Last night I was sitting at the kitchen table with my youngest son. He was doing his math homework. As we worked through the page, I began to get frustrated. He seemed to truly understand what he had to do but when pen went to paper the answers were just plain wrong. I had left him to do a few questions on his own. When I came back, I saw that the answers were not correct and asked him how he came up with his responses. He told me how he needed to figure things out. The process was right but the results were a disaster.
We joked as we went along that he must be out of range. He was making foolish mistakes. I chalked it up to rushing through. As we progressed 14-7 equalled 5 and I knew that there was something seriously wrong! He looked a little pale and finally he took it upon himself to test. He was 19(345).
"That explains it! I think its time to take a small break. Show me some of the other homework that you have done while we wait for you to come down." I told him.
He got his other homework and a new infusion set. It turned out that his site change was due the day before. I had woke him up early that morning to change the site because he had gone up a bit overnight and I assumed the site was bad but being my son...well he didn't do it.
Each year I talk to parents and educators about children with diabetes in schools. Each year I mention this very thing--children who are hyperglycemic are cognitively impaired. I have seen it is effects in my son on occasions before. Each time it happens it both amazes and scares me.
You cannot see diabetes. You cannot "see" a high--well if you know him he might look a little off but still for the most part it is invisible to the naked eye. The average person would just assume my son was not overly intelligent. An uneducated teacher would assume he just was not getting the concept, had not paid attention or had not studied.
Each time this happens, I see the reality. My son cannot fix this. Yes he can change his site but highs will occur for other reasons that he cannot control. Diabetes does not play nice. It does not show itself to the outside world. There is no gaping hole in his stomach area to show that his pancreas has failed. It just quietly impacts his life. It silently attacks and as parents we must continue to work to train those around our loved ones what these attacks look like and how to handle them. Until there is a cure, we can only educate and pray for the best.
November is Diabetes Awareness month. Many people are wearing blue on Fridays to raise awareness, Facebook pictures are appearing with blue circles posted around them, and others are gearing up for the Big Blue Test.
Another awareness initiative that has been suggested was "30 days and 30 wishes". The idea was to take the 30 days of November and each day publish a diabetes related wish. The first day, I asked the question of what your wish was for day one on my Diabetes Advocacy Facebook page. The overwhelming answer was "A Cure!" plain and simple. That one is a given so my wish was posted in yesterday's post--that my son did not have to worry about his blood sugar before bed or know the danger of going low in his sleep.
Today's wish is that we did not have to have glucose stored all over the house and in our car. As you can see by today's picture, my son believes in being prepared and recently has begun keeping a tube of glucose gel in the bathroom he uses to get ready for school and shower. Now I just wish that I knew what in the world possessed him to put a tube there!
My son came home from school yesterday and we talked about what he had done during the day. He told me about having whipped cream thrown at him by little kids and showed me the treats that he had been given. After our chat, I asked for his meter. I looked through it and saw that once again he had not bothered to test after his breakfast. His first test was at lunch time and he was 23 (414). I was not impressed.
"I am guessing that not only did you NOT remember to test, but you also forgot to bolus your breakfast didn't you?"
"Now Mom, would I do that?" He asked innocently as he began scrolling through his pump history. "There is a bolus here at 7:30. Oh wait, its just a correction. There doesn't seem to be a breakfast bolus. Oops."
Once again I reminded him to test AND bolus. He went off to do his thing and I was left to shake my head. I felt a little guilty because I knew that I hadn't given him the carb count for his meal that morning but I also know that he is pretty good at knowing it on his own. End of guilt. He messed up.
Before I went to bed that evening, I asked him what his bg level was. I use that number as a gauge of when I should set my internal alarm clock to get up during the night. He said he was 4.1 (73). I asked him what he was going to do about that. He said that he had had a glucose gel. I thought that that might have been a bit much since he had eaten a snack not long ago and asked him why the gel?
He replied, "Never drive when you are under five and never sleep if you are under six!"
Well he could certainly regurgitate the information that I have given him over the years but when would he actually use a bit more of it? I responded, "Great, you can remember the rules but you can't remember to test and bolus in the morning?"
