So a few months ago we had a little problem.
M's pump broke.
That's right, it broke. It started scrolling numbers independently and did not deliver insulin or anything else.
Now, I have to say that Medtronic makes a pretty tough insulin pump. M drops it on the floor from the chair in which she watches television on a fairly regular basis. It is often unprotected at the bottom of field hockey and lacrosse equipment bags, and she shoves it in the map pocket of my car when she goes for a swim on hot days.
So I can't complain. And neither can she.
We made this terminal discovery on the way home from a lacrosse game.
Typically I attend M's games so as to relieve pressure on the coaches as far as looking out for M's diabetic needs. She has not had a problem during a game since high school, but I think the girls on the team also kind of like the idea of that crazy mom coming to every game, even if it's two hours away. Bonus: I get to see her play every time. On a few occasions I have been the only "away" parent in attendance. Unfortunately for the team, I am not a yeller. I am an urgent whisperer, which means they don't really hear my cheers of support. But I digress.
Although I encourage M to take the bus back from the game as part of the team bonding experience, she has thus far declined my offer and rides with me in the car, usually chowing down on a sandwich and a bag of chips, while beating herself up over the goals that the opposing team scored.
This is how it went down:
M: (fiddling with the device) "What the....?"
Me: "What's the matter?"
M: "This stupid pump! It did this this morning, but I got it to work. Now it just won't stop scrolling numbers!"
Me: (slowing down and taking my eyes off the road), "What? It was doing it this morning?"
M: (Smacking the device with the palm of her hand) "Yeah, I thought it was the battery. But I changed the battery at school, so that's not it."
Me: "Did you try....?"
Needless to say, voices continued to rise in tension and anxiety. I had M check her bg levels.
Fortunately they were pretty even, buying us some time until we could give her an injection at home. But we soon realized that we would have to do something to solve this problem more long-term.
Since we were in the car and the pharmacy was closed, we decided to use modern technology to help solve our problem. M looked on the back of the pump and found a toll free number to call. After a brief argument in which she tried to convince ME to call, I, as the driver of the car, convinced her to dial the number.
She did. And she did an amazing job.
She talked to the representative from the company, explained who she was and what was happening. After about 10 minutes, the rep determined that M's pump was beyond repair and needed to be replaced immediately. M gave the rep all of the necessary information, and then did something very smart: she asked if it was under warranty.
Now I can truly say that my baby was growing up!
It was, indeed, under warranty, which meant that a "free" purple replacement was on its way.
M concluded the phone call with her pump company, who recommended that she contact her DNE.
With a heavy sigh, M dialed her new DNE at Dartmouth Hitchcock, knowing that it was after hours and that she would need to talk to the answering service and wait for a call back.
The DNE returned her call right away, told her to take an injection of Levemir; the long-lasting insulin that typically goes wasted in our fridge, and asked when the pump was due to arrive.
It was due to arrive in two days, which I found incredible, but the DNE found disappointing. She told M that they are typically shipped to arrive within 24 hours. Then she and M had to figure out her carb ratios and correction factors for the next couple of days of injections. The phone call concluded mere minutes before we landed in our driveway.
M moaned that she had forgotten how much more work it was to calculate, draw up insulin and inject oneself several times each day. But she also felt really proud about handling her own care, and was pleased to have a plan, even if it was less than ideal.
I was also proud. And relieved. She moved one step closer toward independence by handling an equipment malfunction without any interference from me. And I was around to witness it and see that she did it well.
When we arrived home after lacrosse practice the next day, there was a sticky note from UPS on our door. We had missed them, and our package needed a signature. The pump had arrived within 24 hours after all!
I called the number on the note, and learned that we could pick up our package in person between 8:00 pm and 9:00 pm that night. Even though the center was a 45 minute drive from our house, M and I eagerly jumped in the car to do just that.
We tore open the box in the car. Pump in hand, M gleefully looked forward to getting away from her injections yet again.
We carefully read everything in the package, and learned that we had two weeks to return the broken pump via a pre-paid envelope. Failure to do so would cause us to be billed for the entire cost of a new pump (about $6500!). Needless to say, that sucker was in the mail before I went to bed that night!
Medtronic made it pretty easy. It was brilliant that their customer service number is right next to the serial number on the pump itself. Their service was excellent, and saved M a lot of inconvenience. And M, up for the challenge, enjoyed the sweet relief of knowing that she could handle it.
Showing posts with label panic. Show all posts
Showing posts with label panic. Show all posts
Tuesday, July 16, 2013
Saturday, December 22, 2012
Dominoes
Last week, M woke up with a pretty nice bg level: 125 mg/dl.
Then she ate a low carb breakfast of bacon, eggs, and half of a hamburger roll (Don't ask me about the hamburger roll. I was not part of that discussion, if there was one).
We arrived at church about an hour later. We were early. M reached toward the glove compartment, saying, "I feel low". She retrieved a handful of Smartees.
"Please check your blood sugar," I said.
It's 35.
We popped our seatbelts back on and cruised to the pharmacy, where I hurriedly plucked some glucose tabs off of the shelf in the back where there are about 58,000 bg meters on display. Then, knowing that M is often thirsty when her bg is especially high or low, I grabbed a water bottle.
I gratefully approached the customer-free counter, payed for the items, and jogged out to the car, where M started chomping down tabs.
I pulled out the calculator app on my phone and estimated that she should eat 3 glucose tabs (15 carbs) in addition to the two packs of Smartees (13 carbs total) that she has already eaten. Any more would start her on an upward spiral. At roughly 5 mg/dl increase per carb that M eats, she should have a nice bg level of 140, which would give us a little wiggle room.
We returned to the church, attended mass, and met M's boyfriend du jour and his mother in the parking lot afterwards. M had plans to spend time at their house that day. Since they live near the church, and not near our home, we decided to meet them there. I, at this point, am having my doubts about the wisdom of sending M to someone else's house, but I assume that her bg will be in a more comfortable range at this hour. We did the typical pre-departure bg check: 37mg/dl.
Panic ensues. I mean, she just ate a pile of pure sugar an hour ago. If anything, she should have a higher-than-ideal bg level. How could this have happened?
I had a quick conference with M. "How much did you bolus for this morning?"
Answer: "42 carbs"
I would like to pause here for a moment to point out that M handles these fact-finding inquiries much better now. A year and a half ago if I had asked any questions pertaining to figuring out "how this had happened" she would become angry, defensive, and startlingly teen-like.
But back to our story.
Let's revisit the aforementioned breakfast: bacon, eggs, half of a hamburger roll. Bacon: zero carbs. Eggs: zero carbs. A whole hamburger roll: 30 carbs so HALF should be 15 carbs. 15 carbs total for the meal. Not 42 carbs.
Insulin for 42 carbs is way more insulin than M needed this morning. We are lucky that she hasn't passed out yet. I ran into the church hall and grabbed her a coke. I ordered her to drink the whole thing: 39 carbs of fast-acting sugar. Times five is nearly 200. In theory, her bg should be 242 in a matter of minutes.
At this point I would like to point out that Boyfriend's mother is a nurse. As such, she insisted on having M over for the day despite the scary numbers we were reading in the parking lot. After all, she can handle it (which I know she can). I worriedly agreed, and asked that M promise to call me in one hour.
After two hours and no phone call, I called her. Boyfriend's mom tells me that M's bg is still low. It's about 48 - 50 mg/dl. She's having her hang around on the couch instead of helping paint the house as planned. She is forcing orange juice in 4 oz portions. She is making her check her bg every half hour.
Two more hours went by, and I called again. This time I spoke with M. She told me that her bg was now 325. After multiple attempts to bring up her bg, we have now overcompensated. She just bolused, sending insulin through her body to bring her bg back to normal. Boyfriend's mom tells M that she expected this. That we all expected this. Now we need to be careful and not overdo it again.
But no luck. When I picked up M two hours later, her bg was 53.
AAAAAUGH!
After 24 hours, we were back on course. But there is a valuable lesson to be learned here: really think about the number of carbs for which you are bolusing. Over-correction can be frustrating, time-consuming, exhausting, and dangerous.
And it can set off a chain-reaction for which we are unprepared.
It's amazing how life stops when these incidents happen. Our only focus is to get back to normal.
Well, diabetic normal.
Let's just say that rather than cleaning up after ourselves, it's easier not to start tipping that row of dominoes to begin with.
And let's thank God that that these incidents don't happen very often.
Then she ate a low carb breakfast of bacon, eggs, and half of a hamburger roll (Don't ask me about the hamburger roll. I was not part of that discussion, if there was one).
We arrived at church about an hour later. We were early. M reached toward the glove compartment, saying, "I feel low". She retrieved a handful of Smartees.
"Please check your blood sugar," I said.
It's 35.
We popped our seatbelts back on and cruised to the pharmacy, where I hurriedly plucked some glucose tabs off of the shelf in the back where there are about 58,000 bg meters on display. Then, knowing that M is often thirsty when her bg is especially high or low, I grabbed a water bottle.
I gratefully approached the customer-free counter, payed for the items, and jogged out to the car, where M started chomping down tabs.
I pulled out the calculator app on my phone and estimated that she should eat 3 glucose tabs (15 carbs) in addition to the two packs of Smartees (13 carbs total) that she has already eaten. Any more would start her on an upward spiral. At roughly 5 mg/dl increase per carb that M eats, she should have a nice bg level of 140, which would give us a little wiggle room.
We returned to the church, attended mass, and met M's boyfriend du jour and his mother in the parking lot afterwards. M had plans to spend time at their house that day. Since they live near the church, and not near our home, we decided to meet them there. I, at this point, am having my doubts about the wisdom of sending M to someone else's house, but I assume that her bg will be in a more comfortable range at this hour. We did the typical pre-departure bg check: 37mg/dl.
Panic ensues. I mean, she just ate a pile of pure sugar an hour ago. If anything, she should have a higher-than-ideal bg level. How could this have happened?
I had a quick conference with M. "How much did you bolus for this morning?"
Answer: "42 carbs"
I would like to pause here for a moment to point out that M handles these fact-finding inquiries much better now. A year and a half ago if I had asked any questions pertaining to figuring out "how this had happened" she would become angry, defensive, and startlingly teen-like.
