tag:blogger.com,1999:blog-77625673028989840612024-03-14T04:51:25.447-04:00Adventures in Diabetes ParentingIt's been quite an adventure raising a now-teenager who was diagnosed with diabetes just after her first birthday! Please realize that what you'll read here is not intended as medical advice; it's just the ramblings of a sleep-deprived mom. Always consult your medical team about your treatment options, but do stop by from time to time for a bit of perspective.Pam Osbornehttp://www.blogger.com/profile/07523792280274092952noreply@blogger.comBlogger541125tag:blogger.com,1999:blog-7762567302898984061.post-5717811732740172222019-06-19T09:45:00.001-04:002019-06-19T09:45:41.209-04:00Prom<div>
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Among the things I was (somewhat irrationally) worried about years ago was prom. It seemed impossible that the little person so completely dependent on me for all of her insulin-related needs could independently navigate a night of hot hors d'oeuvres, a buffet dinner and hours of dancing. And how would the prom dress fashion challenge work out with an insulin pump to incorporate into the equation?</div>
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Fast forward to May, and she had an amazing night.<br />
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The dress was gorgeous and nobody would have guessed there was so much hardware underneath it.<br />
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She counted the carbs for appetizers, a Shirley temple, dinner and chocolate lava cake.</div>
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She carried a roll of glucose tabs in her clutch purse, and simply went to the bar for a cranberry juice when the dancing led to a low. She was with friends who would help if she needed it.</div>
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Our awesome school nurse was a chaperone and was armed with a spare infusion set, a jar of glucose tabs and glucagon. Their only conversation of the night was about my daughter's dress.<br />
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Despite all the push to trade in the Animas Ping for a new pump this spring, we hung onto it long enough to use the remote bolus feature so that there were no awkward moments of reaching under the dress or disappearing to the ladies room every time food appeared.<br />
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Prom, and so many other things done with diabetes, required prior planning and thoughtful clothes-shopping. It was made less stressful because there were people around who were prepared to be supportive. And then? It was just as fun as it would've been with out diabetes.<br />
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Pam Osbornehttp://www.blogger.com/profile/07523792280274092952noreply@blogger.com1tag:blogger.com,1999:blog-7762567302898984061.post-57107404064386303932019-05-29T14:04:00.001-04:002019-06-19T09:54:40.698-04:00Bolus Less<br />
<span style="font-family: inherit;">There are a few foods consumed around here for which the official carb count just doesn't work. Maybe the packaging is wrong? Maybe my daughter's metabolism is just way different for a few specific foods? We've decided it's more important to get the bolus right than to figure out why it happens.</span><br />
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<span style="font-family: inherit;">Foods in our regular rotation for which we've learned to adjust from standard carb counts include blueberries, for which she needs barely a hint of insulin, and a specific brand of frozen tortellini, which is probably poorly labeled. </span><br />
<span style="font-family: inherit;"></span><br />
<span style="font-family: inherit;">Then there are other foods which we have to periodically relearn, like the Italian ice at our favorite ice cream store, which is significantly lower-carb than the Calorie King app's 'average Italian ice' measurement. This was the first spring we remembered a reasonable estimate and guessed well enough that we didn't have a long, low night.</span><br />
<span style="font-family: inherit;"></span><br />
<span style="font-family: inherit;">Ever in search of non-dairy options, I recently picked up a boxed macaroni and cheese for my daughter to try.</span><br />
<span style="font-family: inherit;"></span><br />
<span style="font-family: inherit;">The package said that the mac and cheese had 50-something carbs per prepared cup. Which seemed high to me, but I thought that whatever made up the 'cheddar flavor' part was, perhaps, super-carby. </span><br />
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<span style="font-family: inherit;">It was not. Or my daughter's system did not perceive it as such. Over the course of the following two hours, she consumed 30 carbs to bring up the ensuing low blood sugar. </span><br />
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<span style="font-family: inherit;">She liked it so it's a keeper. But it's not something that's going to be in the regular rotation. She'll have it after holidays, when there's leftover ham in the house (because mac and cheese with ham is a family favorite), or once in a blue moon as a quick fix meal out of the pantry for an unexpectedly hectic night.</span><br />
<b></b><i></i><u></u><sub></sub><sup></sup><strike></strike><span style="font-family: inherit;"></span><span style="font-family: inherit;"></span><br />
<span style="font-family: inherit;">The lingering question was, how are we going to remember to give less insulin for this next time, which could be months from now? By posting the product label on the inside of the pantry with "Bolus Less!" scrawled across it in sharpie. </span><br />
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<br />Pam Osbornehttp://www.blogger.com/profile/07523792280274092952noreply@blogger.com2tag:blogger.com,1999:blog-7762567302898984061.post-19640755262653970522019-04-12T13:00:00.001-04:002019-04-12T13:00:51.435-04:00The Appointment<br />
Endocrinologist appointments are important touchstones in life with diabetes. It's a quarterly or tri-annual check-in at which months of diabetes are assessed as a whole.<br />
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We went into the city for my daughter's appointment yesterday. <br />
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There were no extraordinary clinical components to the visit except that she's now officially taller than me. Otherwise it was a run-of-the-mill appointment with conversations about adjusting basal rates and when to get lab work done again.<br />
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What distinguished this appointment for me was subtle but significant.<br />
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A few minutes into the conversation I noticed two things.<br />
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I had said nothing since greeting the doctor when we walked into his office.<br />
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I was sitting back in my chair while my daughter was on the front edge of the chair, leaning towards the doctor's desk, and talking with him about her diabetes.<br />
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She's been going to the endocrinologist since she before she could walk. Over the following 16 years, she's answered a few more questions and engaged in a little more conversation each visit, but I've always taken the lead. Until yesterday, when I'm pretty sure she did.<br />
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I had not asked her to be more involved, and I'm not even sure she was intentional about being such a big part of the conversation. I tend to think it was more of a natural progression. She's come a long way since I had to carry a diaper bag full of toys to entertain her through every appointment!<br />
<br />Pam Osbornehttp://www.blogger.com/profile/07523792280274092952noreply@blogger.com1tag:blogger.com,1999:blog-7762567302898984061.post-13076737220931173992019-01-29T15:13:00.000-05:002019-05-01T17:09:58.156-04:00Friday <br />
It was 6:45 p.m.<br />
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My daughter had gone straight from play practice to meet friends who were watching the end of a wrestling match in the high school gym. The plan was to go out for dinner afterwards.<br />
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I received a text:<br />
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'Dexi is dead and the meter won't turn on.'<br />
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We knew the Dexcom sensor was set to expire before the evening was out. But plan B was that she had her meter and would be fine using that instead.<br />
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But now she was not. <br />
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I grabbed two AAA batteries and let her know I would meet her at the front doors of the school.<br />
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'But what if it isn't the batteries?,' my daughter wisely replied.<br />
