Field of dreams

We traditionally eat dinner at my parents' house on Saturday. It's a good way for us to stay in touch and get together for a couple of hours each week. It usually involves some kind of beef (which M loves) some starch and a vegetable.

Not long after M was diagnosed with diabetes, however, we arrived at the house for our traditional fare, when my mother lets us know that we are having spaghetti. I was a little surprised at the announcement, as Mom knows that we had M on the rigid plan. This plan allowed us a certain number of carbs within a 5 carb range at certain times of the day. Pasta would surely put us over our dinner allotment for carbs.

But, Mom was grinning. She had made a discovery at the supermarket: Dreamfields Pasta, which claims to have only 5 net carbs per serving. Oh wait! Look closer. It has 5 digestible carbs per serving.

What?

If the idea of digestible carbs is new to you, it is to me, too. I continued to read the box:

Carbs: 41
Protected carbs: 36
Net digestible carbs: 5

Pardon me for being skeptical, but what the hell is a "protected" carb? I assume we are protecting it from being digested and absorbed into the human blood stream.

I wasn't buying it. Even if the company can somehow "protect" the carbs, how can doing that be any good for you? Do they wrap the carbs in Saran Wrap?

I looked on the Dreamfields website:

"Why do you say that Dreamfields Pasta only has 5 grams of digestible carbs when the nutrition label states that it has 41 grams of carbohydrates?

While the total number of carbohydrates is the same as traditional pasta, our patent-pending formula and unique manufacturing process protects all but 5 grams of carbohydrates from being digested. The Dreamfields fiber and protein blend creates a protective barrier to reduce starch digestion in the small intestine. The unabsorbed, or protected carbohydrates then pass to the colon where they are fermented, providing the same health benefits as fiber."

Yummy.

A unique manufacturing process! That spells flavorific!

Manufacturing: the same nutritional professionals that tried to convince us that creating artificial infant formula was better for our babies, only to be shot down by mother nature's unique "manufacturing" of easily digestible proteins.

Pardon me for feeling less than enthusiastic.

But, since Mom had gone to all of that trouble to make a special pasta, we ate it.

But we covered for 41 carbs with insulin. NOT for 5.

And guess what?

M's bg was in pretty good shape afterwards.

You would think that if we had given her enough insulin to cover for 36 extra carbs, she might have suffered a low. But she didn't.

So pardon me, Dreamfields, but I think you are full of hooey.

Hey! Maybe that's the unique manufacturing process!

Breast Cancer Envy

Breast cancer is a horrible disease. It threatens, and sometimes takes, lives. It alters the way a woman feels about herself and her own body. For this reason, it is recommended that women over forty start getting regular mammograms every year or two.

Billions of dollars every year are spent on education, research and prevention of breast cancer.

Kids in the high school where I teach sport "Save the boobies" wrist bands with the support of the administration.

There are organizations that will take your long hair, and use it to create wigs for women who are undergoing chemotherapy.

And every year comes the advent of breast cancer awareness month.

Today, M is participating in a breast cancer walk. A walk that is anticipated to have an attendance of over 5,000 people (it ended up being closer to 5,500!).

There are many wonderful events and campaigns that raise money for breast cancer research. I even remember nearly an entire season of General Hospital dedicated to breast cancer. During the season, the son of the breast cancer victim points out that while AIDS has turned out to be a popular charity, breast cancer kills many more people yearly.

Everyone wants to cure breast cancer. Do you think the victims of breast cancer are going to settle for better treatments? NO! They want a CURE! And I don't blame them.

But lets go back just a minute here. AJ Quartermaine, while breast cancer kills more people annually than AIDS, diabetes kills more people annually than breast cancer and AIDS combined.

While everyone seems to understand what breast cancer is, nearly 100% of the people I meet don't really understand what diabetes is. This includes some medical professionals.

We have diabetes walks. But the JDRF walk I attended last month, in the same community as M's breast cancer walk, had maybe 100 participants. MAYBE.

