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Tuesday, June 26, 2012

"Thank You" ... It Is Not Quite Enough.

A little over a week ago...On Joe's last day of Third Grade and his last day at Hiawatha Elementary School...

Written and folded into a paper airplane by Joe's School Nurse:

A 4 YEAR JOURNEY...

NEVER TO BE FORGOTTEN.

A SPECIAL STUDENT WHO TOUCHED MY LIFE!

A SPECIAL FAMILY WHO MOVED ME!

SOME OF THE LESSONS LEARNED:  HOW TO BE BRAVE, SMARTER, PATIENT, KIND, HARD WORKING, FLEXIBLE, SAFE, A BETTER PERSON, A BETTER FRIEND, GOOD WITH NUMBERS, A BETTER READER, A BETTER NURSE AND A BETTER HUMAN BEING IN HAVING MY LIFE TOUCHED BY YOU JOE MAHER AND FAMILY!

THE LIST COULD GO ON...BUT I WANT THE PLANE TO FLY AND I WANT YOU TO FLY JOE, FLY ON IN LIFE AND COME BACK AND LET ME KNOW WHAT YOU BECOME SOMEDAY!


Kindergarten Joe

I would search the building for her.  I would.  My eyes would have to meet hers before I would leave him there; before I would leave Joe for his full days of Kindergarten.  It was an unspoken thing.  It was a security thing.  It was a "I need to know my kid is gonna make it through the day alive" thing.  The School Nurse was Joe's life-line, which in turn made her mine.

As many of you know, Joe was diagnosed with Type 1 when he was three years old.  I had attended preschool with him for weeks, while the staff learned how to check blood sugars and to treat lows.  I was present for daily snack times to dose Joe with Insulin, as the school ... and I ... were not ready for that responsibility shift.  I had been Joe's pancreatic~shadow for two years prior to his Kindergarten year.  I was not comfortable leaving him with many people, not even Dave.  In hindsight, yes, I realize that this was not a "healthy choice" for myself, for Joe, or for my family.  But, it was how it went down.

After reading the above, you can only begin to imagine the anxiety I experienced when sending Joe "away" for full day Kindergarten.  To experience 7 hours away from Joe, from the numbers, from the "micromanaging", from the tweaking was a bit of a shock.  Frankly, I cried for the first few days of school.  Not sure if the tears were out of happiness, sadness, or fear ... or what.  Perhaps they, the tears, were out of relief.  It was a relief to have a break.  It was a relief to not clock watch.  It was a relief to not carb count.  It was a relief to not bolus, to not worry about activity, to not throw test strips away, to not tote sugar sources.  More importantly ... most importantly ... obviously ... It was a relief to know that he was in safe, capable, and in the most caring of hands.

As Joe matured and traversed the First, Second, and Third Grades he was supported in his growing independence in regards to his diabetes care in the school.  I did not hover.  I did not need to see the School Nurse before I was able to leave Joe at school.  Eventually, I would just drop Joe and "Woodchuck" off at the curb.  The School Nurse and the staff knew Joe; they knew diabetes.  They cared for and nurtured Joe as a growing boy, student, and pancreas.

The School Nurse was integral in facilitating Joe's independence in a safe manner.  She got it.  She shifted and followed Joe's lead.  For Joe to "fly" he needs to learn to manage diabetes safely and independently.  He is well on his way thanks to you Mrs. C. 

A day-in-the-life of "Thank You" just not seeming like quite enough.

Tuesday, June 19, 2012

Socially Acceptable?

I think in the past I...and not Joe ... have done the blood sugar checking in potentially bio-hazard-y situations. 


Yesterday...

The checker~outer~bagger~guy was eye-ing Joe.  Joe had found me in checkout lane #8.  "Mom...I feeeEEEL LOw." I know that climbing and descending octave voice.  It is Joe's low voice.  I could not reach Joe, as I was pinned-in my lane by the shopping cart.  I tossed Woodchuck (Joe's diabetes supply bag) over to checkout lane #7 and instructed Joe to do a check.

Joe had just spent the last four hours swimming and biking on a pump track.  Swimming rarely causes Joe blood sugar issues.  He keeps his Ping on.  No decrease in basal...bolus as normal for food...minimal free carbs are needed to keep him euglycemic.  Pump track riding may be a different story though, as we battled many lows yesterday afternoon, evening, and on through the night and into this morning.

Enough about numbers, let's get back to the checker~outer~bagger~guy and the grocery store blood sugar check...and the blood...oh yeah, the blood....

So, checkout lane #7 was vacant.  Joe walked up to the "conveyor part" of the lane and started unzipping Woodchuck.  Now ... I don't give the whole blood sugar procedure a lot of thought.  You know, the blood borne pathogen business.  I don't really think about the "biohazardness" of our day-in-the-life.  With Joe's Woodchuck splayed out all over lane #7, I started dreading a "gusher" (yes, at times Joe's finger can spew like a volcano..now no one is gonna come over for dinner).  The thought of blood splatter on the conveyor belt and the sequella of that splatter ... blood droplets smeared all over not only the black belt but being smeared all over the hard~to~reach~to~sanitize conveyor parts underneath the checkout counter ... and the possible tainting of fresh produce ... the thought of the blood on the belt and the look of the checker~outer~bagger~guy taking in Joe's predicament had me take pause and instruct Joe to move his procedure to a less traffic-ed spot.  He did it by the checkout lane #7 bagging station.  Not sure if that was much better.

