Sports Induced Adrenaline

It that time of year, basketball and other indoor running sports are in full swing. Diabetes common sense dictates that an hour of running could and likely would cause a drop in your child's blood glucose level. Some of you, heck - most of you, probably have that exact situation going on. Basketball, soccer and other running based sports probably have you checking BGs, whipping out juice boxes and worrying during early morning games in gymnasiums all over the world. 

But if you have a very competitive child... you may be experiencing rising BGs that are impossible to trace. This is the case for Arden. During basketball practice last week her starting BG of 130, never moved throughout the almost ninety minute practice. Arden ran drills, shot the ball and played defense at practice speed (Slower than in a game) without experiencing a change in her BG. As it turns out, when the scoreboard lights up, Arden wants to win, and she wants to win enough for her fight or flight response to kick in. 

I've devised a plan in which we bolus at the beginning of her basketball games in the amount equivalent to what a juice box would require. Most games, I can keep her BG around 180, but last week it jumped up to over 200 and caused me to have to bolus again during the game. The problem we run into with covering adrenaline is this... As soon as the game is over, the adrenaline disappears, and Arden's BG quickly begins do drop.

That's when the adrenaline bolus needs to be feed, luckily Arden is particularly hungry after she plays. This week she fed the bolus a waffle.

You can really see what I'm talking about in the DexCom image above. Arden woke up at 8 AM and I gave her a small correction that didn't do much by the time the game started at 9 am. By the end of the first quarter though, I had to give Arden a huge correction bolus (Big for her, 1 unit) to combat the significant rise (Her DexCom arrow was straight up). By the time the game ended and we sat down in a diner, Arden's CGM was reading 140 with an arrow straight down, I still bolused for half of the waffle, and as you can see Arden's BG was 101 and steady as we left the restaurant. Be aware that these mornings need to be tracked closely in the hours that follow, because after all of the insulin and food finishes, you never know which way BGs are going to go.

Please also keep in mind that the amount and severity of the adrenaline fueled rise will vary from person to person or it may not happen at all. It really does depend on the individual's level of competitiveness, for some children, basketball may react like other exercise. Arden's team lost on Saturday, but she scored all eight of her team's points. You should see her go, she definitely plays with adrenaline! 

Tech Note: Don't forget that the DexCom G4 signal seems to become amplified in some gymnasiums. You may be able to keep the receiver with you as your child runs up and down the floor without losing connectivity. It works for us. I even gave Arden a bolus with her OmniPod PDM this week while she was playing in the game.

Oh Canada... It's DexCom time!

The DexCom G4 continuous glucose monitor is now available in the true north! I'm not exactly sure how DexCom got their device ready for sale in Canada. Perhaps the transmitter will be wearing a tiny little hockey sweater? Who knows...

Getting started looks pretty straightforward. Go to dexcom.com/en-ca and then click "Contact Distributor". The link takes you to www.animas.ca, the company that is handling the distribution for Canada. The Animas page doesn't have any DexCom specific links. I would use the "Contact Us" tab at the top right of the Animas page and ask how to get started.

I found this contact information for Animas Canada at the bottom of the Canadian DexCom page linked above.

Local Dexcom Distributor

Animas Canada

200 Whitehall Drive

Markham, Ontario

L3R0T5

General inquiries: 1-855-293-5083 or 

CustomerCare@Animas.ca

Product support: 1-866-406-4844

I'm so excited for my Canadian friends, you are going to love having a CGM!

Three Days without DexCom

I felt quite like Linus the other day, when time took our diabetes security blanket away.

It was meant to be, the DexCom transmitter is designed with an internal battery that is warranted to last for six months but when our transmitter turned a year old a few weeks ago, I thought maybe we had the one that would never lose it's charge. 

Then, of course, it did.

Only a few days past it's birthday our G4 transmitter let out a death knell in the form of the image that you see above. "Low Battery: Order New Transmitter" - and so I did. Today's blog post isn't about a fight with an insurance company or a medical supply firm filled with inept employees. All of that actually went smooth as silk. I made the call and the new transmitter showed up three days later. But those days taught me a lesson.

