Endo Eclipse Day

A note: School has begun. A semblance of 'routine' is beginning to appear. The opportunity to dust off a couple of posts I began over the summer and never published has arrived. So, yes, you'll see a couple of stories here which might make you think you've time travelled. But eventually we'll be all caught up!

We were not in the 'path of totality,' but a partial eclipse is unusual too, so we were excited to experience it.

But there was a glitch. The peak of the eclipse in our area was expected around 2:45 and we had an endo appointment at 3. In a city a 30-45 minute drive from home. That ruled out the local library's eclipse event, and a few other cool viewing options. Instead, equipped with our homemade cereal box eclipse viewer, we arrived at our doctor's office building about 2:15.

Out on a busy city sidewalk, we watched the shadows in our cereal box slowly change. The light grew dimmer and weirder. Some people near us had eclipse glasses, some had viewers clearly made at the last minute out of office supply boxes. Some were taking pictures with their cell phones while debating whether it was safe to do so. There were a few familiar faces from the diabetes center, including our endo who was entering the building as we arrived. People from throughout the neighborhood and from all walks of life had seemingly abandoned their work to converge on the streets. While it certainly wasn't the viewing opportunity we would have chosen, watching it in a large and diverse sea of people was fascinating, fun and memorable.

"Doing some eclipse viewing, were we?" asked the doctor when we settled into his office chairs.

"Yup- why not?" I replied.

"Why not, indeed," he said.

We could have bailed on the eclipse viewing because of diabetes. Just like we could have bailed on countless other opportunities over the past 14 years. But we chose to find a way to make it work.

Why not?

Glucagon Training

A couple of weeks before my daughter went on the five night youth group trip I met with the chaperones to train them in glucagon use, and to talk about diabetes concerns for the trip. These are people I know well, which has a great deal to do with why my daughter went on this trip without a parent in the first place. They were eager to learn how to help my daughter have a successful first trip away, and how to react should an emergency arise.

We gathered at a table.

"Epi pens make me a little nervous," my first chaperone friend said.

"Well, wait until you see this thing," I replied with a wry smile.

He was, indeed, humbled by the sight of the glucagon kit.

"Here's the deal," I said once it was open in front of us on the table, "We've never needed to use this. We've never come close to needing to use this. You guys know her. She's responsible about her diabetes and she's self-aware. She's got the continuous glucose monitor which alarms when her blood sugar goes low. But because diabetes can be unpredictable, there's an infinitesimal chance you'll need this, so it's important to us that you know how to use it. And besides, once you see this, I'm certain you'll listen even more carefully to the rest of the ways I'd like you to look out for her." Cautious smiles had returned.

I walked them through step by step with an expired kit, and then one chaperone physically set up my second expired kit while the other gave verbal directions. They seemed to get the gist, and learned to look for the pictographs inside the packaging for clues. In the end, I reminded them that the first step would be to call 911 and that if they were flummoxed by the kit, the fact that they knew what it was and where it was would be key for the EMS workers.

After striking a healthy fear of glucagon into their hearts, we went over the very simple things a 15 year old kid who's out of her element might need their help with in order to avoid disastrous low blood sugar:

-Someone to hang back with her if she needs to wait out a low.
-Someone to ask her if she's okay if she's spacey or uncharacteristically emotional, which are the primary signs of low blood sugar for her.
-Someone to stand up for her if someone gives her a hard time about stepping aside when she should be doing her volunteer job, or eating when she "shouldn't be," or looking at an electronic device when the kids have been told not to.
-Someone to get up and nudge her if a dexcom alarm is going off in the middle of the night.
-Help getting supplies should she somehow blow through the snacks, juice and glucose tabs we packed.
-Support if (when?) diabetes causes missed opportunities or unpleasant experiences along the way.

In the end they didn't use the glucagon. In the end, it may not have been necessary to show them how to use it at all. But in the end the glucagon training led to a much more important conversation about ways to keep her safe. Which made all of us more comfortable.

The Trip I Never Thought Could Happen

My daughter is currently in a city 4 hours from here without a parent.

This is it: the moment I thought would never come.  No way. No how. She would NEVER grow up. At least not diabetes-wise.

I'm stunned that it's happening and even more stunned that I'm completely okay with it.

I was welcome to go on this trip- a service trip with the church's youth group. But this seemed, for several reasons, like the ideal opportunity for her to spread her wings.

Why now?

-She's as ready as she'll ever be. She proves it every day. She especially proved it on the high school's spring music department trip which I, of my own free will, volunteered to chaperone so that I could be there 'just in case.' There was no 'just in case.' She did it all by herself while I shared a room with a (as it turned out, perfectly nice) stranger and worried endlessly about the whereabouts and safety of the rest of the kids.

-This trip is relatively close, just a four hour drive should I need to get there. And it's in the middle of a major city so there are hospitals, ambulances and pharmacies readily available should she need them.

-It's a small group: 6 kids and 2 adults. One of the kids is one of my daughter's closest friends. These kids genuinely like and care about each other. The chaperone to kid ratio is pretty great too.

-Speaking of chaperones, if I had to pick two people to send my kid away with for the first time, these two adults would be at the top of my list. Their willingness to take this on was, of course, one of the essential criteria. They're also responsible, concerned, and willing to learn everything necessary to support my daughter. And, probably most importantly, my daughter trusts them and likes them and will therefore include them in any issues she's having- diabetes-wise, and otherwise too.

-Lastly, and probably most importantly, my daughter was willing to go without me. That's been the bottom line for every big step towards diabetes independence we've made thus far. This decision was no different.

So far so good, considering the fact that diabetes does not travel well. One HIGH with double up arrows on the Dexcom required an emergency site change. An 82 at bedtime required some thinking about what to eat in order to make it until morning (a cherry Nutrigrain bar with no insulin- and yes, she made to morning). Otherwise she's guessing carbs as well as I could, remembering to carry her sack of dia-stuff, and keeping an eye on the Dexcom. I'm grateful to have the Dexcom share so I can check in when I'm worried, but I'm checking less than I thought I might.

Meanwhile she's having a huge adventure, both with the volunteer projects they're doing and with the sightseeing opportunities they're squeezing in whenever they can.

It's hard to wrap my head around how we got from a teeny, tiny person with diabetes who was totally dependent on me for every aspect of her care to this particular moment. It wasn't one giant step. It was a million teeny, tiny steps and suddenly, stunningly, here I sit over 200 miles away. And, inexplicably, I'm really pretty okay with it.

Look at That!

"The lady with the Omnipod is still at the pool with her kids most days," my daughter reported the other night.