But back to our story.
Let's revisit the aforementioned breakfast: bacon, eggs, half of a hamburger roll. Bacon: zero carbs. Eggs: zero carbs. A whole hamburger roll: 30 carbs so HALF should be 15 carbs. 15 carbs total for the meal. Not 42 carbs.
Insulin for 42 carbs is way more insulin than M needed this morning. We are lucky that she hasn't passed out yet. I ran into the church hall and grabbed her a coke. I ordered her to drink the whole thing: 39 carbs of fast-acting sugar. Times five is nearly 200. In theory, her bg should be 242 in a matter of minutes.
At this point I would like to point out that Boyfriend's mother is a nurse. As such, she insisted on having M over for the day despite the scary numbers we were reading in the parking lot. After all, she can handle it (which I know she can). I worriedly agreed, and asked that M promise to call me in one hour.
After two hours and no phone call, I called her. Boyfriend's mom tells me that M's bg is still low. It's about 48 - 50 mg/dl. She's having her hang around on the couch instead of helping paint the house as planned. She is forcing orange juice in 4 oz portions. She is making her check her bg every half hour.
Two more hours went by, and I called again. This time I spoke with M. She told me that her bg was now 325. After multiple attempts to bring up her bg, we have now overcompensated. She just bolused, sending insulin through her body to bring her bg back to normal. Boyfriend's mom tells M that she expected this. That we all expected this. Now we need to be careful and not overdo it again.
But no luck. When I picked up M two hours later, her bg was 53.
AAAAAUGH!
After 24 hours, we were back on course. But there is a valuable lesson to be learned here: really think about the number of carbs for which you are bolusing. Over-correction can be frustrating, time-consuming, exhausting, and dangerous.
And it can set off a chain-reaction for which we are unprepared.
It's amazing how life stops when these incidents happen. Our only focus is to get back to normal.
Well, diabetic normal.
Let's just say that rather than cleaning up after ourselves, it's easier not to start tipping that row of dominoes to begin with.
And let's thank God that that these incidents don't happen very often.
Sunday, February 19, 2012
Dangerous and Unintended Consequences
It all started Friday evening, as I was reading the headlines to my husband, Bill. A little article on the front page of the Concord Monitor caught my eye. "New guidlines to prevent distracted driving".
It seems that our U.S. Transporation Secretary, Ray LaHood, has released new federal guidelines for automakers to help prevent distracted driving. He recommends that manufacturers create a device that will block cell phones from working in the car while the wheels are in motion.
Then Mr. LaHood went on to say that the guidelines might be extended to "all portable electronic devices that might find their way into a car."
I told Bill that to me, a "Live Free or Die" New Hampshirite, this seems ridiculous. After all, I don't text or talk on the cell phone while driving, but sometimes I have my children make a call to our destination while I am driving, and they are safely in one of the passenger seats. "Honey, call Grandma and let her know we should be there after lunch" never seemed to threaten our safety as a family on the move.
And while my kids don't have Gameboys or DVD players,I see no problem with letting kids play games on electronic devices while in a car. I thought about how the government tried to force car manufacturers to make seatbelts that belt people in whether they wanted to be or not (remember those cars with the moving seatbelts that hummed into place when you turned the key?).
I supposed out loud that the manufacturing guidelines might be effective, but that going to extreme of blocking all devices seemed silly.
"Don't you think M should be able to text a friend while I am driving?"
Then Bill said, "I wouldn't worry about the texting. I would worry about her insulin pump."
Oh.....
The insulin pump.
That thing that keeps my daughter alive. The portable thing that electronically delivers life-giving insulin to her body. The device that communicates with her glucometer to determine how much insulin she she administer when she eats.
That thing.
She will be driving soon.
If we have a car in which her insulin pump is disabled, she could kill someone, cause a serious accident, or die. If she is in a friend's car with the proposed technology, she could have a medical emergency for which her friend is unprepared. (Talk about distracted driving!)
This is not alarmist "someone could hack into my pump" bologna. After all, hacking into someone's insulin pump would be the least efficient form of terrorism ever.
But this.
This is a genuine hazard.
The thing is, infusion pumps are not only for people on insulin. Some are used for pain medication, or medicine to assist in healing spinal cord injuries. What if these infusion sets are disabled?
Any car that M entered might disable her pump if these guidelines are implemented. And those who have learned to manage their chronic, life-threatening illnesses, might just have to do without.
It is time to act. I am contacting my congressional representatives.
I would appreciate it if you did the same, before the unintended consequences of these guidelines become a reality.
It seems that our U.S. Transporation Secretary, Ray LaHood, has released new federal guidelines for automakers to help prevent distracted driving. He recommends that manufacturers create a device that will block cell phones from working in the car while the wheels are in motion.
Then Mr. LaHood went on to say that the guidelines might be extended to "all portable electronic devices that might find their way into a car."
I told Bill that to me, a "Live Free or Die" New Hampshirite, this seems ridiculous. After all, I don't text or talk on the cell phone while driving, but sometimes I have my children make a call to our destination while I am driving, and they are safely in one of the passenger seats. "Honey, call Grandma and let her know we should be there after lunch" never seemed to threaten our safety as a family on the move.
And while my kids don't have Gameboys or DVD players,I see no problem with letting kids play games on electronic devices while in a car. I thought about how the government tried to force car manufacturers to make seatbelts that belt people in whether they wanted to be or not (remember those cars with the moving seatbelts that hummed into place when you turned the key?).
I supposed out loud that the manufacturing guidelines might be effective, but that going to extreme of blocking all devices seemed silly.
"Don't you think M should be able to text a friend while I am driving?"
Then Bill said, "I wouldn't worry about the texting. I would worry about her insulin pump."
Oh.....
The insulin pump.
That thing that keeps my daughter alive. The portable thing that electronically delivers life-giving insulin to her body. The device that communicates with her glucometer to determine how much insulin she she administer when she eats.
That thing.
She will be driving soon.
If we have a car in which her insulin pump is disabled, she could kill someone, cause a serious accident, or die. If she is in a friend's car with the proposed technology, she could have a medical emergency for which her friend is unprepared. (Talk about distracted driving!)
This is not alarmist "someone could hack into my pump" bologna. After all, hacking into someone's insulin pump would be the least efficient form of terrorism ever.
But this.
This is a genuine hazard.
The thing is, infusion pumps are not only for people on insulin. Some are used for pain medication, or medicine to assist in healing spinal cord injuries. What if these infusion sets are disabled?
Any car that M entered might disable her pump if these guidelines are implemented. And those who have learned to manage their chronic, life-threatening illnesses, might just have to do without.
It is time to act. I am contacting my congressional representatives.
I would appreciate it if you did the same, before the unintended consequences of these guidelines become a reality.
Friday, November 25, 2011
Reboot
Things have been going well, diabetically speaking. M has finished her field hockey season and was designated MVP of her team. Now she is living a more sedentary life. Her grades are going up, as are her blood sugars.
Higher blood glucose readings are to be expected. After all, exercise keeps bg down. Remove the daily 2 mile runs and 1 hour practices, and the bg will go up. So, although it is a bit of a bummer, it is not an unexpected one.
About two weeks after her last game, we noticed M's bgs creeping upward. We adjusted her basal rate by 0.25 units per hour over all.
Her pump had been delivering a steady stream of 3.0 units of insulin per hour at night, and 3.25 units per hour during the day. The basal rate, in theory, is the part that will keep her bg within range when she is not eating. Anything she gives herself when she eats is considered a bolus.
So now she was up to 3.25 at night, and 3.5 during the day, but we did have to make another adjustment about a week later. It seemed we had found the magic numbers. She was healthy, and her numbers seemed to be doing well.
On the Wednesday before Thanksgiving, we drove to pick up big brother at the airport. Since I was not driving, I though I would ask to see M's meter so that I could see how she had been doing the last few days.
She pulled the meter out.
She paused.
She started flipping through her numbers.
This is when I knew that something was up.
"You know, M, " I said casually, "I can read the meter all by myself. Just hand it up."
Long pause. Frantic pushing of buttons.
"M, hand it up," I repeated.
"There's something I have to tell you, " M said.
"Here it comes," I thought.
"Some of my numbers are missing, because I have been forgetting my meter when I go to school. So if you see any missing numbers, it's because I used my other meter at school."
When I collected the meter, I flipped through the numbers for the day. Except that there was only ONE number for the day. In fact, it was the only number for TWO days. She had only checked her bg on that meter six times since October 30th.
Here we go again.
"M," I said, "You told me that your bg was 131 this morning. That number is not here. Did you run to school and use the meter there to check it?"
No answer.
Rather than give her "buck up" speech, I said this.
"All right. starting today you will be checking your bg six times per day, and I will need to see it."
And that was all.
I was worried. I was furious. But yelling was not going to cut it. And neither was telling her that she was putting her life in danger.
So yesterday and today: six times, and I see them all.
Which is great because I can monitor her.
Which is not great, because how is she going to be responsible enough to do it herself? Ever?
I don't know.
But we will need to figure it out.
Higher blood glucose readings are to be expected. After all, exercise keeps bg down. Remove the daily 2 mile runs and 1 hour practices, and the bg will go up. So, although it is a bit of a bummer, it is not an unexpected one.
About two weeks after her last game, we noticed M's bgs creeping upward. We adjusted her basal rate by 0.25 units per hour over all.
Her pump had been delivering a steady stream of 3.0 units of insulin per hour at night, and 3.25 units per hour during the day. The basal rate, in theory, is the part that will keep her bg within range when she is not eating. Anything she gives herself when she eats is considered a bolus.
So now she was up to 3.25 at night, and 3.5 during the day, but we did have to make another adjustment about a week later. It seemed we had found the magic numbers. She was healthy, and her numbers seemed to be doing well.
On the Wednesday before Thanksgiving, we drove to pick up big brother at the airport. Since I was not driving, I though I would ask to see M's meter so that I could see how she had been doing the last few days.
She pulled the meter out.
She paused.
She started flipping through her numbers.
This is when I knew that something was up.
"You know, M, " I said casually, "I can read the meter all by myself. Just hand it up."
