Verio IQ..our opinion

At the beginning of the school year, our diabetes nurse suggested that we try out the Verio IQ meter.  She thought it was really "neat" and very teen friendly. I watched and watched to see if it was going to be given away free with test strips.  I know how many strips we use in a month so I was hoping that there would be some sort of an offer made...but there wasn't.

I had a contact with LifeScan that I could ask for a sample of the meter. I have known him for years and he knows that we test a LOT but I had long since lost his contact information despite seeing him only a few months before.  I really have to be more organized!

I was forced to listen to stories and drool at the thought of playing with a new toy...until the George Canyon Heroes Tour! My luck changed! LifeScan was displaying "OUR" meter!! Better still, they were giving them away! I happily went away with a new white Verio IQ meter and of course the rep's business card to be able to keep in contact.

My son, as I have mentioned, has inherited my love of new gadgets. Its the benefit of life with diabetes--cool new stuff! He began using it sooner than me and based on the fact that it is now his meter of choice when he is home, I am thinking that he likes it.

The first week of use was a learning curve for us.  Part of the problem is my son is male--in my experience this means that he does not believe in reading directions. He will figure it out on his own.  This meant that for at least a week, we had no idea how to turn off the meter and he would let it go off on its own causing the battery to die very quickly.

I finally decided to check out the meter myself.  Note to self, 3am is not the time to try out a new meter. Joel had shown me the amazing light for this meter so I was certain that I could test completely in the dark.  I could open the test strip canister without a light on in the room. I could use the light of the meter to insert the strip, to lance my son's finger and get the exact right amount of blood. You can see where this is heading right? Yes, to complete disaster!

The light was incredibly bright but when I opened the strip canister I grabbed multiple strips rather than one.  The extra strips found themselves scattered all over the floor...and did I mention that this was 3am? I finally got a hold of a test strip and tried to put it in the meter.  It didn't work.  I had two strips in my hand.  I got rid one and tried again.  I put it in upside down.  The light had turned off on me and things were not looking good. When I finally had the strip in and blood on my son's finger...well there was not enough blood for the strip. I gave up!

I decided to learn in the light of day.  I would be prepared next time around. Despite my stumblings, my son kept using his meter and marking off his tests as before or after meals. He was a little disappointed that there was nothing to indicate that he was stressed when he tested. This was an option he found and used on his Contour USB. 

I was impressed at how easy it was to read the history.  At a glance, I had a great view of his tests for the day.  With a click of a button, I could see where the meter saw trouble spots.  It was great! I have to admit that I haven't bothered to sit down and log because when he exclusively uses this meter, its all there. It tells me trends and I can make decisions based on what was going on during that time frame. Its great!

Our rep told me that the meter can be uploaded to some online software at One Touch.  I haven't tried it. I am not great at that sort of stuff. Perhaps if he chooses to use the Verio IQ for school next fall I will have to check it out so we can sync data from the two meters. I never thought I would stop logging with paper and pen but I will say that this meter is beginning to convert me!

Strips on the floor

The Verio IQ is definitely a meter for those who love gadgets.  Its great for night testing as the backlight is amazing! Its actually a front light that lights up the strips and the space in front of it. The downside, I do have a hard time grabbing test strips at night and think that anyone with dexterity issues may find this a problem.  I also find that these test strips walk more than any other we have seen. Perhaps its the fact that they are gold and they have a superior attitude but they can be found anywhere at any time! It amazes me.

The Verio IQ is definitely a keeper! We love it and will definitely be using it to spot trends over the summer and possibly beyond.

Another Step Towards Growing up

My first question to my son each morning when he reaches the breakfast table is "What was your reading this morning?" There are a number of reasons for this greeting. First is the fact that he has been known to get up, eat his breakfast and forget to test.  Another reason is that he also will forget to prebolus when he is high before breakfast or correct for a reading that is high but he thinks is okay.

This morning he hadn't tested when he woke. I said it should be done before he leaves his bed each morning. He said he was too tired. He had been up for over an hour last night because of a high.

Whoa! What? How did I miss this? Was this before I tested him? Was it when he first went to bed? Did he need to do a new site? What was going on? Instead of peppering him with all of those questions, I first asked "What time were you so high? and what is high?  I had tested and corrected a 20 (360) at 2:30am maybe we need to do something." 

He explained that he was up at 4:30 and his bg level was up to 25 (450).  He had air in his cartridge that was creating all of the havoc.  He was pretty sure he had fixed the issue but it took him an hour (so he claims) and he was not a happy camper this morning. He proceeded to correct the 14 (255) that he was down to and bolus for his breakfast. 

