Wednesday, July 31, 2013
Retro-BUDDIES...Perpetuating the MYTH...
Thursday, September 20, 2012
A Mess
It started with Joe rolling up the BETA BUDDIES Book and kind of sitting on it. He did not want the class to see his picture on the cover.
So, Joe and I presented Type 1 Diabetes to his class yesterday...
I think, well I know that I embarrassed Joe. I left his school feeling pretty bad, sad, and mad. Mad at myself for not choosing my words more carefully. Disappointed in myself for still crying. Six years into this life of managing diabetes and I still cry when I tell his classroom that what I want them to take away from my talk about diabetes is that Joe is a normal boy that can do anything that he sets his mind to. Of course I did not say it eloquently like that. I said something like "he likes to run and play just like each one of you...he has brown hair...he has brown eyes...and ..." (* could not speak as my eyes started stinging and I lost my composure a bit*)
Joe's teacher, thankfully, took mercy on me and got the class engaged in talking about all the sporting activities Joe participates in. They talked about his sweating issue, which they all thought was due to diabetes. I chimed in with I think Joe is just a "sweat"-er.
One child then asked how I knew to take Joe into the doctor when Joe was diagnosed. I talked about the sippy cups full of water just to satiate Joe during short car rides to the grocery store. I then said something about urine laden diapers. Apparently, and I realize this is common sense, "sippy cup" and "diaper" and perhaps "urine" are taboo words when talking about your nine year old in front of their entire class. I am sure the "sweat" coversation did not help matters either. I suck.
Joe handled it with grace. He pulled a "Reyna", by diffusing his embarrassment with humor.
I left his school heavy hearted, feeling like I let him down. I think not having the book to focus my attention lead me down the path of insensitive bodily excrement talk and infantile product discussion.
Ruining Joe's day-in-the-life.
Thursday, July 14, 2011
The Ramp

I wonder if I sounded a bit "nerdy" to the teenage boarders and skaters and bikers? Joe took his bike, his Rollerblades, and his skateboard to our local Skate Park yesterday. He consumed about 45 grams of free-carbs just to keep his blood glucose in the 70s and 80s.
The ramps and jumps are a bit intimidating at this particular park. Joe flirts with them a bit as he rides and rolls over the lower portion of the ramps. He is slowly creeping higher and higher up the inclines. His confidence wanes when he is on ramps that are over 5 feet. He rides and skates up them without hesitation. It is the going down that seems to make him stop and take pause.
I was encouraged by his reserved caution, as I looked up and watched him struggle with going down a rather high ramp while he sat at the peak perched on his bike. I could see the desire, the want, of conquering the fear of going down. The internal pull of his fear was visible. The older boys were encouraging to him. I stood back and watched the conflict conveyed through his eyes, his face, and his body. After many minutes, Joe decided he wasn't ready. He slid down the ramp while supporting his bike. He did not seem disappointed in himself. He simply stated "I am just not ready for that ramp".
Which brings me to my post...
A staff member from the Tim Thomas Hockey Camp called me yesterday afternoon. The connection was static-y, which in part, added to my feeling of isolation as I tried briefly to explain Joe's situation with camp, Type 1, lows, exercise.
I started out with a "thank you" for calling me back...blah, blah, blah..."My son Joe is in your camp next week in Vermont ... blah" ... "He has Type 1 Diabetes...insulin pump...blah...blah...blahbitty"... "Do you have a trainer that travels with your staff?"
Static-y...wind-ily...connected staff member responds with "well we do have someone that is CPR certified."
*ugh*
How do I even go into anything about anything with this guy over the phone?
I found out that they divide up the campers by age and ability. The groups will consist of about 15 kids. A coach will be assigned to stay with the group throughout the day as the campers go through different stations. They will be on the ice for 3 hours and then they will be off the ice for 3 hours for outside play, hockey videos, lunch...etc. Joe's schedule will not be known to me until I drop him off Monday morning.
Upon conclusion of the phone call, the pleasant staff member did say that I could give Joe's coach my cell phone number when I drop Joe off on Monday. I almost choked on my spittle at that point, thinking "you bet your bippy he is gonna have my cell phone number and a crash course on lows."