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So I also grabbed her spare pink one-touch mini meter. Since two dead meters don't equal a useful one, I popped in a test strip to check it, and, inevitably, its battery was dead. It takes one obscure flat battery. By the time I found a spare one of those, the contents of our <a href="http://adventuresindiabetesparenting.blogspot.com/2012/11/wordless-wednesday-diabetes-box-2.html" target="_blank">'diabetes box'</a> were strewn across my daughter's floor and she was texting, 'Are you here yet?'<br />
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I pulled up to the doors, and she came out. She sat in the car with me and replaced the batteries in the regular meter. "Low meter batteries," it read. <br />
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"But I just put them in there- you brought <em>new</em> batteries, right?" I had, straight out of a container full of new batteries in the basement, I reassured her. Fortunately, the pink mini meter was working just fine so she was equipped for dinner.<br />
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She enjoyed her evening out and got home early enough to put in a new Dexcom sensor before bed.<br />
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The next morning I replaced the batteries in the usual meter one more time, and it worked. <br />
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Weird stuff can happen on any given Friday.<br />
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<br />Pam Osbornehttp://www.blogger.com/profile/07523792280274092952noreply@blogger.com0tag:blogger.com,1999:blog-7762567302898984061.post-21601854894735662322019-01-18T16:47:00.000-05:002019-01-20T16:38:48.069-05:00Thursday<br />
My daughter and I had dinner around 5:45. It was a regular meal. In fact it was leftovers, so it was the exact same thing she'd eaten earlier in the week. She bolused for the carbs with no correction since her blood sugar was in range. <br />
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She left at 6:25 for jazz band. I left at 7:10 for choir rehearsal. My husband, who we usually leave home alone on Thursday nights, was out late for a work event. By the time I pulled into my destination, I had a Dexcom alert on my phone. My daughter was low-ish. She was in the 60's. Which had happened the night before after dinner too, and she'd gotten kind of stuck there. There are a couple of days every month when sticky lows tend to occur, and I began to wonder if that was what was happening.<br />
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I texted her suggesting that, given the stickiness of last night's low, suspending the pumps's insulin delivery for a while might be a good idea.<br />
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By the time I got upstairs to my rehearsal I had another Dexcom alert and she was now in the 50's. She had not texted back. I resorted to texting, "Please tell me you are okay." Which at the time I felt might not be well received, but I was nervous enough not to care.<br />
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She replied that she was, that she would suspend insulin delivery on her pump, and that she'd had a juice box.<br />
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For the next 25 minutes I sang and texted and watched the Dexcom app and wished my husband was home, two blocks from my daughter, to run her up some more juice. The Dexcom alarms went from low to urgent low. I realized I'd stopped singing entirely. <br />
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By 7:55 my daughter had consumed everything in her bag and a sugar packet she'd scavenged from the band director's desk. Her blood sugar had dropped into the 40's.<br />
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I left rehearsal, clutching my phone, mysteriously muttering, "I need to go," and zipping out the door.<br />
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By the time I got in my car, 2.5 miles away from the high school, the Dexcom app read 'LOW.' That meant her blood sugar had dropped below 40. <br />
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When I texted my daughter I was leaving, she replied, 'Why? No. I'm fine. Go back. Don't Worry.'<br />
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That didn't work. <br />
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I did not drive the speed limit. I texted and drove. I Dexcomed and drove. And I prayed that my daughter would continue to text me and that all of the steps she'd taken so far would tide her over until I could help.<br />
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I ran in and out of my house to grab a juice bottle. I double-checked I still had glucagon in my purse from our Christmas trip.<br />
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She was back 'up' to 44.<br />
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I texted her I was on the way to the school with the juice.<br />
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'Well I can't leave.'<br />
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I left a bottle of Apple and Eve outside the band room door, hoping nobody would think it was anything other than a sealed bottle of apple juice, and asked her to let me know when she'd gotten it. I assumed she would come to her senses and sneak out and retrieve it quickly and surreptitiously. If she didn't I'd have to go back in and make a scene.<br />
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She'd retrieved and consumed it long before I'd driven the two blocks back home.<br />
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As I obsessively refreshed the Dexcom app while trying to distract myself with something on the Food Network, I saw the numbers begin to rise and I began to breathe. <br />
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When jazz band was over at 9, she drove home with a safe blood sugar of 90. <br />
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This wasn't a case of being unprepared. Maybe she was<em> un-overprepared</em>. But when leaving the house for two and a half hours, it's extraordinary to expect to be in a situation where you consume 45 grams of carb and suspend insulin delivery while your blood sugar continues to drop like a rock. At least after an accurately bolused dinner, and no unusual level of activity.<br />
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I'm grateful for whatever combination of grace, steps taken by us, and dumb luck saved us from a bigger disaster. From 7:30-9 last night was the most scared I've been of diabetes in years. We work so hard to keep things predictable and on an even keel but this was a sobering reminder that diabetes is, inherently, a dangerous disease.<br />
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Every diabetes scare we've had has resulted in steps towards preventing a repeat. Extra juice bottles will be squirreled away around my daughter's home-away-from-home in the band room and stage area of the high school. She'll stuff a few more airheads in her diabetes bag. <br />
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Unfortunately we know that there's always another unpredictable moment lurking, on any given Thursday.<br />
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<br />Pam Osbornehttp://www.blogger.com/profile/07523792280274092952noreply@blogger.com1tag:blogger.com,1999:blog-7762567302898984061.post-35364735729350162732019-01-17T15:01:00.000-05:002019-01-17T17:05:52.698-05:00Scene of the Crime<br />
On Christmas eve I had the unexpected opportunity to revisit the emergency room where my <a href="http://adventuresindiabetesparenting.blogspot.com/2011/02/diagnosis.html" target="_blank">daughter was diagnosed with T1D.</a><br />
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I was the patient this time, having passed out on the kitchen floor of my in-laws' home first thing in the morning. It turns out that I probably should have been taking better care of the bronchitis that had been brewing over the preceding week instead of powering through Christmas prep, travel and time with family. The good news was that the experience was more surreal than serious and I'm making what promises to be a full recovery from both the bronchitis and the ribs I injured on the way down.<br />
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We lived two towns away from my in-laws when my daughter was diagnosed, so the drive to the hospital at dawn was familiar. Winding roads taken at a speed slightly over the limit, the beginning of daylight, anxiety and uncertainty. At the ER entrance there seemed to be an upgraded reception area, but the interior was about the same.<br />