Long pause. Frantic pushing of buttons.
"M, hand it up," I repeated.
"There's something I have to tell you, " M said.
"Here it comes," I thought.
"Some of my numbers are missing, because I have been forgetting my meter when I go to school. So if you see any missing numbers, it's because I used my other meter at school."
When I collected the meter, I flipped through the numbers for the day. Except that there was only ONE number for the day. In fact, it was the only number for TWO days. She had only checked her bg on that meter six times since October 30th.
Here we go again.
"M," I said, "You told me that your bg was 131 this morning. That number is not here. Did you run to school and use the meter there to check it?"
No answer.
Rather than give her "buck up" speech, I said this.
"All right. starting today you will be checking your bg six times per day, and I will need to see it."
And that was all.
I was worried. I was furious. But yelling was not going to cut it. And neither was telling her that she was putting her life in danger.
So yesterday and today: six times, and I see them all.
Which is great because I can monitor her.
Which is not great, because how is she going to be responsible enough to do it herself? Ever?
I don't know.
But we will need to figure it out.
 |
| Not shocked this time! |
Tuesday, August 2, 2011
A1C 9
After discovering that M was guessing what her blood glucose levels might be, it was hard to act surprised when the DNE came in with the report that M's A1C was 9 this visit. (Attention non-D people: this is very bad!)
This was the highest it had ever been - even when she was first diagnosed.
The DNE came into the room, trying not to betray her concern when she said that M's numbers looked good, but that her A1C was a 9. M and I nodded. I said, "I can't say that I am surprised."
The DNE's eyebrows shot up, and she asked why it wasn't surprising.
To her credit, M launched into an explanation about her methods for tracking her progress over the last few weeks.
The DNE listened silently, and when M was finished explaining what she had done, she asked her when she stopped using this method.
M replied, "When my mom caught me."
As her eyebrows disappeared further into her hair, the DNE asked me how I caught M lying about her bg levels. I explained my methods, and the DNE congratulated me on my powers of observation, adding that not all parents would notice after a week or so (Big pat on the back for the "control freak" mother).
Then she asked M why she did it.
M said that she's just sick of being diabetic. She's tired of the hassle.
Hearing this always makes me want to cry. I am disappointed that I can't make this particular hassle go away. After all, this isn't something all girls for through and must learn from: like your first bad boyfriend, or doing your three week project entirely on the night before it is due. It's not something I can guide her through in the same way I can typical life lessons with logical consequences.
I told the DNE that I had offered the option of counseling to M, but that she had adamantly refused.
It might have had something to do with the fact that I had just caught her in this self-destructive lie. She might not have been wide open to suggestions at that time.
FLASHBACK~FLASHBACK~FLASHBACK
Me: "If you don't feel comfortable talking to me or Daddy about it, maybe you'd like for us to arrange for you to talk to someone else who might be able to help you."
M: "I don't need a psychiatrist! There is nothing wrong with me!"
Me: "I know there's nothing wrong with you. Everything you are feeling is normal. But if you need to talk to someone so that you can feel better, then I am willing to come up with some way that it can happen."
M: No response, minus a silent glare.
Back in the office, the DNE made the same offer, but it went much better for her. M simply nodded and said that she would keep the option in mind.
One consequence of the whole debacle that I hadn't considered was that we would now have to visit the DNE every month until further notice. This bummed me out. Those visits are not only about $500 a pop, but they also require that I take a minimum of a half day off from work, which I do not enjoy doing.
It makes sense, however. We, as a family, have fallen off the wagon, so to speak. We need time to recover and heal before we can get the all clear.
The DNE was somewhat tactful, saying that she just wanted to make sure that M was "following along the right path" for a while.
So, with stepped up vigilance, we will continue forward. Hopefully we'll find some fantastic support for M along the way....
Diabetes camp can't come soon enough!
This was the highest it had ever been - even when she was first diagnosed.
The DNE came into the room, trying not to betray her concern when she said that M's numbers looked good, but that her A1C was a 9. M and I nodded. I said, "I can't say that I am surprised."
The DNE's eyebrows shot up, and she asked why it wasn't surprising.
To her credit, M launched into an explanation about her methods for tracking her progress over the last few weeks.
The DNE listened silently, and when M was finished explaining what she had done, she asked her when she stopped using this method.
M replied, "When my mom caught me."
As her eyebrows disappeared further into her hair, the DNE asked me how I caught M lying about her bg levels. I explained my methods, and the DNE congratulated me on my powers of observation, adding that not all parents would notice after a week or so (Big pat on the back for the "control freak" mother).
Then she asked M why she did it.
M said that she's just sick of being diabetic. She's tired of the hassle.
Hearing this always makes me want to cry. I am disappointed that I can't make this particular hassle go away. After all, this isn't something all girls for through and must learn from: like your first bad boyfriend, or doing your three week project entirely on the night before it is due. It's not something I can guide her through in the same way I can typical life lessons with logical consequences.
I told the DNE that I had offered the option of counseling to M, but that she had adamantly refused.
It might have had something to do with the fact that I had just caught her in this self-destructive lie. She might not have been wide open to suggestions at that time.
FLASHBACK~FLASHBACK~FLASHBACK
Me: "If you don't feel comfortable talking to me or Daddy about it, maybe you'd like for us to arrange for you to talk to someone else who might be able to help you."
M: "I don't need a psychiatrist! There is nothing wrong with me!"
Me: "I know there's nothing wrong with you. Everything you are feeling is normal. But if you need to talk to someone so that you can feel better, then I am willing to come up with some way that it can happen."
M: No response, minus a silent glare.
Back in the office, the DNE made the same offer, but it went much better for her. M simply nodded and said that she would keep the option in mind.
One consequence of the whole debacle that I hadn't considered was that we would now have to visit the DNE every month until further notice. This bummed me out. Those visits are not only about $500 a pop, but they also require that I take a minimum of a half day off from work, which I do not enjoy doing.
It makes sense, however. We, as a family, have fallen off the wagon, so to speak. We need time to recover and heal before we can get the all clear.
The DNE was somewhat tactful, saying that she just wanted to make sure that M was "following along the right path" for a while.
So, with stepped up vigilance, we will continue forward. Hopefully we'll find some fantastic support for M along the way....
Diabetes camp can't come soon enough!
 |
| Don't fall off! |
Saturday, July 23, 2011
A simple childhood, and other things left behind
M was diagnosed on April 15, 2009. Our first real trip together as a D-family was that summer. Older brother was looking at colleges in California, and we committed to visiting friends, renting a car, and checking out the Four Corners area.
I thoroughly researched the JDRF website, looking for helpful tips about traveling with diabetes: airline requirements, changing time zones, transporting insulin, etc. Upon our arrival in San Diego, we found our warm and loving friends, who let us rest a bit, and then squired us around what they call "Old Town".
M was a bit groggy from a day of traveling, and seemed to be faltering as we climbed the stairs to a Mexican restaurant that our friends frequented. M whined that she wasn't hungry, but I figured that since her energy was low, sitting down in a pleasant atmosphere might not be the worst thing she could do.
Once seated, I asked her to check her bg.
It was 47 mg/dl.
In a panic, M began chowing down on the complementary nachos. I remember that day as being the first that M looked really scared since she had been diagnosed.
A 47 wouldn't scare us a much now, since we have seen her bg range from 22 to 525 over the past two+ years. But it didn't bode well for our travel experiences.
Sometimes we are right on, and everything goes great.
But more often, some minor disaster occurs that necessitates the summoning of my inner MacGyver.
Case in point: last year's trip to Manomet.
M had packed her belongings carefully, and checked the contents of her fashionable diabetes fanny pack twice.
We loaded the car, and about a half hour into the drive, I asked M if she remembered her "diabetes stuff". She assured me that she had. Since this is a near-daily interaction, I was neither concerned nor suspicious that she had not remembered everything.
Two hours later, at the beach, M wanted to eat some lunch. She looked for her fanny pack, so that she could check her blood sugar and make all of the necessary calculations, but couldn't find it in her room. We decided that it must be in the car. She searched. I searched. No fanny pack.
Being a mom, I searched every inch of luggage, beach equipment, and rolled-up towel that we had. M decided that she must have left the fanny pack right where she keeps it at home: next to her seat at the dining room table.
This was a major bummer. First of all, she was on the Luxura pen at the time. The pen was at home. As was her bg meter, Sweet Tarts, glucagon kit, and test strips.
The good news was that she had packed some extra supplies in her suitcase and the cooler.
We took inventory: test strips, extra Humalog cartridges for the pen, a vial of Lantus, 10 syringes, a half box of pen needles.
Hmmm, how could we make this work? We had no way to test M's bg, and no way to administer the fast-acting Humalog for meals.
M did have an appointment at Children's Hospital in a few days. Was there something we could do until then?
I called the diabetes hotline at the hospital.
Me: "Uh, Duuuhhh. I am an idiot mother who didn't verify the presence of my daughter's diabetes stuff when we left for vacation. Any suggestions?"
The hotline nurse was super helpful, and didn't even hint that I was a completely disorganized bag of moronhood.
I gave her my inventory list, and explained our financial limitations.
The plan became this:
1) Buy a new meter (cost: about $19).
2) Use the syringes to CAREFULLY remove the Humalog from the Luxura pen cartridges.
3) Inject insulin as needed.
4) At our appointment, request a new sample of a Luxura pen.
5) Resume life as if nothing had happened.
Considering that the alternative was driving home and back (a total of 5 hours), or missing our vacation, the proposed solution brought tears of relief to my eyes.
When we went to our appointment that week, our DNE scolded us mildly, and reminded us that using a pen cartridge in such a manner was less than ideal (apparently the cartridges are very fragile), but was in good cheer when she saw that we kept M's bg in check.
This year's Manomet trip was also fun. Especially since, being an emerging adult, M was very self-conscious about making any mistakes.
In addition to guessing what her blood glucose reading might be, we had the additional challenge, unbeknownst to me, of not having enough insulin or test strips.
M revealed her secret when she could no longer keep it: the day her insulin would run out (also the day that I learned that she was not testing her bg levels).
The solution was two-pronged.
I made some calls to the local pharmacy, who transferred M's Humalog prescription to Manomet.