"And there was another woman there. She had a pump clipped to her bikini top but the tubing was connected to her hip.  It would make sense if the site was in her arm maybe. It looked uncomfortable to me.  Or like you could accidentally yank it out with your own arm somehow- but whatever I guess...it's up to her."

It's summer again, which is prime pump-sighting season, especially at the pool and the beach.

Last years' beach vacation tally was 2 dexcoms and an Omnipod.  Our town pool tally was 2 omnipods and a tubed pump a little too far way to identify the brand of.  Walking around various cities and towns added 3 more pumps that I can remember. 

We've never spoken to any of these people about their devices.

But we always speak to each other about them. "That guy has something on his stomach...over there by the purple striped umbrella...is it a Dexcom or an Omnipod?" Or "That lady's making me nervous standing knee deep in the water- over there near the jetty- I think that's a Medtronic pump, right- those aren't waterproof are they? The tide's coming in fast." We discuss where the devices are worn, attempts to disguise them or not, and how far down the beach the people with diabetes walk without bringing a meter or a container of glucose tabs with them.

It's fascinating to watch other people with diabetes in the wild. It's also comforting since every sighting-spurred conversation boils down to this: "Hey- look- there's another person with diabetes just living life," and especially at the beach or the pool, "and having fun."

In Other People's Hands

I met a woman the other day who was an occasional substitute nurse at the middle school.  While this was the first time we'd met, she knew my daughter well.  There are others like her.

I have sent my child to school, on field trips, to birthday parties, to marching band camp and more.  The older she gets, the more people we collect who've helped her with her diabetes care. Some I know well, some I've been introduced to, and some I've never met.

I wonder if the people in whose hands I've left her fully understand how I feel about them.

These people have taken my child's life in their hands. Maybe they don't realize that, or look at it that way. I certainly wasn't going to point it out in quite those terms to the preschool director who agreed to accept her into the program. Those weren't the words I used when I thanked the parents who invited her for her first sleepover. But these, and many more adults, have been aware that having my daughter in their class, in their home, or in their field trip group necessitated an extra level of responsibility and vigilance.

If taking on that level of responsibility wasn't enough, these people have, quite often, gone above and beyond what I would have expected. Parents have contacted the birthday party venue for carbohydrate counts on food. Teachers have requested to be glucagon trained for my child's safety. Chaperones have sat with her while she stopped to check her blood sugar. Guidance counselors have called about 504 accommodations I never would have considered. Nurses have called just to reassure me that everything was okay. I'm incredibly grateful for every one of these thoughtful acts.

Being the parent of a kid with diabetes is a huge job. Being a kid with diabetes is an endless challenge. We're incredibly grateful for the people who step in to ease the burden in whatever ways they can.

Upper Hand

Last week, diabetes had the upper hand. It issued a series of decrees.

They included:

*Alarms will sound nightly from midnight until four a.m.

*You will wake a sleeping teenager for Cookie Monster Juice at least twice per night.

*Delirium will lead you to wonder if the nightly need for multiple juice boxes has something to do with the Cookie Monster themed branding. As in, 'Me Want More JUICEEE.'

*You will wake each morning to say, or to hear your child say, "Uck- juice box breath again. This is so gross."

*You will become so exhausted by overnight low blood sugars that you will increasingly limit dinner and bedtime boluses until the alarms turn from low to high, though still reliably from 12-4.

*You will try multiple tactics to stabilize overnight numbers and each will backfire more mysteriously than the next.

Diabetes, I have news for you. You don't get to win.

We issued only the only decree we need:

*We will not give up.

With perseverance and patience the trend is abating as mysteriously as it appeared. Maybe we finally made the right basal adjustments. Maybe we fixed the bolus dosing for the evening hours.

Or maybe it's all because we switched back to Juicy Juice boxes.

Unsolicited Advice- We Are Not Alone

I thought armchair medical quarterbacking might be a unique diabetes phenomenon. People who live with diabetes often hear these kinds of things:

That new pump with automatic shut-off sounds like something everyone should have- when are you getting one?

I can't believe you let her go to the carnival without an adult- that seems so risky.

My coworker with diabetes completely eliminated carbs and she's doing great! You should try that.

My nephew never had a 504 plan and he graduated high school with straight A's and a 1300 on his SAT's. Why would you have one for your daughter?

I happen to be spending time with a few different people these days who have medical conditions other than diabetes. I'm learning that we diabetes people are not alone. The free dispensing of unsolicited advice crosses many disease platforms. I've heard 'suggestions' like:

I never went to a doctor for my rotator cuff issue- my chiropractor is amazing. Alternative medicine is the only way to go.

My cousin had that kind of cancer and never considered new or experimental treatments. It seems really risky.

Dad wouldn't have put up with the pain long enough to try physical therapy and pain management for his back issue. He went straight for surgery. I can't believe you're going through all of that.

There's a catch-phrase in the diabetes community: Your Diabetes May Vary (YDMV). In many ways it applies to other physical conditions too. There are so many reasons (more than this short list) that different treatments and lifestyles work better for different people with the same diagnosis:

-First of all, the diagnosis might not be quite the same at all...type 1 vs. type 2, different kinds of back injuries, different kinds and stages of cancer.

-A condition can physiologically manifest itself differently in a different body.

-Insurance coverage and ability to pay can influence medical choices.

-Education and prior life experiences influence decisions people make about treatment.

-Quality of life has a different meaning for everyone, leading to different tactics for managing a health condition while living a full life.

I think it's okay, if not downright helpful, to talk to each other about the different ways we manage diseases. We can certainly learn from one another, and it's often useful to hear and to try new ideas. What's not helpful is insert assumptions or judgements into the conversation. It's important to respect and support the decisions people make, even if they're different than yours. What works for one may not work for another.

At least, diabetes friends, we're not alone. It turns out that Your Disease, Discomfort, Distress, or Dietary Restriction May (Also) Vary. And that people have opinions about all of them.

Growing Things

Diabetes Blog Week

Lets wrap up the week by sharing a little more about ourselves, beyond the chronic illness we or our loved ones live with.  Share an interest, hobby, passion, something that is YOU.  If you want to explore how it relates to or helps with diabetes you can.   Or let it be a part of you that is completely separate from diabetes, because there is more to life than just diabetes!  (This topic is a suggestion from the 2016 #DBlogWeek survey.)  For more 'more than diabetes stories,' click here!

I like to collect plants.
Not fancy plants, and definitely not fussy plants which need any real attention.
I like plants with a little history, plants which remind me of people or places that are special to me.
Here are a few things which happen to be growing or blooming in my yard today:

The first rosebud of the year.
The bush was in full bloom in the front garden of the house when we moved in.
I love that we see the roses through the living room window.