And, while General Hospital dedicated a lengthy, comprehensive, and detailed story line to breast cancer, what do we in the diabetic community get? Oliver, on Hannah Montana, is diagnosed with diabetes one day. Then we never see his bg meter again. Apparently Oliver is all better, and his daily management would not fit well into such a pop tween sitcom.

Finally, I am tired of people thinking that insulin is "good enough". Do you think that breast cancer patients think that mastectomies are "good enough"? I assure you, they do not.

Diabetics are expected to endure their illnesses, simply because it isn't "in your face". People can manage diabetes without you even noticing, so things must be good enough, right?

Nope.

Not even close.

Diabetes must be managed every minute of every day. It's like taking exams in class every day, except that not doing well could result in death.

Death.

We must need a better marketing team for diabetes. Maybe diabetics and their families are so busy handling the day-to-day struggles, that they don't have time to advocate for others with the disease.

Why does the public not seem to take diabetes seriously?

A nurse who goes to my church may have explained it best. She was commenting on another parishioner who routinely works very hard and volunteers regularly. But she, at times, pushes herself too hard, and doesn't take care of herself. The woman is diabetic.

One day, the nurse approached her and scolded her to take a break during our Christmas fair. Then she turned to me and said, "You know what they call diabetes, don't you? 'The silent killer'."

Well I, for one, am not going to remain "silent" any longer.

Good luck ladies!

The stages of grief

This most recent summer, I realized that being diagnosed with Type 1 diabetes, or any other serious illness for that matter, can fall into that category that utilizes the five (or seven, depending on your school of thought) stages of grief.

I do not necessarily agree that grief can be divided into stages. This is a very inflexible-everything-can- be-qualified-and-quantified-and-progresses-in-a-linear-fashion way of thinking.

But, this summer,  I did get a good look at stage 1 - Denial.

Although in M's case, it was more like stage 4. Her first stage was acceptance, which is technically supposed to be stage 5.

Never let it be said that M does anything halfway. She did denial absolute justice.

She denied herself information that would better help her manage her diabetes, by not checking her blood sugar.

She denied the value of that information by simply making up blood sugar numbers to plug into her pump.

She denied that this could cause her any health problems by thinking that her method of "management" would be adequate.

And when I started probing her with questions about her management, she denied to herself that I would ever figure it out.

Now that she is no longer in denial, I will have to wait to see what unexpected turn her grief will take next.

Right now the safe bet might be on one of the unofficial stages: "whining".

Yeah, if we ever get through it!

Concussion

As I may have mentioned, M is the goalie for her field hockey team. Although she has never played before this season, her improvement has been marked.

Earlier this week, however, her team got a new kind of penalty that neither she nor I had heard of. A player fell on the ball, apparently covering it with her body.

I guess this was a serious one, because M was set up in the goal while the rest of her team was set up behind the midline. A girl on the other team was given a one-on-one shot at the goal.

The girl wound up and smacked the ball. It traveled in an upward fashion, hitting May on the front of her (helmeted) head.

It would have been a lot cooler if it had deflected right back into the field, but instead it went into the corner of the goal.

I wondered if it hurt. So when M returned for a time out, I asked her how she felt. She said, "I have a wicked headache!"

Somewhat alarmed, but not panicked, I asked if she wanted some Tylenol. She said she would be fine, and finished out the game.

It is three days later, and she still has the headache. She took "the concussion test", which she did not want to do ("It's so friggin' long!"), and it came back as "not a concussion" but with "22 symptoms."

While I wait to hear from the trainer about her recommendations regarding a doctor visit, I decide to look up information about diabetes and concussions.

To my dismay, I found something. It seems that diabetics do not "withstand impacts to the head" as well as non-diabetics. This is something I had never thought about, and is certainly not up there with the "diabetic feet" issues that are so frequently communicated to the diabetic community.

Why, you may ask, would having diabetes matter to your head with regard to impact?

Evidently, if brain cells contain high levels of glucose and magnesium, they are practically invincible. Unfortunately, since the diabetic body doesn't use glucose very efficiently, and depletion of magnesium nearly always predates insulin resistance (in Type 2),  we have the perfect cocktail of brain cells' natural defenses going down.