We used the old meter that M had packed with her corresponding test strips as a back-up. This meter did not automatically communicate with her pump. She tested her bg on that meter and plugged in the numbers necessary on her pump.
It wasn't until she reminded me about last year, that I understood her trepidation about sharing her mistake.
She said to me, "Mom, maybe YOU should pack my diabetes stuff for me."
But she's not getting off that easy.
I said, "No, but the next time you go away, I will double check that you packed what you think you packed. As a young adult, you need to pack it yourself."
M nodded in agreement, and the rest of the car ride went smoothly.
She is going away on a Catholic retreat this weekend. She has already made her D-list.
She has checked it twice. And so have I.
I thoroughly researched the JDRF website, looking for helpful tips about traveling with diabetes: airline requirements, changing time zones, transporting insulin, etc. Upon our arrival in San Diego, we found our warm and loving friends, who let us rest a bit, and then squired us around what they call "Old Town".
M was a bit groggy from a day of traveling, and seemed to be faltering as we climbed the stairs to a Mexican restaurant that our friends frequented. M whined that she wasn't hungry, but I figured that since her energy was low, sitting down in a pleasant atmosphere might not be the worst thing she could do.
Once seated, I asked her to check her bg.
It was 47 mg/dl.
In a panic, M began chowing down on the complementary nachos. I remember that day as being the first that M looked really scared since she had been diagnosed.
A 47 wouldn't scare us a much now, since we have seen her bg range from 22 to 525 over the past two+ years. But it didn't bode well for our travel experiences.
Sometimes we are right on, and everything goes great.
But more often, some minor disaster occurs that necessitates the summoning of my inner MacGyver.
Case in point: last year's trip to Manomet.
M had packed her belongings carefully, and checked the contents of her fashionable diabetes fanny pack twice.
We loaded the car, and about a half hour into the drive, I asked M if she remembered her "diabetes stuff". She assured me that she had. Since this is a near-daily interaction, I was neither concerned nor suspicious that she had not remembered everything.
Two hours later, at the beach, M wanted to eat some lunch. She looked for her fanny pack, so that she could check her blood sugar and make all of the necessary calculations, but couldn't find it in her room. We decided that it must be in the car. She searched. I searched. No fanny pack.
Being a mom, I searched every inch of luggage, beach equipment, and rolled-up towel that we had. M decided that she must have left the fanny pack right where she keeps it at home: next to her seat at the dining room table.
This was a major bummer. First of all, she was on the Luxura pen at the time. The pen was at home. As was her bg meter, Sweet Tarts, glucagon kit, and test strips.
The good news was that she had packed some extra supplies in her suitcase and the cooler.
We took inventory: test strips, extra Humalog cartridges for the pen, a vial of Lantus, 10 syringes, a half box of pen needles.
Hmmm, how could we make this work? We had no way to test M's bg, and no way to administer the fast-acting Humalog for meals.
M did have an appointment at Children's Hospital in a few days. Was there something we could do until then?
I called the diabetes hotline at the hospital.
Me: "Uh, Duuuhhh. I am an idiot mother who didn't verify the presence of my daughter's diabetes stuff when we left for vacation. Any suggestions?"
The hotline nurse was super helpful, and didn't even hint that I was a completely disorganized bag of moronhood.
I gave her my inventory list, and explained our financial limitations.
The plan became this:
1) Buy a new meter (cost: about $19).
2) Use the syringes to CAREFULLY remove the Humalog from the Luxura pen cartridges.
3) Inject insulin as needed.
4) At our appointment, request a new sample of a Luxura pen.
5) Resume life as if nothing had happened.
Considering that the alternative was driving home and back (a total of 5 hours), or missing our vacation, the proposed solution brought tears of relief to my eyes.
When we went to our appointment that week, our DNE scolded us mildly, and reminded us that using a pen cartridge in such a manner was less than ideal (apparently the cartridges are very fragile), but was in good cheer when she saw that we kept M's bg in check.
This year's Manomet trip was also fun. Especially since, being an emerging adult, M was very self-conscious about making any mistakes.
In addition to guessing what her blood glucose reading might be, we had the additional challenge, unbeknownst to me, of not having enough insulin or test strips.
M revealed her secret when she could no longer keep it: the day her insulin would run out (also the day that I learned that she was not testing her bg levels).
The solution was two-pronged.
I made some calls to the local pharmacy, who transferred M's Humalog prescription to Manomet.
We used the old meter that M had packed with her corresponding test strips as a back-up. This meter did not automatically communicate with her pump. She tested her bg on that meter and plugged in the numbers necessary on her pump.
It wasn't until she reminded me about last year, that I understood her trepidation about sharing her mistake.
She said to me, "Mom, maybe YOU should pack my diabetes stuff for me."
But she's not getting off that easy.
I said, "No, but the next time you go away, I will double check that you packed what you think you packed. As a young adult, you need to pack it yourself."
M nodded in agreement, and the rest of the car ride went smoothly.
She is going away on a Catholic retreat this weekend. She has already made her D-list.
She has checked it twice. And so have I.
 | |
| And a whole bunch of diabetes stuff.... |
Tuesday, July 19, 2011
Snowed
Have you ever avoided looking at your bank statement?
Most of us at one time or another (not you, Mom!) have been aware that our bank statement would only provide us with the bad news that we already knew - that we didn't have enough money in the account, and there were still bills that had to be paid, gas to be bought, and food to be picked up from the grocery store.
Rather than face reality, some of us might go ahead and buy the groceries and fill the gas tank. Then we would figure out what was left (if anything) to pay the bills.
If you are one who has had this experience, then by the end of this post you will feel a lot of sympathy for M.
When I returned from my trip to Spain, I of course asked M how her blood glucose had been while I was away. She said, "pretty good."
Not completely trusting her memory, I asked her to Carelink. The printout did indeed show some pretty good bg, especially starting a few days before my return. I was pleased and relieved that she had done so well without me.
As I was, evidently, not satisfied with leaving the country for two weeks, I did my laundry and packed up. M and I headed to Manomet, MA for a week of fun and sun at the beach with Auntie, cousins, Nana and Papa.
There is typically a lot of tempting food with high carb counts when we go to the beach with the family. But I have always felt that M had to learn how to cope with situations where the food selection was less than ideal, rather than force her diabetes-style diet on everyone else while they are on vacation.
Despite the breakfast sandwiches, the potato chips, the candy, and the ice cream, M reported that her bg numbers were generally in the high 100s (173, 157, 144 etc.) "Not bad," I thought. "I guess that walking-along-the-beach thing is really keeping her numbers in check."
But as a few days went by, M didn't have any bgs over 200.
I began to grow suspicious.
"When exactly was she checking her bg?" I wondered. I wasn't seeing her do it. Was she doing it in her room so that it wouldn't bother her cousins at the dinner table? Or was she not checking it at all?
To test her reaction, I asked M to check her bg in front of me.
She checked it. Then she told me the results, but didn't show me.
I asked to see her meter so that I could see the results from the previous days. I tried to sound casual.
This is where it hit the fan.
When we asked her bg meter to "show all results", it showed only 5 readings from the past 7 days.
One of them was the one she did right in front of me.
That's right, folks. M had only checked her bg 5 times in the last 7 days! The pump manufacturer recommends a minimum of 5 tests per day.
Needless to say, this is not healthy diabetic behavior!
M tried to convince me that she had been checking her bg several times every day, that there must be something wrong with the meter.
HA!
I was a teenaged girl myself, once. Covering one's butt is high on the list of priorities when one makes a bad choice.
What I didn't know, was how, exactly, M got the Carelink readings that showed up on her printout?
I learned the answer when, later during our vacation, circumstances required that M enter her bg manually into the pump itself.
Aha! M had been estimating (aka guessing) what her bg was, then entering it into the meter so that it would administer the appropriate bolus. The printout comes directly from the pump, not the meter.
So on any given day, M might think to herself, "Hmmm. I would like a snack. I will have a cheese stick and some grapes. That's about ten carbs. And I feel fine, so I'll enter 143 for bg levels and take whatever insulin the pump decides I need."
For all of you out there in blog land, in case you didn't know, this is a BAD IDEA.
If you guess too high on your bg levels, you are in danger of going into a bg low, for which side effects include, shakiness, dizziness, weakness, and, oh......death.
If you guess too low on your bg, you will not get enough insulin into your system to keep you healthy. Long-term side effects include kidney problems, loss of vision, poor circulation, and, of course, death.
It was time to have a talk.
M and I had a heart to heart. It included my understanding how it feels not to be in control of your life; to be tired of knowing that you must always be thinking about your health, and not wanting to talk to your parents about it.
When we returned home, I let Bill know that we had been snowed. We had pulled back from our responsibility, and allowed M to monitor things herself. In pulling back, we allowed M's choices to go unchecked for a couple of weeks. Now it was time to bring down the hammer. Sympathy and empathy aside, M's health is too important for us to let it go.
Accepting our decision, and our sense of urgency, M has had a (probably temporary) turn around. Her attitude its better, and she is checking her bg 6 times per day. It is too high, but now that we know truly what we are up against, we can put together a plan of action.
Together.
Most of us at one time or another (not you, Mom!) have been aware that our bank statement would only provide us with the bad news that we already knew - that we didn't have enough money in the account, and there were still bills that had to be paid, gas to be bought, and food to be picked up from the grocery store.
Rather than face reality, some of us might go ahead and buy the groceries and fill the gas tank. Then we would figure out what was left (if anything) to pay the bills.
If you are one who has had this experience, then by the end of this post you will feel a lot of sympathy for M.
When I returned from my trip to Spain, I of course asked M how her blood glucose had been while I was away. She said, "pretty good."
Not completely trusting her memory, I asked her to Carelink. The printout did indeed show some pretty good bg, especially starting a few days before my return. I was pleased and relieved that she had done so well without me.
As I was, evidently, not satisfied with leaving the country for two weeks, I did my laundry and packed up. M and I headed to Manomet, MA for a week of fun and sun at the beach with Auntie, cousins, Nana and Papa.