Lily of the Valley transplanted from my childhood home's garden

The mint in the back is from plants which grew at the farm where my grandmother grew up,
divided and transplanted in several locations since then.

The rosemary in the foreground is a plant which lived over from last year- not as much a history story as a gardening win!

We went to a local public garden's plant sale the first year we lived in our house.
I purchased a small bleeding heart plant, divided from one on the garden's grounds.
It's now threatening to take over the corner of my yard.

These Japanese iris, also in the front garden, came from my husband's
childhood home.

An Hour's Worth of Emotions

Diabetes Blog Week

Today let’s revisit a prompt from 2014 - May is Mental Health Month so now seems like a great time to explore the emotional side of living with, or caring for someone with, diabetes. What things can make dealing with diabetes an emotional issue for you and / or your loved one, and how do you cope?

I present to you the story of the events of Monday morning, with words describing our wide-ranging emotions about said events highlighted in bold print:

On Monday, my kid arrived at school anxious- not about the first day of standardized testing, but about which teacher had been chosen to proctor her private testing room. Her 504 plan has accommodations allowing her to stop and restart testing to deal with any diabetes issues, so she is separated from other kids since her test might be timed differently than that of others. "It's so awkward, mom, I hope it's a teacher I know at least." She checked the list posted in the school lobby and was confused. She had, inexplicably, been assigned to a room with a large group of special education kids. The texts to me began...

"Help! What do I do?"

"Go to guidance and explain that you've been told you were testing alone."

We texted back and forth for 25 minutes or so while she sat in the guidance office. People came in and out asking her questions and then disappearing for stretches of time. All of the teachers not assigned to a testing room were summoned to the principal's office via the PA system. She eventually stopped answering my texts at which point I assumed the situation had been resolved and that she had started taking the test somewhere- with someone.

Scrolling back through those texts, the words and emojis described the following emotions:


Those were interspersed, because how else were we going to cope, with

Amusement and

In the end she was relieved that it got resolved, and amazed that the stress hadn't spiked her blood sugar. We were surprised that the rules required 2 teachers to be in the room with her and thankful that they were two teachers she knew and liked. They helped her settle in well and she feels confident about how she did on the day's tests.

In the end, I was proud of her for handling the situation herself and happy that technology allowed me to support her via text.

I would be embarrassed, however, if school officials discovered the number of circus-themed emojis I sent over the course of the morning.

While this story highlights in a somewhat lighthearted way how diabetes can lead to a wide range of emotions in just an hour of every day life, the possibility of long-term serious mental health issues is real. Depression, burnout, anxiety and other mental health issues impact most people with diabetes and their caregivers at one time or another. To read other perspectives on this topic, click here.

Lost in the Dark

Diabetes Blog Week

I chose the 'wildcard' option for my Diabetes Blog Week day 3 post:

Whether you or your loved one are newly diagnosed or have been dealing with diabetes for a while, you probably realize that things can (and will) go wrong.  But sometimes the things that go wrong aren’t stressful - instead sometimes they are downright funny!  Go ahead and share your Diabetes Blooper - your “I can’t believe I did that" moment - your big “D-oh” - and let’s all have a good laugh together!!

Okay- a caveat- this one was stressful for my daughter. But because I didn't hear about it until everything was resolved, I'm able to laugh about it:

She boarded the dark roller coaster and discovered the seat was cramped. Before using the safety harness, she decided she'd be more comfortable if she removed her Dexcom receiver which was clipped to her waistband. She stashed the receiver in her string backpack and put the bag in the pouch area in front of her.

The ride was scarier than she'd hoped. She got off, grabbed her bag, and quickly headed for the exit.

Once outside, she opened her bag to grab the Dexcom. It wasn't at the top where she'd put it. She frantically removed every item from the bag. It wasn't in there. She had her friends double-check. No Dexi.

She approached the attendant at the ride entrance. "I lost my medical device on the ride."

She described the device, an electronic item in a black case with a belt clip. She answered questions about which seat she'd been in and how long ago she rode.

The attendant checked his station first since all lost and found items ultimately ended up there. He didn't have it. He called the person at the stand next to the ride, where any lost items would be turned in by riders who found them in their cars, and was told it wasn't there either.

"We may have to shut down the ride and turn on all the lights if it doesn't show up."

My daughter was horrified. Her mistake could potentially shut down one of the most popular rides at the amusement park.

"We'll wait a few more minutes and see if anyone turns it in."

At that point, it was time for the ride attendants to rotate stations or take their breaks. The guy helping my daughter left and was replaced by the person who had been at the stand next to the ride.

"Describe it to me again?" he asked.

She did.

"OH ...  Yup. I have it. I thought it was an I-Pod."

It was a scary 15 minutes.

Lessons were learned about securing valuable items.

Ultimately everybody lived happily ever after, and now we can laugh about it.

Want to read more stories about 'Diabetes Oops Moments?' Click here!

Getting Our Money's Worth

Diabetes Blog Week

It's Day 2 of Diabetes Blog Week! Today's topic is: Insulin and other diabetes medications and supplies can be costly.  Here in the US, insurance status and age (as in Medicare eligibility) can impact both the cost and coverage.  So today, let’s discuss how cost impacts our diabetes care.  Do you have advice to share?  For those outside the US, is cost a concern?  Are there other factors such as accessibility or education that cause barriers to your diabetes care?

I'm grateful that our family is able to secure what most in this country would consider 'good' health insurance through an employer and that we're able to afford what are still extraordinarily expensive premiums, deductibles and copays. There are so many people who are unable to afford care which would allow them to live...let alone live well...with diabetes. Having access to quality diabetes care is not, in this country, in this day and age, something to take for granted. Instead, both because it's not guaranteed and because we pay dearly for it is, for us, a precious resource which should be used wisely in lots of ways, including these:

We prepare well for, and take full advantage of visits to the endocrinologist. Our copay to visit a specialist is $50- no small price.  We choose our specialists carefully, and if we're not happy we don't go back, just like we wouldn't return to a restaurant that served a sub-par $50 meal. Fortunately, after some trial and error, we found a great endo years ago. In the days leading up to the appointment, we talk as a family about what problems we're hoping to get solutions to and what questions we need answered. Once we're there, we give the 20-30 minute conversation all of our energy and focus. We take notes, and when we get home we implement the suggestions.

We also choose and purchase our diabetes equipment carefully. We pay a 20-30% copay for pump and CGM supplies. So we do our homework there too, extensively researching options. Then we talk with the doctor to choose the best insulin delivery and glucose monitoring methods for my child's particular needs. Over the course of many years I have managed to stockpile some extra pump and CGM supplies in case there is a lapse in our insurance or in our ability to pay that 20-30% copay.