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I was settled onto a gurney in an ER sized cubicle room and asked a hundred questions. A team of professionals got busy taking my vitals, taking some blood, and hooking me up to machines to continuously monitor my oxygen, blood pressure and heart. And all I could think about was 16 years and 3 days before, when I stood where my husband was standing. Out of the way, but in clear view, watching my daughter being hooked up to all of those things. And the interminable wait while they tried to get blood and insert an IV into her tiny dehydrated veins. I made out much better in that department.<br />
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Near the end of my 4 hour visit I was taken for a walk around the unit while hooked up to equipment to monitor my blood pressure and oxygen - making sure nothing dropped precipitously while I was upright and moving. <br />
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We passed the cubicle my daughter had been in. We saw the conference room where the doctor had taken us to discuss her condition. We walked over the place where I had stood with the helicopter EMT when she demanded insulin be started before transporting my daughter. <br />
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When I was released, I exited through the ER doors and we drove past the helipad from which my daughter and I had taken off, headed to the big children's' hospital in the city. We drove back to my in-laws' where my daughter had been hanging out with her grandfathers, playing cards, starting a crock-pot dinner and making and bolusing for her lunch. <br />
<br />Pam Osbornehttp://www.blogger.com/profile/07523792280274092952noreply@blogger.com1tag:blogger.com,1999:blog-7762567302898984061.post-2289331844657338852018-12-21T12:55:00.001-05:002018-12-21T12:55:49.997-05:00Sweet Sixteen<br />
Sixteen sweet things about the past sixteen years with T1D:<br />
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1. My daughter was diagnosed in time.<br />
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2. Christmas in a children's hospital is not an experience I'd wish on anyone and yet was magical in ways no other Christmas could be.<br />
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3. She and I both survived the toddler diabetes years.<br />
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4. We found other families with diabetes quickly.<br />
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5. We continue to have diabetes people in our lives: friendships we treasure both despite and because of their diabetes glue.<br />
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6. Ruby, the teddy bear with diabetes, lives with us and continues to be a fuzzy source of support.<br />
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7. A perfect and welcoming preschool was, essentially, in our backyard.<br />
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8. I found the diabetes online community; and then I got to start a blog and revisit my second grade goal of being a writer when I grew up.<br />
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9. The elementary school nurse was a treasure; and her diabetes care was great too.<br />
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10. Friends' parents invited my daughter over for playdates, however uncomfortable they may have been.<br />
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11.Lots of friends and family have gone out of their way (especially in those early pre-pump years) to loop us in on menu plans and eating schedules, making our visits easy. <br />
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12. Teachers have kept an extra eye out, no matter the other chaos in their classrooms.<br />
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13. Schools have found a way to make trips, special events and after-school activities work.<br />
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14. We've had amazing medical professionals on our team.<br />
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15. Math has always come easily for my daughter (and my math skills have greatly improved).<br />
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16. My daughter has grown into a responsible, self-confident and compassionate young woman.<br />
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Sixteen years ago today we had a tough day. There have been quite a few tough diabetes days every year since then. But, from time to time, it's worth counting our blessings.<br />
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Pam Osbornehttp://www.blogger.com/profile/07523792280274092952noreply@blogger.com0tag:blogger.com,1999:blog-7762567302898984061.post-12835660162569419382018-12-12T17:06:00.000-05:002018-12-12T17:06:28.413-05:00Insurance of the Year Club<br />
We're switching insurance again.<br />
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Of all the employer-sponsored insurance plans offered for 2019, our current plan will now be three thousand dollars more expensive for the year than the least expensive one. The cheapest of the three, of course, is the one we've never had. We will sign up for what the company calls a 'gold plan,' and the system is tiered so that all insurers in the gold plan cover similar medical services, charge the same copays and have the same deductibles. The gold plan's coverage fits our high medical use and costs, and so is our best choice. But the per-paycheck cost is staggeringly different for each plan.<br />
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We did our homework, which was easier this year after lots of practice last year. The new insurer will cover all of our current doctors and drugs (though still not Novolog which stinks). It's possible we'll be able to escape Edgepark's grip since other DME providers are listed, but I'm not holding my breath since they are still one of the options. And while I generally subscribe to the adage, 'the devil you know is better than the devil you don't know,' $3000 is a lot of money.<br />
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The big risk, the one we can't get a clear answer on, is whether there will be hoops we have to jump through to get coverage for diabetes-related equipment. We delved pretty deep into the new insurer's website and made phone calls to learn about diabetes coverage and could not come away with a clear answer on whether we'd have to prove my daughter's need for an insulin pump and CGM before coverage is granted. Between reading and conversations, the possible answers range from 'you might need a letter of medical necessity from your doctor' (which is pretty standard), to needing to submit tons of documentation, to maybe they don't cover CGM unless it's some sort of dire situation. <br />
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I'm well aware that we're incredibly fortunate that we have access to insurance at all. That we've consistently had access to really good insurance, which for the most part covered what we needed with little to no hassle, is unusual. Maybe that's about to change, but after 16 years at this, I'm prepared to use every tool I now have up my sleeve to fight for what my daughter needs. Hopefully we'll repurpose that $3000 wisely. If need be we'll spend it on things that aren't covered. Or on a little getaway to help me recover from a year of insurance fights.<br />
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Pam Osbornehttp://www.blogger.com/profile/07523792280274092952noreply@blogger.com0tag:blogger.com,1999:blog-7762567302898984061.post-56043356591451765752018-12-06T10:26:00.000-05:002018-12-06T10:26:45.413-05:00Slowly but Surely<br />
Our household diabetes policy (yours may vary) has been for my daughter to take on diabetes responsibilities as she feels ready. The understanding has been that while we do not expect to live in her college dorm with her, she should not feel rushed. Every diabetes task will ultimately be hers, for the foreseeable future. For now, we're here to help.<br />
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Slowly but surely over the past sixteen years, one or two things at a time, my daughter has taken over her own care: blood sugar checks, carb counting, then insulin pump site changes, and so many more in between.<br />
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The Dexcom was at the center of the two lingering exceptions.<br />
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Because of the awkwardness of the G4's insertion device, I continued to assist with putting in a new sensor every 7 or so days. She did it once, to prove to herself that she could in case it failed while she was traveling without me, but it was super-awkward and I was happy to keep helping. The insertion device for the G6 is a much easier to handle one-handed push-button device. My daughter inserted the first and second ones with no problem. It's easy and nearly painless, she reports, though the spring-loaded insertion contraption is alarmingly loud.<br />
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The second area of responsibility we've recently relinquished (to some extent) is overnight diabetes care. Until the G6 arrived, the Dexcom receiver remained on a parent's bedside table each night. We got up to deal with its alarms while my daughter slept, or roused herself briefly for juice. That routine, of course, followed years of setting 2 a.m. alarms for fingerstick checks.<br />
