentioned that as we entered the line."

"You're allowed to have these items in here, but you should tell the bag screener they're there," the bag checker admonished us.

When I repeated that I told the person at the head of the line, the bag checker pointed to a man behind the 8 foot high bag x-ray machine, and said I should also have told him.  Which seemed challenging in any circumstance, but particularly since I would have had to speak with him at the same time I had to explain to the metal detector screener that my child was wearing an insulin pump and stay with my child while it was examined.

In the end, the Clifford juice boxes were carefully scrutinized and swabbed. They did not contain any liquid explosives, so we were permitted to continue on to begin our vacation.

On the way home (which is invariably, no matter where we go, a better TSA experience than our local airport), people were nicer. The juice boxes were not swabbed for explosives but the water bottle was. Instead of being scolded we received a helpful piece of advice.  The agent suggested that even if we're TSA prescreened, we should remove the juice and water from the backpack and send it through separately, which will make it clearer that we're not trying to smuggle anything suspect onto the plane.

We'll keep that in mind, of course, but I'm guessing that by the next time we fly they'll be questioning the syringes and lancets instead...just to keep us on our toes.