We find opportunities to save money on supplies when it's reasonable to do so. We recently had the choice whether to pay full price for Lantus to keep in the fridge- and hopefully never use- for pump failure, or to receive a different long-acting insulin for no copay at all. That was a no brainer. We chose last year to stick with the longer-lasting transmitters and sensors of the Dexcom G4 instead of upgrading to the G5 which would cost us more in maintenance supplies. On a much smaller scale, I stock up during juice box sales and buy out the Smarties post-Halloween.

Despite the alarming annual tally of medical costs I compile each year for the income tax file, we are among the fortunate ones. Those costs don't preclude our ability to pay for housing, groceries, or even annual family vacations. So when there are unneeded supplies in the closet, or a charitable organization to support, we try to help those who are unable to afford the costs of diabetes. We've donated test strips and meters to Insulin for Life. We participate in an annual JDRF walk. We share information on social media about local organizations willing to take and redistribute unexpired diabetes supplies. We write letters and make phone calls to government representatives, insurance companies, and medical companies.

We do what we can to use our resources wisely and to help and advocate for those who don't have adequate resources to use.

More Diabetes Blog Week posts on the cost of diabetes can be found by clicking here.

Stuff Happens

Diabetes Blog Week

Today's the first day of Diabetes Blog Week! (!!!)

Today's topic is: Diabetes can sometimes seem to play by a rulebook that makes no sense, tossing out unexpected challenges at random.  What are your best tips for being prepared when the unexpected happens? Or, take this topic another way and tell us about some good things diabetes has brought into your, or your loved one’s, life that you never could have expected?
I try to maintain a family-friendly blog here, so I'll put it this way: Diabetes stuff happens. Like sitting down to lunch only to discover there's only a unit of insulin left in the pump. Or being so low all day that you run out of glucose tabs. Or discovering the meter battery is dead while you're on a sleepover. The stuff is not always preventable. So we try to be prepared for as many eventualities as possible.
At home or at school there are plenty of supplies to address any diabetes disaster. When we're out but close to home I can run over to a friend's house with a battery or we can stop home between errands for a new infusion set if we need to.
But sometimes we travel further afield. For day trips, excursions while on vacation and school field trips, we throw this Ziploc bag (or a facsimile thereof from school) in the backpack:

A spare vial of test strips
Spare batteries for both the meter and the pump
Glucagon (even though there's usually one in my purse)
The current open vial of insulin
Long-acting insulin for pump failure - at least if we'll be more than an hour or so away
A couple of syringes
Everything needed for a site change including 2 insertion sets
Dexcom tape
Extra glucose tabs

If it's hot, we put the contents in this insulated zipper bag.
It's a lot to carry around. We usually also carry extra juice boxes and water. But it beats the possibility of having to return home (or to our home away from home) if the infusion set rips out, or the pump battery dies, or somebody accidentally dumps all the test strips on the ground.
Nobody ever said having diabetes was predictable. Stuff happens. That stuff is less likely to stop us if we're prepared for it.

Want to read more posts about the Unexpected? Click here!

The Insulin is Insulin Conversations

At last month's endo appointment we needed just one prescription: Lantus to have on hand in case of pump failure.  Our doctor sent the Lantus prescription directly to our local CVS through the diabetes center's online ordering system, just as he's done every time our emergency vial has expired.

By the time we got home there was a voice mail from a pharmacist. The Lantus was no longer covered by our insurance. I needed to return the call to talk about next steps.

When I called back, a pharmacist walked me through possible substitutions. I explained that I wasn't terribly picky as long as there was something in the fridge which would keep my kid alive for a day or two until a new pump arrived. We decided that whatever the doctor ordered to substitute would be fine with me and that if there were choices I'd take the one with the lowest copay.

We left for spring break the next day expecting a voice mail upon our return telling us that the prescription was ready for pickup. There wasn't one, so I called.

"Yes- I see that the Lantus wasn't covered but that the Novalog was picked up as a substitution."

"Um...no. The Novalog was a different prescription which we refilled around the same time. Novalog isn't a substitution for Lantus- they're different kinds of insulin. The pharmacist I spoke to was going to call the doctor to request an appropriate substitute."

"Oh- I'll give the message to the pharmacist so that he can call later today."

Two days later, still having received no notification that the prescription was ready, I called to follow up.

"Yes I see that the Lantus wasn't covered, but the Novalog was the substitute for the Lantus, right?"

"No. It wasn't. And also, that's not possible. They do different things."

Again, "I'll have the pharmacist call the doctor's office."

I responded with something only slightly nicer than, "Don't make me have to call you again."

Two days later I called again and was transferred to the actual pharmacist.

"We've been calling the doctor since yesterday afternoon and haven't been able to reach anyone."

"It's a huge clinic, not a private practice. That seems highly unusual."

"Yes, but it just rings and rings."

We verified that they had the correct number, which they did, and then the pharmacist asked if I would call instead.

So I did. I called the office, where I was quickly connected to someone who answers the 'prescription line.'

I recited my tale of woe and provided the necessary details about the pharmacy.

An hour or so later I received a call back from the diabetes center.

"Hi- I'm calling you back about the Lantus. You have the Novalog, right?"

"Yes- that's not the problem."

"So then what is it that you need?"

"An alternative for the Lantus."

"But you have the Novalog."

"Yes- and they're two different things...right?" I was right ... wasn't I? 

"We have the Novalog which is in my daughter's pump- the fast acting insulin she uses 24/7. Then we keep Lantus, the 24 hour insulin, on hand in case the pump fails."

"Well...yes. I don't know what the pharmacist was saying then. Let me call him back."

An hour or so later the woman from our doctor's office called back and said that doctor's orders for Basaglar insulin had been sent over to our CVS. I received confirmation of this new order through the office's online patient portal.

Another weekend passed with no news from CVS, so on Monday I called and inquired about the status of my daughter's Basaglar insulin order.

"Yes. We are working on that."

"You're working on it?"

"Yes. Well. Let me see if we have that in stock." There was a brief interlude of top volume static-y piano music and then, "Yes. I have it here. We will have it for you this afternoon."

And, believe it or not, they did. Except it was in the form of pens, which we've never used.

So now I have to call to get insulin pen needles.
Meanwhile, a quick google search tells me that if push comes to shove I can draw the insulin out of the pen with a regular syringe. Which is reassuring, since who knows how long the next step will take.

The Trip

I chaperoned a five day, four night, 120 kid high school field trip last month.

While there was a school nurse traveling with the group, and while my kid does most of her diabetes management alone at this point, I wasn't completely comfortable letting her take this trip on her own. And, perhaps more importantly, she didn't feel completely comfortable either. Our concerns included:

-The farthest my kid has ever travelled for a sleepover is 5 blocks from home. She's never been away for more than about 18 hours. Going from that level of overnight diabetes self-care to a 4 night trip over a thousand miles from home felt to both of us like way too big of a leap.

