Left, Left, Left, Right, Left.

Arden's right hand knows a secret that her left hand doesn't, but it wants to tell...

I know that there are days when you worry about your child's ability to adapt and grow with type I diabetes - I worry too. That's why I loved it when Arden came to me recently for help becasue she couldn't figure out how to test the fingers on her right hand. Arden is right-handed and the other day she came to me and said that she knows she needs to vary the fingers that she uses for testing more frequently. The problem with that... she can't seem to hold the lance properly with her left hand.

This was maybe some of the best news that I heard all summer, here's why. First, it means that she really does hear the conversations about site rotation and she understands them. Second, she hit a speed bump and wasn't afraid, embarrassed or nervous to ask for help. Last of course, she is taking ownership of her diabetes, slowly, as she is prepared to do so. Diabetes on her terms, I love it!

The rest of the tale isn't as story book. I too wasn't able to hold the lance properly left-handed and after two tries she, a bit annoyed, took it from me and then proceeded to similarly fail at the task. So while the core issue was left unresolved, all that the issue shed light on is now out in the open and cause for celebration. That celebration only resides however, in my head and on this blog, two places where Arden doesn't have access. I did tell her that I was proud that she was thinking about rotating and we spoke for a few minutes about the fact that it would take some practice to use her left hand for the task, but I didn't make a big deal about it, not to her. I am however, celebrating in my head. This was a great moment and a clear sign of maturity and understanding.

Low Blood Glucose: Then and Now

I always think of anniversaries as a perfect time to reflect about how far we've come. It doesn't matter if you are talking about a wedding anniversary or an amount of time since something has happened, once and a while it is valuable to reflect and take a moment to feel not only what has transpired but what you've learned.

On August seventeenth of 2007, the second day that this blog existed, I was preparing to make a video with my kids when Arden's BG suddenly and significantly, dropped. Since my first inclination about the blog back then was to educate, I made the difficult decision to ask my son to turn on the camera as I was tending to Arden's low BG. More difficult was the task of later editing the footage. The video is not pleasant to watch, it's terrible in fact but if you have ever wondered what it was like to try and get a three year old whose blood glucose is dangerously low and falling to take in carbs, well, this sure does show what that is like.

Before you watch the video, I want you to please take a moment to read another post about low BGs that I wrote in June of 2011. I think that the two juxtaposed like this will leave you with more then enough hope if you are still struggling and if you happened to be past this part of your life, I think these two posts together will allow you the benefit of seeing how far that you've come. Either way, be proud of yourself.

June 1, 2011

Twenty Eight

I hope that this post serves as a source of hope to families that are newly diagnosed or still struggling to find calm... read on, I think it will.

 

Last Friday we were packing up and getting ready to enjoy a sleepover at Adventure Aquarium to celebrate Arden’s birthday. Arden invited two of her girlfriends and one of them arrived at our door as I was testing Arden’s BG.

 

Minutes before, Arden tripped while walking in her room and when I asked her if she was okay, she responded, “I feel dizzy all of the sudden”, we had just changed her DexCom an hour before so it wasn’t reporting BGs. As we made our way to the kitchen where her OmniPod PDM was I went over the afternoon in my mind and I couldn’t imagine that she was low. 

 

Test strip...

 

Knock at the door...

 

Blood drop...

 

“Hello, I’ll be right with you...”

 

Beep... and her blood glucose is 28.

 

So, there is a woman that I barely know in my foyer, sleeping bags and pillows all over the hallway and Arden’s BG is 28. Not just 28 but very unexpectedly 28 and she was still in the middle of a bolus and I expected (no DexCom) that she was falling.

 

This next bit is where you take hope from the story...

 

I didn’t flinch. No elevated heart, no sense of panic, I wasn’t upset and as a matter of fact I maintained a calming conversation with the woman in my house as she considering panicking.

 

I explained the situation to Arden, shut off her basal and she began eating and drinking. 64 grams later all was normal again - except, it never wasn’t normal. A sad statement perhaps that this all could be a normal part of someone’s life but what the hell, it is... When it was over and the mother left, I felt like I was ten feet tall. In the past I did my best to stay calm in situations like this (they don’t happen often thankfully) but I was doing just that, trying to stay calm. That is, in the past I wasn’t calm, I was frightened and I was trying to maintain my composure and stop Arden from having a seizure. I was scrambling to stay ahead of the situation.