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The new plan is that my daughter keeps her phone, and the Dexcom receiver, on her bedside so that she can awaken to deal with the alarms. She started with just the phone, but the Dexcom app alarms were not loud enough to consistently wake her (though they woke both of her parents in the next room). She's added the receiver, which she keeps on the bed with her to feel its vibrations, and so that two alarms are blaring at once. She still does not consistently wake to the alarms, while I, of course, still do. But things are improving. She did wake up and treat a low this week without my hearing anything, which was good news. And the alarms are diminishing after the Thanksgiving leftovers are gone, and as we use the Dexcom data to work on keeping numbers more consistently in range...which is the ultimate goal.<br />
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It's bittersweet to watch my kid take on these responsibilities. Yes- by all rights they're hers to deal with and it's important for her to practice with the safety net of mom and dad around to help. But how I wish she didn't have to.<br />
<br />Pam Osbornehttp://www.blogger.com/profile/07523792280274092952noreply@blogger.com1tag:blogger.com,1999:blog-7762567302898984061.post-81816801606282907722018-11-29T16:10:00.001-05:002018-11-29T16:10:27.742-05:00G6<br />
The Dexcom G6 is up and running, and it's keeping us running.<br />
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Technologically we're totally impressed. It's accurate. The readings flow seamlessly from the transmitter to my daughter's iPhone and the Dexcom receiver, and then on to my phone and the Dexcom Clarity page online. And no fingersticks? Amazing.<br />
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We used our previous CGM, the G4, only as a general guide. Heading up or down? Always alarms between 2-3 a.m.? Should she do anything before changing for gym? It was less accurate and had crapped out months ago on sharing numbers to anybody's phone, so unless it was alarming with an urgent low, it was mostly background noise to be addressed eventually.<br />
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The G6 feels less like a lowly assistant making suggestions from the corner of the conference room and more like the boss. What it says goes. Low predicted in 15 minutes? Eat something. Now! Suddenly skyrocketing? Drop your pants and check that site! Clarity shows you've gone over 220 after lunch five of the past seven days? Fix something!<br />
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Some of that is good for us. Most of us get lazy with diabetes at one time or another, and of late, we have. Having the G6 looking over our shoulders and nudging us at every turn is causing more action than had been happening here, at least in terms of more minor excursions from a target blood sugar range.<br />
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Some of it, though, is wearing. Already. After 12 days. (But who's counting?)<br />
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The alarms are driving us nuts. Starting it up over a busy school play weekend followed by a Thanksgiving week full of family and food certainly didn't help. Diner pancakes at 10 p.m., daily servings of stuffing, and pecan pie two nights in a row are rare treats, and as the schedule goes back to normal, alarms are settling down. We learned quickly not to have both the Dexcom receiver, and all of our phones set to alarm when all of them are in the same house. The cacophony and the subsequent process of silencing them all would jar anybody's nerves. <br />
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We're also struggling with information overload. The numbers are in our faces all the time. Because the previous system's data went only to its own receiver, my daughter would look at it at mealtime, before bed, and when it alarmed. Now can see numbers whenever she opens her phone. And with share operational again, I too can see numbers anytime I want instead of looking at the receiver once a day- or less. A diabetes-life balance is, in my opinion, a very important aspect of living sanely. It will take some time to figure out how to compartmentalize the extra information so that it does not overwhelm.<br />
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Was it worth waiting for? Absolutely. The steady stream of accurate data is incredibly useful. It helps with hour to hour decision-making. Once the bulk of the data isn't skewed by Thanksgiving food, the long-term graphs will be incredibly valuable in adjusting basal rates and bolus ratios. And maybe when the data settles down into a more predictable range we won't mind seeing it so often.<br />
<br />Pam Osbornehttp://www.blogger.com/profile/07523792280274092952noreply@blogger.com1tag:blogger.com,1999:blog-7762567302898984061.post-55466569986355462172018-11-14T13:59:00.001-05:002018-11-14T14:04:50.394-05:00Humbled<br />
Have you signed<a href="https://bantingsbirthday.org/" target="_blank"> Dr. Frederick Banting's birthday card</a> yet? <br />
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I did, first thing this morning. On the card (you'll see it when you click the link above to sign it) there's an area to write a personal message. I wrote, "Thanks to your work, I have an amazing teenager." <br />
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Before Dr. Banting and Dr. Best made their discovery of insulin in 1921, people with Type 1 Diabetes died. Their bodies wasted away. It's humbling to consider.<br />
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In 2002, on a crisp December morning, we rushed my daughter to the hospital, and by mid-morning she was receiving insulin. She's now a thriving high school student who is looking forward to this weekend's school play, college in a couple of years, and a career in education. <br />
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Had she been born less than 100 years earlier, she simply would have died. Probably by Christmas, only a few days after we'd called the local doctor to stop by on his rounds to examine her.<br />
<br />
I'm thankful to Dr. Banting, and his colleague, Dr. Best, for making insulin available so that my daughter can be alive. And I'm thankful for all of the discoveries and inventions that ensued, including modern synthetic insulins, increasingly accurate technology for glucose monitoring, and insulin-delivery tools that have come a long way from regularly boiling and sharpening the one syringe in the household.<br />
<br />
Dr. Banting's birthday, now <em><a href="https://www.worlddiabetesday.org/about-wdd.html" target="_blank">World Diabetes Day</a></em>, helps put life with diabetes in perspective. There was no life with T1D before Dr. Banting. It's still a daily challenge, and the dangers aren't completely gone, but my daughter is here, and thriving. I couldn't be more grateful.<br />
<br />
Happy Birthday, Dr. Banting.<br />
<br />Pam Osbornehttp://www.blogger.com/profile/07523792280274092952noreply@blogger.com1tag:blogger.com,1999:blog-7762567302898984061.post-75613914785670580182018-11-01T14:47:00.000-04:002018-11-01T14:47:57.070-04:00Trick-or-Treat <br />
It was 8:45 on Halloween. The doorbell hadn't rung for almost an hour. And then it did. We paused <em>Survivor</em>, and my daughter got up to greet the trick-or-treaters. She had enjoyed her door-answering responsibility all night, and I was glad to let her get up one more time.<br />
<br />
Peeking through the living room window, she recognized a life-long friend at the door, dressed as Kim Kardashian. <br />
<br />
She opened the door, and I could hear another voice, in addition to my daughter's and Kim's. There was a little chatting about the nice weather and what the girls had acquired in their travels. "There was a house handing out <em>apples</em>. Honeycrisp ones though, which are <em>amazing</em>, so I guess if I wash it I can eat it?"<br />
<br />
My daughter then offered as much of our loot as the girls wanted to take. We didn't have as many kids as usual, and so generosity was in order. <br />
<br />
"Are you sure? Thanks so much," Kim Kardashian exclaimed.<br />
<br />
<a href="https://mail.aol.com/webmail/getPart?uid=APA3XskdtiJiW9tCogLx6IF6-lU&partId=2&saveAs=IMG_5752.JPG&scope=STANDARD" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;" target="_blank"><img class="AOLAttachedImage" filename="IMG_5752.JPG" height="320" partid="2" src="https://mail.aol.com/webmail/getPart?uid=APA3XskdtiJiW9tCogLx6IF6-lU&partId=2&saveAs=IMG_5752.JPG&scope=STANDARD" style="border: 1px solid rgb(218, 218, 214); margin-bottom: 30px; visibility: visible;" width="240" /></a>"Ugh, my mom won't let me eat most of it anyway," replied the other voice, which I was still trying to place.<br />
<br />
"Take the airheads" was my daughter's quick response. "They're great for low blood sugars!" <br />
<br />