-The trip involved air travel.  My arrival for an emergency (gastrointestinal illness, first-ever glucagon use, other unforeseeable situation) would be both significantly delayed and extraordinarily expensive. Also, while I'm sure someone could have walked her through airport security, the TSA checkpoint is a minefield for people with diabetes and we were concerned about her potential need for a strong advocate should she get pulled aside.

-The trip involved five days of dining out. My daughter has never managed more than two restaurant meals in a row on her own and was nervous about not having someone there to eyeball the carb counts with her and/or help her pick up the pieces after a bad guess.

-The trip's itinerary was intense. And the itinerary didn't lie. My Fitbit tells me I walked 10 miles a day with lots of 'active' time. We rose by 6:30, earlier some days, and the kids were not required to be in their rooms until 11 p.m. There were regular transitions from place to place with few moments to stop and regroup. Amusement park rides, swimming pools, and several performances including marching in a parade were all on the agenda. We were concerned that the level of activity combined with the lack of time to stop and think about diabetes could lead to problems significant enough to slow my kid down or derail her participation. It felt important to have someone there both to remind and support her as she took the time to care for her diabetes, and to stay behind with her should she need to stop and wait out a low or trouble-shoot a high.

We decided that sending her on this trip without a parent was too much to ask of my child, the nurse, and the staff. Also, spending 5 days flipping between the Dexcom app and the 'Find My Friends' app on my phone while simultaneously trying to remember to breathe didn't really appeal. After a couple of conversations with the teacher in charge of the trip I was, despite a certain level of anxiety about chaperoning a group of high school kids, grateful to be given the opportunity to go.

On the trip I performed a variety of general chaperone duties, got to know some great kids and adults, and got to be part of a unique adventure. As far as my mom-of-a-kid-with-diabetes role, I mostly watched from a safe distance while my kid did her own thing. She talked to the TSA people on her own. She kept the Dexcom with her overnight and woke to respond to its alarms. She did her own site change in her hotel room. She counted her own carbs, asked questions at restaurants, and, on more than one occasion, sent back sweetened iced tea for the unsweetened she'd ordered. She made decisions about dosing and snacking based on her activity level. She carried her own supplies. Her blood sugars weren't perfect, but given the food and schedule they were good enough. She spent the days with her friends and I spent them with the other chaperones.

As it turned out my presence was more of a convenience than a necessity. I provided some in-line coaching and moral support as we went through airport security. I handed her extra water to combat the effect of heat on her blood sugars. I helped her with an unanticipated Dexcom sensor change when the one we put in the day before the trip inexplicably conked out. I met her at a water flume ride to hold her diabetes stuff so it didn't get soaked. I carried the glucagon, a spare infusion set and some extra glucose tabs, always close enough to jump in to assist if needed. When the large group divided and headed to different destinations I stuck with my kid, making the division of chaperones a non-issue. My presence allowed the nurse traveling with us to focus on other kids without worrying about keeping track of mine.

But now that I've seen how well she handled most everything without my help, I'm excited for her to have an opportunity to travel without me. Just maybe on a trip that's a little closer, and a little slower-paced.

Bolus-worthy Bunny

As my daughter looked through her Easter basket yesterday she remarked,
"My friends all get chocolate bunnies from CVS. I'm glad mine is always homemade dark chocolate. It makes it so much more worth eating it."
The Easter Bunny's reasoning (as far as I understand it, though we've never met) is that if your basket is not going to be filled to the brim with candy, the candy that's in there should be worth eating... 'bolus-worthy' as it were.
So nestled among a few silly Easter toys, a package of baseball cards, a couple of  EOS products, an i-tunes gift card and some marigold seeds there's always a really good chocolate rabbit the Easter Bunny has picked up at a local candy store.

What We Know

My daughter got a new pump a couple of weeks ago. It's her fourth Animas pump.

We know there are other options out there. The new Medtronic pump with it's built-in glucose-responsive CGM technology is by far the closest to the ultimate goal of a closed-loop system. The slim and durable Tandem has some nice user-friendly touchscreen and Bluetooth features. The tubeless Omnipod would be convenient with exercise clothes and on the beach.

We briefly considered all of the options.

In the end we decided not to undertake the challenge of learning to use a whole new insulin delivery system. We decided to stick with what we know.

My daughter has been attached to an Animas pump since fall 2004, 24 hours a day, seven days a week. It's as close to a part of her body as an electronic device can be. Replacing it with a new brand of pump would, we think, require an extraordinary amount of learning, thinking and adjustment. Which seems unnecessary since we're perfectly happy with the results we've had.
We use several of Animas' unique features to our advantage. My kid has very low basal rates during certain parts of the day, so the tiny basal adjustment increments the pump offers are great for really fine-tuning her doses. The meter remote is a huge quality-of-life feature because it allows my daughter to program a bolus without extracting her pump from underneath a dress or a marching band uniform.  We have a good feel for the current insulin-on-board set-up, and for how the bolus calculator takes her blood sugar into account so that we can easily factor that knowledge into dosing decisions. We've rarely had problems with our pumps but when we have, we've consistently had good experiences with Animas' customer service department. After 12 years of the same pump I'm able to do site changes, battery swaps, and cartridge changes under almost any circumstances. My kid can program a bolus and have a conversation or keep an eye on the baseball game at the same time. Using this pump has become second nature.
In four years, or maybe sooner, our decision making process may be different. There could be some amazing new technology on the market by then, like an honest-to-goodness artificial pancreas or at least something much, much closer than the current options. For that we would certainly switch brands and learn something completely new. Until then we'll stick with what we know.

Endo Day

As I started to write about yesterday's endocrinologist visit the words felt familiar. I looked back and found a post (which you can read below) from 2013. The only difference between the old story and yesterday's visit was the added visual aid of a Dexcom graph which showed that the average range of blood sugars was about 40 points higher than we'd like it to be. "This whole graph just needs to move down an inch or two," was our doctor's assessment of the issue. The rest of the conversation was about the same as this one four years ago:

We visited the endocrinologist this week. 

In the weeks leading up to a visit, I am usually motivated to keep a more detailed log and to scan through the meter's averages and graphs.  I try to identify any major issues we need to discuss.   Sometimes I am able to fix a few things or at least narrow down the issues to a few really tricky ones.  I do this so that we can spend our endocrinologist time on issues I really need help with.

This time I tried to think about it.  I really tried to weed through all of those numbers and find the places we needed to change things.  I didn't know where to begin.  I gave up.  It turns out my confusion was warranted. The doctor's initial impression?