I rolled my eyes and left him to deal with his four (72) while I headed off to read. The next morning he asked if he had been high the night before. I said that he was. He said that it had taken him a lot of glucose to move past 4.1 so he was glad to see that at one point the sugar finally kicked in. Poor kid. What a thing to have to worry about before he could think about sleep.
The missed test and bolus in the morning didn't kill him. It could have been worse--he did correct the high before breakfast and did correct before his lunch. We still have a long ways to go but its also good to know that we are making some progress. I still wish however that my son and I did not have to have any of this knowledge--that it was not so important for him to have to learn.
Its a rainy, windy Halloween morning. One of my son's is curled up in his bed waiting for the power to return to his home and my youngest son is off to scare little children during Halloween events at school. Such is the life of family with teen aged boys.
At this point in our lives, Halloween is no longer about treats and goodies. We have begun to enjoy a few Halloween decorations and waiting to see what little ghosts and ghouls will arrive on our doorstep.
What to do about Halloween parties at school and big bags of Halloween candy are no longer issues in our house. Reading worries from parents of children who are relatively newly diagnosed made me think that perhaps a recap of some of the things that I learned over the years may not be a bad topic for today. So here we go....
1. Its okay to let him eat candy while he is out trick or treating. In fact, it should be encouraged (as long as usual Halloween safety rules are applied of course--Mom/Dad checks candy or it is from the home of a good family friend). All of the walking, running and general excitement would always drop my son's bg levels. Letting him eat bars, rockets (Smarties for my US friends) and other treats was a fun way to keep him in range and allow him to be a "normal" child.
2. Snack sized Halloween treats are fabulous for lows. Chocolate bars work for those evening lows that aren't lows yet but will be and a slow release of glucose would be ideal. Rockets and Starburst are great for keeping in your pocket or purse for those lows that need immediate sugar and your child thinks that they have one the little kid lottery!
3. Snack sized treats are often equivalent to one fruit for anyone who may still use and exchange system and what child will not exchange a fruit for a bar? Well, my kids but they are weird!
4. Snack sized chips are often equal to a slice of bread. Again, for those on the exchange system, you can skip a slice of toast or a potato and switch in a bag of chips for the day as a special treat.
5. Mom and Dad will eat the bulk of the candy. My children had candy that would last until Easter and beyond. Parents would gain weight while the children carefully savored each morsel.
6. For those who have kids who will either not eat the candy or would overindulge, many parent exchange the treats through an Easter Witch or Great Pumpkin. The treats are left out and gift cards or trinkets are delivered in exchange for the treats. I have also heard of treats being packed up and given to homeless shelters or hospitals.
7. No matter how old your child is, he/she will most likely still want some of those treats. The carb counts are now on most candies and for those that are not, there are many great resources that provide the counts on many other items so that your child does not "have" to go without on Halloween.
Halloween was a great time for my boys. We drove all over the neighbourhood, met up with pals and had fun racing across lawns and warming up in cars. Diabetes did not change this for them. It meant that we brought a meter on our adventure. Insulin was nearby but not always required. Basal rates were often dropped later that evening. Sandwiches were packed but usually exchanged for hot dogs or chips for just this night. Juice boxes were a bonus when given out at the door as they added extra glucose to get to the next house.
This year my youngest son will be greeting the little ghouls and handing out treats. He will be counting each child and hoping that we will have more treats than children so that he can enjoy a few bars for himself. He has great memories of Halloweens past and to me that is a sign of successful diabetes management.
"Can you bring me your meters please?"
My son came out of his room with three glucometers for me to review.
"Mom, I have made a few tweaks of my own."
"Oh really? What did you change?" I asked rather intrigued.
"Well I have been coming home low the past few days so I figured I should make some small changes and see how it goes. I adjusted my basal rate."
Basal rates? Those can be tricky. "When were you low and what time did you set the adjustment for?"
"I am low at about 3pm so I brought the noon rate down a bit."
Holy cow! I am impressed. He had been listening and learning after all! "Are you sure its not a carb to insulin adjustment? How long after you eat does this happen?"
"I am not positive but this seems to be working. I was in the twos (low 40s) for a few days and today I was 3.8 (64) when I got home."
"Okay, keep an eye on it and if you are still low try the lunchtime carb ratio."
With that my son headed downstairs to have his shower. I was still in shocked and very impressed. He was taking charge of his diabetes care! He was making the changes as they needed to be made without my help and doing a great job of it. My little boy was growing up!