Not good.

In the meantime, I will wait for advice from the trainer and the school nurse.

And I will look up new and exciting things for me to worry about.

JDRF vs. ADA

I am beginning to wonder if there is a competition /rivalry going on between JDRF and the ADA.

The fundraising walk in our area is a JDRF sponsored walk. I have been twice. About 100 people showed up both times.

The closest ADA "STOP DIABETES" walk is in Boston. Last year about 5,000 people showed up.

There are a couple of factors to take into account here. 1) Boston is a real, no-joke city and 2) the ADA supports research regarding both type 1 and type 2 diabetes. Since 90- 95% of all diabetes cases are type 2, perhaps the ADA will get more press and support as a result.

The JDRF only works with patients and research pertaining to type 1 diabetes, which is the one with the "dead" pancreas, that will not "go away".  (Since I am pretty sure that type 2 doesn't "go away" either, I am always surprised how often I must answer the question: "will she grow out of it?")

While the ADA sponsors M's diabetes camp, I have a soft spot in my heart for the JDRF.

On the other hand the aggressive tag "STOP DIABETES" makes it sound as if there will be cutting edge technology on the way at any moment. Bret Michaels has thrown his weight behind this organization.

Of course we have Nick Jonas and Mary Tyler Moore behind the JDRF.

What to do, what to do?

Since the JDRF walk was only a half an hour from my home, M and I volunteered what limited resources we had behind them.

The first time we walked, we simply showed up, paid $25 each, and walked the 5K circuit around the pond at NHTI.

This time we decided we would actually try to raise some money. After a few Facebook appeals, we recruited five walkers and raised over $600 (Thanks to all who donated!).

Again, there were only about 100 people there. There was a local radio station. There was a raffle. There was donated food. But there weren't a lot of people. The groups raised about $25,000 total. Which for 100 people isn't too bad. But it is disheartening to see such a tiny response. After all, the JDRF is the worldwide leader in funding research on Type 1, including the artificial pancreas, and the prevention of Type 1.

I know that Type 1 doesn't sound as sexy or life-threatening as cancer does. I know that people see insulin as a godsend that makes people's lives "normal". But more people die from diabetes than from breast cancer. And even though it is manageable, it is still hard. And when someone you love has it, it's really hard.

So maybe that's why the STOP DIABETES campaign is picking up steam. Maybe it sounds more exciting and proactive than a "research foundation".

Of course I wish both organizations the best of luck and a lot of support. We need to do whatever we can to find a cure.

Our walking team! Thanks guys!

A call from the nurse

So M has been in high school for about 6 weeks.

As with most high-schoolers, there have been some bumps along the way, but for the most part her transition has been pretty smooth, especially considering that her previous school was so tiny. And Montessori.

In a small Montessori school, diabetes was pretty easy to manage.

M could eat when she was hungry. She could check her bg any time she felt like it. She could leave her work for a moment without losing valuable instruction time.

In traditional public school, these options are not typically available.

For example, students are not allowed to eat in class.

Oh sure, because she has a "disability", M is permitted to eat in class. But if no one else is permitted to eat in class, then M feels like she is making a big stinky deal out of being "special".

To check her bg, M either has to check it in class, which causes a distraction, or excuse herself to go to the bathroom (Ick! High school bathrooms!) or the nurse's office. Leaving the room excludes her from valuable instruction time.

Not to mention that racing from room to room, visiting her locker, carrying and organizing a bunch of stuff, etc. gives her plenty of opportunities to "forget" that she has to take care of herself.

Overall, she forgets less than she might.

However, while at work the other day, the phone in my classroom rings. I pick up the phone and our school secretary asks me to hold the line for M's school nurse.

I go into "I-am-calm-and-will-not-panic" mode.

I try to sound pleasant as the nurse asks how I am. I say something foolish like, "I don't know. You tell me!"

She explains that M has had a couple of lows that morning, and that it took her a few hours to shake them. She had to lie down in the office for a while and missed her Spanish class and thus valuable instruction time. She is fine now.