"She needs more insulin...like most of the day."

Her A1C was up, only by .3, but after going down a couple of times in a row it wasn't great news.  It wasn't surprising either.

Many things had changed since our last visit.  She'd added height.  She'd added weight. Yet she was missing a sufficient quantity of a key ingredient.

So we added insulin to almost every basal rate.  We added insulin to almost every carb ratio.  We added insulin to the correction factor.

We've been doing diabetes for ten and a half years.  I'm able to tweak a basal rate here and there, or recognize when the correction factor is no longer correcting.   I'm a person who, given sufficient knowledge, tries to solve problems on my own before asking for help.

Yet once in a while, particularly with a growing child with diabetes, the time comes for a major overhaul. In many ways, it was freeing to hand that whole pile of 'undesirable' numbers over to the endo and say, 'please fix this.'   Now we'll watch and see if he did, and hope he at least got close enough that I can trouble-shoot the rest from there.

I don't imagine all of yesterday's adjustments will work perfectly. We'll be following up with more tweaking in the weeks to come. But I'm grateful for yesterday's major overhaul so that we can get back on track, an inch or two lower on that Dexcom graph.

Different Every Time

Airport security experiences are like snowflakes- they're different every time. Fortunately this week's travel was different in a good way.

Our journey began at a huge, busy international airport.

My daughter's boarding pass was marked pre-check. The procedure was shoes on, metal detector only. She approached metal detector and said to the TSA agent, "I'm wearing an insulin pump which could set this off."

"Try it," the agent replied.

My kid walked through metal detector, and did not set it off. She looked at the agent who gave a friendly wave. "Have a good trip!"

On the way home, at a smaller airport, the procedure was different:

Our boarding passes were, once again,  marked pre-check. Upon arrival at the first security checkpoint we were informed that because the boarding passes were printed at the hotel and not on site at the airport, the authorization was not valid and would not scan in their system. We were ushered to the full security, shoes-off, body scanner line.

My kid approached the body scanner with her disconnected insulin pump in hand. "This is my insulin pump. It can't go through the luggage x-ray or the body scanner. It needs to be visually inspected."

She was instructed to hand it to the agent behind the luggage scanner. As she did so, she reiterated that it could not go through the luggage scanner. He smiled and nodded, and seemed familiar with the issue. "Yup- I'll meet you on the other side."

The agent walked away with the pump (a little unsettling) and my daughter went through the scanner. The pump was handed back on the other side, as promised, and we continued on our way.

A couple of notes on our experience:

-On past trips I've been the person to speak to the TSA people, but I asked my daughter before we left if she'd be willing to be her own spokesperson through security. Eventually an opportunity may come for her to fly without me and I want her to be comfortable with the process. We talked quite a bit ahead of time about what could happen and how she would respond. She handled both experiences well.

-We're often tempted not to mention the insulin pump and just go through the metal detector hoping for the best. We certainly do that at museums and other more minor security checkpoints. But for some reason the pump occasionally does set off the metal detector. Also, because my daughter is on the smaller side, the pump is always visible in her pocket or on her waist band so it's immediately obvious that she hasn't followed the instructions to empty her pockets. For those reasons, when we're at TSA security or touring a highly secure location like a government building, we've always mentioned the pump first with the goal of heading off suspicion before it can begin.

-People make a variety of choices about going through the full body scanners and about putting their pumps through the luggage scanners. Some leave the pump on and opt for a pat-down, after telling the TSA agent that they want to avoid the body scanner altogether. Some send the pump through the luggage scanner and hope for the best despite many pump manufacturers' recommendations to the contrary. Some wear pumps through the body scanner, which is also not recommended for my daughter's brand of pump. To us the option of asking for it to be visually inspected seemed like the safest, easiest, least intrusive, and most efficient solution.

We don't fly often, but thus far we've had no two TSA experiences which were alike diabetes-wise. Sometimes the carry-on's contents have been called into question. Sometimes she's patted down despite the insulin pump being the obvious reason for the metal detector alarm. This week's TSA experiences were our smoothest ever. Maybe we've finally hit the sweet spot on the security learning curve. Maybe the voices, including my own, of people who've been reaching out to the TSA requesting common-sense security measures for people with diabetes are finally being heard. Or maybe the TSA is finally realizing there are more important things to worry about than a 15 year old girl with an insulin pump.

New and Sparkly

We fired up my daughter's new insulin pump over the weekend.

Our four year warranty was up and, while the pump still worked, its appearance led us to believe it might be living on borrowed time:

The screen protector was peeling off.

And so was the paint.

It was still effectively giving insulin, but the idea of having no warranty was making us nervous.

We've had very few issues with Animas pumps over the past 12 years, but when we have, having one under warranty has unfailingly led to an overnight replacement.

That's hugely reassuring, especially considering how long it took to order a new one from scratch.

Granted this wasn't an emergency since my daughter's pump was still perfectly operational, but it took about six weeks between my first call to inquire about a replacement and its arrival on our doorstep. The process began with two different phone calls with questions for me, then doctor's orders, insurance authorization (which was the longest process), another phone call to discuss our copayment and the shipping details, and then actually getting it shipped out.

The possibility of reverting to multiple daily injections for even a fraction of that time is not appealing to us.

The new pump is silver, and sparkly all over, with no chipped paint. The screen protector is intact and clean.

And we expect to have a reliable source of insulin delivery for four more years.



Reading is Fundamental

My daughter had a few late afternoon and evening lows last week.

When she's out and about, she carries juice boxes, glucose tabs and smarties. When she's home she prefers something different. There are occasional seasonal choices in the fridge like fresh apple cider or high-test lemonade leftover from a cookout. Usually, though, the home juice of choice is orange juice. She pours four ounces into her pink sippy cup and waits for the low to turn around. Nine times out of ten, unless she's under 50 or been exercising heavily, those 4 ounces bring the low up within 15 minutes and life goes on.

Last week, not so much. The lows seemed slower to respond. If it was dinner time and she hit 70 after 15 minutes, we'd eat and subtract some bolus insulin. Otherwise, she found herself adding more juice, or a little snack of fruit or crackers to make sure she came all the way up.

A couple of seemingly sticky lows in one week was weird. And a nuisance, especially at dinner time. What was going on? Maybe it had to do with impending full moon or some other such mysterious and passing variable. Or maybe something had changed and my daughter's new normal involved closer to 20 carbs per low.

Then I walked into the kitchen as she poured the last of the orange juice into her cup:

I accidentally bought low-carb orange juice. I don't drink it and my husband hadn't noticed when he slugged it down still half asleep in the mornings.