There is typically a lot of tempting food with high carb counts when we go to the beach with the family. But I have always felt that M had to learn how to cope with situations where the food selection was less than ideal, rather than force her diabetes-style diet on everyone else while they are on vacation.
Despite the breakfast sandwiches, the potato chips, the candy, and the ice cream, M reported that her bg numbers were generally in the high 100s (173, 157, 144 etc.) "Not bad," I thought. "I guess that walking-along-the-beach thing is really keeping her numbers in check."
But as a few days went by, M didn't have any bgs over 200.
I began to grow suspicious.
"When exactly was she checking her bg?" I wondered. I wasn't seeing her do it. Was she doing it in her room so that it wouldn't bother her cousins at the dinner table? Or was she not checking it at all?
To test her reaction, I asked M to check her bg in front of me.
She checked it. Then she told me the results, but didn't show me.
I asked to see her meter so that I could see the results from the previous days. I tried to sound casual.
This is where it hit the fan.
When we asked her bg meter to "show all results", it showed only 5 readings from the past 7 days.
One of them was the one she did right in front of me.
That's right, folks. M had only checked her bg 5 times in the last 7 days! The pump manufacturer recommends a minimum of 5 tests per day.
Needless to say, this is not healthy diabetic behavior!
M tried to convince me that she had been checking her bg several times every day, that there must be something wrong with the meter.
HA!
I was a teenaged girl myself, once. Covering one's butt is high on the list of priorities when one makes a bad choice.
What I didn't know, was how, exactly, M got the Carelink readings that showed up on her printout?
I learned the answer when, later during our vacation, circumstances required that M enter her bg manually into the pump itself.
Aha! M had been estimating (aka guessing) what her bg was, then entering it into the meter so that it would administer the appropriate bolus. The printout comes directly from the pump, not the meter.
So on any given day, M might think to herself, "Hmmm. I would like a snack. I will have a cheese stick and some grapes. That's about ten carbs. And I feel fine, so I'll enter 143 for bg levels and take whatever insulin the pump decides I need."
For all of you out there in blog land, in case you didn't know, this is a BAD IDEA.
If you guess too high on your bg levels, you are in danger of going into a bg low, for which side effects include, shakiness, dizziness, weakness, and, oh......death.
If you guess too low on your bg, you will not get enough insulin into your system to keep you healthy. Long-term side effects include kidney problems, loss of vision, poor circulation, and, of course, death.
It was time to have a talk.
M and I had a heart to heart. It included my understanding how it feels not to be in control of your life; to be tired of knowing that you must always be thinking about your health, and not wanting to talk to your parents about it.
When we returned home, I let Bill know that we had been snowed. We had pulled back from our responsibility, and allowed M to monitor things herself. In pulling back, we allowed M's choices to go unchecked for a couple of weeks. Now it was time to bring down the hammer. Sympathy and empathy aside, M's health is too important for us to let it go.
Accepting our decision, and our sense of urgency, M has had a (probably temporary) turn around. Her attitude its better, and she is checking her bg 6 times per day. It is too high, but now that we know truly what we are up against, we can put together a plan of action.
Together.
 | |
| Not anymore, M. But it was a nice try. |
Thursday, June 2, 2011
Run away
We had a visitor recently. Two actually. My sister and a close friend from college came over to socialize.
I hate to say that this is a rare occurrence, but it is. We are all of a certain age when running children to various events and activities, coupled with our desire to earn enough money to pay our copious bills kind of eats into our social time. Nonetheless, an effort was made, and we managed to pull it off.
My kids are social animals, and so were excited to see our guests. We cooked some burgers on the grill and sat on the porch talking until the mosquitoes came out. The adults then sat down to a game of cards in the dining room. M sat at the computer, facebooking or something, while her brother chose to play video games in the next room.
We had had burgers, as mentioned before. M had one and with it, she had a nice big bulkie roll. A bulkie roll is about 39 carbs all by itself, plus, as bread is a fast-acting carb, its effect on M's bg levels can be somewhat unpredictable. In cases like these, we typically test M's bg levels about 2 hours after eating to determine if any action must be taken.
With my back to M, I casually ask her to test her bg.
She tries.
I hear an exasperated sigh as her test strip makes itself useless.
With M's old (pre-pump) test strips, M had five seconds after it absorbed her blood before we learned the results. These new strips start the five second countdown immediately upon contact with blood. If she doesn't bleed enough onto the strip, it malfunctions, giving an obnoxious reading like "failure" or some such thing on the screen of her bg monitor.
She tries again. After a moment, I notice her slip up to her room.
My sister reports that she made a face before ascending the stairs. I finish the hand, and go up to check on her.
What I encounter surprises me. It is sheer panic, personified.
M is shaking, red-faced, and teary-eyed.
Gently, I ask, "What happened?"
Shrilly, M responds, "My blood sugar was really high!"
Quietly and calmly, "How high?"
Panicked, "Really, really high! 525!"
Wow, that is high. I pause and quietly ask if M has checked to see if her pump is working. She tells me in a high pitched tremolo that it said "No delivery" on the screen, so she pushed the buttons to administer the dose again.
I check the pump. On the screen I see that it is indeed counting down the dose that is being pumped into her body.
"How much did you have to administer?" I ask.
"19 units."
"Well, let's set the kitchen timer for 20 minutes and see if it your bg is headed in the right direction. If not, we'll give you an injection and change your infusion set, okay?"
She nods and tells me that she's scared. I hold her and tell her that I'm glad that she knows that this is serious, but that we will take care of it. I keep calm by reminding myself that her bg was likely this high for at least a week before she was diagnosed, and that she will not die in the next 20 minutes while we wait to see if the pump is working.
I head downstairs to play cards some for a little while, and dutifully set the timer.
After a very long 20 minutes, I ascend the stairs to check on my daughter. She has changed into her pajamas, and looks a little more relaxed. We test her bg: 228.
Well, now we know that the pump is working, which is a relief. M decides to bolus again, to continue to correct her bg to more normal levels. I allow her to make the call, and we agree to check her bg again in a half an hour, to make sure that she didn't over correct.
I join our guests at the table, who are witness to the joys of worrying about one's diabetic child. My friend reaches over to sympathetically trace the furrows in my brow. I always joke with my students that I need Botox thanks to them, but maybe it is this: worrying about my children, especially the one with the life-threatening illness.
M comes downstairs and sits at the table with us. She is relaxed. Smiling. Sociable. You could almost say that she is a whole other person. We check her bg again. It is 103. This whole other person is the one I am used to: the one who is pleasant, rational, and friendly. The one I knew before the diabetes.
Later M and I have the required discussion about a) making sure that you tell someone when you need help, and b) not hiding from the people who can help you.
At one point in the evening, my friend ad asked, "Do you think she ran off because I am here?"
And I reassured him, saying, "No, I think she just panicked."
But guess what? During our conversation, M told me that the reason she ran off is that she didn't know what to do with guests in the house. She was embarrassed, confused about how to be polite, and of course, somewhat irrational due to the high bg levels.
As far as WHY the bg levels spiked so high that night, we don't really know. I have my theory, which is that when M went to administer her dinner dose of insulin, she did not push the delivery button twice as required (for confirmation). It is the most logical explanation. But M says she distinctly remembers pushing the delivery button twice.
Not wanting to argue with her after her ordeal, I relent, and call it a mystery. Then again, what else could cause her bg to go up by over 350 mg/dl in two hours? I am hard pressed to think of another explanation.
I hate to say that this is a rare occurrence, but it is. We are all of a certain age when running children to various events and activities, coupled with our desire to earn enough money to pay our copious bills kind of eats into our social time. Nonetheless, an effort was made, and we managed to pull it off.
My kids are social animals, and so were excited to see our guests. We cooked some burgers on the grill and sat on the porch talking until the mosquitoes came out. The adults then sat down to a game of cards in the dining room. M sat at the computer, facebooking or something, while her brother chose to play video games in the next room.
We had had burgers, as mentioned before. M had one and with it, she had a nice big bulkie roll. A bulkie roll is about 39 carbs all by itself, plus, as bread is a fast-acting carb, its effect on M's bg levels can be somewhat unpredictable. In cases like these, we typically test M's bg levels about 2 hours after eating to determine if any action must be taken.
With my back to M, I casually ask her to test her bg.
She tries.
I hear an exasperated sigh as her test strip makes itself useless.
With M's old (pre-pump) test strips, M had five seconds after it absorbed her blood before we learned the results. These new strips start the five second countdown immediately upon contact with blood. If she doesn't bleed enough onto the strip, it malfunctions, giving an obnoxious reading like "failure" or some such thing on the screen of her bg monitor.
She tries again. After a moment, I notice her slip up to her room.
My sister reports that she made a face before ascending the stairs. I finish the hand, and go up to check on her.
What I encounter surprises me. It is sheer panic, personified.
M is shaking, red-faced, and teary-eyed.
Gently, I ask, "What happened?"
Shrilly, M responds, "My blood sugar was really high!"
Quietly and calmly, "How high?"
Panicked, "Really, really high! 525!"
Wow, that is high. I pause and quietly ask if M has checked to see if her pump is working. She tells me in a high pitched tremolo that it said "No delivery" on the screen, so she pushed the buttons to administer the dose again.
I check the pump. On the screen I see that it is indeed counting down the dose that is being pumped into her body.
"How much did you have to administer?" I ask.
"19 units."
"Well, let's set the kitchen timer for 20 minutes and see if it your bg is headed in the right direction. If not, we'll give you an injection and change your infusion set, okay?"
She nods and tells me that she's scared. I hold her and tell her that I'm glad that she knows that this is serious, but that we will take care of it. I keep calm by reminding myself that her bg was likely this high for at least a week before she was diagnosed, and that she will not die in the next 20 minutes while we wait to see if the pump is working.
I head downstairs to play cards some for a little while, and dutifully set the timer.
After a very long 20 minutes, I ascend the stairs to check on my daughter. She has changed into her pajamas, and looks a little more relaxed. We test her bg: 228.
Well, now we know that the pump is working, which is a relief. M decides to bolus again, to continue to correct her bg to more normal levels. I allow her to make the call, and we agree to check her bg again in a half an hour, to make sure that she didn't over correct.
