Driving!

"GOOD MORNING! Go ahead and get in the driver's seat. You'll tell me if you're feeling high or low, right?"

And that's why we waited for this driving instructor.

My daughter turned 16 in November and passed the written part of the state driving test at the end of that month. The next step, per our state's motor vehicle department, was to begin six hours of behind-the-wheel instruction through a certified driving school.

The high school's gym teacher of few- but loud -words I've written about here is an instructor with the driving school most kids in town use. Other instructors were available in December, but we waited.

That little interaction at the beginning of the first lesson made me glad we did.

We wanted her first few hours on the road, since it would not be with us, to be with someone with whom she was comfortable sharing any diabetes-related needs she had during the lesson. This guy checked all the boxes. My daughter knew and liked him. He was, professionally as a gym teacher, aware of low and high blood sugars and the seriousness there-of. We also know that he has a niece with T1D, so would be attuned in a more personal way to the issue.

As it turned out, diabetes was a non-issue during any of the three lessons.

As with so many things diabetes, though, we were comforted knowing that while we hoped for the best case scenario we had a safety net in case things went awry.

Crisis! (Averted)

'AAAAH CRISIS'

That text arrived around 11:30 the other morning.

Having a 16 year old girl, lots of possibilities came to mind. Forgotten clarinet on a band day, wardrobe malfunction, unexpected test? Turns out it was a diabetes crisis.

'I bolused 10.8 for lunch then 2 more for muffins so then I looked at Dexi and I was skyrocketing and then I looked at history to see if I had bolused and I only saw the 2 units so then I bolused 8.8 more ahhhhh'

So, I confirmed with her via text, she had bolused 8.8 units of insulin with no matching food? She had forgotten that she had bolused for the main part of her lunch, panicked at the rapidly rising blood sugar, and therefore given insulin for it twice?

'YES I RLY SCREWED UP'

While she freaked out, knowing that an overdose of insulin had the potential to be catastrophic, I trusted that her friends would take care of her mental health while I focused on how to fix the problem.

'What's the current insulin to carb ratio?'

'1:8.'

If 1 unit of insulin covers 8 carbs, I reasoned, then 8 units covers 64 carbs, 9 units covers 72 carbs- essentially reverse-engineering of the math to figure out a game plan. She would need to consume some serious carbs to balance out the equation.

'I'm currently eating a tootsie roll pop which is 15 carbs.' (There's a teacher who sells these, essentially at cost, in his classroom...a little mysterious but very helpful at that particular moment.)
'And then I need how many more? Math for me.'

I'll spare you some details, but because to it turned out she was, indeed, skyrocketing we decided that the tootsie pop, one juice box and the pretzels which were to be her snack after school before play rehearsal would be a sufficient start as long as she kept a close eye on the Dexcom. It was a total of about 50 carbs.

It worked out pretty well. At the two hour mark from the error, she was about 150 and continued a slow downward trajectory during play rehearsal but was over 100 when she got home- hungry because she'd eaten her afternoon snack at 11:30 a.m.

And to Drink?

The waiter at the BYOB restaurant arrived, opened the wine, and started pouring it into glasses that were preset on the table.

One glass, two, three...

"Uh...only two glasses," my husband said, with a pointed glance towards my 16 year old daughter who was our only dining companion.

"Oh- yeah- sorry- I wasn't paying attention... Can I put in any appetizers for your table?"

We ordered something that had caught our eye and then my daughter asked for unsweetened iced tea.

The waiter returned a minute or two later with a glass of clear bubbling liquid. "You said Sprite, right?"

"No...iced tea please."

"Sweet or unsweetened?"

"Unsweetened."

He returned again with a glass of tea. "All we have today is sweet- I hope that's okay."

All three of us shook our heads.

"No? No sugar then?"

"Right."

"I think all I can offer you then is water or seltzer."

Eventually she received a very small glass of plain seltzer.

"I should've asked for a lime or something," she said regretfully.

But in the end she was just happy to have gotten something to drink.

The Sensor Order

I ordered Dexcom sensors at the beginning of December.

Two weeks later I got an email from Byram telling me that an order was shipping. Good news, I thought- the sensors would be here soon.

Early on a late December morning a box from Byram arrived on my doorstep. It seemed big for a three month supply of sensors.

That's because it wasn't. It was our quarterly, automatically refilled, shipment of pump supplies. I hadn't clicked on the email details, mistakenly thinking that we weren't due for any more pump supplies until January so assuming it could only be about the sensors.

I looked up my sensor order on Byram's online patient portal. 'Order in progress,' it said. But it seemed unusual to me that an order placed over 2 weeks ago would still be 'in progress.'

I called Byram and explained the situation to a representative who really seemed like he cared.

Side note: all of Byram's representatives really seem like they care and I'll be deeply disappointed if next year's new insurance company does not allow us to continue to do business with them.

'I see here it needed insurance authorization, but that should have happened quickly. Can you hold a moment while I look into this a little further?'

So I held.

'So it looks like, as I said, it needed insurance authorization, but it seems nobody followed up on the order. I've expedited the claim and it should be taken care of within an hour or two. And I've set the order up for free express overnight shipping because it was our mistake. Would it be alright if I call you back when it's taken care of?'

'Thank you so much, and yes- a call would be great.'

An hour or so later, the phone rang.

'It's been processed and headed out for shipping. You should have it tomorrow.'

I thanked him again, profusely.

So many things about diabetes are hard, and the grind of procuring supplies and insulin is often punishing. This interaction was anything but.