We Wouldn't Do This Again

At 8th Grade Graduation practice my daughter's class was told in no uncertain terms that they could not carry anything as they marched down the aisle. A two minute conversation would have led to her being allowed to carry her meter, but she didn't want to.  She wanted to walk in empty-handed like the rest of her classmates. Having a 'what's the worst that could happen- it'll all be fine,' moment, I acquiesced.  Here's what we did and why I wouldn't do it again:

Because the middle school's auditorium is small and infamously hot, the program was held in a large gymnasium at different school.  The kids were to arrive at 9 a.m. and meet in the building next door to the one where the ceremony was held.  At 9:30 they would process in and sit together in the front of the room.  The program was expected to last until about 11 a.m.

Creating a safe diabetes plan would have been easier with pockets as part of the equation, but she had a great dress to wear.  We knew a pump pack fit well underneath, but when we tried to add the Dexcom, there was an obvious bulge.  At least when we added a roll of glucose tabs tucked into the waist band of the pump pack, there was not. Those glucose tabs were our insurance policy.

We decided that she would check her blood sugar and make any needed adjustments in the car on the way to the ceremony. There had been no mid-morning blood sugar issues of late, which made us feel more comfortable with this plan. If at any point when we were not together she felt she was low, she would err on the side of caution and would (with a discreet move practiced before leaving the house) obtain glucose tabs from beneath her dress and eat a couple.  Then, once she was in the room with us, I would have the Dexcom and be able to signal her to eat glucose tabs as needed.  No problem.  Except these two unforeseen problems:

At about 9:25, just before the kids were to make their way into the ceremony, an audience member experienced a medical emergency.  There was a nearly half hour delay while the person was treated and eventually taken away by ambulance.  The kids were kept in their holding room in the next building over, too far away for the Dexcom to reach.  The half hour we'd expected to be apart turned into an hour.

Also, as we arrived at the venue, we learned that the kids would be seated in the empty chairs facing the podium, not facing us as we'd originally assumed. So there was no eye contact to be made and no hand signals to be used should my daughter need to be aware of a need for her hidden glucose tabs.

The story has a happy ending.  She left the ceremony with a blood sugar of 132, and a lovely award from the music department.  But in retrospect this was not a smart decision.  We should have had her carry her bag. Or asked a teacher who was supervising the kids in the other room to bring it over and slip it to my daughter once she was seated.  Or found a roomier dress with pockets.  As a rule, we don't even go around the corner without carrying a meter and a juice box.  Because as we were reminded on 8th grade graduation day, you never really know what's going to happen.

Party Trick

We've been busy taking pictures of 8th grade graduation events here, but those aren't the only interesting moments we've been able to capture.  I present to you The Amazing Finger:

Only one hole was pricked.
We've seen 2 for the price of 1 before, but never 3.


The Boy on the Field Trip

My daughter's 8th grade wasn't the only group visiting the family resort/camp on the day of their field trip.  After telling me that she hadn't talked to her school nurse all day, my daughter shared this contrasting story about a boy from another school:

There was another kid there with diabetes.  I felt so bad for him. I saw him out of the corner of my eye when I sat down for lunch.  He was a table over from us.  I could see him checking his blood sugar.  His nurse was hovering over him with her giant bag of stuff.  It took him a long time to check.  Then they got out a Calorie King book.  You know- not the app but one of those old books like we have on top of the refrigerator? 

Please rest assured we no longer use this alarmingly outdated 2003
COLOR edition to look up restaurant foods or packaged foods.
It's for fruit, grains, baking ingredients and other natural and recipe basics.

I could hear their conversation.  It was painful. They were looking up hamburger buns and macaroni and cheese.  It took them forever.  They came up with 65 first but the nurse decided that was too high (I think she was right) so they rounded down to 55 but weren't sure about that either. I thought about going over there and saying, 'a hamburger bun is usually 21 and half a cup of macaroni is 20-ish.  Enjoy your lunch.'  But I didn't.

I'm not even sure he'd started eating by the time we left.  I felt really bad for him.

We talked about what might have slowed this boy down.  The most likely scenario was that he was newly diagnosed and that this adventure was all new territory for him, diabetes-wise.  Or maybe he didn't eat out much and/or burgers and mac and cheese weren't on his usual menu.  Maybe his was a nervous nurse who needed to be sure they were taking care of his diabetes 'by the book.' 

Whatever the scenario, I understand my daughter's decision not to jump into the conversation. They probably would not have taken advice from another kid, and so her appearance would likely have just further delayed the poor boy's lunch.  She did wish she'd run into him later at one of the activities.

I do wish I'd seen him somewhere else. I would've told him that it'll get easier but I never saw him again.  I hope he didn't spend the rest of the day in the dining hall trying to figure out his lunch carbs.

