Who Will Do the Pouring?

It was 6:30am.  I woke up in shock at first that I had slept so long and then calmed myself. I had gone to bed after 1am and my son was still up doing his “thing” for a few more hours.  He tests before he goes to bed so it was probably just the right time to test. And I was right…

I checked, doing my best to stay 3/4 asleep so I could doze instantly when I returned to bed.  He was low.  No such sleeping allowed. I got a glass of juice and told him to drink.  I continued my routine of heading back to my room to wait for 15 minutes.  As I headed back however, I began to think…what will he do when I am not there to wake him and bring him juice? I know that many adults with Type 1 diabetes handle it fine.  They have glucose or juice boxes by their beds. They wake up and deal with it. Its part of their lives…but this is my kid. He is not an adult that I know.  No matter how big he gets he’s my little boy.

I hope that he will wake on his own. I know he has done it (and complained about this new-found ability) when he was away from me. It still makes me worried. My son is very private about his diabetes. He is also very independent.  That is a good thing and a terrible thing for a mom.  I know he has good friends. I know that they would watch for him if he was living with one of them…but what if he wants to live alone? Well, he should have that right! But as his mom, I worry. I know it will sort itself out. I can’t borrow worry. I can’t predict the future.  At night, nightmares rear their heads though.

Its daytime now.  Time to focus on the today…like getting him to take out the garbage and Swifter the floors! He will soon be 16 and there will be enough to worry about with him learning how to drive.  I will save the worry about how he will handle nights alone for a few more years…or another late night/early morning low worrying session!

No Blood? No Tears? What Happened?

Wow! Did that really happen? Was it really that painless? Did I miss something? Why am I not ready to cry in frustration? Are we making progress?

The other day, I sat down with our notebook. Its the one that says what sort of workout my son did, how intense it was and what we did about diabetes care as well as what sort of results were had. I asked for his meter and I plugged it into my iPod.  It had only been a few days since I had done this. I was still a little nervous about what I would find. 

Despite the fact that bg level reviews are supposed to be a time for discussion and learning, they normally are times when I cringe and want to cry while my son glazes over and comes up with strange excuses for missed readings. This time was very different!

I noted the readings.  We talked about foods before exercise. We talked about foods after exercise. He talked about how he felt exercising with various foods in his system.  We looked at missed readings and high readings. He was quick to point out his own errors and state that he needed to improve to get back to that guy he had been the week before.

I told him he had done really well. I was impressed.  He walked away with his own definition of what needed to be done and I did a small bit of tweaking based on my own feelings.  The biggest shock was the feelings and the atmosphere when the process was over...It was great! There was peace.

I felt good. I was happy to see readings and an interest. He felt pretty happy with things in general. He had seen decent numbers and had a strategy for readings that were a little off.  There was no blood spilt.  There were no tears.  Could we be making progress??

He goes away in a week and will be on his own for his diabetes care. This is normally a time when he applies the motto "When the cat's away, the mouse will play!" or his his case when the mouse is away from the cat but you get the idea! I have been reading Moira McCarthy's book as often as I can.(Blog review to come later!) I think I have a better grasp of will most likely happen while he is gone and why.  I think I may be better able to handle it when he comes back...well maybe...well I will try anyway! For now, I will just savor a really nice sharing of diabetes information with my son. 

Another Night, Another Battle with the DMonster

3:15am.  I looked at the clock and began to do the math. How long was it since my son went to bed? What would his bg level have been? Do I really need to test yet or was it too soon? My bed was comfy.  It took me forever to fall asleep.  Did I need to get up or should I sleep another hour?

I figured that he had probably tested around 1am but something still made me drag my tired butt out of bed. I made sure to not be fully awake. No major movements to disturb the still sleeping parts of my body.  All would be fine. My mind would be appeased and I could go back to bed…or so I would have liked but the meter said differently.

He was 4.3 (77).  Not ideal for sleeping in my world.  I quickly woke the rest of my body and my brain began to fire on a few more cylinders.  It was time to find some glucose! I went to the fridge and for some reason it was filled with diet Pepsi, diet lemonade, and zero calorie flavored water.  Nothing with any decent amount of carbs in it! Okay no panic I had glucose somewhere. Eventually I found a bottle of liquid glucose.  I got my son up enough to drink and sat on the couch to wait.

I checked out the world of Twitter. I caught up on the latest happenings in the world of Facebook and read a few pages of my book.  Soon it was time to check him again.  Success…well sort of. He was now 4.6 (83).  It was still far from ideals but he was on his way up.  I scoured his room and found a bottle of glucose tablets. He would not be happy in the morning. He says that they leave a crappy taste in his mouth when he gets up but a glucose hangover it would be.  I fed him three tablets while he slept and returned to my own bed.

I wish I could say that I instantly fell asleep but I didn’t.  By 5:30 I was still staring at  the clock.  Thankfully its Saturday so I could sleep in a little bit but by 6 I checked one more time just to make sure all was still okay. He was a lovely 7(126) so I was happy to doze for a few more hours.