Explaining to the general public that a low blood sugar is something that must be dealt with immediately is complicated. It is difficult to convey that Joe may become a bit "off", confused, or be totally "normal" with a dropping glucose level. The lows can come on suddenly and they must be tended to...and Joe may not be in his right mind to help himself in this situation as the only fuel source for brain cells is glucose. The lows are one thing. Then add in what must go into eating: the blood sugar check, the carb counting, the bolusing, the "he must eat everything" ... and ... the compensation of insulin doses for activity, well, it is too much to communicate in an abbreviated manner for a week long camp.
I am looking down the "ramp" much like Joe was yesterday.
Am I ready?
Here is what I have come up with:
- Joe and I talked about a basal reduction for the day of 35% (I said 30%, he said 40%, and then he compromised with 35% ~ fine).
- I tweaked the Play Date Cheat Sheet for camp, keeping it simple...1 page.
- I will briefly go over the Camp Day Cheat Sheet and emphasize the importance of treating a low blood sugar with Joe's coach. I will have my cell phone number highlighted at the bottom of the Cheat Sheet.
- I will have Joe carry Woodchuck everywhere with him. It houses his glucometer and sugar sources.
- I am going to only partially bolus for breakfast. My biggest concern is Joe skating with breakfast IOB circulating. He will drop over a 100 points in 30 minutes with breakfast IOB lurking in his system. I can always correct a high before I leave him if need be.
- I will pack separate bags for snacks and lunch. Each bag will contain a carb count to make it simple for Joe to bolus.
- Buying TracFone today or tomorrow so that Joe can "practice" calling me over the weekend.
- I think I will go in every hour or hour and a half on the first day and go from there.
I wanna make it down the ramp. I wanna have the courage to push off and go. However, I think I may need to slide down the "ramp" on my butt.
A day-in-the-life of a glimpse of what it takes to send Type 1 to camp or anywhere really. It takes courage.
Thursday, February 17, 2011
This Could Be Any One Of YOU...
"Reyna you will hear things out there that will make you angry."
When Joe's Endocrinologist said these words to me shortly after Joe was diagnosed, I had no idea what he was talking about. I was dealing with the down-and-dirty of diabetes care. The public perception of diabetes had not entered my conscience.
***
After school yesterday...
I slipped and slid as I carried the precariously lodged three-legged Vietnamese Bamboo Xylophone (don't ask, and thanks Sunshine Grandma) to the car for Joe.
I then slipped and slid my way back to Joe's backpack that was on the sidewalk in front of a massive snow-ice mound by his school.
I unzipped the backpack.
I looked for and found "Woodchuck".
I looked at Joe's daily diabetes log.
Damn, he has been high all day. Joe has a cold and has been running in the low 200s consistently for two days now.
We were planning on staying to play on the school's playground for an hour while Bridget had band practice. According to the log, Joe received a correction dose of insulin about an hour prior for a 331. I needed to check a blood sugar to ensure his "safety" while he played for the next hour or so.
I zipped up the "Woodchuck".
I slipped.
I slid.
I tripped.
I fell on the ice.
I cursed.
I got up and continued to paint my life with some more colorful descriptors as I headed over to Joe, who happened to be pulling a "Penguin Maneuver" as he sailed down the ice hill head first on his belly with a group of his friends.
He ran to me rosy-cheeked and smiling, as he removed his glove. I removed my gloves. I fumbled with the test strip container with my near-numb finger tips. Woodchuck sat on the snow covered ground as it provided me with my supplies. The glucometer readied. Cold tissue was lanced. Blood was expelled. Blood was wicked up the test strip. 5...4...3...2...1 and a 231 was obtained. Off he went...until the next blood sugar check that would take place in an hour, or so.
You see, here is the thing...
Living with type 1 in our lives hour-to-hour, meal-to-meal, activity-to-activity, blood glucose level-to-blood glucose level is difficult enough. It demands a "never-ending-ness" that many cannot wrap their cerebral gray matter around. When you see me at the park stabbing my kid's finger tips as he slides; or, when you see me measuring his food as I am driving down two lane highways; or, when you see me in my life-sized Pez Dispenser role "mother birding" Glucose Tabs into Joe's pie hole; or, when you see me spiking a juice and holding it to a limp-y, noodle-y, sweat-y Joe... or, when you see me rink-side, field-side, yard-side stalking a potentially low Joe...
