Flu shots

As I drive around scouting Back to School sales, I have begun to notice those signs cropping up outside of pharmacies.

Back in my more carefree days, I thought flu shots were for the elderly and infirm.

I have scoffed at flu shots, thinking that they were an unnecessary expense and a hassle. I had heard too many stories about people getting a mild case of the flu from the flu shot, and I thought that I would take my chances with the real flu.

My gambling paid off. My kids had never had neither the shot nor the flu. After 21 years of teaching, I have had the flu twice. Each time it was two horrible days of torture, and then it was over.

What doesn't kill you makes you stronger, right?

But then M was diagnosed with diabetes, and I had to reconsider my relationship with the flu shot. I hated to do it, but she was going to have to get it.

Every year.

Vomiting is just too big a deal when you are diabetic.

Another one of life's choices robbed by diabetes.

Cheat sheet

To: Coaches X and Y

From: Annoying mother

Re: My diabetic kid

There is a lot of information about Type 1 diabetes out there. If you are curious, you may check out these websites:

www.jdrf.org

www.diabetes.org

But here is the stuff you really need to know about My diabetic kid.

1)   M treats her diabetes by using an infusion pump, which can be removed. The pump is a remarkable machine that helps M calculate how much insulin she needs and administers it through a tube into the fatty layer just below the skin.

2)   There are blood sugar (bg) highs and lows. An average person’s bg is between 80 and 100. M checks her bg with another machine, called a blood glucose meter. She will prick her finger to get a drop of blood and apply it to a strip. The meter will tell her what her bg is in about 5 seconds. She will test her bg immediately before and immediately after a game or a practice.

3)   I am not as worried about bg highs.

Bg highs tend to cause long-term complications. When you hear about someone going blind, or having their foot amputated due to diabetes, it is generally caused by unchecked bg highs.

In diabetes world, anything over 200 is high. 350 is considered serious, over 400 is ridiculously high. If M checks her bg levels right before a game, and immediately after, she will not have time to have her bg climb that high. It takes several hours for a bg to climb to what we would consider a dangerous level.

SYMPTOMS OF A HIGH: Extreme irrational crankiness. Have her check her bg and treat as necessary She can do this independently, but a bg high is like serious PMS: You think you are upset for a valid reason. A quick 5 second bg check can put everyone at ease.

4)   Bg lows are more serious, and more likely to happen during a game.

M will try to snack before every game, and enter every game or practice with a slightly higher bg, because her bg tends to go down when she exercises.

Treatment for a low is candy. M will keep a stockpile of Smarties with her equipment, just in case. When her bg is low, a really sugary (in diabetes language – fast acting carb) treat will make her feel better within about 20 minutes. These include Smarties, and fully sugared soda, like Coke, or juice.

A low bg is under 70. Since she is exercising, she will need to eat something before it gets more dangerous ( in the 50s is considered dangerous, although she once hit 22 and revived herself by eating candy and checking her bg every 10 minutes)

M easily recognizes when she is going low. She will give you a signal that she needs to be benched, will check her bg, and give herself the appropriate treatment. She should communicate to you how long she will need to sit. Some days it is ten minutes, other days it could be the rest of the game.

SYMPTOMS OF A LOW: Stumbling, fogginess, shaky, hot. The shakiness really stands out. M is always bright red when she exercises. Do not worry about it. It does not signify anything on the diabetic scale.

5)   We have never had a hospitalization or diabetic emergency since she has been diagnosed. We have never had to use the glucagon. Glucagon is basically pure sugar in a shot. It will be in a bright red case in her equipment bag. It only gets used if she is not alert enough to drink a soda or eat candy. This has not happened to her as of this day.

HOW TO USE GLUCAGON: 1) Open the case, remove the syringe and the vial with the brown stuff in it 2) Inject all of the liquid in the syringe into the vial 3) Using a spinning motion, mix the liquid and the brown stuff together 4) Draw all of the liquid back into the syringe 5)Inject .75 (three quarters) of the syringe into her shoulder or the front of her leg. We want to hit muscle if possible 6) call 911

I will make every attempt to be at as many games as possible, to take the pressure off of you.  But as I said, M hasn’t let us down yet. Most of the time, she is just a normal kid, and aside from seeing her check her bg, you might forget she has diabetes. Chaperones, teachers, and coaches tell me that they forget all of the time, which is usually a good sign that things are under control. I just want you to be prepared in the unlikely event that something comes up.

Thank you for having a great attitude, and giving M a chance to play on your team. She is SUPER excited!

If you have any questions, please call XXX-XXXX or e-mail mye-mail@email.email

Ursula

Thanks for letting my kid feel normal.

First big shot

While it has been over a year since we left the hospital armed with new information and knowledge regarding diabetes and how to manage it, I still remember preparing M to give herself a shot.

I remember thinking that when she went off to college, she had better have a roommate with diabetes, too. Who else could give her a shot in the butt?

When a person is diagnosed with insulin-dependent diabetes, there are factors to consider that may not have come up before.

1) You cannot give your insulin shots in the same place all of the time, no matter how inconvenient all other locations might be for you. It is necessary to "rotate" where you give insulin shots. If you give yourself shots in the same place repeatedly, you are likely to develop callouses, which in turn make the absorption of insulin more difficult.

2) The best places to give shots are in locations with fat on them: the back of the arm, the belly, the butt, the thigh, the back of the leg.... Of course, if you have recently been diagnosed with type one diabetes, there is no fat on your body anywhere.

Inject yourself where it's yellow. Good luck!

3) It is hard to give yourself a shot in the butt, the back of the arm, or the back of the leg. There are tricks, but you have to learn them at diabetes camp. At least it seems that way.

4) Giving yourself a shot for the first time is scary.

5) The needles for insulin are thin and short. You want the insulin to get into your fat layer for better absorption. To make sure that you get into the fat layer, you pinch a nice meaty part of your body, inject the insulin, release the pinch, then remove the needle.

6) Other shots do not require the pinch.

So we leave the hospital with the parental skills necessary for M to survive in our home. But M has not yet injected herself. Just as we were, she was nervous about possibly hurting herself while injecting the insulin.

Our goal is for her to inject herself at least once per day so that she may do it herself at school.

I encourage her. Cajole her. Point out that she keeps telling me that it doesn't hurt. Intellectually, we are on the same page. She KNOWS it doesn't hurt. It just freaks her out to think about doing it to herself.

This is understandable considering that she was unable to look at needles until she had to. Now she was fully invested in her new life of "needles, needles, needles, all the time". Life had changed, and it had only been a week. On the other hand, M would be returning to school very shortly. Time was running out.

Several meals in a row, M sat at the dinner table, with her needle poised, readying herself to inject insulin into her belly. She would pull the needle away to brace herself for jabbing it in there quickly. She would begin to "shoot" the needle, and stop mere centimeters away from the quivering flesh. She repeated this action, growing more frustrated each time.

Sometimes she would dissolve into tears. M knew she could do it, but she was scared. Every time she cried, a piece of me would cry with her. The part of me she could see, however,  would say, "Don't worry. When you're ready, you'll do it. It will be fine."

But I don't think she believed it.

Meals passed. Days passed.

I needed to go to the dump. I left the house for a few hours. When I returned, M gave me the big news: she had injected herself! She was so proud. So happy. So relieved.

"How did you do it?" I asked.

And the answer was, as it has been many times before, "Daddy made me do it."

I always wonder how Daddy does these things. What a miracle worker my beloved life partner is.

Relieved that I might no longer have to suffer watching my daughter bear the anxiety of self injection, I again said a prayer of thanks to the mating gods. Thank you, mating gods. Thank you.