I read a lot of labels: cereals, snacks, bread, starches and countless other packages are fully assessed before they're consumed. I missed this one. Which explains why those lows wouldn't come up.

No Diabetes In There

Yesterday was the dreaded eye doctor day. Dreaded for several reasons:

   -Making time for any appointment is a challenge with the busy high school schedule.

   -Most of the homework had to be finished prior to the appointment since she expected to be blurry afterwards.

   -While we truly appreciate the thorough exam and attention to detail we receive at this office, we've learned that an appointment there is an hour and a half commitment.

   -And, of course, the diabetes what-ifs.

The plus, in addition to liking this doctor, is that the office is less than a mile from home. So a few minutes before five we hopped in the car with the last of the homework in hand. We arrived, signed in, and took our seats in the waiting room. After half an hour of reading for history class and watching a series of increasingly unsettling segments on the 5:00 news (Car crash! Bomb scare! Everything could kill you!) we were ushered into the exam room.

The doctor started with the basic vision tests, which came out about the same as last time. My daughter has 20/20 vision in one eye, which she apparently uses to compensate for astigmatism in the other. No glasses yet but probably some day. Then there were the eye drops- which she hates but which she took like a champ.

Next up was the visual field test. Our doc usually gives this once, as a baseline in kids. But because having diabetes isn't enough of an eyeball challenge, my kid also has an 'it's probably nothing but we're going to keep an eye on it' issue going on with her optic nerves. So into the dark room she went to squeeze a clicker every time she saw a light flash in a machine. She did great, just like last time, so we put this concern off for another year.

Round three involved the actual looking into the eye part. The part when the fingers get crossed and the breath gets held. The doctor used a couple of different instruments to look into the eye herself and, after that, took the retinal photograph. She then pronounced,

"They look great- perfect. There's no diabetes in there."

Which is kind of a peculiar way to put it, but the exact words don't matter. My kid, despite still being a kid, has had diabetes for 14 years. That starts to get into the potential collateral damage timeframe.

So far so good. All the ophthalmologist had left to say was, "See you next year."

A New Low

There have been two evening concert band rehearsals this winter, from 6:30-9 p.m. These are intense monthly rehearsals during which the kids are playing challenging music non-stop.

The nights after both of these rehearsals have been multiple juice box affairs.

After 14 years of T1D, we have learned when to expect most lows.

Running, dancing, swimming, and miscalculating the number of carbs in a meal are the causes everyone knowledgeable about diabetes would expect. 

Slow but steady walking, staying up late even if it involves no physical activity, and being sick with a cold all also trigger lows for my kid.

Could playing a wind instrument for an extended period also lead to dropping blood sugar?

The first post- concert band rehearsal low seemed to come completely out of the blue. She hadn't been having any overnight lows at the time, and the rest of the day hadn't involved any unusual food or activity. The only variable I could come up with was the rehearsal. Could the physical exertion of playing her clarinet for that long combined with the mental energy to concentrate on and learn new and difficult music be what led to a 50-something blood sugar so slow to budge? Maybe, I guessed, but since one instance doesn't make a pattern, we chalked up to a mystery low and set the episode aside.

Until it happened again this week. Both times she was at a nice 90-ish number when she came home and had a snack. Then around 1 a.m., she tanked.

Despite using a variety of search terms, my research turned up only one mention of this phenomenon. It's master's thesis from 2006 by Derrick Alan Crow called 'The Effect of Instrumental Rehearsal on Blood Glucose Levels of Five Low Brass Players.'  The link will take you to a several-page preview of the study, which was all I was able to access. His participants, as far as I can tell, did not have diabetes. The blood sugar checks were before, during and immediately after rehearsals, not hours later. But his preliminary background research was interesting and, based on it, he posed some logical hypotheses. His results, while inconclusive mostly due to the small sample, did note some trends of lowering blood sugars during long rehearsals. His theory was that between the mental, aerobic (from breathing), and muscular energy expended by a wind instrument player during a lengthy rehearsal, blood sugar levels drop.

I'd love to see this study repeated in instrumentalists with diabetes. I'd love to see the research include investigating a delayed drop of the sort people with diabetes see with some other kinds of exercise. Clearly, I need to befriend a musical scholar. Or convince my kid to become one.

Meanwhile, we'll plan on covering fewer carbs on concert band nights, and/or setting a temporary basal rate. Or maybe next time this won't happen at all.

Fancy Berry Muffins

What should one do on Valentine's Eve when there is a bag of 'Fancy Grade A Berry Medley' ossifying in the freezer because nobody's been in the mood for a smoothie? 
Make some fancy muffins, of course!

You could, of course, chop large unfrozen berries by hand.
This was my quick alternative- just a few pulses did the trick.
I got them a little smaller than I'd intended,
but it worked well for the mini muffins.

Fancy Berry Muffins

3 Tbsp. butter, melted
3 1/2 Tbsp. sugar
1 egg
1 c. white flour
1 c. whole wheat flour
1 Tbsp. baking powder
1/2 tsp. salt
1 c. milk
1 c. berries (fresh or frozen, any variety, chop anything larger than an average blueberry)

1. Combine the butter, sugar and egg in a large bowl. This is the bowl all of the batter will end up in.
2. Sift the flour, baking powder and salt together.
3. Add flour mixture alternately with milk to the butter/sugar/egg bowl, mixing after each addition.
4. Beat well, then stir in berries.

Your batter will be colorful!

5. Fill muffin tins 3/4 full. Use paper liners or grease pan well.
6. Bake at 350 for 15 minutes (mini muffins) or 30 minutes (lg. muffins).

I ended up with 32 mini muffins with approximately 8 total carbs each.

Next time? Some cinnamon sugar on top for color and crunch.

Maybe these would make a nice treat for your Valentine in addition to that rose I'm hoping you've already spared?

The Nervous Nurse

I glanced at the caller ID on my phone, which read  'SCHOOL.' It was my daughter on the line from the nurse's office.

"I was told to call you.  My blood sugar is 77.  I was 60 when I got here 15 minutes ago. I had a juice then and couple of glucose tabs just now. Lunch is in 20 minutes. It's Mrs. X.  She's not sure if I should go back to class. I'm worried about missing the final review and study-guide handout for tomorrow's math quiz."

"Mrs. X is the nervous substitute nurse, right?"


"Put her on. I'll tell her to let you go back to class."

Encounters with nervous nurses are, at best, like the one above. But they have also been known to go like this:




Our full-time nurse for the duration of fourth grade was a nervous nurse.

We spent hours over the course of that school year talking her down from the ledge. With each phone call we explained again that every blip on the blood sugar graph was not a full-blown medical emergency.