 

Last Friday, I was calmer then George Clooney on an old episode of E.R.. Not ‘old’ George Clooney, the one that is starting to look like he doesn’t belong with those young girls... young George Clooney, back when he was bedding down those nurses in the break room. I was all suave like that, except instead of nurses, I was rockin’ the juice box and I’m fairly positive that the bottom of G.C.’s foot is more handsome then I... However, other then those differences, I was exactly like that. ;)

 

I finally have my 10,000 hours of practice and one day you will too. Moments that now may feel like they are happening at 100 miles an hour will slow down to a Matrix like kung fu speed and you’ll just move through the slow motion around you, completely in control. I bent the spoon baby!

 

Okay, I’m out of odd movie and TV reference so I’m going stop.

Now you can watch the video from 2007... Be prepared, it is tough to watch.

Low Blood Glucose Isn't Pretty

In two more days Arden's Day will be six years old and on the 22nd, Arden will be living with diabetes for seven years. These years have at times been nearly impossible to traverse, there have been countless low BGs and moments that I was sure that I couldn't live through... but I did, we all did. Arden is fine, I'm not crazy, Kelly and I are still married and Cole seems pretty normal (as normal as a thirteen year old can be). Diabetes hasn't stopped us, in fact, and I say this with great deference to all the bad that it brings... I think it's made us better. More tired maybe, but stronger and more resilient. Today, as I reflect on all that has happened to us I can see how far we have come. I no longer feel the fear from that video when I watch it, just the triumph of living through it. My advice is simple, reflect today and give yourself the credit that you are due.

Small World

Kelly, Arden and Cole went to a movie the other day while I stayed home to write. They were gone just a little over an hour when I received a text from Kelly, she was concerned that Arden's canula had become dislodged. Arden's BG was rocketing in the darkened theater and Kelly thought that I should bring some insulin and a needle.

With two syringes and a vial of Apidra in my pocket, I approached the customer service counter at our local multiplex expecting to find someone who wouldn't understand why I needed to enter the building without buying a ticket. When it was my turn a young lady asked if she could help me and I said, "My daughter is in theater fourteen, her insulin pump isn't working and I'm here to give her an injection". Before I could tell her that I would only be in the building for a few moments she said, "No problem, go right in". I have to admit that I thought her lack of resistance was because she heard some "medical words" and didn't want to get involved.

I texted Arden, she came into the lobby to meet me, we tested and shot right there on the bench. Our entire interaction lasted maybe four minutes.

On my way out I waved to the girl so she would know I was leaving. To my surprise she called to me and asked which pump Arden uses. I told her OmniPod and she responded, "Oh, the one without the tubing... how do you like it?". Now this girl was perhaps nineteen and I could only think of one way that she would know that so I said, "How old were you?".

The lovely CSR told me that she was diagnosed when she was nine and then asked about Arden. "Just after her second birthday", I answered. The girl smiled and said, "She has me beat!".

We exchanged pleasantries before I said, "Small world". Turns out that the pod was delivering insulin just fine though Arden did need the insulin that we injected. I think maybe the entire trip was just the universe's way of letting me meet a happy, polite and thoughtful young girl who has type I diabetes. I smiled all the way to my car.

(Almost) Up in the Air

How many OmniPods would you take on a ten day vacation?

If you were going to leave your home early one morning and drive over an hour to an airport to catch a four hour flight, one that would take you to a remote island location for ten days... how may OmniPods would you bring?

I brought eleven

I also brought two hundred test strips, an extra MultiClix, an entire package of lancet cartridges, one backup OmniPod PDM, a ketone meter with a 50 strips, two glucogon kits, four vials of Apidra, five DexCom sensors, a brick of juice boxes, candy, fast acting glucose tablets, five packages of needles, FlexiFix, AAA batteries, a DexCom charger and three copies of the travel letter that our endo wrote.