I turned to the meters to see what else was going on that I didn't know about.
Ugh! Missed tests at school! One morning test out of four. I was not happy. I reminded myself that he was making strides in one area. Baby steps, baby steps.
It would be a miracle if he was actually doing everything he was supposed to. I did not freak out completely. I did not take away privileges. I did suggest what could happen if he forgot again but for the most part I just tried to bask in the glow of the "Mom I did a bit of tweaking on my own".
My son has complained of a "glucose tab" hangover after I treat him for a nighttime low. This morning I realized that diabetes gives me my own kind of hangover.
Last night something happened that I never expected. I should have remembered that we are dealing with diabetes and it is never predictable but I was complacent.
I woke up at 1:30am ready to test until I realized that it was a bit too early. I rolled over to sleep for another hour. The hour became an hour and a half but my son was still fine(8 or 136). I felt confident that basal rates were working. He had been low the night before and I had made adjustments. Life was good and I headed back to a peaceful sleep for a few more hours...or so I thought.
At 5am Larry woke me up. He said that my son was up using the washroom. He never does that during the night unless there is a problem so Larry knew I should be getting up. I did and asked my son if he had tested. He had and was 17 (289). What the??? His bg level had more than doubled in just two hours!! Something was seriously wrong! I told my son to change his site. This was way to fast of a spike. He told me it was fine , corrected and rolled over to go to sleep.
I went back to bed second guessing myself. Did I miss a low at 1:30? Was he alive thanks to a rebound? If he rebounded there would be hell to pay the next day with highs and fears of another low. Was the site bad? Was the new pump failing already? I eventually managed to fall back to sleep, but not for long.
An hour later I awoke to the sound of vomit hitting the toilet bowl. This was so not good! I had been right. My son was not getting insulin. The site must be kinked. Again, I got up and waited. My son looked terribly pale. I told him we needed a new site. He had one in his hand.
"I can't believe I would be throwing up at 17." he said.
I told him that he had probably gone up in the past hour. We tested and he was now over 19 (+323). We chanced a correction on his pump and both went back to sleep for a few minutes. At 7am I tested him again. He had dropped down to 14 (238) and said he felt a lot better. He was no longer a ghostly white so we decided he was okay to go to school.
I still am not positive as to what happened. His site looked fine when we took it out. Despite a trip back to bed after my son was ready for school, I still felt out of sorts. The night continued to haunt me. Questions plagued me. Where had I gone wrong? As things ran through my head, I realized that like my son's glucose hangover, diabetes gives me its own hangover. It messes with my emotions and my physical being the next day and then some. Sadly there is only one fix for my hangover and that's a cure for diabetes.
It was recently that time of year again...time to clean out our diabetes supplies. What once was able to fit in a drawer was now taking up a drawer, a roll-out tote, and underneath of my youngest son's bed. This had to stop. I had no clue that he had supplies hidden in all of these places and was no longer sure as to what supplies we had and what we needed.
We found boxes of Cozmo reservoirs, a few different types of infusion sets, his very first meter, a Polar bear meter holder, way too many lancing devices and enough lancets to keep him going until he is 100. We also found test strips that were about to expire. There was no way I was going to waste these strips. This was $100 and many people can't even afford to buy them. The strips would be used at home until such time as they were gone.
My son was fine with that. Like his mother, he loves trying out new meters. This meter was far from new but since he hadn't used it in a few years, it was new to him again. The novelty quickly wore off.
"Mom, this meter takes FOREVER to read!"
"How long is forever?"
"15 seconds! Can you believe that? This is crazy!"
I started to laugh! My son was far to used to the immediate gratification found after a five second countdown. He did not remember the days of his first meter. Thirty seconds seemed like an eternity and yet I remember back then knowing how lucky we were, the previous generation of meters had taken 60 seconds to show results.
Despite the "long" wait, he continued to use the old strips. A few lows and bad sites meant that it did not take more than a few weekends for the 100 test strips to be used up. I must admit that I had been spoiled too. A few nights of having to wait for those extra 10 seconds did seem like forever. Nonetheless, it still was not as long as waiting 30 seconds and wondering if your toddler was asleep because he was tired or passed out from a low.
I love technology!