We indoctrinated her, slowly but surely, into the idea of addressing diabetes concerns in the moment and then letting that moment pass and continuing on with the regularly-scheduled programming.

It was a delicate dance of acknowledging her concerns while inserting a dose of reality. We were unable to completely reprogram her but she became less panicky as the year progressed.

Substitute nurses are trickier- they definitely don't know my daughter as well, and they often have less experience with children with diabetes in general. I do hear we're making progress with one we've known since early elementary school. Generally, though, we resort to phone calls like the one above, on a case-by-case basis.

I absolutely understand the concerns. A nurse's job is to focus on the medical concern of the moment, with a 'safety-first' mentality. Which begets worry. Which I understand.  I know worry. I worry a lot about diabetes. So does my kid. But after 14 years, we've learned when to worry and when not to. We have learned when the time to worry has passed. We have learned how to incorporate life with a chronic illness into life lived fully. So sometimes we need to talk a nervous nurse down from the ledge.

Why Not A Dozen?

I live in Suburbia, USA and I'm worried about diabetes.

I'm worried about the future of access to quality, comprehensive, affordable healthcare.

I'm worried about whether current diabetes treatments are enough to lead to long-term health.

I'm worried about whether there will ever be a diabetes cure for anybody but mice.

I'm worried about the financial cost of diabetes care.

I'm worried about the emotional cost of diabetes care.

I'm worried about the daily to-do list of living with diabetes.

 You Can Spare A Rose By Clicking Here

Then I imagine being a mother of a child with diabetes in Syria. Or Sudan. Or Rwanda.

Their children are dying from having diabetes.

My daily worries pale in comparison.

Fortunately it's February and I'm reminded regularly of the work of Life for a Child. 

One rose for one month of life. A dozen roses for a year of life.

Eliminate one rose from your traditional Valentine's bouquet and donate $5.

Or follow my husband's lead and eliminate the whole dozen.

Roses die and children shouldn't.

One of the best ways I've found to reduce worry is to do something.

Saving the life of a child seems like a pretty good thing to do.


My twitter feed has been weird for the past couple of weeks.

I use Twitter to follow diabetes-related accounts and current events.

The tweets from the news accounts and politicians are usually easily distinguishable from those from diabetes organizations and bloggers. 'Earthquake rocks Italy' and 'Mayor jailed' fall into an obviously different bucket from 'Drowsy from a 3 juicebox night' and 'Just passed the 30 minute mark on hold with insurance co.'

I now have to take a closer look. Was the tweet about the cost of insulin a Bernie Sanders quote or was it from the American Diabetes Association? Will the link to the article on repealing the affordable care act take me to the New York Times or to a Blogger site? Is the anxious political tweet from a political commentator or from a person with diabetes afraid of losing her health insurance ?

It's getting very murky.

Just Another Morning

6:15     Teen crawls out of bed later than is ideal. Finds nondairy yogurt, granola, berries.

6:18      Checks blood sugar. Programs breakfast bolus.

6:19      Discovers pump's insulin cartridge is almost empty after bolus. Implores mother to fill
             a new one.

6:20      Mother inhales cheerios, chugs coffee, gets dressed, packs lunch.

6:40      Mother listens to stream of consciousness commentary on teen's outfit, hair, and tonight's
             potential homework while filling an insulin cartridge and priming the pump.

6:59      Teen is delivered to school.

7:26      Text: 'I forgot Dexi.'

7:27      Text: 'Unless you put it in my bag?'

7:45      Mother (belatedly) texts back:  'Nope. It's here on the kitchen counter.'

7:47      Text: 'Oh well.'

7:55      Text: 'You wouldn't drop it off for me would you?'

7:56      Mother takes deep breath and decides that, yes, she would (and should) drop it off.

7:57      Text: 'I'll drop it off by 8:15.'

8:13      Mother arrives at school. Mother who is usually happy that school is secured as tightly as
             Fort Knox is not happy today. Mother is buzzed into vestibule with table on which to leave
             forgotten items for kids to pick up. Mother is uncomfortably holding Dexcom thinking, 'I'm
             not so sure about leaving this here' a when kind secretary appears behind large (bulletproof?)
             window in vestibule.

8:15      Mother says, 'Hi. This is a medical device- I'm not sure I want to just leave it here. My
             daughter knows it's coming and will pick it up between periods.'

8:16      Kind secretary says, 'Here- let me take it. I'll give it to the nurse.' Secretary jimmies open
             a pass-through slot like one might find at a shady check-cashing joint, and takes Dexi.

8:17      Mother thanks secretary and leaves.

8:18      Text: 'Gave Dexi to secretary who will give to the nurse.'

8:50      Text: 'Ok I will go grab it now.'

9:29      Proof arrives, in form of blaring cell phone alarm, that teen is in possession of Dexcom: 

9:42     Text: 'I'm low so I'm not playing gym.'
And so on and so forth...

Muffin Chronicles Part 4: Applesauce Theme Week Edition


Applesauce Mini Muffins

Since too much applesauce is never enough, here's the latest batch of muffins for the lunchbox:

1 c. whole wheat flour
3/4 c. white flour
1 tsp. baking soda
1/2 tsp. salt
1 tsp. cinnamon
1/4 tsp. nutmeg
(you could also add 1/4 tsp. clove if you like it but we don't)

1/2 c. shortening or softened butter
1/2 c. sugar
1 egg

1 c. applesauce

Mix flour, soda, salt and spices in a small bowl or in a glass measuring cup with spout. If you use a spouted measuring cup (which makes a later step easier) it's still best to measure your flour first with a standard measure for dry ingredients (you know- a metal or plastic one that'll let you level the flour off across the top). Set this mixture aside.

In a large bowl, cream the shortening and then add the sugar gradually until the mixture is light and fluffy. Then add the egg.

The shortening/sugar/egg mixture will look like this.
Also of note, these single-serve applesauce packs are
1/2 cup each which is convenient.

Add the dry ingredients, alternating with the applesauce, to the bowl containing the shortening mixture. Stir between each addition. I usually add about a quarter of each at a time. This is the part my daughter has always loved to help with!


How much dough? I just used a teaspoon from my silverware drawer-
one heaping spoonful per muffin cup.

Spoon into mini-muffin tins and bake at 350° for about 18 minutes until a toothpick inserted in the center comes out clean. I made 33 mini muffins for about 8.5 g. each.

The recipe is adapted from my husband's Nana's applesauce cake recipe. To adapt it back for a great dessert, use all white flour and a full cup of sugar. Bake it in a standard sized loaf pan for an hour (which sounds like it would be too long but trust me, it isn't).

We love this recipe because - yum - but also because we almost always have the ingredients we need for them in the pantry.
Hope you'll enjoy it too.