Other than the fact that everyone was a mix of exhausted (long year) and excited (we never go on vacations like this), our flight to the Caribbean was uneventful. The TSA experience in New York was fast, pleasant and so accommodating that the multiple juice boxes we brought through screening were treated like medication. Actually, for the first nine and a half days of this vacation all of my extra supply preparation was unnecessary. We never had one issue with our D technology, sensors stayed on, insulin resisted the heat and diabetes was a perfectly behaved travel partner.

It wasn't until we were literally walking out of the door to return home from our island getaway that things began to go the other way. I knew that the odds were stacked against us, I mean, how often do you get to go ten days without a significant diabetes issue that requires your inner MacGyver?

During travel, I keep enough supplies in my carry on bag to complete one site change. The bag also contains enough insulin and needles to manage for a full day without needing the backup supplies that are in my larger luggage. I lug that stuff with me when we fly with the hopes that I'll never need it.

Was it an omen, probably not... I don't believe in omens, but I did drop a vial of insulin as I was packaging the Apidra back into it's ice pack for the trip home. Fun Fact: I've never broken a vial of insulin until the one in my hand hit the stone floor of our rental home. No matter, I had three more. #prepared

We drove our rental jeep to the ferry, made the short trip from island to island and then jumped into a taxi destine for the airport. It was during that taxi ride that Arden's BG got a little squirrelly, I bolused. TSA was again a dream and before we knew it our bags were off to the belly of the plane. All that was left to do was to grab a pre-flight meal and wait to board. We ate, found our way to the correct gate and planted ourselves in some soft chairs. 

Ferry Departure

BEEP BEEP goes the DexCom

"I must have miscalculated the airport food", that's what I thought when Arden's CGM indicated that her BG was rising thirty minutes after our meal. I reassessed and added more insulin but the beeping continued, soon after the arrows changed from diagonal up to one arrow straight up. Before long, the arrow found a friend... two arrows up. Hmmm, WTF!? Turns out that Arden must have unknowingly banged her leg into something during our trip from paradise to the airport, I noticed a tear on the OmniPod adhesive and the canula looked withdrawn. Interestingly, on the same day that I dropped my first vial of insulin our first canula became dislodged. What a diabetes day we were having, I wonder what could make it even odder? How about my first airport pod change at gate 4. Honestly, it didn't bother me to change the pod there and Arden didn't care... she isn't shy about diabetes in public. So I balanced everything on my lap and set what didn't fit on my leg behind Kelly on the chair next to me. I filled the pod, primed, inserted and removed the old device in a few moments. We tested, increased Arden's basal rate and then busted out a good ole' fashioned needle to combat her wildly high BG of 425. 

I'll admit that I was a bit panicky for a moment, the notion of chasing this high number in the air dind't sit well but then I remembered that we had a full complement of juice and other items. I did experience a wave of dread as I used the only spare pod that I had in my carry on bag. I began to run through scenarios in my mind, how I could talk TSA into retrieving my luggage from the plane so I could get more? But then I calmed down, we boarded the island way (see pic at top) and a number of hours later we landed at JFK airport where Arden's BG was 113. Seems Ben Franklin was correct, An ounce of prevention is worth a pound of cure. Smart guy. I may not be Franklin but I know this for sure... Bring extra supplies when you travel, you never know what may happen.

Luckily, we can only afford to go on a trip like this once a decade, so I have time to rest and recover!

Finally, here are some obligatory vacation photos.

OmniPod, DexCom... you impress me

 

Tonight is the sixth night of our island vacation and I wanted to take a second to report in. So far during our trip Arden has been on an airplane, outside in the rain, lived in 90º heat and spent countless, often consecutive hours in the ocean. 

I am here to report that Arden's diabetes tech has not skipped a beat... I can't tell you just how invaluable these tools are in difficult situations like these. Between odd sleep times, varied and strangely timed meals and all of the activity, there is enough going on to mess with even the most Zen diabetes guru. I am not ashamed to tell you that I'd be just a little lost without our gear. 

I'll leave you with a picture of Arden in a mango tree.

I hope everyone is having a great week!