On Our Own

'Snow will change over to a wintery mix this morning after accumulations of 6-10 inches.  Freezing rain will change back to snow mid-afternoon which will taper off around the evening commute.  The national weather service has issued a flash freeze warning beginning at 4 p.m. and continuing through the night.'

That was the weather situation which prompted me to cancel yesterday afternoon's endo appointment. We undertake a drive averaging 45 minutes into the city through heavy traffic to visit the diabetes center.  There are multiple hazards on a sunny day in June.  The new-to-me concept of a 'flash freeze warning' convinced me we'd definitely be better off at home with a jigsaw puzzle.

When I called to reschedule, the receptionist was very understanding but the next available appointment was in mid-March.  So it's not until then that we'll head in for a face-to-face professional assessment and help. Our usual 4 month interval between appointments will turn into more than 5.

Four months is really the right amount of time for us. As we approach each appointment, we inevitably start to build a list of problems for which we need solutions.   Maybe the after dinner lows discussed at the last appointment, which were perfectly resolved for a while, have turned into highs.  Or the afternoon basal rates seem way off but we haven't been successful in tweaking them ourselves.  Perhaps we're considering a new type of infusion set or want to talk about a new technology coming down the pipeline. We always need a prescription or a school form or a lab slip.  By three and half months, we're running out of ideas and enthusiasm.  We could do some research, try new tactics, or call the diabetes center for help, but a visit is so much better.

A visit allows us to take the sum total of all of the diabetes problems we're facing and hand them over to someone else.  'Please fix this,' we say.  While our endo does not have a magic wand, and therefore can't make it all go away, he can look at it with a fresh and well educated eye.  His suggestions work, and are often beyond what I could have come up with on my own.  He's able to put the pile of data downloaded from the diabetes devices together with the information we give him in an incredibly helpful way.

For just a part of an hour every 4 months, someone else worries about my daughter's diabetes.  Someone else struggles with the countless numbers, the trends, the mysteries of it all.

For the next month or so it's still ours to think about and do the best we can with.  If we're stuck with an issue that's particularly challenging, or if we need a prescription refilled, I'll call.  Otherwise we're still on our own.  March can't come quick enough!

What If?

 This is a story about something that happened last weekend.  It is not advice, medical or otherwise.  Except maybe to be extra-careful when walking on frozen lakes.

'Does your daughter have any medical conditions?'

I mumbled a little.  "Nothing that's relevant here."

'Too young to have much of a medical history, huh?'

'Mmm,' I said with a tight smile.

The EMT continued to treat the facial injury.

We were at a family resort for a girl scout troop overnight.  Our last outdoor stop of the day was to explore the frozen lake.  I saw it happen in super slow-mo from about 30 feet away.  My daughter was walking towards her friends when her feet went out from under her and her face hit the ice. We're unable to reconstruct where her arms went, but they were of no help to her mouth.

She bit deeply into her left outer lower lip. The left side of her mouth was swollen and riddled with abrasions and braces marks inside and out. There was a lot of blood. We took her inside, got ice, washed up her face and rinsed out her mouth.  The bleeding wouldn't subside.  We were told there was an EMT on site.  I decided, particularly being far from home, that it would be smart to have it looked at carefully so I wouldn't wonder later if more should have been done.

My daughter later described our time with the EMT eloquently.  "He had trouble finishing his sentences.  And he kept repeating himself."  He was perfectly kind, and gentle, and competent.  But 20 minutes into his work, he was still cleaning the cut.  He had reassured us that she didn't need stitches and that her teeth seemed fine. He was finally getting out antibiotic ointment and bandages.  Then he asked the question.  "Does your daughter have any medical conditions?"

I looked over at the rest of my daughter's girl scout troop, so patiently and lovingly gathered with the other parents, waiting for her.  I thought about bumper cars, and dinner, and the evening fun to come.

I ran through the diabetes-related possibilities in my head.  I knew I should be honest. But could anything either he or I would gain from the potential conversation be worth the 20 minutes it would take to have it?  I mumbled my answer.

It felt really weird.  As I denied the diabetes, her life flashed before my eyes: the traumatic events of diagnosis, the countless endocrinology visits, the pump and CGM stashed under her winter layers.  What if none of that had happened?  What if this lip injury was one of the most significant medical events of her young life?

Eventually we were walking towards the bumper cars with an adorable stuffed lion her friends chose for her from the gift shop (conveniently located adjacent to where we met up with the EMT) when my coat pocket vibrated and beeped. A glance confirmed the inevitable:  240, double arrows up.  The adrenaline was at work.  Diabetes was, indeed, relevant to this situation just as it is to just about every other one.

But I refuse to let it slow us down.

Chionophobia

I learned a new word this week.

Chionophobia is defined by Dictionary.com as the 'fear of snow.'

If weather conditions don't improve soon, I'm at risk of developing a full-blown case of this disorder.  For now, my fear is limited to times when snow and diabetes cross paths.

As the years go by, there are more and more places I'll let my daughter go without me. The 'what-ifs' of diabetes are ever-present, but visits to friends' houses and evenings at school events have become activities with which I'm fairly comfortable.  This is good, giving her a sense of independence and allowing her to test the waters of responsibility.

A couple of weeks ago a friend's family invited her to go sledding with them.  I momentarily considered dropping her off with her sled and coming back to my cozy house.  Then I began to gather my snow clothes. Sledding and even walking in the snow can cause, for my child, steep and unpredictable drops in blood sugar.

When we arrived at the sledding hill on this particular day, my pockets were stuffed with diabetes paraphernalia.  She began sledding with a blood sugar of 190, and dropped very, very slowly over the next hour and a half. I watched the Dexcom graph and made her stop an hour in to double-check with the meter. As we walked back to the car with the Dexcom reading 150 straight ahead, I was beginning to feel foolish for having tagged along.  I was not. By the time we'd walked three hundred yards to the parking lot, I saw 68, with double down arrows.   This turned into a juice and glucose tab and snack kind of low which wouldn't quit.  Even my 'tween' girl was the first to admit she was glad I was there to help her.

A week later, a friend's mom called.  Could she take the girls for a walk in the latest snow storm?  Once again, I tagged along.  We were climbing through snow banks and un-shoveled sidewalks.  It was fun, but strenuous.  We stopped twice for blood sugar checks and glucose tabs.  We followed those up with juice and a hearty snack.

It's unlikely that at 16 she'll want her mom to come with her to the sledding hill.  She'll need to figure out how to carry and use all those supplies in the snow in order to keep herself safe.

In the meantime, having a personal nurse and Sherpa is, I think, a perk to appreciate.

Snow Day #7

We headed around the corner to the school playground this morning.

It's amazing how much energy it takes to walk through snow:

Or maybe Dexi is just trying to ask to go sledding?