Guess what?
This stuff is going on all.the.time.
Always.
Around the clock.
Day.And.Night.
24 hours a day.
7 days a week.
365 days a year.
There are no breaks.
Ever.
So, when I read something like this article written in the Santa Barbara Daily Sound, I feel my spirit, my energy level, my spunk deflate a bit. My "fight" for the "damage control", for the "setting the record straight" is sapped. I am simply tired physically and emotionally. I am left without much vigor by the end of the day for a retaliation. But, when I go back the following morning after a 4am blood sugar check to re-read this:
"A child who acquires type 1 is much different that an adult who acquires type 1. Maybe a child was born with a worse hand? Could a child’s diabetic situation arise from their parent’s decisions in life such as lack of activity and over consumption of processed sugars? If that is possible then maybe the child inherited genes that were mores predisposed to the condition. Or maybe it’s a combination of genes and lifestyle. Many researchers are claiming that childhood diabetes type 1 and type 2 could be related to excess sugar intake and a poor quality diet. Children consuming sodas, juices, milkshakes and candy in excess may be a big contributing factor in acquiring type 1 or type 2. A child who consumes these choices in excess and is more sedentary and has parents who are sedentary may just have the recipe for early onset diabetes of either type".
When I go back and read this, ... I get angry. Once again, misinformation is disseminated. Once again, we are left picking up the pieces. Once again, I am left shouting "DIET AND EXERCISE CANNOT CURE TYPE 1 DIABETES, NOR DOES THE LACK OF A HEALTHY DIET AND A LACK OF EXERCISE CAUSE TYPE 1 DIABETES!" Once again, I am left defending my son, Joe. My son was diagnosed with Type 1 diabetes when he was just over three years old. Soda had not passed his lips. Milk shakes, perhaps he had one or two...well a bite or two of one or two. Processed foods? Sure, some I suppose. Sedentary? I am unsure if he knows the definition of that word...it certainly could not be used in the same sentence or perhaps paragraph when discussing Joe's qualities.
Type 1 Diabetes is an autoimmune disorder in which a person's own body (white blood cells) attack the insulin producing cells (beta cells) in the Pancreas. To develop Type 1 Diabetes three risk factors must be present. They are inheritance (genetic), autoimmunity (self-allergy), and environmental damage (example: from a chemical or virus). So, in other words, a person must have the genetic "set-up" to be susceptible to the environmental stimulus (chemical or virus) in order for the autoimmune "attack" (self-allergy) on the beta cells of the pancreas to occur.
Clearly, Type 1 diabetes is on the rise. My hunch is it is related to the "environmental trigger" component...whether it be viral, chemical, cow milk exposure, vitamin d deficiencies...who knows? The research is still being conducted. Answers are still elusive. More questions arise. More research is initiated.
What I do know is that I need to raise my voice along with my friends. I need to speak up for Joe.
I need to speak up for you.
This could be anyone of you in my position. This could be your child. This could be your day-in-the-life.
A day-in-the-life of defending our day-in-the-life.
My Response To Ignorance: One Voice
Dear Mr. Wilcher
**********************************************************************
JUST IN: The RETRACTED STATEMENT By Dr. Wilcher...2/17/2011:
My sincere apologies go out to the type 1 diabetic community for the article I wrote that was published in the Daily Sound on Feb 16th, 2011.
The main intention of the article was to say that for type 1 or type 2 diabetics a lifestyle of healthy habits may significantly help their quality of life. My statements about excess sugar were meant to be directed toward type 2 diabetics, which has been linked strongly to lifestyle habits.
Type 1 and Type 2 diabetes are basically 2 different diseases. They both involve the pancreas and insulin, but the cause of the diseases are much different. Type 1 diabetes is clearly an autoimmune disorder with no known cause while type 2 diabetes is more of a metabolic issue. I can understand the frustration of type 1 diabetics being categorized with type 2 diabetics.