Now, of course, I was able to narrow down which friend was accompanying Kim Kardashian on her rounds.<br />
<br />
"Ha! Yes- I will! My mom buys terrible glucose tabs at Costco. I can't stand them." <br />
<br />
Now Kim Kardashian's friend has a nice stash of airheads for her low blood sugar needs. <br />
<br />
Who says Halloween and diabetes can't go well together?<br />
<br />
Pam Osbornehttp://www.blogger.com/profile/07523792280274092952noreply@blogger.com1tag:blogger.com,1999:blog-7762567302898984061.post-37020613474672931092018-10-09T12:28:00.000-04:002018-10-09T12:28:41.022-04:00Another Wait<br />
<a href="https://mail.aol.com/webmail/getPart?uid=AKO_iQ1gqpHcW7do6wGeEBgx__w&partId=2&saveAs=IMG_5664.JPG&scope=STANDARD" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;" target="_blank"><img class="AOLAttachedImage" filename="IMG_5664.JPG" height="320" partid="2" src="https://mail.aol.com/webmail/getPart?uid=AKO_iQ1gqpHcW7do6wGeEBgx__w&partId=2&saveAs=IMG_5664.JPG&scope=STANDARD" style="border: 1px solid rgb(218, 218, 214); margin-bottom: 30px; visibility: visible;" width="240" /></a>The Dexcom G6 finally arrived last week, <a href="https://adventuresindiabetesparenting.blogspot.com/2018/09/the-edgpark-order-that-wont-die.html" target="_blank">after a wait which was entirely too long.</a><br />
<br />
And yet, we've decided to put off using it.<br />
<br />
There are still 3 Dexcom G4 sensors here, and we've decided to use them up.<br />
<br />
The wait is, in most respects, really hard. It's like getting a new toy on Christmas morning and not getting to play with it until February. Why would we torture ourselves like this?<br />
<br />
We have our reasons:<br />
<br />
We are grateful for what we have, and don't want to waste the G4 sensors. We're certain that once the switch is made, there's no way my daughter will want to go back to the G4 for a few weeks to use up the old supplies.<br />
<br />
We feel much more comfortable with supplies in reserve. By waiting a couple of weeks, we build up a few extra G6 sensors in the supply closet for a rainy day. <br />
<br />
We want to take the time to start it and to set it up right. Because of our family's marching band commitments, time is at a premium in October. We're waiting for a quiet evening, or weekend morning, to sit and learn the minimal but important basics of insertion and sensor start-up, download the apps and software, and learn how to use them. That might not be until November.<br />
<br />
And the most trivial reason? The Dexcom receiver fits perfectly in the tiny pocket of the marching band uniform jacket, and my daughter's phone (which will be her new receiver) does not. Waiting until next year to solve that problem, which will likely involve some stealthy sewing, feels easier.<br />
<br />
So we wait, the box of G6 stuff taunting us from the corner of the dining room.<br />
<br />
Pam Osbornehttp://www.blogger.com/profile/07523792280274092952noreply@blogger.com1tag:blogger.com,1999:blog-7762567302898984061.post-19769378132327699062018-09-20T16:57:00.004-04:002018-09-24T15:44:40.813-04:00Back to Insulin One<br />
A change in insurance has led to a change in insulin. <br />
<br />
We've used up our stash of Novolog, and the first cartridge of Humalog in several years went in the pump 3 days before back to school.<br />
<br />
Some people say they experience no difference at all between the two insulins. Some think Novolog withstands heat better. Maybe Humalog sticks around in the system longer. Humalog could be more likely to clog infusion sets. We switched to Novolog a few years ago because it was reported to kick in just a little bit faster. Some of the differences are detailed <a href="http://www.t1dliving.com/novolog-vs-humalog/" target="_blank">here, on T1D Living.</a><br />
<br />
The key difference to us is that insurance will pay for Humalog now, and it won't pay for Novolog anymore.<br />
<br />
There are too many variables here for this switch to serve as a scientific experiment. The change coincided with an already <a href="https://adventuresindiabetesparenting.blogspot.com/2018/09/you-know-what-to-do.html" target="_blank">established need to make some pump setting adjustments</a>. It also coincided with back-to-school, and with the hamster wheel which is marching band season. A couple of things do seem obviously different, despite the chaos.<br />
<br />
What we've noticed for sure is a greater need to pre-bolus breakfast. That aspect feels familiar to me from our switch from Humalog to Novolog a few years ago. Breakfast, after which my daughter's bg had spiked significantly almost every day since diagnosis, became more manageable with Novolog. The Humalog is a little more sluggish. <br />
<br />
I'd also agree that Humalog sticks around a little longer. It's hard to see during the day, but I'm noticing that the Dexcom graph's downward slope continues longer on the last-before-bed bolus, or for any overnight corrections. <br />
<br />
Because we're changing basal rates anyway, based both on feedback from our last endo appointment, and on the schedule changes from the start of school, it's hard to tell what other differences there are. It won't be until we finish tweaking that we can see, for example, if the total daily dose went up.<br />
<br />
Given my druthers, I'd say Novolog is probably a snappier variety of insulin, and that it would be nice to go back. But in accounting for Humalog's more sluggish nature we're making adjustments that are working. <br />
<br />
Humalog and NPH were the first insulins prescribed when my daughter was diagnosed. The glass-half-full part of me will note that Humalog's challenges are minor and manageable compared to <a href="https://adventuresindiabetesparenting.blogspot.com/2011/05/nph-days-or-why-we-got-pump.html" target="_blank">the nightmare that was NPH</a>. <br />
<br />
<br />Pam Osbornehttp://www.blogger.com/profile/07523792280274092952noreply@blogger.com0tag:blogger.com,1999:blog-7762567302898984061.post-20853886425782782832018-09-18T16:02:00.000-04:002018-09-18T16:02:31.101-04:00The Edgpark Order that Won't Die<br />
We placed our initial Edgepark order in March. <a href="http://adventuresindiabetesparenting.blogspot.com/2018/03/it-shouldnt-be-this-hard.html" target="_blank">The details of that ordeal are here</a>, if you'd like to read the beginning of this story. <br />
<br />
I returned two of the three items in that shipment on April 11th, using the return label sent to me by Edgepark, because they were not items my daughter uses, nor were they the items prescribed.<br />
<br />
I subsequently received a bill for the Verio Test strips I'd returned. When I called, the representative said to disregard the bill. Edgepark was in the process of 'billing the return' with our insurance.<br />
<br />
Ignore it I did, along with a couple of subsequent, identical bills I received in quick succession.<br />
<br />
Mid-summer, after another bill, I called and was told again to disregard it.<br />
<br />
Fast forward to the beginning of this month. I placed an order for a new Dexcom G6 system.<br />
<br />
I then received an email telling me I had an outstanding bill. I called and was told once again to disregard it.<br />
<br />
Two weeks later, I followed up, since there'd been no word on the G6. They'd just processed the order with the doctor's prescription, I was told, and it would be shipping from the Ohio warehouse within 24 hours. It would be at my house by Friday via FedEx. It was very specific information.<br />
<br />
I then received another bill, for a higher amount than the previous ones, and a subsequent email warning me that no further orders would ship until I had resolved my delinquent account with the Edgepark billing department. <br />
<br />
So I called. Yes, I was told, they had 'billed the return' and refunded my account $63.60 for the test strips. I acknowledged that as a good start, but then noted that I had paid them $288, and that they were now sending me bills for over $400. It was an unproductive conversation which ended in the representative telling me she was sending March's whole order and subsequent billing back for a 'full review.'<br />
<br />
So, did that mean my upcoming order would be cleared to ship? "Oh- yes - that wouldn't have been on hold anyway."<br />
<br />
Today, still no word on the Dexcom, so I went onto the patient portal to check the status. There were 'urgent alerts' posted warning me that no further orders could be processed until I paid my outstanding bill of what was now two hundred-something dollars. <br />
<br />
An hour phone call, piles of explanation-of-benefits and bills reviewed, and lots of math later I agreed with the billing representative that the current number was correct. In (very) short, the original billing on the one item I did keep (Dexcom G4 sensors) was also incorrect, not in my favor, and that error was reflected on a subsequent explanation of benefits in July. After the whole day's bills were sent back for review, my account was credited with the rest of the Verio money Edgepark owed me, in order to pay for part of the cost of the Dexcom sensors. I still owed the balance for those supplies. <br />
