Wednesday, March 14, 2012

Close Call

He has fallen off of playground equipment; fairly big falls over the years. A fall off the top of monkey bars when he was 4 years old with a blood sugar of 43 resulted in a scraped up contused, screaming Joe and a shaken D' Mama. I was a novice then; a novice "pancrent" dealing with a 5 year old Bridget, a 4 year old friend of Joe's, and low...injured...less than tolerant Joe. He was also low during "The Concussion Incident". I don't know if that low made him more prone to falling off the slide or not. I cannot help but wonder though. It must always be taken into consideration during our day-in-the-life. Always.

A few days ago while sledding...

Joe and his pals had found a little stream at the base of the sled hill. The ice was thawing. The combination of mud, ice, and water was inviting the boys to build dams with ice chunks, throw ice chunks and to explore the path of the water and the ice chunks. The stream was directed under a two-laned country road via a large drainage pipe. It was perhaps a couple of feet in diameter.

You can see where this is going...

Per my usual, I am paying some attention to the boys antics but am not overly involved in micro-managing their play.

During my neglect, I hear Joe's peers calling his name in an "echo-y" fashion. I look over to see them all hovered around the drainage pipe. Of course my Joe ... my kid, Joe, who has diabetes is on his hands and knees crawling through this icy, wet, muddy drainage pipe.

Now, most moms may be a bit hacked by the wetness and mud that they are gonna have to contend with after such an expedition. Some moms may be cool with such and adventure. Me? Well, I was cool with Joe exploring the pipe. But. You want to know what was going through my head? The first thing that popped up was "please Dear Lord do not let him realize that he is low in the middle of the crawl through the pipe." You know those lows that his legs and body stop "working". I was imagining pulling "The Wounded Soldier" through the confines of the space to access Joe's oral cavity with glucose.

He made it out without incident. Muddy and wet, he ran over to to me. He felt low. He was 31. It was a bad one.

Thankful for a near miss in our day-in-the-life with diabetes.

Saturday, March 10, 2012

The Waiting Game

For Non-"D" readers LOW BLOOD SUGAR effects can range from mild dysphoria to more serious issues such as seizures, unconsciousness, and (rarely) permanent brain damage or death.

This photo says it all...

The pallor, the grim expression, the dark circles creeping up under his eyes.


His focus wouldn't settle. It was like he couldn't find a place or an activity to make him feel "OK" or "right" in his body. This is what I observed of Joe at the New York Hall Of Science in Queens, NY last weekend when we were visiting my sister.

I suspected a low. Right as I was suggesting a blood sugar check, he stopped abruptly, sat, and said in a decrescendo voice "I feeeel low." He was ... a 50 graced the glucometer screen. Four Starbursts were dispensed to Joe, one to Bridget, and one to Cousin Chloe. We all copped a squat next to Joe right in the middle of the exhibition floor. We then waited. We waited with Joe. We waited for his legs to work. We waited for his mind to clear. We waited for him to feel well enough to move on.

At times I find it difficult to explain life with diabetes. Sure, it is relatively easy to talk about insulin, pumping, counting carbohydrates, and "boosting" for activity. But there is oh so much more to it. The waiting. The waiting is something I don't talk much about. We do it. Quite often, I suppose. Joe has some lows that will stop him dead in his tracks. When I see him splayed on the ground, on the floor, on the ice and hear the words "my legs won't work". I know. I know it is a bad one and we will be waiting a good 10 minutes or so before he will feel well enough to continue with his day. Sometimes there will be crying. Sometimes he needs to curl up in my lap. Intense hunger accompanies these lows as his brain waits for the glucose to hit his blood stream and cross the the blood brain barrier.  Eyes stinging... ****ing diabetes.

A day-in-the-life of loving and supporting a child with type 1 diabetes.

Thursday, March 1, 2012


Essentially I send my kid out into the world daily hooked up to a hormone that can kill him. Yep. It is true. I don't think many people "get" that. Managing type 1 diabetes is tenuous. Balancing activity, carbohydrates, and the hormone insulin is the nuts and bolts of the matter. It is difficult at best. The balance of blood sugar numbers is not easily achieved in an active, growing child. Perhaps just as challenging is balancing "safety" while my type 1 child, Joe matures.

It was a first, the above text. Joe sent it to me from my mother-in-law's phone. She was watching him while I ran out to the store.

Times are changing.

This year the calls from school are from him, not from the School Nurse.

Each and every call to my cell phone is initiated with a whispery-question-y, subdued Joe voice "Ah... ... mom?" (who does he think is gonna answer?) "I am 72, double down ... should I do a combo bolus heading into lunch?" "I am 45, I was 42 before that ... I think we should turn down the basal..." "MOM!!!" (frustrated) "you don't understand... it is a Substitute Nurse ... she cannot help me with the Beef Taco carb count!"

Times are changing.

He asks to run across the street to play with friends. <*GASP*> Inside their homes even. He checks his blood sugar first. He lets me know where he is at "number-wise". He takes sugar according to his IOB and Dexter arrows. He consults with me, sure. I usually respond to any questions with "what do you think you should do Joe?" Many times he is spot-on. He is excellent at considering possible activity. He is getting better at recognizing the impact of IOB. Once in awhile, I will mention a combo bolus or a temp basal as a suggested action as well. He knows the implications of a bad lows and will boost, boost, boost to avoid them. He does not seem too concerned about highs and does not report them to me. He thinks he is "good-to-go" with numbers in the 200's, even in the 300's, and will head across the street care-free without a word to me.

As he becomes more independent, I notice that we tend to run him a bit higher; we run him a bit higher for "safety-sake". Times are changing. And. With the changing of times, Joe's last A1C bumped up a bit. And. With the changing of times, there are more people involved in Joe's management ... namely, Joe. As with everything else that requires balancing in diabetes care, the carbs, the activity, the insulin; the transference of care, the evolving independence demands balance and careful attention too. During Joe's last Endocrinology appointment, his doctor cautioned me about Joe's independence level with his diabetes care. A "let the reins out gradually ... and ever so slowly" approach was encouraged. Makes sense. Wish me luck.

A day-in-the-life of raising a child with type 1 diabetes.