The (Im)possible Field Trip

Something caught my eye as I skimmed through the school communications three years ago, at the end of my daughter's 5th grade year.  The 8th grade was preparing for its annual end-of-year celebration field trip.  They would be going to a family resort over an hour away.  They'd leave early in the morning and return around six at night.  There would be swimming, boating, a ropes course, tennis, volleyball, hiking and countless other fun outdoor activities.  Lunch and snacks would be served.  The only chaperones would be school staff.  And I thought, 'No way. There is no way she'll be able to participate in that.  The diabetes stuff is way too complicated.'

Last Friday I dropped her off in time to board a bus for the very same trip, without a second thought.  I made sure she'd packed well, filling a string bag with her meter, juice boxes, glucose tabs, smarties, and her dexcom.  She had a deep desire to keep her blood sugar in range so that she could play tennis, swim, and try the ropes course rather than spend any time with the nurse.  But the nurse was there, just in case, both to help if needed and to be a source of back-up supplies. Lunch was easy to count: hot dog and hamburger buns, pretzels, watermelon. The 8th grade teachers all know my kid, and they were stationed around the property to supervise the activities. I knew that they would help her if she needed it.

Especially considering what a big deal the idea of this trip felt like when she was a 5th grader, by last week it felt like no big deal at all.  It turns out she's come a long way in the past 3 years.  She can count carbs with the best of them, keep an eye on how she feels, carry her own supplies, troubleshoot problems and trust her own judgement. 

The only conversation she had with the nurse was at the door of the bus for the return trip home:

Nurse:  Hi!  Everything good?

Kid:  Yup!

Last Field Day!!!

This week marked our 9th and final field day. I never much liked it as a kid.  As a parent of a kid with diabetes, I like it less because:

It's always hot.  Dehydration and diabetes don't mix well.  Insulin and heat don't mix well.  And the whole 'am sweaty and weak because I've just run a relay in the sun or because I'm low' question is on replay all day.

Everyone is in constant motion.  The obvious risk of this for my child is exercise-induced low blood sugar, but there are other risks to her from the chaos.  Teachers are just barely keeping their groups together and the events going, let alone keeping an extra eye on my kid to potentially notice symptoms of low blood sugar.  My kid is encouraged to keep up with the group and less likely to have a moment to assess how she feels and use her glucometer or drink water as needed.  The nurse is busy because constant motion means constant bandaids and ice packs, which means my kid may find a line at the nurse's tent if she shows up there needing help.

The distractions are endless.  When she was little it was worse, but even today my daughter is still less likely to notice an approaching or full-blown low blood sugar when there are lots of other things going on.  The constant sensory input from the events, the people, and the novel outdoor setting could easily cause her to miss the sensation of dropping blood sugar.

Field day often includes a treat.  This week, for example, she played volleyball, did some activities on the track and then ate a popsicle at 11 a.m.  For the first 3 years of elementary school there was a pizza lunch between the morning circuit of games and the end-of-day tug of war and popsicle event.  Managing unusual and unusually timed exercise is challenging.  Managing unusual and unusually timed treats is too.  Putting the two together adds yet more variables to an already very complicated equation.

Field day got easier over the years as my daughter became more aware of and responsible for keeping an eye on her blood sugar.  Once she started middle school I no longer felt compelled to send extensive communications to the staff imploring them to look out for her.  And I've felt decreasingly anxious over the years that something truly disastrous would occur.  But this year, like most years past, she ended up in the nurse with a low blood sugar by the time it was over, and the following hours provided a line of peaks and valleys on her Dexcom graph. 

At least her team won the day.

I Can't Remember

There are some diabetes facts (and  'facts') which are always readily available to me for instant recall.

I'm always able to remember that ritz crackers have 2 carbs each, that walking around a museum results in a steady decline in blood sugar, and that the total amount of insulin needed to fill the canula for a site change is 0.7 units. These and many other oft-used bits of information will forever be embedded in my mind.  I'll likely still remember them well beyond their usefulness to me.

Yet there are other bits and pieces which I am simply unable to retain.

We've had 12 Thanksgivings with diabetes, but every year I have to look up carb counts for squash and pie.  Similarly, corn on the cob doesn't stick with me from summer to summer.  Worse yet, I find myself looking up Italian ice if it's been more than 3 days since the last cup.

Doctors' visits regularly stump me with questions like, 'When was her last blood work/dental appointment/eye exam?'  Or 'What is your copay?'  If I could even remember ahead of time that I'd be asked, I could at least look them up and make myself notes. Instead I have to slowly work my way through the recesses of my memory to come up with an answer, or an approximation there-of.

When was the last site change?  Half the time we have to look in the pump's history to find out.  Did I call  to change the amounts on the order for pump supplies after the last box was delivered or do I still need to do that?  Did this bill for the lab work cross in the mail with my check or did I never get around to paying it?  When is nurse's day again? 

Fortunately, none of these are unanswerable questions.  I can turn to calorie king, the memories of our diabetes devices, my thoroughly annotated planner, the checkbook, and the internet. 

Which is good, because on the whole it is impossible to remember every detail about diabetes.  At least if I also want to remember anything else.