I join our guests at the table, who are witness to the joys of worrying about one's diabetic child. My friend reaches over to sympathetically trace the furrows in my brow. I always joke with my students that I need Botox thanks to them, but maybe it is this: worrying about my children, especially the one with the life-threatening illness.
M comes downstairs and sits at the table with us. She is relaxed. Smiling. Sociable. You could almost say that she is a whole other person. We check her bg again. It is 103. This whole other person is the one I am used to: the one who is pleasant, rational, and friendly. The one I knew before the diabetes.
Later M and I have the required discussion about a) making sure that you tell someone when you need help, and b) not hiding from the people who can help you.
At one point in the evening, my friend ad asked, "Do you think she ran off because I am here?"
And I reassured him, saying, "No, I think she just panicked."
But guess what? During our conversation, M told me that the reason she ran off is that she didn't know what to do with guests in the house. She was embarrassed, confused about how to be polite, and of course, somewhat irrational due to the high bg levels.
As far as WHY the bg levels spiked so high that night, we don't really know. I have my theory, which is that when M went to administer her dinner dose of insulin, she did not push the delivery button twice as required (for confirmation). It is the most logical explanation. But M says she distinctly remembers pushing the delivery button twice.
Not wanting to argue with her after her ordeal, I relent, and call it a mystery. Then again, what else could cause her bg to go up by over 350 mg/dl in two hours? I am hard pressed to think of another explanation.
 |
| Don't do this next time, please. |
Saturday, April 30, 2011
Pump Visit Number Five: Mysteries solved
Have I mentioned that driving in and around Boston is a bit problematic?
That is, the traffic is unpredictable, with swings in perception and mood that cannot be foreseen. As a result, M and I routinely leave 2 hours ahead of our scheduled appointment. Sometimes the journey takes one hour and a quarter from my place of work. More typically it takes about an hour and a half.
Today it took two hours and twenty minutes.
We were ten minutes late.
We had been repeatedly warned that being late for an appointment can result in having to reschedule it, so I was panicked. I don't have time for this again in the near future.
Fortunately, the dire warnings must allow for some traffic-related flexibility. Everyone in the office was telling me not to worry about it.
I was probably still in my traffic-induced anxiety when we were ushered in to see Dr.
Firstly, I want to say that Dr. looks great now that her braces are off.
She also looks really fat in the middle, as if carrying a basketball under her shirt. Apparently this will be child number three for her.
Before M goes in to see the doctor, she typically hands over her bg meter to the nurse, who then gathers information from it via some really cool computer thing. This time, the nurse collected M's insulin pump from her, and apparently gathered a multitude of information from it, printed out the information, and handed it over to Dr. Dr. looked at the printout of M's readings from her insulin pump.
The good news was that M's A1C was 6.3, the lowest it had ever been. Again, great news, except that it might be due to the many, many episodes of low bg that occurred over the last two weeks.
I expressed my frustration at the insane variation of numbers and lack of control I felt. I began to tear up as I explained how tired I was, how concerned I was that her numbers were dangerously all over the place, and how I am not finding the pump to be any better than the basal-bolus system with Lantus and Humalog.
I told her that I need logic, and while I am trying to make sense of how these numbers can go from one extreme to another, I am growing frustrated, because I can't make heads or tails of it.
Dr. listened and nodded as she looked over M's printout. She was silent, biting her lip as she tried to make sense of the numbers she was seeing.
Then she dropped the bomb.
"M. I think that it is clear that your numbers are higher when you eat a large number of carbs. For example, here, on Sunday (Easter Sunday), you ate 527 carbs in one day." (!!!)
M tried to say that she couldn't have, but Dr. politely stopped her protests. "I see here that you covered for every carb you ate, and that's great. I am really glad you are doing that, but it might be a good idea for you to visit with Karen, our dietician."
She looked at the printout again, and cited other days with high carb amounts (over 200 in a day). She looked at me meaningfully as she explained that M really should try to keep her carb count below 170 per day.
While Dr. was looking at me, I was looking at M with the same meaningful gaze. M and I had had this conversation before. Many times. She typically glared, got angry, got defensive, covered her tracks, and sneaked food. Thank God she always covered for her food with insulin, but I knew she wasn't always telling me the truth when she told me what she ate.
Now we have proof.
M can't hide from the numbers. Because of the pump, which tracks everything for which she boluses, what her bg is, and how much insulin she takes, we can now have a real, honest conversation about managing her diet, and therefore her diabetes.
But she won't like it.
When we first started on this diabetic adventure, M and I were a team. We were going to show diabetes who was boss! And we did. We counted carbs with precision, logged exercise and insulin doses into a cute little book, and learned how to fill her up with low-carb snacks.
But it got old for M. After all, it's not an adventure. It's a hassle having a life-threatening illness. Two years is a long time to keep up one's adventuresome spirit about managing something that you are stuck with for life. There is only so much sugar-free jello one can eat.
Because I am a mom, however, it will never get old for me. I will continue to remind, suggest, and advise (nag, from M's point of view), because I understand the consequences if I don't.
This is where worlds collide.
So yes, we will make our appointment with Karen. It might be good for M to hear the same information from another source besides her annoying mother. And Dr., you might want to start addressing this information to the perfectly capable 13-year-old.
It is she who is ultimately responsible for what goes in her mouth.
That is, the traffic is unpredictable, with swings in perception and mood that cannot be foreseen. As a result, M and I routinely leave 2 hours ahead of our scheduled appointment. Sometimes the journey takes one hour and a quarter from my place of work. More typically it takes about an hour and a half.
Today it took two hours and twenty minutes.
We were ten minutes late.
We had been repeatedly warned that being late for an appointment can result in having to reschedule it, so I was panicked. I don't have time for this again in the near future.
Fortunately, the dire warnings must allow for some traffic-related flexibility. Everyone in the office was telling me not to worry about it.
I was probably still in my traffic-induced anxiety when we were ushered in to see Dr.
Firstly, I want to say that Dr. looks great now that her braces are off.
She also looks really fat in the middle, as if carrying a basketball under her shirt. Apparently this will be child number three for her.
Before M goes in to see the doctor, she typically hands over her bg meter to the nurse, who then gathers information from it via some really cool computer thing. This time, the nurse collected M's insulin pump from her, and apparently gathered a multitude of information from it, printed out the information, and handed it over to Dr. Dr. looked at the printout of M's readings from her insulin pump.
The good news was that M's A1C was 6.3, the lowest it had ever been. Again, great news, except that it might be due to the many, many episodes of low bg that occurred over the last two weeks.
I expressed my frustration at the insane variation of numbers and lack of control I felt. I began to tear up as I explained how tired I was, how concerned I was that her numbers were dangerously all over the place, and how I am not finding the pump to be any better than the basal-bolus system with Lantus and Humalog.
I told her that I need logic, and while I am trying to make sense of how these numbers can go from one extreme to another, I am growing frustrated, because I can't make heads or tails of it.
Dr. listened and nodded as she looked over M's printout. She was silent, biting her lip as she tried to make sense of the numbers she was seeing.
Then she dropped the bomb.
"M. I think that it is clear that your numbers are higher when you eat a large number of carbs. For example, here, on Sunday (Easter Sunday), you ate 527 carbs in one day." (!!!)
M tried to say that she couldn't have, but Dr. politely stopped her protests. "I see here that you covered for every carb you ate, and that's great. I am really glad you are doing that, but it might be a good idea for you to visit with Karen, our dietician."
She looked at the printout again, and cited other days with high carb amounts (over 200 in a day). She looked at me meaningfully as she explained that M really should try to keep her carb count below 170 per day.
While Dr. was looking at me, I was looking at M with the same meaningful gaze. M and I had had this conversation before. Many times. She typically glared, got angry, got defensive, covered her tracks, and sneaked food. Thank God she always covered for her food with insulin, but I knew she wasn't always telling me the truth when she told me what she ate.
Now we have proof.
M can't hide from the numbers. Because of the pump, which tracks everything for which she boluses, what her bg is, and how much insulin she takes, we can now have a real, honest conversation about managing her diet, and therefore her diabetes.
But she won't like it.
When we first started on this diabetic adventure, M and I were a team. We were going to show diabetes who was boss! And we did. We counted carbs with precision, logged exercise and insulin doses into a cute little book, and learned how to fill her up with low-carb snacks.
But it got old for M. After all, it's not an adventure. It's a hassle having a life-threatening illness. Two years is a long time to keep up one's adventuresome spirit about managing something that you are stuck with for life. There is only so much sugar-free jello one can eat.
Because I am a mom, however, it will never get old for me. I will continue to remind, suggest, and advise (nag, from M's point of view), because I understand the consequences if I don't.
This is where worlds collide.
So yes, we will make our appointment with Karen. It might be good for M to hear the same information from another source besides her annoying mother. And Dr., you might want to start addressing this information to the perfectly capable 13-year-old.
It is she who is ultimately responsible for what goes in her mouth.
 |
| Choose your poison. |
Thursday, April 28, 2011
Bumps along the road
This pump is not doing what it promised.
Just look at all of those happy, carefree people on the brochure, literally jumping for joy. "Just look how simple living with diabetes will be! Look at all of the freedom you will have! Welcome to your new life!"
Bullshit.
It has been two weeks since M started on insulin with the pump. The first third of this time period was fraught with dangerous lows. M's bg level was generally in the 40s and 50s. Sometimes it dropped to the 30s, which left me in the bizarre position of force-feeding her carbs at all kinds of hours throughout the day and night.
We adjusted her basal rate. We lowered it so that she was receiving fewer units of Humalog per hour. 1.35 to 1.25 to 1.15, to 1.1 at night, and 1.15 during the day.
Then it happened. Two days where nearly every test came back with a bg in range. 108, 99, 112, 128, 89.
Yes! We found the magic numbers.
After the two days though, her bg began to spike 348, 398, 378.... What the hell?
We looked at her new infusion site. She had just changed it to the front of her thigh, where some folks had told her she might be more comfortable. Everything was connected. She gave herself bolus after bolus with no visible result. Her blood sugar wasn't going up, at least. We checked, but there was no leak in the tubing.
