Saturday, May 28, 2016

Life Support Fad

 A fad or trend or craze is any form of collective behavior that develops within a culture, a generation or social group and which impulse is followed enthusiastically by a group of people for a finite period of time.

More on track ...

I don't think about it much.  They are a part of him; his CGM and his pump.  When I see him, I see Joe.  The devices are a seamless blur on the backs of his arms.  They help keep him safe; alive.

I remember when he was three.  I remember when the choice was made to start him on the pump.  It was a mere three months after his diagnosis; maybe not even that long.  I struggled with that decision.  Between the meals and the snacks, between the needles and the blood, and between the monitoring and the carb counting... he looked typical.  There was nothing "visible" about the disease.  There were no reminders that he had a chronic condition.  He looked like his peers. Adding technology, adding devices changed that.

Joe has never felt the need to hide his diabetes.  He wears his pump and CGM where people may see them.  Sure he gets questions. Usually, he responds to them.  Sometimes, if he is focused on something else, he may divert the conversation elsewhere. 

Last week, while we were at the track meet where Joe learned about kidney-pancreas transplants...

I was timing with a group of parents.  Joe came over to me, to my purse, for money.  As he walked away, a parent commented on the "new fad".

Timing Lady: "What is this new fad?"

Me:  "What?"

I followed her line of vision, she was watching Joe walk away from us.

Timing Lady:  "I've seen a lot of kids wearing those, what are they?  ... on the back of his arms?"

Me:  "OH."  I then saw what she saw.  "My son is a diabetic.  That is his insulin pump and a continuous glucometer."

Timing Lady:  "I thought it was some new kind of accessory the kids were wearing on their arms."

Nah,  just life support.

The "craze" of sporting some life support in his day-in-the-life.

Wednesday, May 25, 2016

Not the "Cure" I Would Want for Him

Joe ran up to me, as we were leaving his track meet yesterday.  An excited  "Mom, I just met a man who said he 'used to have diabetes'".

I looked directly at Joe .."What?"

"Yea, he saw my pump and then told me."

My head did a subtle side-to-side shake.  My mind then went to the word "whack-a-doodle".  I was worried Joe had ran into someone who gave him false hope; someone who was telling him a tale about a Dr. MoonLoveJoy who cured his diabetes with a rainbow, sparkling with unicorn horn dust.

"Joe, don't believe it.  Whatever he told you isn't true.  There's not a cure for type 1."

"He said he got a kidney-pancreas transplant."

Oh.  Now.  This changed everything.  "Yes, then yes.. he is technically cured.  But ... Joe ... that isn't the way you want to get a cure ... by having your kidneys .. fail."

Joe and I talked more about transplants.  I used to take care of  kidney transplants post-op.  Typically, a pancreas transplant takes place in a person with severe t1d who is also in need of a kidney transplant. The transplanted organs require life-long use of anti-rejection medications.

"So, you don't typically see a person just receive a pancreas transplant."

"I know mom ... I wouldn't just get one for sh*#'s and gigs."

Ha!  "No Joe, you wouldn't just go get one for the heck of it.  Anti-rejection drugs can have some serious side effects."

As we drove home, we talked more about kidney failure.  It's been years now.  Years, since I've thought of this manifestation of poorly controlled t1d.

A day-in-the-life of talking organ transplants with my 13 year old.

Thursday, May 19, 2016

Insulin Reigns Supreme

200x200D' Blog Week:  Day 4:  I went with the Wildcard of getting physical.  Managing diabetes during exercise can be tricky, so share what works for you or your loved one with diabetes and maybe it can help someone else.  What do you do when you want to work out, but your blood sugar is lower or higher than you would want?  How do you cope with this?  Or how do you manage gym days at school for your child with diabetes?

I was living the dream...

Pancreating for a stubborn three year old who was as active as a rabid squirrel ingesting cases of Red Bull.  Fast forward 10 years ... I've learned a few things about t1d and activity.

Never, ever, never, ever, never, ever, never, ever, never underestimate the power of IOB (Insulin On Board).  If possible, I try to have Joe avoid a large bolus of insulin within 2 hours of a workout that will last for an hour or longer.  We don't correct highs (up to 300) and do about 1/2 correction for a BG over 300, before a workout.

Never, ever, never, ever, never, ever, never, ever, never underestimate the domination of insulin.  Joe's preferred sport is ice hockey.  During practices, we struggle with lows.  During games, we struggle with highs.  For hockey practice, I decrease Joe's basal by 40-50% starting about 1 hour prior to practice and keep it decreased for the duration of practice. He typically drinks a chocolate milk (28 grams CHO) before practice to "boost" his BG.  He drinks a Gatorade (another 20-something grams CHO) during practice.  And he typically has a "free snack" (18-30 grams of CHO) after practice.  During a game, his blood glucose will spike up to the high 200s to the 300s.  We typically do a 1/2 correction after the game and this will bring his BG back into range.

Never, ever, never, ever, never, ever, never, ever, never underestimate the potency of insulin.  Have access to plenty of fast acting sugar sources and longer acting carbohydrates during periods of activity.  Fast acting sugar is great for heading off an imminent low and then follow-up with something more complex to keep that number up.

In addition to our ice capades...

Joe also participates on his school's track team.  The practice is held at school, immediately after school is dismissed.  I added a "sliding scale" of sorts on his daily diabetes log.  I used to do something similar for PE days.

A person with t1d can be active; they, like all of us, should be active.  Yes, they need to pay attention to BG trends and what works and what doesn't work.  The above tips took years of logging and tweaking and will inevitably change over the next few years.  Also, sugar sources are a must if you are going to work out.  Have them on your person.  Have a stash of change to buy sugar.  I've had to raid vending machines after depleting our Skittles supply during hockey practices.  Just be prepared for the unexpected.  It happens.  But, it shouldn't deter you from getting out there.

A behind the scenes look at what goes into an active day-in-the-life of living with t1d.