Diabetes may have kicked my sleep pattern to the curb for one night but we are ready to fight another day…and make a few changes to summer basal patterns!

 

School's out for SUMMER!

Wow! Its finally here…the last day of school before summer vacation.  I am excited and sad.  Gone are the days when I would attend the last day with my boys, watch an awards ceremony, share in events, and cry tears of joy as I watched them grow.  I only have one child in school now and school as become his domain.  I can meet with teachers at the appropriate times.  I can send them a note about his diabetes care but the rest is up to him.

Last week was exam week.  For at least some of those exams he actually tested before he started to write his tests.  In at least one case he was high before he started. I asked him what he did?  He told me that it was a two hour exam but they had been given three hours to complete it.  The first hour he used to get his bg levels back in check. The final two hours he did his exam and corrected anything he had got wrong in the first hour.  I was proud and sad.

I was excited that he had checked! I was proud that he was able to take control of the situation and make it work. I was sad that once again diabetes had to mess with such a normal activity…a science exam.

The momma bear in me was all prepared to stand up for him and ask for accomodations if his mark was not where it should be.  The mom of a young man with diabetes said,” he has handled this his way.  Let it be.” and I have.

I often write about how I fear that he will never take the lead in his diabetes care. He has a very cavalier attitude about so much in life, will he ever realize that this is serious? Adults tell me that he will. They tell me he will struggle, he will trip but that I have given him a good foundation to fall back on. I hold onto those words with both hands!

I am seeing changes. As I have written about a lot lately, his interest in diet and exercise has had a very positive impact on his testing, his readings and his interest in his care.  He knows that his bg levels need to be at their best so that he can perform at his best.  That is a more powerful motivator than any of Mom’s lectures. He still isn’t perfect…but he is learning. The true test will be when he is away from me and dealing with his care on his own this summer.  I admit that I am nervous. When he went away over Easter his care was non-existent.  He tested once a day on a good day.  I can’t worry about that. I can’t think about it.  These short stints will prepare him for the next few years when he decides to move away from me and begin his own life…but its hard not to worry because I am a mom after all!  

Diabetes and Exercise...What I learned last week

In the past few months my son has really gotten into body building.  I am not talking on the competitive Mr. Universe scale of things, but simply getting fit, building muscles and looking "buff".  He was following the George St. Pierre workouts and is currently working out to the "Body Beast". I am excited to see him taking an interest in his health.  I am impressed to see the muscle tone and the dedication that he is giving these efforts but it is also presenting new challenges to us--how to manage diabetes and exercise!

I was therefore overjoyed when I saw a poster from my Animas rep stating that she would be bringing two people into our area to speak on just that topic! I was dying for my son to actually attend and learn himself.  He was equally sure that I could go and bring him home the Coles Notes version!  In the end, he won with the valid excuse of having to study for final exams.

The night's two speakers were Sebastien Sasseville and Heather Buckle. Both of these people are extremely athletic and living with Type 1 diabetes.  You may know Sebastien from his mountain climbing expedition to the top of Mount Everest, his recent run across the Sahara, or perhaps his many IronMan races. His motivational talk incorporated how important his diagnosis of diabetes has been in his personal growth as well as to his development as an athlete.

He explained how vital it was to have dreams and actually work towards them! With or without diabetes, it is important that we refuse to be still and we continue to evolve at all times. He refers to diabetes as a houseguest that is now your roommate and how you must learn to live with him/her in order to get the most out of your life.  He reminded his audience living with diabetes that it is not about the A1c, its about the journey to get there.  As a personal life coach, it was great to hear him reiterate some of the same things that I had recently talked about in my "Normal is Just a Setting on the Dryer" session!

Sebastien also spoke a bit about his control and how he handled his diabetes care. I was surprised (although I should have intuitively known this) that the same exercise at different times of the day has to be handle in different ways.  This was important to bring home to my son who may workout at 8pm on a weeknight but 2pm on a weekend.  I tend to worry about workout times more in the terms of "let's make sure he is not low during the night" and that is where it ended. This was a great talking point to use when I got home.

Heather continued the discussion on how to handle exercise and diabetes care by giving some great information on physiology.  She has been living with diabetes for 27 years and is an athlete as well as a physiotherapist and Certified Diabetes Educator.  She offered tips that my son and I had not even considered!

She noted that basal rates should be dropped by even a small bit up to two hours BEFORE exercise, the importance of eating within 15 minutes of exercise, and keeping an exercise diary.  She is the first person to show me real guidelines for when you can and cannot exercise when dealing with a high blood glucose level.  Its a question that parents often ask me when writing up plans for school--when is my child too high to participate in gym class? It turns out that the magic number--with or without ketones, is 17mmol (306mgdl).  Even without the presence of ketones, after 17, you will go higher with exercise! Fabulous to know for real world application!

Heather also showed us scenarios of why you may go higher after prolonged exercise even it you managed to stay in range for the entire period of exercise as well as how to fix this!  She talked about supplements, as well as the effect of temperature on insulin absorption.  Another light bulb moment for many people was when she discussed using multiple basal rates for one exercise time period! If you were doing an activity that required various levels of intensity, use various temporary basal rates.  This made many audience members go "Of course!" A final tidbit to remember--injuries will raise blood glucose levels. Duh! but still how often do we really think about it?

