The Life of a Stay-at-Home D-Dad: Scott Benner’s Story

I was interviewed recently by Laura K. from Discuss Diabetes about blogging, advocacy and being a father. Laura and I talked for over an hour and we covered some topics that I don't usually get to write about here on Arden's Day. 

In the book Scott tells the stories of what he saw as pivotal moments. “I wanted to leave people feeling uplifted, more connected with the idea of family being most important,” he said. “It comes from recognizing there’s probably nothing more important that you can do than just watch your kid at baseball practice for five minutes because it means more to him than you can understand.” 

Laura closes the interview by giving her thoughts on Life Is Short, Laundry Is Eternal. They are among the most touching words that I could imagine hearing. I hope you have a few seconds to check it out.

Speaking of my new book that arrives on April 2nd...

I've added a review section to my book page. Look for recent reviews by Manny Hernandez from TUDiabetes and Chris Snider from the Just Talking PodCast.

I'm being told that the eBook formats often become available weeks before the launch date - I'll let you know when you can download.

Those wanting a paperback take note: Amazon and Barnes & Noble have both dropped the price for LIS to $9.47. If you are planning on buying the book, this is the lowest price that I've seen yet. Pre-Orders should arrive at your home on the release date. Links to both sites, as well as Canadian and UK Amazon are here.

I'm humbled and a bit taken aback by the amount of requests that I'm receiving for autographed copies of LIS. So far we only have one signing scheduled but I'm working on getting more opportunities set up. I'm also trying to work out a way that I can provide copies directly without adding tons of shopping costs. Stay tuned and follow Life Is Short on FaceBook for updates.

Have a great weekend!

Scott

Update on Friday, March 8, 2013 at 9:36PM by Scott Benner

The Kindle Version of 'Life Is Short' just populated on Amazon US, Canada and UK. The system is accepting pre-orders now and your Kindle version will be available for download on March 12 - that's 21 days before the paperback. No word yet about Nook and iBooks, should be soon. 

Our Community

Yesterday I wrote a blog post that described how I felt about the DRI controversy. It was long, angry and just as I was about to post it, the man who started this whole mess wrote on his blog and tried to explain why he did what he did - I deleted my draft.

His words caused me to think about the DOC.

I've never met Tom in person, as a matter of fact I don't believe that I've ever "met" him online - but I have read his blog. I've seen how people in the community trust him, how they believe that he is one of them. I know that because that is how I feel about this man whom I do not know. I began to wonder if I am that person for you. I thought long and hard about your belief in my blog and the responsibility that your trust makes me feel. I tried to imagine what influence could make me write something online that could hurt so many people. I couldn't think of one thing in my life that could push me to so thoughtlessly disseminate my feelings as though they were more than feelings. What Tom did, in my opinion, was cruel and where he did it was unthinkable.

I was so angry that the appearance of hype was brought into our community, disguised as hope.

I'm glad that I didn't post my thoughts yesterday because they weren't thoughts, they were anger. Holding back allowed me more time to consider what must have been going through Tom's mind as he wrote and I can only come to one conclusion. Tom is a D-Dad twice over, he is a tireless advocate for us and I can only imagine that he wants a cure for my daughter as much as he wants one for his own children.

Tom must have seen something that made him believe in a cure. I, for one, am elated that there is research in the world that could make a man like Tom that excited. If that is the case, then I understand why he was so enthusiastic about telling us. He only made one mistake and I'm quite sure that he won't do it again, I'm quite sure that none of us will. His actions, misguided as they were, taught us all a very valuable lesson this week. Our voices are strong, they carry meaning and people are listening. We have a responsibility that is bigger than perhaps we may have imagined. We aren't just a collection of people connected by FaceBook, Twitter and the rest. We are a family. Actually, we are more than a family. We are people with diabetes and the people that love people with diabetes. We all want the same thing and we want it now. Tom forgot that for a few minutes, but I can tell that he remembers now.

If you were angry like I was, I hope that you can find your way past that feeling and join me in hoping that what Tom saw was so amazingly exciting that he lost his head for a moment. Because if that is the case, well, we all have something to look forward to. Even if Tom just mis-spoke or didn't give proper consideration to how his message would be received - he's done more for all of us than I imagine we could know... he deserves a pass. Trust me when I tell you that I was in full blown, Philly anger yesterday. I could have choked Tom with my bare hands. Today, I was able to see clearly again. I don't take how I felt is a condemnation of me or of Tom's actions - I see it as an indication of how much I don't want Arden and all of you to have to live with diabetes for one second longer.

