MicroCell to the rescue

Lately the cell coverage has been spotty in Arden's classroom. The school does have WiFi and Arden's phone is connected to it but we still seem to be having interment signal issues. The other day Arden sent me a text that said...

"58 one arrow down", but none of my return texts made it back to her phone. I quickly called the office and they put me through to the room, but I don't want that to ever happen again so I called AT&T to inquire about the poor signal quality and find an answer to our problem.

The CSR thought (and I agreed) that a good fix would be to install a MicroCell in Arden's classroom. A MicroCell creates a cell signal with the a wired Internet connect, Arden's class has ethernet. We have one in our house and get good results so I thought it was worth a try. A few minutes later the CSR explained that he thought he could help with the price (It's $200) because of the medical need. Later that afternoon I went to my local AT&T store, purchased the MicroCell and by the time I dropped it off at Arden's school, AT&T had credited the purchase price back to my cell phone bill.

As I was saying goodbye to the gentleman on the , I expressed my gratitude one more time and he responded, "Think nothing of it, my dad has diabetes... I understand."

A huge thank you to the kind CSR and another to AT&T for hiring great people who take the time to listen.

Diabetes Sucks

We swapped Arden's OmniPod last night after basketball practice, it was a little later in the evening then I would have liked as being tired combined with jabbing a hole into yourself, seldom goes well - but then, what does go well with piercing your skin with a needle?

After we finished, Arden asked me if I would "cuddle" with her for "ten minutes" when she went to bed, great offer, I of course said, "Yes!". 

As we climbed into bed Arden had to reposition herself a few times, she told me that it takes a little while to become accustomed to having a pod in a new site and that she was going to sleep on her side because of the placement of this pod. Even though I am aware that she uses different sleep positions based on pod placement, the look on her face as she tried to get comfortable, mixed with the mature way that she explained the annoyance, brought me a moment of melancholy. 

When we finally got comfy Arden kept talking, and she told me that she wished we didn't have to change her infusion site so often. My mind immediatly raced back to before we began using an insulin pump and those long sad days of giving my baby ten needles.

"I know it hurts", I began. Arden stopped me and made it clear that I didn't know what it felt like to have type I diabetes and then she added this exclamation to her sentence saying, "Diabetes sucks!". "You're right", I replied, "I don't know what it's like". I rephrased, "I imagine that it hurts to get stuck with a needle and I know that having it happen every three days must suck.

Do you remember when you received insulin with needles?". She did not.

I told Arden how I would give her two needles every morning when she woke up. I explained how we'd test and shoot insulin later in the morning for breakfast, how sometimes a couple of hours after a meal she would need more. Breakfast, lunch dinner and "You would eat a snack everyday around three in the afternoon and one before bed". "Did I get a needle at snack time too?", she asked. By the time I finished explaining how we managed her BGs with needles, we counted ten injection. Two in the morning (BG maintenance and slow acting), at times two for meals (Carbs and BG maintenance), an afternoon snack, evening snack and two before bed (BG maintenance and slow acting). We decided that most days she experienced about ten shots and then we did some math. When Arden realized that with injections she would get stuck about a hundred and forty times in two weeks, she looked relived. More math told us that two weeks of needle sticks was the equivalent to one year of site changes. With that news, she proclaimed that changing her pods wasn't "too bad" but, "it still sucks".

A car accident that results in a broken arm is certainly not a cancer diagnosis, but it may well be the worst thing happening in your life. Perspective is certainly very important to have, but not at the expense of your own feelings. I am elated that Arden knows that her insulin pump has made her life better without forgetting that needing to wear it, to stay alive, sucks.

I left her room feeling proud, the melancholy had left me. Diabetes may suck, but she owns it.

Recall: FreeStyle and FreeStyle Lite Test Strips

From Abbott Diabetes Website:

November 20, 2013

Dear Valued Customer,

Recently, it has come to our attention that certain lots of FreeStyle® and FreeStyle Lite® Blood Glucose Test Strips produce erroneously low blood glucose results when using FreeStyle® Blood Glucose Meters, FreeStyle Flash® Blood Glucose Meters and the FreeStyle® blood glucose meter built into the OmniPod® system. Erroneously low results that are not recognized may pose significant risks to your health.

If you do not use the meters in the photographs below, your blood glucose test results are not affected and you do not need to read any further.