<br />
I paid the bill then and there on the phone.<br />
<br />
My daughter's Dexcom G6, the third person in so many weeks told me, is on its way. She's, once again, really looking forward to getting it. It seems highly unlikely to me that there isn't at least one more phone call involved in this. And then, of course, the next set of bills...<br />
<br />
Stay tuned. <br />
<br />
And if you have a choice to get supplies from someone other than Edgepark, do.<br />
<br />
Pam Osbornehttp://www.blogger.com/profile/07523792280274092952noreply@blogger.com1tag:blogger.com,1999:blog-7762567302898984061.post-47536925913759054622018-09-12T17:34:00.000-04:002018-09-12T17:34:22.860-04:00You Know What To Do<br />
We visited the endocrinologist a couple of weeks ago.<br />
<br />
My daughter's A1C was up a smidge, which isn't unusual at her end of summer visit. We do better keeping her blood sugar stable when her schedule is more predictable, as it is during the school year.<br />
<br />
The numbers downloaded at the beginning of the visit from the pump and Dexcom covered the prior two weeks of blood sugars. One week was from vacation and the other was from the youth group mission trip. Both involved strange meals at strange times, late nights, periods of heavy activity at all different times of day and night, and at least during the second week, a few moments of stress. <br />
<br />
There seemed to be a couple of patterns, but they could just have easily been a pattern of what happens when you follow a heavy, late lunch with a busy afternoon, an unusual dinner, a walk, and no 9 p.m. snack.<br />
<br />
After talking things over, the endo said something like this:<br />
<br />
<em>Look- it looks like you need a little more insulin in a couple of different places here. You could tweak a couple of things now, like maybe this after-dinner spike, but maybe you don't want to do too much yet. Why don't you wait a week- get through band camp where you don't want a bunch of lows, and then once school starts look at these patterns again and make the adjustments. You know what to do. And hopefully by then you'll have the G6 which'll make it so much easier.</em><br />
<br />
Band camp was, predictably, another week of unusual eating, busy schedule and extreme heat. It felt safer to run a little higher than what we'd ordinarily consider ideal.<br />
<br />
School started last week with a weird schedule for the first day and an unexpected half day on day 2 due to a heat advisory, which was followed by a takeout lunch with friends. Friday night was the first marching band performance at the football game, preceded by a 4:30 p.m. dinner. This week will be slightly more predictable, so we'll see if some basal tweaks we made over the weekend make a difference. And we'll add more insulin for dinner. That was the one change we did make after the endo visit but it isn't doing the trick yet. No G6 yet either- more on that another day- but we've been managing T1D in a growing, changing child since long before any CGM at all.<br />
<br />
We'll keep watching and adjusting. We know what to do. <br />
Pam Osbornehttp://www.blogger.com/profile/07523792280274092952noreply@blogger.com0tag:blogger.com,1999:blog-7762567302898984061.post-37785702626289928612018-08-30T15:46:00.000-04:002018-08-30T15:46:53.397-04:00Piecemeal<br />
We talked technology at last week's endocrinologist appointment. My daughter is using an Animas Ping pump and a Dexcom G4 CGM. The Animas can be serviced or replaced for another year before we'll have to <a href="http://adventuresindiabetesparenting.blogspot.com/2017/10/our-options-cant-include-going-down.html" target="_blank">switch to Medtronic for the last two years of its warranty</a>. The Dexcom version we're using is almost obsolete, so we have to change something, but the question is, how much?<br />
<br />
We could close our eyes and jump headfirst into a full switch to all things Medtronic. We would likely be transitioned to their 630G model which works with their Guardian brand CGM system and a Contour meter as a meter remote. This pump would suspend insulin delivery when low blood sugar is detected by the CGM sensor. <br />
<br />
The low glucose suspend feature would be reassuring, especially for those few nights per year that my daughter spends away from us. On the other hand we've heard mixed reviews of the Medtronic sensors, in terms of accuracy and calibration neediness. We hear they're improving with each version, which is incentive to wait a while. There is already a more current Medtronic pump, which adjusts the basal rate every few minutes based on feedback from the CGM.. We wonder if we wait a year if we'll have the option of switching directly to their most recent version, whatever that is at the time, which would surely have more bells and whistles than the current offer.<br />
<br />
Our other option is to keep the Animas pump for another year and upgrade to Dexcom's G6 CGM. The G6 requires no fingersticks for calibration, and can be worn for 10 days before changing the sensor. The CGM data can go straight to my daughter's phone, and be shared with us from there, or we can choose to use a receiver. The reviews of its accuracy are stellar.<br />
<br />
My daughter is comfortable with the Animas pump, and super-excited about the Dexcom G6. So the plan is to move forward with those for the next year.<br />
<br />
It feels like a piecemeal solution. But it's not a perfect world. Insurance and corporate deals dictate the diabetes choices we can make. We are destined to be Medtronic people. <br />
<br />
Just not yet.<br />
<br />
<br />
Pam Osbornehttp://www.blogger.com/profile/07523792280274092952noreply@blogger.com1tag:blogger.com,1999:blog-7762567302898984061.post-74294470975298354132018-08-17T16:14:00.000-04:002018-08-17T16:14:05.494-04:00After Midnight<br />
"Mom?"<br />
<br />
<em>"Mom?" </em>My eyes must have opened slightly, or I mumbled something.<br />
<br />
"Something's wrong with my pump."<br />
<br />
And then I was awake.<br />
<br />
"It was beeping when it woke me up … booEEp, booEEp … but now it's dead. Nothing happens when I push the buttons. And it's hot."<br />
<br />
It was the wee hours of the morning. We were on vacation in a cottage near the beach.<br />
<br />
"Ok- let's see."<br />
<br />
I got up and followed her back to her little room where we turned on a light and set to work.<br />
<br />
Hoping the simplest explanation was the right one, I took out the battery, using a coin from the pile on her bedside table set aside for an expedition to the penny candy store. The battery was hot. <br />
<br />
I inserted a new battery and screwed the cap back on. I prayed, thought good thoughts, and implored the diabetes gods for mercy. The pump <em>would</em> spring back to life. We would <em>not</em>, in the middle of the night, on vacation, have to go back to injecting insulin for the first time in 13 years. <br />
<br />
Time stood still for an infinite moment and then, there it was, the familiar alien-like startup beep of the Animas pump. I confirmed, when prompted, the battery type, and the date and time, which were reassuringly still correct. Then, as the pump requires with every battery replacement, I set in motion a full rewind of the cartridge area. Knowing that the full rewind also signals the pump to perform a full system check I once again sent out pleas to the universe that a pump failure would not, <em>please</em>, be among our vacation memories. <br />
<br />
The motor whirred. And whirred. And whirred. And then...<br />
<br />
"<span style="font-family: "courier new" , "courier" , monospace; font-size: x-small;">beep</span>!" Just the usual, friendly little 'I'm ready,' beep. I finished the process and my daughter reconnected.<br />
<br />
Still more than a little freaked out, and now wide awake, I photographed every pump setting, not sure if my most recent records were recent enough. I tucked my daughter in and returned to bed where I lay; not at all optimistic that the crisis had actually been averted. I considered all of the options for obtaining a replacement pump if need be. I sorted out what I could remember about multiple daily injections. I tried to figure out what had happened in the first place. I got up twice to make sure her blood sugar was staying steady- that the pump was still working correctly.<br />
<br />
In the light of day, with the pump working properly again, the explanation seemed fairly logical. The hot battery was familiar from times we've changed it after the 'I'm going to die in half an hour or less' warning. The initial low battery warning, indicating a couple of days' power remaining, had been visible on the pump for at least most of that day, my daughter said, and she'd planned to change it during the next day's site change. But it's possible it had been there longer, since we were in vacation mode and, as is our custom, paying less attention to diabetes than usual while enjoying vacation things. Or maybe the battery died a little faster than usual with all the extra use for vacation food. Maybe the pump alarmed for the full half an hour foretelling its imminent demise, and simply didn't wake my daughter from her vacation-induced deep slumber - we'd been out late and came home tired. <br />