I watched him both proud and sad.  He had woken up (at least he wakes for highs if nothing else).  He had taken charge of his care at a time when we all want to sleep instead of engage our mind.  He had not come and woke me up.  He dealt with this on his own as he had been taught.

He is not yet 15.  He should not have to be getting up at 4:30am to fight with air getting into his body.  He should not have to feel the ramifications of a high blood glucose level.  He should not know what any of this means and how dangerous it can be. 

But he did. But he does. This is his life. This is his disease. This is part of growing up as a child with diabetes...and I still hate it.  

The old bait and switch!

Last night I laid in bed and realized that my son could easily be a used car salesman...any salesman. He could probably sell ice to Eskimos. 

Exam week for both of my boys is next week. I have said that I am glad that they live in two different homes because my stress level for both of them would be through the roof. For my oldest...well this is for all of the marbles. Its his final set of final exams in high school.  For my younger son, its his last set of exams before he officially begins his high school years. Either way, I will worry and I fret knowing that both of them can do well and praying that they won't cave under pressure.

It was this mindset that took me into my son's room last night. We went over his science information. He aced it. How was math coming along? They had had extra periods and he had a firm grasp of the concepts.  I asked him about social studies. He didn't have any books to study with...he hadn't bothered to bring them home yet but he swore that he knew what he needed to study. I told him to bring home books!

I then moved on to  diabetes care and his glucometer. "How have your readings been?"

"Pretty good actually.  Well, except for that last reading. That one was pretty high but I am sure it was an error. I think there was something on my hands."

"Did you retest?"

"Yeah, but it still read kind of high.  There is no worries about my social studies Mom. Its all about World War Two and I know it cold.  I know everything there is to know about Hitler. He was born in April of 1889.  His mother died of breast cancer when he was 16 and his father was dead when he was 12...." and the conversation went on. He wowed me with his intricate knowledge of the life and times of one of the most evil men to walk our planet.  He continued right up until the time of Hitler's suicide, highlighting salient points and noting theories such as his cruelty was driven by the damage syphilis had caused to his brain.

I left his room amazed and impressed. If he was right and this was the focus of his exam, well he will ace it! As my head hit the pillow I realized that I had been duped. I had fallen for the old "bait and switch" and swallowed it hook, line and sinker.  I never asked if he had checked his pump. I never asked if he had corrected. I never asked when the last site change was. He managed to move my mind away from the issue of why he was high. I just listened to the huge wealth of information that he had in his head with pride and blissfully left the room.

At 1:30am, I woke wondering if we would pay for me being snookered and my son would still be high.  Sure enough, Mr. 22 (400) was still rearing its ugly head!  I checked his pump and he should have changed his infusion site days before. I got my own revenge as I prepared his exposed arm and did a site change right there and then.

I stumbled back into bed and shook my head.  Yes, my son had managed to wow me with his knowledge of history and distract me from his poor diabetes care with the ease of the slickest of sales men.  He may need to rethink his career plans yet!

Is a person with diabetes "disabled"?

Recent conversations have me thinking about something that honestly I have never really personalized.  For many years, I have been knee deep in the debate on whether diabetes is or is not a disability. In that debate, I was put in the position of stating that diabetes was not a disability. It was a disease that required Life Sustaining Therapy.  I knew that my son did not in any way shape or form see himself as disabled but what was my own feeling? Would I be okay with my son being labelled this way?

My first answer is an unequivocal no.  This is the gut talking so I decided to investigate the concept a little further. What was the actual definition of "disabled"? Did my son fit this definition if I was honest with myself? I went to the Webster's dictionary and looked up "disabled".  They defined it as "incapacitated by illness, injury, or wounds; broadly it is defined as "physically or mentally impaired".  I would not say that my son is incapacitated in any way but what what about the "physically impaired" part of the definition?

I looked up the word "impaired". It stated that to be impaired was "being in a less than perfect or whole condition:  as disabled or functionally defective."  So was my son physically in less than perfect or whole condition?  Technically yes.  He was born with a fully functioning pancreas but now he relies on technology to do that work for him and with him.  Is he functionally defective? Again, I guess so.  If you leave his body to its own devices...well he will die. Its sadly that simple. 