FreeStyle Flash® 
Blood Glucose Meter
 FreeStyle®
Blood Glucose Meter
OmniPod®

Please click here for Abbott's complete announcement that lists affected lot numbers and information about what to do next if you have strips that are part of the recall.

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.

Sure, you can go to the Selena Gomez concert

If you read Arden's Day with any frequency you know that we manage Arden's Bgs with text messages while she is in school, at a friend's house and every other time that she isn't in our physical space. I've written how the process has eliminated so many issues, lowered her A1c and making us all to feel more independent are but two. I am genuinely excited to tell you that we have recently added, "Go to a concert" to that list! Now you may be thinking that there is a world of difference between managing type I from across town and being an hour away in a stadium singing along with the former Wizard of Waverly Place, but you know what - not so much. It turns out that the biggest hurdle when considering the difference between the two situations is realizing that there aren't any.

I have two main concerns when Arden isn't with me. Loss of communication and An unexpected low BG. All that remains is manageable with pre planning. Supplies, food, and juice is no issue to pack and have at the ready. A well thought out testing schedule eliminates most surprise BGs and Arden's DexCom G4 finds the ones that slip through the cracks. Of course no one can plan for a significant BG drop that defies logic, that possibility is the diabetes equivalent of having a car accident - you wear your seatbelt, drive safely and hope for the best.

I received a call asking if Arden could go to the Selena Gomez concert with one of her best friends, I didn't hesitate to say, "Yes!". One year ago the mom on the other end of the phone wouldn't have been able to finish her sentence before I said, "Thank you but no". But so much has changed in the last year. Now when a person that I trust calls and asks for Arden to accompany them for an evening, I can say yes with less trepidation and that makes me very happy for Arden.

Here's how I handled Arden going to the concert...

First, the mother and I had a nice lunch together the week before the event. Even though Arden goes to their house for play dates, we still manage through texts while she is there so the mom doesn't have a lot of interaction with diabetes. She understood the basics and knows how to react in an emergency but the concert was going to require me to advance her understanding of type I diabetes. 

We spoke about all emergency possibilities in very, very real terms. I explained that I needed her to understand all that could happen, even though the likelihood of it happening was extremely remote. 

I said thank you for her willingness to except the extra responsibility and went about the seemingly impossible task of preparing a person for an evening with type I without overwhelming or causing them to obsess during the event. The last thing I wanted was for the extra considerations to take away from the experience that she was going to have with her own daughter.

We spoke about supplies, testing times, CGM check ins and how to talk to the security guys in a way that makes bringing food and drinks into the venue easy. We talked about panic situations, CGM arrows and how to use glucose gel. I explained low blood glucose seizures and that I was going to discreetly slip her the glucose gel because the sight of it makes Arden anxious.

I couldn't have been prouder of Arden and her friend's mother when they pulled out of our driveway for the concert. The conversations that we had and the topics that they had to consider, just to go to a concert, were more than a nine year old and her friend's mom should be asked to think about - but they did it. When Arden got into the car with her friends she was smiling just as a little girl on her way to a concert should. Thankfully, her BG's were rather uneventful during the evening, she required two maintenance boluses during the show (Adrenaline I imagine)  and a juice box on the ride home (No more Adrenaline) but other than that, easy sailing. When she walked through the door at almost eleven, her BG was 104 (DexCom had the BG at 74). Success!

Never once that night did I have to speak with the adult who accompanied Arden about anything related to diabetes. Actually, at one point she sent me a text and asked, "Is there anything I need to be doing?".

The bag of supplies I sent was returned to us unopened. Arden didn't need the extra OmniPods, insulin, needles or food. In fact, she would have been just fine had I not sent any extra supplies, all she needed was the juice box that she always carries in her bag.

I want this story to illustrate that everything is possible with type I, but what I don't want is to make you feel like planning ahead isn't necessary. This trip included a number of conversations, pre planning, a well packed bag and a little luck. Actually, to show you how much luck - Arden's OmniPod experienced an error the morning after the concert and I had to go to school and change it around 8:30 am. Can you imagine if the pod would have shut down during the concert? I could, and that's why we had a plan for how to handle that situation, should it arise. We planned for every conceivable possibility and talked about each ahead of time so that if they did occur, no one would be caught off guard or be unprepared for what to do next. 

Arden popped out of bed for school the next day and put on her concert t-shirt still smiling from the evening before -- suddenly, the effort that it took to get to that moment felt like no effort at all.