There was a lot more that both Heather and Sebastien had to say but those were some of the key points that were important for us.  Exercise is vital and as important as insulin when living with diabetes.  Attitude is everything--diabetes is not going away anytime soon so make it a positive part of your life!  Enjoy taking care of yourself. Enjoy being active and be the very best that you can be. Great messages from wonderful people!

Join me on De-Nial

This has been a very emotional week and I have tried to insulate myself from a lot because...well I don't know if I can handle too much more.  Recently, my family lost a dear young friend. He spent a lot of time at my house while growing up, was a good friend to my children and had only just become a new father himself. He death was both sudden and shocking.  He was only 21 and I still cannot begin to imagine the pain of his parents.

This week I have been seeing many Facebook posts about 3 or 4 children with Type 1 diabetes who died in the within the past few days.  That is way too much death for me to handle.  I honestly have not read the stories. I have heard of officials questioning the diet of an undiagnosed toddler who died--as if his sugar intake could "cause" type 1 diabetes rather than the medical community not diagnosing him? The horror is unimaginable.

As I mentioned the other day, this was also diabetes clinic week.  I still don't have our most recent A1c back but we got a great pep talk about how its just a number and its only a concern if there is continued problems. I give that speech but it was nice to hear them saying the same thing to my son.  No matter what  reading comes back, I hope we do watch things more carefully, learn and move with forward with a stronger footing.

After the doctor's pep talk and my mention of the possibility of a rebound at night after what I assumed was an undetected low, our nurse came in.  She reviewed the documentation and said "Oh, he had a really bad low did he?"

I was kind of puzzled. What bad low? What happened? Where was I?

"He went low at night. How terrifying for you!"

Crap! That low! I had put "that low" out of my head.  It was my big failure. It was my biggest fear almost realized. Did she have to mess with my protective bubble? As I said, this has been a rough week and I was doing a great job at insulating myself against any more stress or guilt.

Mess with my bubble she did! Instantly I had a flood of guilt as I remembered hearing someone else innocently telling me that they had woke up to hear my son moaning in his sleep and knowing that I didn't wake up!  The panic stormed back in as I relived the fear of "what if his body hadn't kicked out glycogen?"  Was he really going that low? Could something horrible really have happened between the 3am check when he was perfect and the 7am check when he was high?

I quickly shrugged her comment off stating that I didn't know "for sure" that it had happened. I made adjustments the following night based on assumptions and the fact that he was insulin resistant for most of the next day.  Extreme testing, him waking and telling me he was dropping, and subsequent basal reductions would suggest that a problem may have occurred, but let's again say that this was all very theoretical.

She simply nodded as if to say "if it looks like a duck, quacks like a duck, and walks like a duck, its probably a duck."  Or in diabetes terms "If it looked like a rebound, you had subsequent lows at a similar time, and a reduced basal fixed it, he probably went low and you missed it!"  Thank heavens she just nodded and smiled.  That allowed me to slip back into my lounger on the River De-Nial.  Its a beautiful place.  With all of the ugliness of the week, I think I will happily float there a little while longer. The alternative is not a good place to be--terror, guilt, and more sleeplessness.

Its a BAD day for Da 'Beetus

"Mom you should have warned me!"

What was he talking about?

"Mom you should have warned me that we have a clinic appointment tomorrow! I would have done a lot better. Today was a really bad day for da 'beetus!"

He did know that he had a clinic appointment today. He simply chose to forget...like he forgot to test a number of key times throughout the day and like he forgot to bolus for his supper! It was a very bad day for "da beetus" alright!

I have downloaded his meter. I have written out his basal patterns and the result is that I don't want to know what his A1c is because I know it will be bad.  I also wonder what I have been thinking in looking at his basal patterns on the weekend versus the weekdays.  The weekdays are a mess. My first guilty thought was "its time to do some serious basal testing and fix this!"  My second thought was "why?"  This is my son's last full week of school.  Next week is an exam every morning and then slacking...I mean studying every afternoon. After that it is basically summer vacation, a time when we switch over to a permanent "weekend" basal pattern.

I hate the thought of our team looking at his readings. They are a mess but each one tells a story.  They say... "He didn't weigh his cereal."  "He eats constantly and there is no break to test basal patterns."  "He is working out and we are working at learning how exercise impacts his insulin needs."  "Mom has given up asking for data and works with the little information that she gets."

My son said that I should just let our team do their job. That would be great but they have no data either! How do you say adjust that basal or bolus ratio based on a reading that was taken 20 minutes AFTER he ate? Hopefully they will simply be on board with helping to get us a CGM in the fall or whenever the DexCom comes to market.  Perhaps they they will remind him to test if he wants his licence.

I hate clinic appointments. Why do they always feel like you are going into the principal's even though you know that you are doing your very best? Perhaps I will just go in, keep quiet and let my son handle all of this one...that would make things interesting! Wish us luck!