Friday, September 30, 2011

How To Check Nighttime Blood Sugars (And scare your neighbors)

Every evening around midnight, my husband dutifully creeps into each of our daughter's rooms and quietly checks their blood sugars while they are slumbering. 

I usually pretend to be asleep, which is nonsense, because the baby monitors located directly next to my head loudly communicate each whir, click and beep of my husbands' testing.  For anyone who does this often, the piercing sound of a blood glucose meter can cut through any noise level immediately. 

As soon as I hear that first bit of beeping, I completely wake up. 

My husband usually gives a stage whisper into the baby monitor as to what the actual number is.  "189", he says.  Then a pause and I hear him shuffle into the next child's room. 

Whirrrr.  Click.  Beep.  Beep, Beep, Beep.  "How in the world? 425!", he loudly whispers a moment later.  This is not new information.  Our oldest daughter is running higher overnight, most likely due to hormone fluctuations that she is experiencing.  No matter how much basal we give her, it just isn't enough to cut the highs.

My breathing pauses for a second.

I know that I will be getting up at the 3:00 a.m. shift to ensure that she is in a safe range after receiving a midnight bolus.


So like any good middle-of-the-night burglar, I arm myself.  Alarm clock, check.  Battery operated lantern, check.  Lancets prepped with needles, check.  Meter and strips next to lancet, check.  Kleenex ready to wrap around fingers so that mom doesn't have to wash a million droplets of blood off the comforters, check. 

The alarm goes off in what seems like moments.  Instantly awake with a bit of panic and dread, I walk down the hall to test our oldest daughter.

Whirrr. Click.  Beep.  "156". 

I still can't relax. 

Sleeping next door is another child with Type 1 Diabetes.  My mind plays tricks on me.  What if, what if, what if.  I creep next door and fumble because I didn't get things ready. 

Then something amazing happens.

Whirrr.  Click.  Beep.  "156".  Which instantly makes me laugh and wish that I could wake everyone up to see the matching numbers. 

I go back to bed and lay down thinking about it.  The blood sugar checks, the high, the matching numbers, the basal corrections I will be making in the morning, the fact that I can't remember if we received both sets of pump supplies or just one, and so much more. 

Sleep never does come but morning does.

And I wonder one last thought... did the night-owl neighbor see me walking down the hall with a lantern?

Thursday, September 29, 2011

It's Just a Piece of Bubble Gum

"It's just a piece of bubble gum Mom!", said my adorable youngest child.  She grinned at me while trying to blow the world's largest bubble.

It really is just a piece of bubble gum.

Yet, with type 1 diabetes, that piece of bubble gum represents exactly 1.5 grams of carbohydrates.  If my daughter decides to pop a handful of pieces of bubble gum into her mouth in order to make the world's largest bubble, than that innocent piece of bubble gum reflects about 10 grams of carbohydrates.

10 carbs can raise her blood sugar about 30 points.  If she is at a comfortable 170 before chewing, she most certainly be at 200 afterward.

So she needs insulin.

Even with a piece of bubble gum.

With type 1 diabetes, everything is just a bit more complicated.  The hardest part for me as a parent is to try to manage that constant barrage of thoughts so that I can sit back and enjoy watching my daughter blow the world's largest bubble without letting type 1 diabetes pop it.

Wednesday, September 28, 2011

Handy and Dandy But Not Just For Fun

While we wait for a cure, the improvement of diabetes care using medical technology is very important to our family.  It isn't to be trendy or to become digi-heads.  I am only interested if I feel it will actually help either one of my children in obtaining a higher quality of life.  To me, a higher quality of life includes the ability to feel better emotionally or physically.  After all, our invisible disease can wreck havoc on not only our bodies but our minds too.

When our youngest daughter was diagnosed in 2006, we were immediately given a box of syringes by our hospital nurses.  In the initial learning trainwreck, these tiny BD Ultra-Fine II needles were very intimidating.  The 1/2 unit markings were difficult to see and as parents giving their first injections, we were terrified to draw and dispense an incorrect dose.  A few weeks in and we were old pros.  Something about 6 injections per day will do that to you.


After a few months of reviewing the massive logs of poking, it seemed like there had to be a better piece of technology.  After a few nights of googling, I stumbled across the I-Port.  One slightly larger needle inserted cannula allowed a port to be open with which to insert the syringe.  Brilliant!  The port cannula immediately reduced the number of pokes from a three day total of 18 to 1.  Our daughter loved it with the exception that the port often became unglued when she entered any body of water, even the nightly shower would wash it off.


This brought us to researching our first insulin pump.  The Johnson and Johnson Animas 2020.  At the time (2007) it dispensed the smallest amount of basal insulin.  For a three year old, this was incredibly important as her total body weight was not quite 30lbs.  Her tiny size combined with toddler eating habits made long lasting insulin dangerous to the degree that a smidge of a unit was often too much.  The Animas 2020 helped to solve the MDI issue by allowing us to shut off basal rates at night and to keep her safe while her body fluctuated in the honeymoon state.