His number?  It was 59.

A day-in-the-life of trying to manage diabetes in the checkout line in a "socially acceptable" manner.

Monday, June 18, 2012

"Same-Same" At 70mph...

I think this was the first wedding ceremony that I actually enjoyed a beverage, an alcoholic one at that, while spectating.  Tara and I clinked bottles, as we waited for Chloe, Bridget, and Joe to escort Mom down the aisle.  My mom got married at my sister's lake house this weekend.  Congrats Mom!


Yesterday....

As we were driving home from Connecticut...where the ceremony took place....

I was zoning out in the front passenger seat, as Dave drove.  Then I saw it.  A Connecticut license plate had the letters "D" "I" "B" "E" "T" "E" "S".  No, that could not be.  I wondered if the "DIBETES" was short for "DIABETES".  My answer quickly flashed by before I had time to verbalize all that had been going down on my side of the car with the license plate and my curiosity.  My answer was in the form of an arm site...a CGM?.  I caught a glimpse of it as Dave whizzed by the young adult female.

"Dave!!!  I gotta get by that car again." I think I was kinda excited.

"She has a license plate that says D-I-B-E-T-E-S...and she has diabetes!!!"

"She has an arm site of sorts."

" I think it was a Dexcom."

I desperately wanted to share some sort of "uniting" moment with this woman.  So, I talked Dave into slowing up and positioning the car so that I may "interact" with her on some level while we careen down the highway.  My idea was to wave some sort of diabetes paraphernalia out the window.  Bridget was horrified.  Joe did not even know what was going down as he was head-phoned and engrossed in The Princess Bride.

Dave maneuvered us in and out of traffic.  He slowed.  He weaved.  He got us over to the right lane.  She, "DIBETES License Plate Lady", was in the middle lane.  She passed us.  Dave then crossed the middle lane and got us into position in the left lane.  He stepped on it.  I rolled down my window.  I had Joe's Dexcom receiver in my hand.  I was waving it out the window ... kinda fist pumping it in the air ... at "DIBETES License Plate Lady".  I think I was screaming "WOHOOOOOOOOOO!!!" or something.  She and the passenger, another young adult female, took notice of me and responded in like with multiple fist pumps, while "Wohoooooooo-ing".  Huge grins were gracing our faces.

Upon closer inspection, her arm site was a pump site.  It looked "Medtronic-y".

A day-in-the-life of wanting to express "same-same" at 70 mph.

Saturday, June 9, 2012

Tuff Mutha


The RULE OF 15: If your blood glucose is 70 mg/dL (3.9mmol/L) or below, use the rule of 15 to treat hypoglycemia.  Treat with 15 grams of rapid-acting carbohydrate.  Check blood glucose in 15 minutes.  If your blood glucose is still less than 70mg/dL, eat another 15 grams of rapid-acting carbohydrate and re-check blood glucose in 15 minutes. Repeat as needed until blood glucose is in goal range.

We all know about this rule.  Who breaks it? 


Memorial Day Parade 2012...The Essence Of "Joe" (Thank You Nikki)

A couple of days ago...

A pause...then the heavy Joe breathing that I know as heavy Joe breathing because it seems he is always breathing heavily when he calls me from school.

"Mom?"

"Yeah Joe."

"I am 56.  Can I please just eat my snack with my friends?"

"Joe, you need to wait for the 56 to come up."

(tears and a quivery voice were then heard) "Please mom.  You have let me eat when I am like 68"

"56 is too low Joe.  Wait for your number to come up."

"Please mom." (tears)

"Joe, put Mrs. School Nurse on the phone." (firm voice)

"Please mom." (tears)

"Joe, put Mrs. School Nurse on the phone." (firm voice)

"Please mom." (tears)

"Joe, put Mrs. School Nurse on the phone...now." (extra-firm voice)

I explained that the 50s was just too low to go ahead and let Joe eat.  I wanted Joe to wait 'til the fast acting sugar brought his number back to a safe range (greater than 70) before he ate his snack.  He ended up missing snack time with his peers.  He waited out his low in the Health Office, with the nurse...he ate 15 minutes or so after his buddies.  Sucks.  But it is life with "D".  Rarely is a complaint voiced by Joe.

I am not sure if Joe's tears were out of frustration or due to the low.  Most likely they were a product of both.  When parenting a child with a chronic condition, restrictions and limitations are part of our day-in and out.  Sure they are a part of everyday parenting of any child to keep  them safe and to raise them to be a somewhat kind, caring, respectful human being.  However, in our situation...the limitations and restrictions are present on yet another level.  On a few levels actually...for safety~sake...and for guiding their self-management for the one day when they will be independent with this big time, high maintenance, laborious condition. 

I have let Joe go ahead an eat when he has been in the mid to high 60s.  After fast acting sugar has been consumed, he has sat down to eat.  The bolus in this situation would be given after his meal is consumed..and/or an extended bolus may be executed.  The 50s, while he is at school...and not under my watchful eye, was too low for me to acquiesce.

What is your cut-off low number?  How do you manage it...delayed bolus...combo bolus...extended bolus...free carbs?

A day-in-the-life of being a tuff mutha.