I am truly sorry for any pain I have caused any of you and your families. I know how hard it must be to have a child who is diagnosed with type 1 and knowing that you have done everything in your power to keep your child healthy.
I quickly scanned the article without giving it a thorough proofreading and I understand that some of the issues I addressed were misleading.
I should have written the article in a much different way, and I do apologize again. My intentions were to raise questions about lifestyle habits and how it can affect one’s lifestyle with these diseases. I hope we can all agree that healthier habits can help us live more full lives no mater what conditions we have.
Bob Wilcher is a Chiropractor and personal trainer in Santa Barbara, CA. He owns Killer B Fitness, a personal and group training studio also located in Santa Barbara, CA. You can contact him at www.killerbfitness.com or (805) 448-2222.
Saturday, August 14, 2010
HEEELLLLLLOOOO N.U.R.S.E.!!!

BLOOD SUGAR CHECKING ROUTINE
Joe’s blood sugar may be checked by the School Nurse or designated persons.
2. Check daily prior to lunch.
3. Check prior to P.E.
4. Check daily @ 1:45 – 2:00.
*Joe’s blood sugar must be checked promptly when he appears LOW.
***If Joe’s blood sugar is less than 70 - Give 3 glucose tablets OR a juice box
- Have someone call 911 and then parents
- Give Glucagon (in the red container - needs to be "reconstituted) 1mg into the front of Joe's thigh
- Roll Joe onto his side
- Once he regains consciousness...have him take sips of juice if he is able
WHEN TO GIVE INSULIN
1. Daily with morning snack.
2. Daily with lunch.
3. Daily with any extra food
4. To correct a high blood sugar
*Extra insulin will be needed when there are ketones present…call parents for instructions/or Joe may need to go home for large ketones.
HOW TO GIVE INSULIN (note this is for the Animas Ping Pump - I also give a copy of the Ping Manual to the Nurse for her office - this is a "cheat sheet").
For Carbs with Blood Sugar Check:
- Unlock pump by pressing up and down arrows at the same time (sometimes I have to do it twice)…the pump will make a beep and the home screen will appear.
- Select menu on the pump and press “OK”
- Select “Bolus” and press “OK”
- When having food with carbs select “eZCarb” and press “OK”
- Enter in carbs (using arrows) and select “OK”
- Enter in blood sugar (using arrows…it will start you at 80) and then press “OK”
- The pump will say “show result” select “OK”
- The pump will then show Carb…/BG…/IOB (insulin on board) with numbers by them…then, there will be a row that says “Total”…use the number of units stated by total for dosing. Use the up arrow to get to the number listed by “Total” then press “OK”. You then need to press “OK” again for the pump to deliver the insulin.
- Press the up and down arrows at the same time to lock pump.
For Blood Sugar Correction Only: (correct blood sugars > 200)
- Follow steps 1-3 above
- When correcting for blood sugar only select “eZBG” and press “OK”
- Using arrows, scroll up to the number that corresponds to Joe’s blood sugar and press “OK”
- Select “show result” and select “OK”
- Next to the word “total” there will be the number of units of insulin you should give Joe
- Use the arrows and scroll up to the number displayed by the word “total” and then press “OK”
- Then press “OK” again for the pump to deliver the insulin
- Press the up and down arrows together to lock the pump.
Ketones must be checked if Joe has two consecutive readings greater than 250 and/or if he complains of abdominal pain or vomits. Please call parents if he has moderate to large ketones (a blood ketone reading > 0.6 or moderate to large urine ketones). He may need his pump site changed (parents will change) and extra insulin and/or he may need to go home for closer monitoring. Please have him drink water and have liberal access to the bathroom.
WHAT TO DO FOR P.E.
WHEN TO CALL PARENTS
1. Blood sugar less than 70
2. Blood sugar greater than 250
3. Moderate to large ketones
4. If Joe’s pump becomes disconnected
5. If Joe’s pump is alarming
6. If Joe becomes sick or vomits
7. For questions on carb counting
8. For ANY questions or concerns
And that-is-that...HOPING to make your "day-in-the-life" a little easier FRIENDS.