The meter asked nicely first, on Sunday if I recall correctly.  "Replace meter batteries soon." Or some similar request accompanied by a gentle, high pitched 'beep beep.'  It asks for new batteries periodically, and thus far we've always replaced them by the third or fourth reminder.

But we didn't. We had all kinds of excuses. We were out to dinner. The batteries were in the basement.  The phone was ringing. It was bedtime.  I'd do it after the getting to school chaos had ended.  We were about to sit down to eat. 

So today, it decided we needed stronger words:

This message was still accompanied by the gentle 'beep beep,'
though it reads like it should be accompanied by a blaring horn.

We've never ignored the gentle reminder long enough to get yelled at like this before. It worked, of course.  The batteries are changed and things are back to normal.  Sometimes we just need to be spoken to in no uncertain terms.

Sleepover Dilemma

Sleepovers at friends' houses always pose dilemmas: uncertain menus, late night activity, relying on the Dexom for alerts of overnight issues,  heavy breakfasts, and more; but this weekend was the first time I found myself in a quandary right here at home.

Home game sleepovers aren't completely uneventful, diabetes-wise.  We've had to check blood sugars at 2 or 3 a.m. with another child in the room, and even had to give juice or corrections.  To my knowledge the friend I desperately try not to step on as she dreams in her sleeping bag has never woken up.  Snacks and bedtime involve a more structured routine than most of our guests are used to but they are, of course, kind and flexible as any good friends would be.

Sunday morning presented a new quandary though.  I woke up at 7, and my daughter and her friend were, as expected, still silent in my daughter's room.  The Dexcom read 80, straight across.  At 7:30 it read 76 straight across and it was still very quiet in the house.  At 8, it alarmed:  69.  Here's my thought process:

At 2 a.m., the friend would certainly sleep through my barging in, but at 8 a.m., chances are good I'm going to wake her up.  I don't want to do that.  The sensor is only a day or two old and it seems to have been running a little low since we revved it up.  It's probably just still a little bit off.  And with the margin of error on all blood sugar readings if  I wasn't running in there at 76, how different is 69, really? But, of course, what if it's off in the other direction and she's really 50 and I don't do anything about it? If she's 50, that's bordering on dangerous.  But maybe it'll go back up.

By the time I'd hemmed and hawed over all of this, it was 8:20 and the Dexcom alarmed again:  under 50.  It buzzed four times since we had it set to vibrate first, then to beep if the vibration went unacknowledged.  Now at this point, I'd been listening very intently, hoping for any sounds of life from the bedroom.  I was pretty sure I'd heard my daughter moving around in her bed (there's a squeaky spring). So I put Dexi in the bathroom, on a shelf which backs up to the head of my daughter's bed.  A minute or two later it blared, "beep beep beep beep!" 

At which point I heard her get up, grab her meter and check, and get back into bed.  It was still quiet.  The rattles, clicks and beeps of the blood sugar check hadn't woken her friend.

Within 10 minutes, the line on the Dexcom graph started going back up.  My daughter's friend woke up a few minutes before 9, and they came out for breakfast soon thereafter.

"I guess you corrected when Dexi alarmed at 8:20?"

"No- I was 88.  I just got back into bed."

Should I have acted sooner?  Probably.  A severe low blood sugar emergency would have been worse for the friend to wake to than me creeping around her air mattress.  But am I  glad I didn't wake her up for nothing?  I am.  What would others have done in my shoes (or slippers)?  I'd love to know.

The Screen as a Diabetes Management Tool

This article, Tech Can Be a Boost to Teens' Diabetes Self-Management, crossed my twitter feed this week.  It lists five specific technologies used by kids with diabetes: social networks, texting, mobile diabetes apps, diabetes-focused websites and pump or meter software. Our household's experience mirrors the positive results of technology on diabetes management found in the study.

The most used technology for management in our family is texting.  I get texts from parties and visits to friends' houses.  A mystery food has appeared- here's a picture and would I help guess the carbs?  She knows she'll be tired when she gets home but wants us to remember to do site change since she's down to 8 units.  She's low and has treated it but needs a virtual hug.  She's awake the morning after the sleepover- I can enjoy my coffee in peace. Texting is a quick and inconspicuous way to ask me for advice, help and support.

We do a little less with software. When we get around to downloading the Dexcom, looking at those numbers together does help her buy into any changes we need to talk about making.  She can see, for example,  the daily spike after breakfast and (at least for a few days) will be more likely to bolus before starting to make breakfast instead of as the food is entering her mouth.  This calendar year will bring 'Dexcom Share' to our family's cell phones, which I imagine will also increase awareness and communication. 

Social media is, to me, the most interesting tool.  It's where the intangible boost comes from. My daughter will share memes with me from accounts she follows on Instagram.  I'll send along blog posts or let her read funny tweets I come across.  She's not learning any specific treatment tips from her Instagram feed. Instead, she's getting support, encouragement and a sense of community.  She's able to see that there's a whole world of people out there living well with the wins and losses, laughter and tears, and the endless daily grind of diabetes. 

Being able to text me questions allows for better blood sugar control even with increased independence. Being able to visualize blood sugar trends allows us to work together to attempt to improve them.  But knowing that there are all those people out there who have so many of the same diabetes-related experiences she does?  That might be the most important boost to self-management: a healthy perspective on the whole mess.

It's Great- But It's Not For Us

Last week, the American Girl company started selling a diabetes care kit for dolls.  It's a great option for girls with diabetes and for those who love them.  Play is a great way to process all sorts of childhood experiences, including that of having diabetes. My daughter has spent countless hours playing with her teddy bears with diabetes- checking their blood sugars, providing them with pretend pumps, and feeding them carefully calculated treats at tea parties.

Her American Girl doll, however, does not have diabetes. And, as I wrote a couple of years ago in the post below, she does not want to. I double checked with both girl and doll, and neither wants the diabetes care kit.  They may want to visit the American Girl store to check it out, though. I definitely do.

The American Girl Store sells a variety of medical and dental accessories.  Depending on her needs, a doll could have her own allergy-free lunch, a wheelchair, a hearing aid, a retainer, or glasses.  These items allow children to make their dolls a bit more like themselves, or like people they know.
My daughter was perusing the catalog one recent afternoon, dreaming of all the items she'd own if we had a dedicated 'American Girl Wing' in our home.  She was considering whether her doll, Kit, would ever need a wheelchair.
"Maybe some day, they'll make an insulin pump for American Girl dolls," I thought out loud.
The reply was instant and adamant. 
"I wouldn't want one."
A pause. 
Then, "Why would anyone want that?"
"Why not?" I asked. 
"I wouldn't want Kit to have diabetes," was the quick reply.
"No?" I prompted, thinking about how much Kit has in common with my daughter.  She has a ballet outfit, a softball uniform, her own instrument and music stand, and tons of tiny books.
"Can you imagine me telling her she suddenly had diabetes?  She'd be so upset.  I wouldn't want to do that to her.  She wouldn't want to have diabetes."
Of course she wouldn't.  
Indeed, who would?