The lesson? I lean so hard on that continuous glucose monitor that I was initially lost without it. Now, today's blog post isn't about how great diabetes technology can be, and I'm not going to sing the praises of DexCom (Though I could) - Today is about shining a light on the true meaning of what the CGM brings into a life lived with type I diabetes. 

Continuous Glucose Monitoring brings a sense of calm and peace while it removes uncertainty and blindness.

I can see the insulin go in but where does it go, what will it do, when will it do it and how long will it be before it has completed it's task? I can see the food go in, but how, when and with what intensity will it impact Arden's blood glucose level?

I stand in a dark room, it's walls built with uncertain nervousness, waiting for the room to catch fire. I think that's what injecting insulin felt like before we had a CGM. It felt like the five seconds before the knife wielding lunatic jumps from the shadows in your favorite horror movie. But it feels like that all day, at least it did in the past and it did again for these three days, well, it tried to feel like that but I was able to stop it with the knowledge that I've gained living with a CGM in our life.

My first reaction when the battery in Arden's transmitter failed the day after it's first warning that it would, was fear. I thought about how positively Arden's A1c was effected when we added glucose monitoring to our life and worried that our success was solely based on the information that our devices report. I was actually concerned that I wouldn't remember how to handle things without the technology that I've rightfully grown to trust. The first night I gave in to the pressure and I stayed up half the night testing. Do you know what those tests showed me? They showed that even though diabetes is unpredictable, I have a pretty good feeling for when it's going to be unpredictable. I know when a miscalculated bolus will become an issue, and low BGs aren't as elusive as they felt before I was able to watch twenty-four hours of blood sugars on the DexCom screen. There's no doubt that I can't predict everything and I certainly don't know when an unexpected change in Arden's BG will happen, but I can guess with some reasonable certainty. My educated guesses are now more educated than they once were, and I think that there are times when I lean too hard on the information coming from the Dex. I think that sometimes I know what the correct action to take is, and I use the DexCom data to convince me that I'm correct. 

So I found my bravery and went back to managing Arden's diabetes the way I did in the past... By closing my eyes, trusting myself and hoping for the best (And I tested more often).

I'll tell you what though, I put all that high-mindedness aside the second that the FedEx driver handed me the package that contained Arden's new transmitter. I tore the box open, grabbed the transmitter and drove directly to her school to pop it in. I trust myself, I do, but this diabetes dance is much easier when you have someone or something to lean on.

Update on Wednesday, November 20, 2013 at 1:28PM by Scott Benner

There is still time - enter to win our diabetes circle shoe laces giveaway!

Bermuda Triangle

Last week around eleven in the morning, Arden texted from school to say that it was lunch time and she couldn't get any of her test strips to work. "I've tried five and they've all errored", her text read. 

No problem I thought, "What's your CGM say?"

"???", Arden replied.

We found that Arden could still deliver insulin with her OmniPod PDM so we bolused for lunch in the blind and I told Arden that I was leaving to bring her a backup meter. On the way to the school I spoke with OmniPod customer service (Picked up on the first ring!) and they suggested that I try a new vial of test strips. The CSR finished the conversation by saying that if the test strips weren't the issue, they would happily overnight us a new PDM.

I met Arden in the office a few moments later and we tested successfully with the new strips. The CGM sensor however, was toast, so we changed our testing strategy slightly and synched our reminder alarms. Arden went back to lunch and we managed the remaining four hours of the day the ole fashion way... with a meter.

In all of the years that Arden has had diabetes, this is the first time we've experienced a total and simultaneous loss of the ability to quantify her BG. Even though the timing couldn't have been worse, I never felt frazzled and I can only attribute that calm to having so much experience. I'm quite certain that this moment would have given me an aneurysm five years ago. 

Before I say this next bit, I want to remind you that I am not a medical professional and that the things that I share on Arden's Day are never meant as advice. There is a disclaimer at the bottom of the page if you'd like to read it. I gave Arden her lunchtime insulin in this situation without testing or the benefit of a CGM based on a number of factors. Time of day as it relates to her last bolus, we spoke about how she felt at length, based on historical data - Arden's BGs at this time of day over the week, the fact that she was going to immediately begin eating and I would be there with a new meter and strips in less than 10 minutes. I would never bolus without knowing the state of her BG in a normal situation.