A little more than one year later (2008), a new pump from J&J went on the market.  The pump was named the Animas Ping.  With all of the features of the Animas 2020, it also had a new feature referred to as a meter/remote.  The remote, which was also a One -Touch meter, allowed the user to stand away from the child and simply direct in a bolus of insulin much like using a remote to change television stations on a t.v., hence "pinging" the signal and correct dose.  We loved it!  It freed the school staff from having to remove a pump from under a dress or to have us parents stop a child in mid-play to be dosed for a cracker. 


About two years later, our oldest daughter was diagnosed at age 8.  Instantly, we started her on an Animas Ping.  Nothing like sisterly sharing.  It only made sense to share diabetes supplies and keep things consistent in our house.  The upside was that all training occurred at home and as soon as Fed-Ex made a delivery, our oldest daughter was off and pumping.  At age 8, this was a life-saver.  Puberty, growth hormones and sports have made pumping even more necessary.

As our older daughter grew, we realized that pumping alone wasn't enough to combat the barrage of physical changes and exercise demands.  Our research online and through discussion with other adult's with Type 1 Diabetes led us to the DexCom 7 Plus Continuous Glucose Monitor.  Truly, this is the best invention that we have found yet.  The CGM allows us to reduce the number of blood glucose checks while still watching the monitor for unexplained high and low blood sugars.  Both of girls now wear their CGMs to after school functions, sleepovers, field trips and vacations - places that used to be difficult to manage the highs and lows without a million little checks.


We await new proposed technology such as the Animas Vibe which is only available in Europe.  The Vibe combines the best of pumping with an integrated CGM. 


As a mom, I am hoping for the day where I can review both of my daughter's blood sugars from a remote location with perhaps an I-phone App.  I have also heard of a meter product that will one day be integrated into a new car, enforcing the rule that good blood sugars must be in place before getting behind the wheel. There is also the promise of a closed loop pump which sounds promising.

My mind is wide open to the variety of ways to manage "our" (children's) type 1 diabetes.  The only thing that I scoff at is the widely Internet circulated natural cure using vinegar or cinnamon.  If there was a cure, we would all have been on top of it by now!

While a cure is our distant light, modern technology keeps our future bright.

Surgery Is Scary (even without Type 1 Diabetes)

Our oldest daughter broke her hand while playing a recreational league soccer game. 

It happened last June.

Remarkable as we have been taught to keep our children with diabetes healthy.  Even the tiniest blister or torn toenail can raise a red flag.  Yet somehow, this broken little scaphoid bone managed to stay well below the always present "Mom Radar" - for two months.

After two sets of x-rays, one MRI without contrast, one MRI with contrast, too-many-to-count physical exams and a brand new set of specialists, surgery is happening.

And it is scary.

Fasting and stable blood sugars do not seem to go together. Similiar in the way that an incurable disease and a child shouldn't be happening either.

The wisest words were spoken directly from the patient, "Mom, I just really wish that this could be all over but I don't want to go through any of it to get there."

I understand dear child.  Me too.

Tuesday, September 27, 2011

It is the little things...

A finger poke with a nice blood droplet.

A perfectly healed up arm.

A non-hurting site injection.

A sister-to-sister meter race that ends with a tie.

A waiter who actually understands why you need an appetizer STAT.

A nurse that turns the other cheek when you steal latex gloves in order to create a chicken head.

A friend who thinks your pump is cool.

A doctor who doesn't emphasize an unattainable A1C.

A neighbor who offers to watch your girls for an evening.

A loaded carb treat just because you want to.

A perfect carb free treat because you want to.

A flat line on the CGM.

A coach who isn't scared to play you.

A teacher who understands the need to wait for an in-range blood sugar.

A test strip discovered in a remote place to remind you that others have walked the same path.

Most importantly,

A day where you forget all about type 1 diabetes.

Monday, September 26, 2011

Post Walk - Another Year Has Come and Gone

The 2011 JDRF Walk to Cure Diabetes was held this past Saturday.  The turnout was much the same; families and businesses coming together in an effort to raise awareness of Type 1 diabetes and to funnel research dollars into a possible cure. 

This is our fifth year of participating in the walk. 

There is no cure.

We walked because it is our duty.  Simply because if the families decide not to walk, then the corporations will  lose interest in our disease and move onto one of those "hot topic" diseases that seem to gather lots of media attention.  If we stop walking, JDRF, our biggest advocate of finding a cure, will lose funding and government pressure will cease to exist.  If we stop walking, my girls will think that we have given up hope.

If that happens, there will still be no cure.

Over the years, my walk tears have dried up.  I now find myself positioned as a team captain for our group.  Lining us up for photo shoots, passing our parking vouchers, ensuring that everyone walking has found their way to the food tent, or the petting zoo or to the bathrooms. 

People see me smiling.  I laugh, nod at strangers and make silly jokes to keep the newest team members from feeling sad.  After it is over, I hug everyone and thank them for coming.  I hear a lot of them say they can't wait for next year! 

And I know next year will come.  The year after, too.  In fact, it will be years before we have even FDA approval for new technology.  Most certainly, a cure is far, far, far in the future.

In the future.  In the future.  In the future.

But still, someday.