According to Websters dictionary, I would have to agree that my son is disabled.  Did you just see that tear roll down my cheek? My heart says my son is NOT disabled.  There is little that he cannot do but he is not the same as everyone else who is completely healthy.  My older son does not have to worry about being found dead in bed.  He does not have to count every carb that enters his mouth so that he can balance it with insulin, his body does this.  He does not need to make himself bleed multiple times during the day just to make sure that he is in optimal health.  He does not need to sit out physical activities because his blood glucose level is too high or too low to participate in an activity. My older son does not need to worry about how alcohol effects his glucose levels when he chooses to drink.  He does not need to test his blood glucose level before getting into a car.  Their lives, while similar, are also very different.

I still cannot call my son disabled. I will not fight for a special parking spot at the grocery store in case he is low.  I will fight for teachers to recognized that he is not always cognitively able to write tests or exams based on blood glucose levels. I will not however get in the way of his dreams.  People with diabetes have overcome the "disabled" or "diabetes" stigma to fly commercial aircraft, play professional sports, climb mountains, become police officers, and loving parents. 

For those who chose to allow their children to have this label...well I guess that they have valid reasons according to the dictionary for doing so.  Personally it still remains a very grey area and that I still cannot enter but I now have a new perspective on those who feel just as passionately that the label does apply.

Angels and alarm clocks

"Mom, I am going out on bike for a bit!"

"Did you test?"

"Did I test? Mom, would I engage in strenuous physical activity without first testing my blood sugar levels? Of course I tested!"

Insert eye roll! "Yes you would!" I yelled to him as he headed out the door. I do have to admit however, that he is improving. He still forgets to test. He still is not keen on testing or showing his pump in public but he is getting better.

When he goes out, I still have moments of panic.  Will he deal with a low when he is with his friends or will he find himself in trouble? Did he remember all of his supplies? Are his pockets filled with glucose? Does he have his phone? The moments of panic are fading a little more quickly. I am starting to have a bit of confidence in his abilities but I am sure that I will never be 100% free of worry.

My son returned to the house after an hour, full of sweat and ready to jump in the shower. "Don't forget to test!" I reminded him. It was his turn to give me the eye roll!

That night I went through his meter. I had been slack in checking but all had seemed good. I knew that with increased summer activity problems were soon going to arise but once again I debated...lower the night time basal and risk him going high or let it ride? He hadn't been that active...or so I thought. Perhaps the day of studying and being a lump would offset the activity in the evening and he would be good to go. I left things alone reminding him to test before he went to bed.  His meter had shown that he was staying up a lot later than normal and was testing before he went to sleep so he should have had a good gauge of his night reading before he pulled up the sheets.

I went to bed, resetting my internal alarm clock to a little later than normal.  It didn't work. I woke up at 1.  My son was still up. He had tested and was 6.8(120ish).  Why is it that you always assume that they will drop during the night? I liked 6.8. It was a nice reading but I didn't trust it. He was going to drop. I reset my internal alarm until 3 or 4am and back to sleep I went. On cue, I was awake by 4.  On cue, he was 4.1(74). I gave him a large glass of apple juice and crawled back into my bed for 15 minutes.  A retest revealed....that his blood glucose level had not moved. CRAP and thank goodness I woke up! More juice, more waiting and finally, close to 6am, he was back in range. I drifted back to sleep with plans of changing his basal rates in the morning.

I hate diabetes but once again, I am so grateful that I have those guardian angels that wake me up before we reach extreme lows.

Unsafe at School Reaches BC Medical Journal

Last week, the BC Medical Journal published an article called "Unsafe at School: Advocating for Children with Type 1 diabetes."  It is my understanding that the document was created by parents and endorsed by many in the medical community.  It was a huge feat to have this reach such a publication.  It added weight to the argument that children with diabetes in schools do have special needs based on their medical condition. Parents are not asking for help for their children with diabetes in schools just because they are too lazy to take time off work to run to schools.  There are many more concerns here and those concerns are justified.

The article does a great job of highlighting the real impact of hyperglycemia on learning. They note that extended exposure to hyperglycemia can have a long term impact on cognitive performance.  The authors further state that because some parents are not able to get to school themselves nor are they able to get a friend or relative to go to the school to inject their child, they are put on inferior insulin regimens and the children are often forced to run high during school hours.  As previously noted, this means that the student's ability to learn in the afternoon session is severely reduced. 

This problem could be alleviated if aides or other school staff were allowed to assist with injections or boluses.  Sadly, the article states that the BC Nursing Support Services feel that such people are not qualified to do these tasks. Personally this is political rhetoric.  If this was the case, that a teacher or aide could not be trained to inject insulin or deal with glucagon, then why are we as parents, not sent home with a nurse when we leave the hospital with our child? Parents of children with diabetes come from all walks of life and all education levels and yet everyone of us is required to test, inject, and manage glucagon if the need arises. We are trained by diabetes educators and if we do not use that training we are charge with criminal negligence regarding the safety of our children. I have spoken with educator and classes of students wanting to work in the school system, most are very willing to learn and be taught to assist their students to the best of their abilities.  