<br />
All that really matters is that the new battery continues to work just fine, a couple of weeks later, and we were able to enjoy the rest of our vacation.<br />
<br />
<br />
<br />
<br />
<br />
<br />Pam Osbornehttp://www.blogger.com/profile/07523792280274092952noreply@blogger.com1tag:blogger.com,1999:blog-7762567302898984061.post-20475137485225838532018-08-01T14:36:00.000-04:002018-08-01T14:36:15.133-04:00Still Lending a Hand<br />
Our family has experienced several turning points over the years when it comes to my daughter taking on increased responsibility for her care. To us, each of these has been a big deal. She can check her own blood sugar! She can troubleshoot enough to be left alone at a birthday party! She can count her own carbs at a restaurant with friends! She can change her own site! She can go away overnight! The list of these moments is long. For some families, this list doesn't exist at all because their kids were diagnosed at an age when they naturally took on all or at least most of these tasks independently from the start. For others of us, it's been and continues to be a long incremental journey.<br />
<br />
Sometimes I feel weird, or even guilty, that I still help my daughter with her Dexcom sensor insertions or that until a couple of years ago I did almost all of her site changes. The little voice in my head nags, 'She's a teenager for goodness' sake- she should be doing all of this by herself. Other kids are doing it by 8.' <br />
<br />
But if I step back and reflect on how we got here, it feels okay. <br />
<br />
When she was diagnosed at 13 months old, we did EVERYTHING. Obviously. <br />
<br />
Then around 3 she wanted to help...as many 3-year-olds want to do. It's the 'I can do it by myself 'age and we took full advantage. She learned to use the lancet and apply blood to the test strip. She learned to read the number on the glucometer out loud. She learned to gather all of the supplies for her site changes. She was in charge of separating the various wipe packets which come in perforated pairs of two. She also spent quite a bit of time taking care of the diabetes needs of her dolls and stuffed animals who, occasionally, also had to count carbs at tea parties, check their blood sugar or drink juice boxes. <br />
<br />
By the age of 5 she knew how to use her insulin pump, with supervision and an adult counting the carbs. She knew to drink a juice box if her meter said she was low and to wait 15 minutes and check again before she could go back to what she was doing - again, with an adult around to support her.<br />
<br />
In early elementary school she learned how to count and bolus for a simple snack like goldfish crackers or pretzels so that she could go to a friend's house after school.<br />
<br />
If she WANTED to do it, we figured out how to make that happen. If she didn't want to, we didn't push. <br />
<br />
She now, of necessity, knows how to do it all. And yet, still, I help if asked. Diabetes is a huge undertaking. For now, the least I can do is give her a hand filling the insulin cartridge if she has to do a site change in a hurry, or be an extra set of hands for the awkward Dexcom insertion. She's going to have to do it all by herself soon enough.<br />
<br />
<br />
<br />Pam Osbornehttp://www.blogger.com/profile/07523792280274092952noreply@blogger.com1tag:blogger.com,1999:blog-7762567302898984061.post-28737570003388557512018-07-23T14:28:00.000-04:002018-07-23T14:28:12.977-04:00The Gatorade Trick<br />
<em>I have no official connection to Gatorade, and this is not medical advice, but marching band practice is well underway here, and I have stocked up...</em><br />
<br />
Gatorade's low-carb G2 is my daughter's go-to drink for evening marching band practice.<br />
<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://3.bp.blogspot.com/-eCd1Vfdkr5s/W1YbyhAvmkI/AAAAAAAABIk/d8q2mR96xH4HwA5HJ-Yl7QddAy0aKEPjQCLcBGAs/s1600/gatorade.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1600" data-original-width="1200" height="320" src="https://3.bp.blogspot.com/-eCd1Vfdkr5s/W1YbyhAvmkI/AAAAAAAABIk/d8q2mR96xH4HwA5HJ-Yl7QddAy0aKEPjQCLcBGAs/s320/gatorade.JPG" width="240" /></a></div>
<br />
<br />
We first tried G2 for middle school volleyball which was a slow-paced, instructional, noncompetitive evening rec. league activity. We tried it mostly as a compromise because middle school is the era of 'all my friends are...,' and all her friends brought Gatorade to volleyball. As it turned out, it also helped her end up with better blood sugars than on the nights she didn't take it to practice.<br />
<br />
There are eight grams of carbohydrate in twelve ounces of G2. About that amount, poured over an abundance of ice and sometimes diluted with water to fill a large container, sipped slowly over the course of a 3 hour marching band practice, is just about right. Infusing just a few carbs per hour to burn off immediately seems, for her, to keep the lows at bay. <br />
<br />
We've tried, as an alternative to this plan (generally when I've neglected to stock up at the grocery store), bolusing less insulin for pre-practice dinner, which just leads to an immediate spike. We've set temp basals, which lead to overnight highs. The Gatorade is what works for her.<br />
<br />
Two years in, there have been 2 occasions when she's had to sit on the sidelines for a few minutes for a significant low to come up. That's with hundreds of hours of practice and performance. <br />
<br />
It's obviously not just the Gatorade. A solid, healthy meal before practice, assessing the Dexcom or glucometer at breaks and reacting accordingly, and having a well-stocked bag of diabetes tricks including healthy snacks and fast-acting carbs are among countless factors crucial to staying in range enough to participate and enjoy the activity. But on occasions when I've neglected to replenish the Gatorade supply things have not worked out as well.<br />
<br />
<br />
<br />
<br />Pam Osbornehttp://www.blogger.com/profile/07523792280274092952noreply@blogger.com0tag:blogger.com,1999:blog-7762567302898984061.post-58694111227322372172018-06-18T13:33:00.000-04:002018-06-18T13:33:20.562-04:00A Long Night<br />
<em>It's 10 p.m. The teenager has been home for an hour from band practice. She has showered and is thinking about going to bed. She checks her blood sugar in order to calibrate the Dexcom.</em><br />
<em></em><br />
<strong>"WHAT?!?!"</strong><br />
<strong></strong><br />
<em>The parents watch warily from the couch while the teenager gets another test strip and rechecks her bg.</em><br />
<em></em><br />
<strong>"WHAT IS GOING ON??? HOW IS THAT POSSIBLE??? HOW DID THAT <u>HAPPEN</u>???"</strong><br />
<strong></strong><br />
<em>The teenager is distraught. </em><br />
<em></em><br />
<strong>"Mom...can you help me do a site change so it goes faster? APPARENTLY I'M 485."</strong><br />
<strong></strong><br />
<em>The mother rises wearily from the sofa, her plans for quiet time with her book followed by a good night's sleep dashed. She fetches a large glass of water for the daughter, in hopes of keeping ketones at bay.</em><br />
<em></em><br />
<em>"</em>Yup. Drink this first. What happened do you think?"<br />
<br />
<strong>"I DON'T KNOW!!!"</strong><br />
<br />
<em>The teenager is grumpy, irrational and teary. Probably because of the blood sugar of 485. She gathers herself for a moment.</em><br />
<em></em><br />
"I don't know... I was fine at dinner - 130 something. I don't remember Dexi alarming at band but it must have. It alarmed again a little while ago. But not <strong>that</strong> high. It's been iffy all day- it's like 10 days old - but I didn't know it was that far off and now I'm really high <strong>and I don't know WHY!"</strong><br />
<strong></strong><br />
<em>The mother and teenager go off to the teenager's room to change the site. The chain of events leading up to the current situation is reviewed.</em><br />
<em></em><br />
"I bolused dinner - I'm sure..." <em>opens the pump's memory and double-checks </em>"yup- and it wasn't a lot of carbs and you used the measuring cup. And then I just went <strong>UP! </strong>And I didn't eat anything at band- I just drank my water and I never had anything when I got home and now I'm SO HIGH FOR <strong>NO REASON."</strong><br />
<strong></strong><br />
<em>When the site is removed the cannula is gunky, clearly clogged up. The mother thinks out loud.</em><br />
<em></em><br />
"I don't think, in 13 years of pumping, you've had a pump site conk out that quickly. Usually they take a gradual turn for the worse, but this one seems to have suddenly and completely stopped working. That's the only logical explanation to go from 130 to almost 500 in 4 hours." <br />
<strong></strong><br />
<em>The teenager curls up on her bed, nursing her second pint of water. She is clearly miserable. She complains of a headache.</em><br />
<em></em><br />
