Monday, May 30, 2011

Pump Visit Number Six: Don't Worry, Be Happy

The day after her NYC trip, M has to go in for another pump visit.

We arrive in a timely manner this time, and our DNE looks over M's numbers.

To her, they look fine, even though they range from 45 to 389 mg/dl. The DNE speculates aloud that perhaps I don't like the feeling of losing control of M or the management of her diabetes. I am "worrying too much."

I think to myself, that once M demonstrates consistency, I will be more than happy to completely hand over responsibility for her care. As it is, she is very much in charge. I simply remind her to check her bg before going to bed, and ask her what her results are maybe three times per day, to make sure we are staying on top of any body changes. All changes we make in her dosing are discussions in which we compromise and agree on a course of action.

However, I find that when dealing with medical professionals with whom one disagrees, it is easier to let him or her think that you agree with them.

For example, when my son was an infant, he was nursed (aka breastfed) exclusively for six months. Then he moved straight to solid food. I think he ate two jars of baby food, and then started grabbing food out of my hand at dinner time.

The doctor wanted me to start him on whole milk right away, because "babies need fat." While I agree that babies need fat, it doesn't mean that a 30 pound 6 month old needs fat when he is still nursing 4-6 times per day.

Also, she said, he would need iron supplements.

I am a "good girl", a rule follower. So I tried to give our baby the iron supplements. He gagged on them, cried, and spit them out. They irreparably stained his shirts. I found the exercise to be futile, as his blood iron levels were healthy prior to my attempts to administer the supplements.

Logic, sometimes, must rule over whatever the doctor said.

I explained my objections about whole milk to the doctor. I said, "The baby's nursing 4-6 times per day, and eating a pint of Ben and Jerry's every week. I think he is getting enough fat for now. I don't enjoy drinking whole milk, so he's getting 2% like the rest of us."

The doctor grew alarmed, thinking that I was putting my son "on a diet", and cautioned against doing something so dangerous as giving him 2% milk.

Exasperated, I didn't even broach the subject of the iron supplements.

So, the next time we went in to visit the doctor, I lied.
Dr: "Is he drinking plenty of whole milk?"
Me: "Yes, he is."
Dr: "Does he like his iron supplements?"
Me: "He loves them."

See? That was easy!

Fast forward to this month, with the DNE, when she told me that I worried about M's bg levels too much, and suggested that I was some sort of control freak. I did not cite the research that I had read about those who had survived diabetes for 75 years or more. I did not say that the evidence shows that long-lived survivors all had tight control over their bg levels, exercised more often, ate more healthfully, and did not waver from 48 to 315 mg/dl in one day.

Instead I said, "Maybe I am."

She gets to be right, and I get left alone. Everybody wins.

And, of course, since I want M to be in that club of people who survive for years and years with this disease, I will continue to ask questions about her bg levels, what she ate, and how she is feeling.

After all, that's my job.

wooo, hoo, hoo, hoo, hoo, hoowooooh-ooh, oohoohooh...

Tuesday, May 24, 2011

Travels with Daddy

M got to go to New York City last week for her 8th grade class field trip.

Gee, for my class trip we went to the coast of our own tiny state, and went deep sea fishing for a day.

The students and teacher planned out their destinations, and readied themselves to go. They would visit Ellis Island, the Statue of Liberty, the Empire State Building, the Museum of Modern Art, NBC Studios, and see a Broadway show. Bill and I decided that one of us should go, too. But not because we love spending time with hormonal young people.

M's tiny Montessori school has no nurse. It seemed only fair to the director of the trip for one of us to chaperone so that we could relieve her of the care and responsibility for M's type 1 diabetes. After all, she had plenty of other normal children with normal issues going on the trip. Her hands were already full.

After a heated round of rock, paper, scissors, it was decided that Bill would hang around with 8th graders for three days, and I would drive the 500 miles (one way) to pick up our son from college.

I am not sure who got the better deal.

Bill tells me that all went well. That M's bg was pretty steady. He also told me that he was surprised and dismayed by the number of carbs she ate, but he felt that he couldn't argue with success.

The secret was walking.

They walked everywhere.

And it seems that, as long as M is moving, she can eat nearly anything.

Nevertheless, I was not thrilled to find a foot long plastic pixie stick straw (empty) in her laundry pile at the end of the trip.

Bad diabetic, M. Bad, bad diabetic.
Ahhh, pixie stix. Just like I remember them!

Friday, May 20, 2011

Lacrosse and diabetes

So this has been interesting.

As I may have mentioned, M is an athlete. This season she is playing her favorite sport of all time, lacrosse.

