Thursday, April 17, 2014

Fearing The Airport

Child to Cherish Going to Grandma's Suitcase

Sometimes, I wonder if being tuned into the global T1D landscape on the internet is really a good idea.

Sure there is a wealth of information designed to help families but there is also, a ton of scary information to contend with.

For example, if anyone Googles type 1 diabetes and the Transportation Security Administration (TSA), like I recently did, there is plenty of interesting material to read.  Especially material based on flying horror stories.  Even though I am usually pretty relaxed about going through new adventures with my girls, like airport security - an ultimate trip in adventure!, reading those scary Google stories became enough to make my instinctive parenting alarms sound off.

There are tales of invasive pat-downs, scared children separated from parents, expensive, non-insured, insulin pumps that malfunctioned to the tune of $6,000 or more, after overzealous TSA employees placed them through damaging metal detectors and body imaging scans.

Not to mention that I don't want to put my girls through a security system that automatically believes all people are guilty until proven otherwise.  Having to explain why someone would think they have built a bomb is not a great conversation to have with little girls that still do fully understand the impact of 9-11.  It seems like forcing another adult sinister theme of how some people are truly evil in this world.  I would rather focus on the positives of caring souls that make the world a better place.

If you read beyond those grim airport tales, there are also stories of patients living with type 1 diabetes that sailed right through the airport security checkpoints and onto comfortable, albeit cramped, seats on the plane for uneventful flights to their destinations.

And yes, that is exactly what I am going for... a very smooth trip. I'll even overlook the zero leg room!

Our family will be flying shortly and it will be the first flight that I have had TWO children with type 1 diabetes also flying along.  Four years ago, we only had one daughter diagnosed.  I still remember the newness of children with insulin pumps and how many TSA agents weren't even quite sure what to do.  Today, however, there is an entire new world of medical progress and so I am sure that TSA agents have a better handle on how to deal with families like ours.

In any case, I have been doing my homework in order to prepare and prep ahead of time.

Three things that I have been advised to do are as follows:

1.)  Obtain a note from our pediatric endocrinologist with information on our daughters' diagnosis and medical needs, including use of an insulin pump and a continuous glucose monitor.

2.)  Call ahead and speak directly to TSA Cares, an open line to coordinate your medical needs with security.  

From the TSA Cares website:

TSA Cares Help Line

TSA Cares is a help line to assist travelers with disabilities and medical conditions. TSA recommends that passengers call 72 hours ahead of travel for information about what to expect during screening.
Travelers may call TSA Cares toll free at 1-855-787-2227 prior to traveling with questions about screening policies, procedures and what to expect at the security checkpoint. TSA Cares will serve as an additional, dedicated resource specifically for passengers with disabilities, medical conditions or other circumstances or their loved ones who want to prepare for the screening process prior to flying.  Travelers may also request a Passenger Support Specialist ahead of time by calling the TSA Cares hotline at 1-855-787-2227.
3.)  Upon packing, be sure to separate, the medical supplies from the rest of the luggage and declare it upon arriving at the security check point.  From TSA Cares, also declare medical devices and if you do not want to go through a metal detector or Advanced Imaging Technology (AIT), request a modified pat down at this point.  
Finally, if anything should arise where you feel uncertain, you can also ask for a Passenger Support Expert to be brought into the screening process.  The job of a Passenger Support Expert is to help assist families that have questions or concerns about screening with disabilities and medical conditions.   
If you are flying for spring break or saving this for summer vacation, have a great trip and try not to let the small seats bug you!

Monday, April 14, 2014

Whoops! Middle of The Night Lows

We have been working on blood sugars since the last A1c appointment.  The push is to try to keep blood sugar ranges tighter than they ever have been before.

Ranges like 80-120 for our oldest and 80 -140 mg/dl for our youngest.

All of the time.

It is a tricky balancing act, especially as the girls are well into a life of type 1 diabetes with a cumulative diagnosis of over seven years and who just a short while ago, were still considered little girls.

Now,  if you read this blog, you also know that they are in the middle of puberty and finding success with such a tight range is a huge challenge.

But I do see improvements in how they feel.  Oldest daughter tells me that she has more energy and youngest daughter is generally more even-tempered.  Both are positives.

That tight range is great and helpful, most of the time.

Sometimes though, the girls still go low.

Especially if there is a whoops during the day.  Like, 'Whoops, Mom.  I am so sorry that I forgot to bolus for that snack at school.'  Or 'Whoops, Mom, did you say 50 carbs?  I thought it was only 30 carbs!'.

Which then leads to a much higher than desired, blood glucose number.

With a tight range like that, it seems like the higher the whoops, the lower the low, shortly after.  And of course, the lows happen more frequently at night.  It's Newton's Law.  What goes up, must come down.  I think he just forgot to add, 'in the middle of the night.'

Which is NOT great nor helpful.  

Last night, I went into our oldest daughter's room after hearing the CGM alarm it's first low warning. BEEP!  Under 80 mg/dl.

On the face of the CGM, I could see a 77 mg/dl staring back at me.  Quietly, I confirmed with a blood glucose test and the meter matched with a close 75 mg/dl.

Oldest daughter promptly sat up after I gently touched her arm and without opening her eyes, dutifully drank her juice.

As she lay back down, she just reached for me and patted my arm.

'Thank you, Mom.'

Sweet girl.

In the most gentle of ways, she managed to erase all of the whoops so we can try again tomorrow.

Thursday, April 10, 2014

Throwback Thursday With A Hefty Dose of Foreshadowing.

I remember snapping this picture back in 2008.  They had spent the summer playing various forms of 'doctoring', with a heavy emphasis on Endocrinology.

It was the summer of borrowing plastic gloves and paper masks from the doctor's office and making complicated looking paper charts for the girls to customize with their stuffed animals vital signs.

During that summer, they decided that they both needed to be doctors (definitely not a nurse or a vet) and I remember trying frantically to find another medical costume when Halloween was too far away to be helpful.

It was a fun summer and as a result, the next door neighbor little girl even made up her own version of a cardboard insulin pump - just so she could be part of the t1d scene with youngest daughter.

But above all, what I remember most was oldest daughter being diagnosed later that year.