I thought that maybe the cannula was kinked, delivering some of the insulin, but not all. We decided to switch her infusion site. M took an injection of Humalog using her insulin pen. In an hour her bg was 118.
Phew!
M chose to put the new infusion set on the back of her arm so that her belly could get a rest.
Later that day, she ripped it out while doing some yard work.
Ugh.
Insurance only covers one new infusion set for every three days. Now we will have gone through three in one day.
Super.
M put a new infusion set in the back of her arm. Things are better, but we are still readjusting her basal rates back up. Right now, we have her at 1.35 during the day, and 1.15 at night. Her bg is still in the 200s for the most part.
I am sure that not sleeping through the night isn't helping, but this pump is making me mad.
Evidently, I had some unrealistic expectation that perhaps M's insulin doses would start making sense to me. That maybe we would have better control of her bg.
Right now the control has seemed worse.
I am also sure that it's not the pump's fault. I am sure that I am doing something wrong. Or maybe I am not patient enough.
All I know is that we haven't even paid for the damned thing, and I am ready to send it back.
I am waiting for M to look like those happy people on the cover of the package that we were given, instead of bewildered about her bg levels.
It can't happen fast enough.
Just look at all of those happy, carefree people on the brochure, literally jumping for joy. "Just look how simple living with diabetes will be! Look at all of the freedom you will have! Welcome to your new life!"
Bullshit.
It has been two weeks since M started on insulin with the pump. The first third of this time period was fraught with dangerous lows. M's bg level was generally in the 40s and 50s. Sometimes it dropped to the 30s, which left me in the bizarre position of force-feeding her carbs at all kinds of hours throughout the day and night.
We adjusted her basal rate. We lowered it so that she was receiving fewer units of Humalog per hour. 1.35 to 1.25 to 1.15, to 1.1 at night, and 1.15 during the day.
Then it happened. Two days where nearly every test came back with a bg in range. 108, 99, 112, 128, 89.
Yes! We found the magic numbers.
After the two days though, her bg began to spike 348, 398, 378.... What the hell?
We looked at her new infusion site. She had just changed it to the front of her thigh, where some folks had told her she might be more comfortable. Everything was connected. She gave herself bolus after bolus with no visible result. Her blood sugar wasn't going up, at least. We checked, but there was no leak in the tubing.
I thought that maybe the cannula was kinked, delivering some of the insulin, but not all. We decided to switch her infusion site. M took an injection of Humalog using her insulin pen. In an hour her bg was 118.
Phew!
M chose to put the new infusion set on the back of her arm so that her belly could get a rest.
Later that day, she ripped it out while doing some yard work.
Ugh.
Insurance only covers one new infusion set for every three days. Now we will have gone through three in one day.
Super.
M put a new infusion set in the back of her arm. Things are better, but we are still readjusting her basal rates back up. Right now, we have her at 1.35 during the day, and 1.15 at night. Her bg is still in the 200s for the most part.
I am sure that not sleeping through the night isn't helping, but this pump is making me mad.
Evidently, I had some unrealistic expectation that perhaps M's insulin doses would start making sense to me. That maybe we would have better control of her bg.
Right now the control has seemed worse.
I am also sure that it's not the pump's fault. I am sure that I am doing something wrong. Or maybe I am not patient enough.
All I know is that we haven't even paid for the damned thing, and I am ready to send it back.
I am waiting for M to look like those happy people on the cover of the package that we were given, instead of bewildered about her bg levels.
It can't happen fast enough.
 |
| Bewildered parent and/or diabetic child. |
Friday, April 1, 2011
Sick
Tap, tap, tap "I puked."
It was three in the morning, but M was outside my bedroom door, and I had to spring into action. The first thing I ask is, "What day is this, Sunday?" She tells me it's Tuesday. Now I know I have to call in for a substitute.
I remembered that nearly two years ago, when M was diagnosed with Type 1, we were told that vomiting is very serious business that could lead to hospitalization. This was the first time in those two years that we have had to face this problem.
I remembered nothing. Oddly enough, when M and I went down to Children's Hospital for her infusion set appointment, I went out of my way to grab a pamphlet on sick day management. But where was it? Where was all the information I was given two years ago?
Braaaack
Okay, now that's twice. I am glad this child knows how to get all the way to the toilet.
She wasn't feeling better after vomiting, which is not a good sign. I mean, I usually feel fantastic after throwing up. It must be that rush of adrenaline...
BRaaaack.
Three times in less than half an hour. This is going to be a long night.
Okay, so a loss of glucose from vomiting can mean a drop in blood glucose (bg). We had better monitor this. We pull out the monitor, and with a comforting beeDEEP, we are advised that M's bg is 161. I think that's good, because it leaves us a safety net of about 80 mg/dl.
She vomits again. We test again. 172.
Again. test again, 162.
M continues to vomit every 15 to 20 minutes. It is 4:00. At this point I have pulled an extra mattress into her room, written up sub plans for my Spanish class, brought M a glass of water, and brought up enough test strips to supply a battalion for a week.
I doze between vomits. So does M. After a while I realize that a) I must call the substitute coordinator, and b) testing M's bg every 15 minutes might be excessive. I decide we will test every other time she vomits. I have a sheet of scrap paper with a long list of times that M has vomited. Next to it is the bg level.
The sub coordinator at my school is an excellent human being. He knows that I am never sick. He knows that if I will be out, I will leave plans. He know that I feel guilty if I screw something up. He understands me, because he, too, suffers from Catholic Guilt. When I call him, he gives me no indication that this is a bad time (which, I soon discover, it really was). He just says, "Okay, thanks for calling."
Having handled the school situation as best I can, I devote some time between vomiting episodes to trying to find that information about sick day management. Being that my brain is addled and I am exhausted, this is no easy task.
Two years ago, my mother had put together a binder with M when she was first diagnosed. It helped both of them to organize the information that M had, and made them both feel better empowered and informed. I locate the binder, but there is no sick day management sheet.
I look in the car, hoping I had wedged the guidelines I had taken from our last appointment in between the front seats on my way back from Children's.
Nope.
I go back to the binder. BRaaaaack.
M's bg is 126. I bring up a Coke and ask her to take two sips. M's target is 110. 126 feels a little too close for comfort. I want wiggle room, baby!
Okay, binder. Now, let's look through each individual sheet.
I look. The only information I get is from the test strip company, that says "When to contact your doctor". Vomiting is at the top of the list.
Fine. I vow to call the doctor once office hours begin.
At 9:00 am I call the DNE, who is not in today, would I like to speak to the endocrinologist? As I wait on hold, my anxiety increases. I felt like I was fine before now, but the haste with which the operator referred me to someone else makes me nervous.
I speak to M's doctor, who tells me to watch her Ketones. Damn! I forgot about those things! M hasn't has a high enough bg to warrant checking them in a while. If the Ketones are higher than 2, Dr advises us to go to the hospital.
Now where are those Ketone test strips? M says that she doesn't know, and I sure as hell don't. I find the urine strips, but not the nice blood strips for her monitor. Hopefully she will be hydrated enough to pee. I have been forcing her to drink two sips of water every time she vomits.
I run up to her room with the urine strip. She is asleep. Sound asleep. For the first time in 7 hours, she looks comfortable. I choose to leave her alone.
After two hours she awakens. I explain about the Ketones. She says she can pee. She does, but then she gets upset. The Ketone strip indicates a 5 or a trace amount. She says, "Should I pack for the hospital?"
I tell her to hold on, I will telephone the DNE on call for the day and ask. I think "trace" doesn't sound that bad....
Before I get downstairs, the phone rings. It is Dr. She asks about M. I tell her about the trace. She tells me, "Trace is fine. Stay home. Why don't you phone the DNE on call, and fill her in, just so we have a baseline in case something else develops."
M doesn't feel like vomiting any more. The final score: her bg ranged from 126 to 202. I feel like congratulating myself. When I talk to the DNE, she does. "Good job!" she says.
She then advises me to allow M to stay a little high in her bg range over the next day or two. Also, reduce her Lantus by about 20% for tonight. After all, she has no stores on which to draw. Keep pushing liquids. Maybe see if she will eat some broth or something.
Phew! We made it through our first test.
Now for the big question: Will sick day management be easier on the pump?
It was three in the morning, but M was outside my bedroom door, and I had to spring into action. The first thing I ask is, "What day is this, Sunday?" She tells me it's Tuesday. Now I know I have to call in for a substitute.
I remembered that nearly two years ago, when M was diagnosed with Type 1, we were told that vomiting is very serious business that could lead to hospitalization. This was the first time in those two years that we have had to face this problem.
I remembered nothing. Oddly enough, when M and I went down to Children's Hospital for her infusion set appointment, I went out of my way to grab a pamphlet on sick day management. But where was it? Where was all the information I was given two years ago?
Braaaack
Okay, now that's twice. I am glad this child knows how to get all the way to the toilet.
She wasn't feeling better after vomiting, which is not a good sign. I mean, I usually feel fantastic after throwing up. It must be that rush of adrenaline...
BRaaaack.
Three times in less than half an hour. This is going to be a long night.
Okay, so a loss of glucose from vomiting can mean a drop in blood glucose (bg). We had better monitor this. We pull out the monitor, and with a comforting beeDEEP, we are advised that M's bg is 161. I think that's good, because it leaves us a safety net of about 80 mg/dl.
She vomits again. We test again. 172.
Again. test again, 162.
M continues to vomit every 15 to 20 minutes. It is 4:00. At this point I have pulled an extra mattress into her room, written up sub plans for my Spanish class, brought M a glass of water, and brought up enough test strips to supply a battalion for a week.
I doze between vomits. So does M. After a while I realize that a) I must call the substitute coordinator, and b) testing M's bg every 15 minutes might be excessive. I decide we will test every other time she vomits. I have a sheet of scrap paper with a long list of times that M has vomited. Next to it is the bg level.
The sub coordinator at my school is an excellent human being. He knows that I am never sick. He knows that if I will be out, I will leave plans. He know that I feel guilty if I screw something up. He understands me, because he, too, suffers from Catholic Guilt. When I call him, he gives me no indication that this is a bad time (which, I soon discover, it really was). He just says, "Okay, thanks for calling."