I do have two small issues with this article however, but let me preface first that I know how hard it is to get consensus and that some points have to be made at the sacrifice of others.  It can often be necessary to use extremes to get the attention of those most important.

My first concern is the argument of children with diabetes being labelled as disabled.  I was recently made aware that the Human Rights Commission of Canada has chosen to recognize diabetes as a disability.  This is a very sticky area.  Many people with diabetes work very hard to show that there is nothing that they cannot do.  They have fought various organizations to prove that they are just as capable of flying planes and working in the protective services as anyone else.  They do not see diabetes as a disability.  My son would fall under this category of people.

Other people feel that someone with diabetes is disabled. They have a disabled pancreas.  The need to have an external source of insulin, to test blood and carry glucagon is not normal. The fact that a person with diabetes cannot always participate in activities because of hyper- or hypoglycemia, in some people's mind makes them disabled.

In the US, this concept is widely accepted.  In the US, people with diabetes are considered disabled and protected both at work and in school by the American Disabilities Act.  This allows students to receive, on paper at least, protection of their rights to inject, have assistance, and be exempt from writing exams when out of range.  Sadly, schools still fail to provide their students with the proper protections, often discourage parents from implementing these plans, and are looking to remove school nurses from some schools leaving young children with diabetes in a similar situation to our own children here in Canada.

There is no easy answer.  We do need protection for our children.  We do need standard policies in place--not just for our children but for the educators as well. Staff need to understand what diabetes is.  They need to understand how each child is unique in their needs.  They need to understand that while the needs of a child with diabetes change over the years, there is a need for assistance from pre-kindergarten all the way up to grade 12 and beyond. 

This was my second issue with the article.  I wished that there had been a way to expand their focus a little more.  A child who is five may not be able to inject themselves or understand how to bolus but a child of 15 may not be able to see his/her meter when are high and properly handle their diabetes care.  A child of eight may do poorly on an afternoon test because their blood sugar was high but a child of 16 may fail a provincial exam because they were also high but no one noted their blood glucose levels and waited for them to be in range to have them take that test.  Finally, a child who is 7 may not yet recognize when he/she is low and will require an adult to keep an eye out for them when the stumble on the playground and feel out of sorts.  A child of 17 needs the same protection when they stumble in the halls because they are low but are mistakenly sent to the Principal's office for being intoxicated in school. The rights and safety of children of all ages must be protected. They all can be in dangerous situations just because they happen to have Type 1 diabetes.

I applaud the initiative and the passion of these authors. I truly hope that the legitimacy that this article gives to some of the issues children with diabetes in schools face help students not just in BC but throughout Canada.  Our concerns are real.  Diabetes is deadly.  Treatment methods are changing and schools must be able to accommodate the needs of our students, allowing them to use the best possible treatment methods in school so that they can be at their very best to learn while in the classroom.

You just never know

Recently a friend shared her daughter's experience and I wanted to share it with you.  Its a fabulous reminder that no matter what we think or do, Diabetes is always with us.  We must always be prepared and never let our guard down.  There is no situation in which it is okay to forget a meter, insulin or extra glucose.  Things happen and when Diabetes is also in the room, normal things can be dangerous!

Hello Barb. I wanted to let you and your other readers know about something that happened to my daughter. We were staying at a hotel in Toronto last weekend. She went to the pool area for a bit, then got stuck in the elevator for 50 minutes. We rode it up to our floor, then the door wouldn't open, then it continued up and down without opening for 50 minutes. She was in contact with the hotel people with the emergency phone and the hotel contacted our room to let us know what had happened and that they were getting her. But...it took 50 minutes. After she was released from the box she wanted to walk the 7 flights back to our floor, and the security person escorted her. The hotel went to great lengths to make up this inconvenience to us. I hold nothing against them. My reason for sharing this is a reminder that diabetes must be considered for everything we do. Even something as innocuous as an elevator ride...you don't know how long you could be in there. Now I have another time to ask her if she has her glucose.

This experience sent shivers down my spine and I am so grateful that it was shared.  How often have we run out somewhere for just a minute without worrying too much about supplies but how often can we get sidetracked by friends, stuck in traffic or caught up in an emergency that does not allow us to get home when planned.

Diabetes does not care what situation you are in. You must always be on guard. You must always have your supplies...no exceptions because, well you just never know!