Now, as you can likely imagine, running around is a big part of lacrosse, as is whacking sticks and scooping balls off of the ground. It can get a little rough.

So of course M loves it.

The first day of lacrosse practice this season, M opted to wear her pump as well as a purple hair extension that I had to comb into her ponytail, just so everyone could see. I think it was her way of announcing to her new teammates that M is here.

During practice, M learned how to manage having the pump clipped to her shorts or sweats, and experienced no problems. She did have lower bgs than normal, but we knew that was how her body worked after rigorous exercise.

M answered the obligatory questions about the pump from the other girls, and accepted compliments about her hair with grace. She began to get to know people.

After a month or so, along comes the first game. M is playing defense. She is running, blocking, stretching that stick so that nobody can get to the goal.

Then there is a moment of confusion on the field. A time out is called, and M comes running over to me holding the purple device in her hand, infusion set dangling from it.

She hands it to me, saying "I'll deal with this later," and runs back into the field.

I look at the device, decide that it is okay that she is not wearing it- considering her bg generally drops during athletic events- and watch the game.

Don't get me wrong. I am a little annoyed that it has pulled out of her body for the second time in a week. At the same time, I know we will have to figure this out: where to place it on her body, when to disconnect it, etc.

After a few minutes of watching the game, there is a startlingly loud vibrating sound on the bench next to me. It is the pump, much like a cell phone on vibrate, asking for attention.

I dutifully pick it up, look at it, and set it down. I am annoyed with the pump for taking my attention away from my amazing child as she races around the field. Looking at a purple box is not nearly as fun as watching your kid kick butt at a lacrosse game, is it? However, I am fascinated by this new noise.

Evidently, the pump is programmed to do this every fifteen minutes. It is one of those safety features that prevents people from not getting their insulin. It says, "Hey, dummy! I'm not pumping any insulin into you! You wanna do something about that?"

Fortunately, unlike baseball or horse shows, lacrosse is not a long game, so I only have to hear the angry buzz of the pump three more times.

After the game, we jump in the car, check the all-important bg (which is 85mg/dl) and decide to leave the pump off until M showers.

That was just easier.

From now on, the pump is disconnected during a game!
Knock the ball out! Woohoo!

Wednesday, May 4, 2011

Sleeping through the night

After Pump Visit Number Five, I felt a bit better. I now knew that this adjustment process was normal-ish.

No one had warned me that the transition from one method of diabetes management to another would be so challenging. The closest thing I got was, "It's not a panacea," which I knew.

M loves the pump. It's only I that had concerns. I had done my research. I had been reluctant to switch M to the pump, but after talking to parents, students, and medical professionals, I had decided that the switch would be healthier for M.

I usually ask good questions, but I never thought to ask if switching to the pump would be stressful and unpredictable. I figured that someone might tell me that. It took my friend the audiologist to tell me that adjusting to a new medical device is ALWAYS a challenge. But this was after my angry rant about the pump was posted on this here blog.

I seem in control to most people. When I am displeased, I say all of the appropriate things to the appropriate people. My polite words, however,  cannot hide my facial expressions. Anyone who knows me knows that I am possibly the worst liar on the planet.

At visit number five, Dr. asked M how she was liking the pump. M said she loved it, but her mom didn't. When M told Dr. that I wasn't thrilled with the pump, I tried to look like I wasn't that displeased. I could handle this bump in the road! I have a can-do attitude! Look at me, I am a capable woman! I gave a grin to Dr.

Dr. took one look at me and advised me to sleep through the night.

I guess I won't be winning any Oscars any time soon.

How can I sleep through the night? I had been told to check M's bg every three hours. Her numbers were still "out of range".

Dr. said, "It's been a long time since her numbers have been low. I think you can go through the night without checking her bg."

"But it has been high. I just want to do things right," I said.

She looked at me and said, "It's okay if she goes a little high at night."

I looked at her, a little bewildered. "You're telling me that it's okay if she goes high at night."

"Yes."

"So, don't worry about the highs."

"Don't worry about the highs."

To me this sounded like being a bad parent. So I opted instead to check her bg once in the middle of the night to see how she was doing. I felt like not taking a peek in the middle of the night might be irresponsible.

I checked her two nights in a row at 2:00 am. Her bg was 198 on night number one. It was 148 on night number two. They were between 120 and 178 in the morning. That wasn't so bad, all things considered.

So last night I slept through the night. From 10:00 pm to 5:00 am, I slept.

And guess what? We all survived.

Maybe now my students won't have to suffer next week. Maybe.

Don't mess with me, buddy. I'm on two hours sleep!