The nurse goes on to explain that M has not been eating breakfast in the mornings, which is news to me. The nurse suggests that perhaps M doesn't have time in the mornings to eat.

I stupidly begin to argue with the messenger, "She has an hour..." but I cut myself off. It is not the nurse that needs to realize that she has plenty of time. I have met M before. She does not like to eat in the mornings. She never has. In fact, when she was in preschool, her teacher once called to ask me if I fed M breakfast in the morning, because she was always starving at 9:00 am. My answer at the time was, "I try to, but she only eats about two bites before she says she's full."

M is still the same person she was at three years old. She is never hungry in the morning. In Montessori school, M ate when she was hungry. The problem is that traditional schools need to have designated lunch times or students will lose valuable instruction time.

I tell the nurse that I will buy M some Zone bars so that she can shove something into her face before heading to school. The nurse thinks that this is a good idea.

I ask the nurse to please have M come visit her before the end of the day to check her bg again. She had a field hockey game that afternoon, and I didn't want to burden her coaches with a sick, weak, or unstable kid at an away game. The nurse agrees and I hang up.

It was my prep period, so I only had one student in the classroom with me, looking for extra help.

"Is everything okay with M?" she asked. All of my students know about M's type 1.

"Yes," I sigh. "At least it will be."

Mmmm. Breakfast!

Field Hockey and Diabetes

Before I launch into this post, I would like to say that I am so very proud of M for trying field hockey. She loves lacrosse, and decided that she would like to stay conditioned so that she would be in good shape for the high school lacrosse team in the spring. Joining another team so that she could stay in shape seemed an excellent idea.

She had never played field hockey before.

After two weeks, she told the coach that she would like to try the goalie position. The coach assigned her a mentor to show her the ropes, and the following day she was playing goalie for a full Junior Varsity game. WOW! Talk about fearless.

You would think I would have learned all of the coping strategies necessary to deal with her participation in field hockey this fall, after all of the exciting experiences we had last spring in lacrosse.

Well, high school sports are really different from middle school sports.

First of all, in high school, they have practice or a game every day.

This means that M is never home before 5:00 pm on a school night. It also means that two times per week she isn't home before 8:00 pm.

For most parents, this inconvenience means setting aside another plate for dinner, and a grumpy kid trying to get his homework done before 11:00 pm. For many other parents, it means driving forgotten gear to games or packing extra snacks. It also means a lot more laundry and a higher water bill as your teen showers twice every day.

For me, it means all of these things, but it also means not knowing how M is doing that day until she comes home with a headache, or nausea, or battling a low bg that won't go away. All three of these situations occurred during M's first week of school.

Headache- Cause: who knows? Dehydration? Her bg seemed fine, although she didn't test it very often. She is supposed to test it 6 times per day. But, because of the tight schedule during the school day, she managed to test it only once during school, leaving her with tests before school, during lunch, before the game, and after the game/dinner.

Nausea and seemingly ceaseless low- Cause: High bg 437. M "just didn't check" her bg before the game. After the game, that 437 set off a roller coaster for the next 24 hours.

• correct 302
• eat and bolus 258
• bedtime check 198
• 6:00 am 49
• 6:20 am 98
• 8:00 am 62
• 10:00 am 81
• 11:00 am 160 (yea!)
• lunch 215
• 2:00 pm 173
• 7:00 pm 245
• 9:00 pm 181

Sigh.

These are hard-learned lessons for a fourteen-year-old. M is starting to remember how sick diabetes can make one feel. That nausea didn't go away for a long time.

These ups and downs are not as fun as they sound!

For now things are "normal". There are no practices this weekend. Hopefully we can use that time to level her out.

Thinking ahead, maybe we will need to designate another "official" time for her to check her bg during school. Then she might be able to stay on top of her bg levels before they develop into crazy bg swings.

In the meantime, I will try to concentrate on cheering M on during a game, rather than searching for evidence of a diabetic crisis looming on the horizon.