"... not just in one spot but like...my whole head...it just hurts...it's awful."<br />
<br />
<em>The mother initiates calming conversation … a friend's new puppy, a funny story someone posted on Facebook. Eventually, it's been 30 minutes since a correction dose of insulin was given. The teenager rechecks and is now just barely over 400. She gets up to brush her teeth and finish preparing for bed. The Dexcom alarms... </em><strong>FALLING! </strong>…<em> and hope increases that the correction dose will work. </em><br />
<em></em><br />
<em>The teenager goes to bed. The mother gets to read her book, but for much longer than she'd intended, staying up until 12:30 a.m., when the blood sugar has dropped to 230-something. </em><br />
<em></em><br />
<em>The mother is awakened at 2 a.m. by the Dexcom alarm (which is now, incidentally, spot-on again) and gives the teenager some juice for a bg of 76. </em><br />
<em></em><br />
<em>The father gets up at 3:45 to give more juice for a bg of 68. </em><br />
<em></em><br />
<em>The family gets up in the morning. The teenager has a bg of 77. They are all tired. They are all grateful for the discovery of insulin. But moreso now for the discovery of caffeine. .</em><br />
<em></em><br />
<br />
<em></em><br />
<em></em><br />Pam Osbornehttp://www.blogger.com/profile/07523792280274092952noreply@blogger.com2tag:blogger.com,1999:blog-7762567302898984061.post-86011395480311270162018-06-11T17:13:00.000-04:002018-06-11T17:13:12.057-04:00False Advertising<br />
<br />
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<br />
I love this sale. <br />
<br />
We will stock up.<br />
<br />
They will fit perfectly into my daughter's diabetes bag.<br />
<br />
I am grateful for portion-controlled 15 carb. servings of juice.<br />
<br />
But I will not. Ever. Refer to them as "Fun Size."<br />
<br />
<br />
<br />
Pam Osbornehttp://www.blogger.com/profile/07523792280274092952noreply@blogger.com0tag:blogger.com,1999:blog-7762567302898984061.post-61927013461415503002018-06-05T12:04:00.000-04:002018-06-05T12:04:21.199-04:00I Almost Asked<br />
<br />
My daughter's Dexcom G4 sometimes chooses to stop 'sharing' these days, making its receiver the only source of information. When this happens, as it did this week, I try to take a quick peek at the receiver once in a while, just in case we need to talk about tweaks in the basals, carb ratios, correction factors and such. <br />
<br />
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<br />
<br />
I looked at the receiver this morning - it was on the table after breakfast - and yesterday morning showed a spike, reaching the top of the graph, and hanging there for an hour or so before coming back down to a reasonable range by noonish.<br />
<br />
My initial instinct was to ask something along the lines of, 'What the heck happened yesterday???"<br />
<br />
Then I realized three things:<br />
<br />
1. I already knew what happened yesterday. Her grade had a delayed opening because of standardized testing at the high school. She had been out to breakfast with friends and she ate eggs and toast and potatoes- which was a better choice than pancakes - but she clearly either under-guessed on the potatoes or forgot to bolus until too late. <br />
<br />
2. The evidence showed that she'd picked up on her mistake, corrected her blood sugar, and gotten herself back in range by lunch. She had solved the problem by herself.<br />
<br />
3. Nit-picking is counterproductive. She'd just get defensive if I brought it up, no matter how much I tried to turn the conversation towards 'all's well that ends well.' <br />
<br />
So I didn't ask. <br />
Pam Osbornehttp://www.blogger.com/profile/07523792280274092952noreply@blogger.com1tag:blogger.com,1999:blog-7762567302898984061.post-66001360638060857972018-05-24T11:31:00.000-04:002018-05-24T11:31:01.356-04:00What to Say?<br />
We currently have more than one family in our lives with a recently diagnosed blood-sugar-challenged person. While we're hoping this isn't becoming a trend, I'm working on my own initial reaction conversation, and reflecting on some I had 15 or so years ago.<br />
<br />
We were fortunate to be hooked up with a local group of diabetes parents shortly after my daughter's diagnosis. When I called for details about their meetings, the group's facilitator - both a CDE and a diabetes mom herself - stayed on the phone for almost an hour, offering support and encouragement, with lots of, "slowly but surely it'll get easier," and "it sounds like you're doing well, considering how little she is and all you've been through," and "I'll bring you some resources when you come to support group." She then asked if she could have a member of the group call me since this member's daughter had been diagnosed at about the same age as mine. The phone rang a few days later.<br />
<br />
"Oh... I'm so sorry this is happening to you," the well-meaning mom began, "Having diabetes is terrible. It's the hardest thing we've ever done." <br />
<br />
We had other conversations with fellow diabetes families over those first few months, some from that support group and some from other parts of our lives, but I think those two interactions mark the extreme opposite answers to the question, "What should I say to the newly diagnosed?" Should I assume they're in a place of despair, or should I begin with hope?<br />
<br />
Talking with the "diabetes is terrible" mom wasn't all bad. Simply chatting with someone with similar experiences was helpful. But I was left wondering why, 3 weeks in, I seemed to have a better level of acceptance of my new normal than she did after a few years.<br />
<br />
So in my interactions, even on days when I'm feeling like diabetes is particularly terrible, I've decided to aim for encouragement: offering and answering questions, listening, and providing information or resources if I can. If the conversation flows towards the terrible parts, I'm not opposed to supportive commiserating, but want the end message to be, "but we survived those first months, we're surviving now, and you will to."<br />
<br />
I don't think there's anything much more helpful than a real live person saying, "I've been in your shoes. I'm still standing, and even thriving. It's going to be okay, and I'm here to help."<br />
<br />
<br />Pam Osbornehttp://www.blogger.com/profile/07523792280274092952noreply@blogger.com0tag:blogger.com,1999:blog-7762567302898984061.post-81053209609722155012018-05-11T15:03:00.000-04:002018-05-11T15:03:12.015-04:00A Mother's Day Gift<em><span style="font-family: "arial";"></span></em><br />
<em><span style="font-family: "arial"; font-size: large;">A poem written e<em><span style="font-family: "arial"; font-size: large;">specially for moms of young kids with diabetes:</span></em></span></em><br />
<em><span style="font-family: "arial"; font-size: large;"></span></em><br />
<em><span style="font-family: "arial"; font-size: large;"></span></em><br />
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<em><span style="font-family: "arial"; font-size: large;"></span></em><br />
<em><span style="font-family: "arial"; font-size: large;"></span></em><br />
<span style="font-family: "arial"; font-size: large;">Not flowers, nor chocolate - not even fine tea!</span><br />
<span style="font-family: "arial"; font-size: large;">What I want is a break from the numbers, you see.</span><br />
<span style="font-family: "arial"; font-size: large;"></span><br />
<span style="font-family: "arial"; font-size: large;">For three sixty four they've been swirling around</span><br />
<span style="font-family: "arial"; font-size: large;">'Til I fear on some days that my brains will be drowned.</span><br />
<span style="font-family: "arial"; font-size: large;"></span><br />
<span style="font-family: "arial"; font-size: large;">So this Sunday for Mothers, I ask for a rest</span><br />
<span style="font-family: "arial"; font-size: large;">From basal and bolus, from 'What are you- test!'</span><br />
<span style="font-family: "arial"; font-size: large;"></span><br />
<span style="font-family: "arial"; font-size: large;">From site change and carb counts, from dexcoms that blare,</span><br />
<span style="font-family: "arial"; font-size: large;">Insurance and phone calls and 'the juice boxes are there.'</span><br />
<span style="font-family: "arial"; font-size: large;"></span><br />
<span style="font-family: "arial"; font-size: large;">So Sunday at lunch and the walk by the lake,</span><br />
<span style="font-family: "arial"; font-size: large;">I ask that from d-stuff I get a quick break.</span><br />
<span style="font-family: "arial"; font-size: large;"></span><br />
<span style="font-family: "arial"; font-size: large;">I'll be back on Monday, raring to go,</span><br />
<span style="font-family: "arial"; font-size: large;">To support my sweet hero in her diabetes show.</span><br />
<span style="font-family: "arial"; font-size: large;"></span><br />
<span style="font-family: "arial"; font-size: large;"></span><br />
<span style="font-family: "arial"; font-size: large;"></span><br />Pam Osbornehttp://www.blogger.com/profile/07523792280274092952noreply@blogger.com0