We swapped Arden's DexCom G4 sensor (It had done more than its fair share... if you get my drift) when she arrived home and we were back on the path of technology based diabetes care, by dinner time. The PDM/meter has not given us a problem since, so I'm chalking this all up to an anomaly caused by faulty strips - but who knows.

Arden's Day is Six Years Old

Let's celebrate... It's the sixth anniversary of Arden's Day!

At exactly 3 AM on August 16, 2007, I posted my first blog entry on the Internet and "Decided to Share" began my online life as a type I diabetes advocate. I had no idea if anyone would ever read my little blog and there were times that I seriously considered closing Arden's Day because I doubted that I was adding a needed voice to the community. Well, it's six years later and I couldn't be happier that I made the decision to keep blogging, because so much has happened since that overwhelmed and exhausted guy first said these words...

I can’t sleep... Haven’t really been able to for about a year now.  On August 22nd Arden will be a Type I diabetic for one year.  I’m going to try and relay to all of you what Arden’s disease is, how it effects her and how it effects our family.  My goal is to give you a glimpse into our life so that you can better understand Type I diabetes... My hope is that the understanding will result in your advocacy.

Starting now I’ll be updating this site as much as is needed to bring you into all of this as completely as possible.  I’ll be taking pictures and video as much as possible.  I think diabetes is one of those things you need to feel to understand, an explanation just doesn’t do it justice.  It’s a much more visceral experience then you may think. That picture (above) is from just now (3:00 am), Arden just called me from her bed.  She wanted to lay down with us.  I checked her Blood Glucose (from here on out known as BG) and it was good.  Well not really good, high actually about 120 - 150 points higher then a non-diabetics would be at 3 AM but good for our purposes. Don’t worry it’ll all start making sense to you soon...  Please use the “Subscribe” button on the ‘Daddy’s Blog’ page to stay up-to-the-minute.  I really think that being updated every-time something happens will help bring you into the process. Please share this link with any and everyone you know.  Off to get some sleep...

Since that day, I've spoken to Congressmen and Senators, raised funds for the JDRF, written a book and met the most wonderful people. I could probably make a list as long as my arm of amazing things that have happened since I began to blog, but if I had to pick a favorite... it would be easy to choose. I am still, to this day, amazed at how much sharing our story helps others. Honestly, when I began six years ago, I never expected that. Moreover, I'm simply stunned by how powerfully you all return the love. That dynamic is, without a doubt, the most rewarding part of all of this. The relationship that we all have is one of the most uniquely human experiences that I've ever been a part of. Starting Arden's Day in 2007 was, without exaggeration, a life changing moment for me and that feels celebration worthy. Plus, six years is quite an accomplishment for a blog and I'm genuinely very proud to be able to lay claim to six years of diabetes blogging.

You are reading the 568th post that I've written for Arden's Day and the wonderful feeling that comes from sharing with you has not diminished one bit since 2007. It's my pleasure to be able to say that I am, in some small way, a part of something as wonderful as the diabetes online community.

You must be wondering why I am posting about an anniversary eight days before it happens. Easy answer... So you can be ready for what's happening next week. Stuff like...

Lauren's Hope is generously giving away some medical ID swagerrificness in celebration of Arden's Day's sixth anniversary!

Spry Publishing has donated a few copies of my book, Life Is Short, Laundry Is Eternal that I'll be signing and giving away. 

I'll be asking for your thoughts on what your JDRF Walk means to you and your family. A few days later, Arden will randomly select one of your comments and my family will make a $50 donation to your walk efforts.

I'll highlight one of my favorite posts from the past every day next week and reflect on them from today's perspective.

...and an announcement that includes giving away multiple copies of the newest Coco book from the Lilly/Disney collaboration, 'Coco's First Sleepover'.

I'm excited for Monday to arrive and hope that you are too! In the meantime, enjoy your weekend and good luck getting that Flintstones song out of your head!