Having handled the school situation as best I can, I devote some time between vomiting episodes to trying to find that information about sick day management. Being that my brain is addled and I am exhausted, this is no easy task.
Two years ago, my mother had put together a binder with M when she was first diagnosed. It helped both of them to organize the information that M had, and made them both feel better empowered and informed. I locate the binder, but there is no sick day management sheet.
I look in the car, hoping I had wedged the guidelines I had taken from our last appointment in between the front seats on my way back from Children's.
Nope.
I go back to the binder. BRaaaaack.
M's bg is 126. I bring up a Coke and ask her to take two sips. M's target is 110. 126 feels a little too close for comfort. I want wiggle room, baby!
Okay, binder. Now, let's look through each individual sheet.
I look. The only information I get is from the test strip company, that says "When to contact your doctor". Vomiting is at the top of the list.
Fine. I vow to call the doctor once office hours begin.
At 9:00 am I call the DNE, who is not in today, would I like to speak to the endocrinologist? As I wait on hold, my anxiety increases. I felt like I was fine before now, but the haste with which the operator referred me to someone else makes me nervous.
I speak to M's doctor, who tells me to watch her Ketones. Damn! I forgot about those things! M hasn't has a high enough bg to warrant checking them in a while. If the Ketones are higher than 2, Dr advises us to go to the hospital.
Now where are those Ketone test strips? M says that she doesn't know, and I sure as hell don't. I find the urine strips, but not the nice blood strips for her monitor. Hopefully she will be hydrated enough to pee. I have been forcing her to drink two sips of water every time she vomits.
I run up to her room with the urine strip. She is asleep. Sound asleep. For the first time in 7 hours, she looks comfortable. I choose to leave her alone.
After two hours she awakens. I explain about the Ketones. She says she can pee. She does, but then she gets upset. The Ketone strip indicates a 5 or a trace amount. She says, "Should I pack for the hospital?"
I tell her to hold on, I will telephone the DNE on call for the day and ask. I think "trace" doesn't sound that bad....
Before I get downstairs, the phone rings. It is Dr. She asks about M. I tell her about the trace. She tells me, "Trace is fine. Stay home. Why don't you phone the DNE on call, and fill her in, just so we have a baseline in case something else develops."
M doesn't feel like vomiting any more. The final score: her bg ranged from 126 to 202. I feel like congratulating myself. When I talk to the DNE, she does. "Good job!" she says.
She then advises me to allow M to stay a little high in her bg range over the next day or two. Also, reduce her Lantus by about 20% for tonight. After all, she has no stores on which to draw. Keep pushing liquids. Maybe see if she will eat some broth or something.
Phew! We made it through our first test.
Now for the big question: Will sick day management be easier on the pump?
 |
| Boo on being sick. Double Boo on being sick with diabetes. |
Saturday, November 27, 2010
Heretofore known as "the incident"
M is a responsible young woman. Never is this better demonstrated than when she maintains her own health independently. We determined after a suitable time, that unless she was vomiting, she could stay home under her own care when she felt unwell.
I was working half days during this moment in time. Things were financially strained, so I had pieced together a number of part time teaching and tutoring gigs to get us hovering near the black. When M was home sick, it was my habit to call her a few times throughout the day to make sure that she was drinking liquids, hadn't been kidnapped by ninjas, and was generally not in a diabetic coma.
On the day of what we refer to as "the incident", I made my usual morning call.
No answer.
No need to panic. Her bg levels have always been in the acceptable range. She's probably asleep and didn't hear the phone.
Job #1 complete. Try to call again.
No answer. Hm. I will try again a few times in a row to see if that will wake her up.
No answer. Maybe there's a need to panic after all.
I called Job # 2. I can't make it. I have a personal emergency.
I walk out to my car with my cell phone glued to my ear. I vow that I will not be one of those dangerous drivers who is on it during the entire drive home.
I start the car. Shall I call the neighbors?
I call one set. No answer.
I pull onto the main road. I call the neighbors with a key to the house. No answer.
At a stop light I call my third trustworthy set. No answer.
I am now in the car driving northward to home. Do I call an ambulance? She is probably fine. She has never gone into any kind of diabetic shock, coma, or any serious reaction. Her bg was 141 when I left this morning. It's very unlikley that she suddenly had such a dramatic low that she would pass out.
Calling the EMS if she is fine might only draw attention to the fact that I am a horrible mother, leaving my poor diabetic child home alone to fend for herself. On the other hand, not calling them might be too much of a gamble. I call home again twice. I force myself to wait five minutes and call again.
I know she's upstairs with her door closed. The phone is downstairs. Would she hear it even if she were awake?
I call again. Knots in my stomach, I begin to formulate a plan.
Glucagon is in her basket on top of the fridge. Cell phone is in hand.
After a 25 minute drive, I am putting my key in the lock of the house. I see the dog's tail wagging through the window. I open the door and leap for the basket where the glucagon is stored, simultaneously shouting M's name. As I start running toward the stairs, I hear her bedroom door open.
"What?"
I freeze at the bottom of the stairs and gaze at my upright daughter. I have the red, plastic container of glucagon in one hand, and my flipped open cell phone in the other. She knows that something is wrong.
I walk up the stairs to her, trembling and trying to control my voice, which is thick with tears.
"I was so worried. I called and called, and you didn't answer the phone."
M grasps what this means to me. Even though she is not yet a mother herself, she is empathetic enough to understand the panic that I felt.
As she hugs me, we both begin to cry. "I am so sorry, Mom. I am so sorry. I didn't hear the phone."
"I know," I say, "I was just so worried. I am just so glad you're okay."
We repeat this exchange a few times as we both begin to calm down. I eventually ask her how she's feeling. In light of the fact that she has been sleeping soundly all morning, I am not surprised to hear her say that she is feeling a lot better than she did when I left.
Was I overreacting?
I tested this story out on a friend of mine whose children are so healthy that she doesn't even bring them to the doctor for check-ups. I wanted to test to see if I was being an overprotective crazy mother. Before I could even ask her about it, she said, "That would have freaked me out." I didn't know whether to feel better or worse for the knowledge.
It's a balance. Obviously I have felt fine about leaving M home as long as she monitors herself responsibly and we have neighbors who work out of the home. Maybe I shouldn't feel good about that. Maybe I am not a careful enough mother. Maybe I don't overreact enough.
It was a fluke that all of my stay-at-home neighbors were out at the same time. But it served as a wake-up call for my back up system.
M is amazingly responsible about her health, and is decidedly able to stay home for a few hours by herself, but we decided that if she stays home in the future, the cordless phone will stay next to her at all times.
I was working half days during this moment in time. Things were financially strained, so I had pieced together a number of part time teaching and tutoring gigs to get us hovering near the black. When M was home sick, it was my habit to call her a few times throughout the day to make sure that she was drinking liquids, hadn't been kidnapped by ninjas, and was generally not in a diabetic coma.
On the day of what we refer to as "the incident", I made my usual morning call.
No answer.
No need to panic. Her bg levels have always been in the acceptable range. She's probably asleep and didn't hear the phone.
Job #1 complete. Try to call again.
No answer. Hm. I will try again a few times in a row to see if that will wake her up.
No answer. Maybe there's a need to panic after all.
I called Job # 2. I can't make it. I have a personal emergency.
I walk out to my car with my cell phone glued to my ear. I vow that I will not be one of those dangerous drivers who is on it during the entire drive home.
I start the car. Shall I call the neighbors?
I call one set. No answer.
I pull onto the main road. I call the neighbors with a key to the house. No answer.
At a stop light I call my third trustworthy set. No answer.
I am now in the car driving northward to home. Do I call an ambulance? She is probably fine. She has never gone into any kind of diabetic shock, coma, or any serious reaction. Her bg was 141 when I left this morning. It's very unlikley that she suddenly had such a dramatic low that she would pass out.
Calling the EMS if she is fine might only draw attention to the fact that I am a horrible mother, leaving my poor diabetic child home alone to fend for herself. On the other hand, not calling them might be too much of a gamble. I call home again twice. I force myself to wait five minutes and call again.
I know she's upstairs with her door closed. The phone is downstairs. Would she hear it even if she were awake?
I call again. Knots in my stomach, I begin to formulate a plan.
Glucagon is in her basket on top of the fridge. Cell phone is in hand.
After a 25 minute drive, I am putting my key in the lock of the house. I see the dog's tail wagging through the window. I open the door and leap for the basket where the glucagon is stored, simultaneously shouting M's name. As I start running toward the stairs, I hear her bedroom door open.
"What?"
I freeze at the bottom of the stairs and gaze at my upright daughter. I have the red, plastic container of glucagon in one hand, and my flipped open cell phone in the other. She knows that something is wrong.
I walk up the stairs to her, trembling and trying to control my voice, which is thick with tears.
"I was so worried. I called and called, and you didn't answer the phone."
M grasps what this means to me. Even though she is not yet a mother herself, she is empathetic enough to understand the panic that I felt.
As she hugs me, we both begin to cry. "I am so sorry, Mom. I am so sorry. I didn't hear the phone."
"I know," I say, "I was just so worried. I am just so glad you're okay."
We repeat this exchange a few times as we both begin to calm down. I eventually ask her how she's feeling. In light of the fact that she has been sleeping soundly all morning, I am not surprised to hear her say that she is feeling a lot better than she did when I left.
Was I overreacting?
I tested this story out on a friend of mine whose children are so healthy that she doesn't even bring them to the doctor for check-ups. I wanted to test to see if I was being an overprotective crazy mother. Before I could even ask her about it, she said, "That would have freaked me out." I didn't know whether to feel better or worse for the knowledge.
It's a balance. Obviously I have felt fine about leaving M home as long as she monitors herself responsibly and we have neighbors who work out of the home. Maybe I shouldn't feel good about that. Maybe I am not a careful enough mother. Maybe I don't overreact enough.
It was a fluke that all of my stay-at-home neighbors were out at the same time. But it served as a wake-up call for my back up system.
M is amazingly responsible about her health, and is decidedly able to stay home for a few hours by herself, but we decided that if she stays home in the future, the cordless phone will stay next to her at all times.
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| Compromise between overreacting and underreacting. The world's longest apron string. |
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