One day this community will be the way that we all learn about the cure just as it is the conduit for finding out about advancements in treatment, support and friendship. We won't hear of the cure with a press release or a twitter post, our love will carry that message into each of our homes. You all are part of the most amazing man-made thing that I've ever seen. We have compassion for one another in amounts so large it boggles my mind. We help each other up when things are bad and we prop each other up until we can stand again on our own.

Tom, this is me propping you up. Don't beat yourself up too much. I may have done the same thing.

I can't wait to see what got you so excited.

Your Favorites: February 2013

The most popular blog posts from February 2013 are:

The Diabetic Problem

DexCom G4 Platinum: Second Look

Opsite Flexifix

New OmniPod Pictures and Information

Meanwhile over on FaceBook. These two posts were seen by more eyes then all the rest:

Yes or No: Do you get your children a flu shot? Why, Why not?

and

Me: Why are your clean clothes on the floor?

Arden: I had a sensitive moment. When you have diabetes sometimes your blood sugar gets low and you have sensitive moments. 

Me: I see

Arden: I had one on Saturday and it made me pissy.

Me: {silence}

The post that received the most 'likes' was a picture.

Thank you for making February 2013 the most popular in the history of Arden's Day. This blog will be celebrating it's six year anniversary this summer and the number of people that read Arden's story in February is greater then the number of people that read Arden's Day, in it's entirety, over the first three months that it was online. I can't believe how much Arden's Day has grown, and it's all because of you.

Last night my new book was number one on the Amazon Hot New Releases list in the Fatherhood category (U.S.) for over six hours and number three on the same list in the UK. I was so proud (I called my mom) and simultaneously so incredibly overwhelmed by the support that our community gives to one another. It is staggering and a testament to why the DOC is so strong and helpful to the people that are a part of it. I'm proud to be a member of this group and genuinly touched by the love that it has shown me, my family, the book and this blog that I adore.

Best,

Scott

Pre-Bolus

Original art by Mike Lawson - Check out Mike's YouTube page by clicking on the image

This story begins in 2006 just moments after I asked Arden's nurse practitioner if she was "nuts".

NP: <blank stare>

Me: <incredulous gaze>

Only moments before our staring contest began Arden's NP became the first person to suggest that I give Arden her mealtime insulin before she started to eat. I can't be sure if she referred to the practice as pre-bolusing, probably not as we were MDI, but she definitely wanted me to inject before Arden ate.

"Are you nuts?"

I responded emphatically that I could never give Arden insulin before she ate. Arden was two years old and there was no way to be certain of how much food that she would finish. The NP repeated her very reasonable request but I could not wrap my head around this new idea. Pre-Bolusing, bah, Arden would be safer if I left her alone at the mall with money pinned to her shirt.

I was 100% correct on that day. There was absolutely no way to be sure of Arden's appetite. However the inability to guess how much she would eat wasn't the only reason I didn't want to inject before meals. Arden weighed maybe nineteen pounds at the time and Novolog had a way of peaking intensely in her body. She had already experienced a seizure from an insulin miscalculation that I made. That mistakes lesson was still very fresh in my mind and with that bad memory still looming over me, I just couldn't bring myself to administer insulin that wasn't already covered by food or a high BG.

Of course everything that the NP said made total sense. I wanted to give Arden's insulin a head start, I dreamt of a moment when her food would begin to expel it's carbohydrates just as the insulin was pulling her BG lower. I could picture that perfect image in my mind, a tug-of-war with food on one side and insulin on the other. Both combatants pulling furiously without once moving the rope that is Arden's blood glucose value - the dream of a steady mealtime BG. I wanted very much for that to be our reality and so I promised myself that I would make the adjustment when the time was right.

Fear and poor timing stopped me from taking the NP's advice all those years ago. Eventually the day came when I found my footing with the idea and gave up on being scared... that's the day Arden's A1c began to decrease.

We haven't looked back.

The beginning of our trip down the road to pre-bolus freedom was littered with pot holes. The first bump took some time to traverse, we first had to wait until Arden was old enough to give thoughtful consideration to her hunger. After that hurdle was cleared we took the first step, bolusing ten minutes before a meal. Those next ten minutes were the most tense of my day, I would test and worry so much after the bolus that I barely had time to finish cooking. Initial results were less than stunning so I moved the pre-bolus to fifteen minutes before a meal. The extra five minutes increased the impact of the insulin and lessened Arden's post meal spikes, but I still wasn't seeing a huge return on our efforts. I wanted to take the process to another level but I couldn't, in good conscience, give Arden insulin farther from the beginning of her meal. If only I could see the insulin work, I needed a crystal ball...

... or a DexCom CGM

Arden's CGM turned pre-bolusing into the most valuable weapon in our arsenal. It's one thing to have a good idea of how long it takes insulin to begin working in the body. But when you are able to not only witness the movement of the BG, but also the speed with which your glucose level is rising or falling... it's the difference between rumor and fact... between guessing and knowing with reasonable certainty. The day that my eyes were opened to the benefits of wearing a CGM, that was the day that everything changed.

Arden was 149 before dinner last week. I bolused for the elevated BG and pre-bolused for 50 carbs, it was a significant amount of insulin for her. Before DexCom I would have panicked and served the food in less then ten minutes. Now I take my time finishing dinner while Arden and Cole do their homework and leisurely prepare their plates as I wait for the CGM to tell me when to serve.

I put dinner on the table when the arrow on Arden's DexCom G4 turned south, waiting until her BG was below 110. The amount of time between Arden's bolus and her BG decline can vary most days depending on a number of factors. Glucose monitoring grants the flexibility to wait, providing a level playing field for the insulin and those scrappy carbs to wage their battle on.

At least now it's a fair fight.

Don't forget what the bottom of the site says... Always consult your doctor before making changes to your health care. I am not a doctor.

More about the art: The art work displayed at the top of this post is an original piece from Mr. Mike Lawson. Mike is a tireless advocate for people with diabetes, a friend and extremely talented artist. You can find him working at TUdiabetes, on Twitter and through his fantastic YouTube channel.

Insulin to Carb Ratio

It doesn't matter if you infuse insulin with a pump or inject, you probably know how many units of insulin covers one carb. We use multiple Insulin to Carb Ratios (IC Ratio), in the morning Arden's IC is 1 to 16. One unit of insulin, for every sixteen carbs consumed. Her lunch, dinner and evening ratios are all slightly different. 

Two weeks ago Arden began experiencing unusual BG spikes after lunch, I'm happy that this happened, not because I want to see her BG high but because the anomaly caused me to draw a mental line between these new lunch spikes and a similar spike that I see too frequently after dinner. Post dinner spikes have been an ongoing issue for us this year. I was certain that they were happening due to bad carb counting but this new situation jarred something loose in my head and allowed me to see the problem from a different perspective.

I had become lulled into a false sense of calm by consistently good BGs from other times of day. Those triumphs clouded my ability to see simple issues that caused BG spikes, spikes that shouldn't have been difficult to diagnose. I made a mistake, focusing too much on the food in the equation and ignoring the insulin.

Diabetes: "Knock, Knock..."

Me: ("I'm just going to ignore that and see if he leaves")

I wonder now if I didn't subconsciously just need a break, maybe I didn't have enough energy to tackle another diabetes riddle. Whatever the reason, I figured it all out the other day... the answer ended up being so simple that I'm now annoying myself by retelling the story. 

Arden's insulin to carb ratios needed to be changed, one quick adjustment is all it took. I'm still fine tuning the dinner number and the breakfast ratio needs a little help from a temp basal but her BGs haven't been going above about 160 (CGM) after lunch or dinner since I made the adjustments. Everything has been so quiet around here for the last few days. No crazy highs, no panic inducing lows... it's almost too quiet, but I'll happily take that calm for as long as it lasts.

I'll be writing more this week about other simple adjustments that make a huge difference. Don't be afraid to make small changes, you can always put them back if they don't do what you expected. Please remember to record the old numbers before you make any changes in your pump.

Don't forget what the bottom of the site says... Always consult your doctor before making changes to your health care. I am not a doctor.